mainly about tobacco and cancer relation

1. TOBACCO AND CANCER
DR D.Ramu

5. Types of tobacco product
• Chewing tobacco
• Loose leaf
• Pellets
• Plug
• Guṭkha is a preparation of crushed areca nut, tobacco, catechu, parafin wax,
slaked lime and sweet flavourings
• Zarda consists of tobacco, lime, spices and vegetable dyes
• Khaini is made from sun-dried or fermented coarsely cut tobacco leaves

6. • Cigars
• Blunts
• Cigarillos
• Little cigars
• Cigarettes
• Cigarettes
• Filter cigarettes
• Pipe smoking
• Electronic cigarretes
• Bidis
• Kreteks

7. EPIDEMIOLOGY OF TOBACCO AND CANCER
• Doll and Hill and Wynder and Graham
• U.S. Surgeon General as caused by smoking, along with their
corresponding estimated mortality statistics
• common index of cancer risk is pack-years, or the number of packs of
cigarettes smoked per day multiplied by the number of years smoked
in the lifetime.

9. • Tobacco Use Behaviors
• Primary driver of smoking behavior is nicotine—the major
addictive substance and primary reinforcer of continued
smoking
• Rate of nicotine metabolism
• Nicotine is metabolized primarily to cotinine, which is further
metabolized to trans-3′-hydroxycotinine (3HC), catalyzed by the
liver cytochrome P450 2A6 enzyme

10. Evolution of Tobacco Products
• Both laboratory- based and epidemiologic studies indicate neither an
individual, nor a public health bene t from low-tar cigarettes as
compared to full- flavor varieties
• Electronic cigarettes, which vaporize a nicotine solution, have gained
increasing popularity and gener- ated concern among public health
practitioners, particularly with regard to effects on youth

11. CARCINOGENS IN TOBACCO PRODUCTS
• The International Agency for Research on Cancer (IARC)
• Identified 72 measurable carcinogens in cigarette smoke
• Group 1 (carcinogenic to humans),
• 2A (probably carcinogenic to humans), or
• 2B (possibly carcinogenic to humans).

16. EFFECTS OF CONTINUED SMOKING ON CANCER TREATMENT OUTCOMES
• Surgery
• Radiotherapy
• chemotherapy

17. • The key provisions of COTPA -2003 are as follows:
• Prohibition of smoking in public places (including indoor workplaces). This has
been implemented from 2nd October 2008 in the whole of India.
• Prohibition of advertisement, direct and indirect (point-of-sale advertising is
permitted), sponsorship and promotion of tobacco products.
• Prohibition of sales to minors (tobacco products cannot be sold to children less
than 18 years of age and cannot be sold within a radius of 100 yards of any
educational institutions).
• Regulation of health warning in tobacco products packs. English and one more
Indian language to be used for health warnings on tobacco packs. Pictorial health
warnings also to be included.
• Regulation and testing of tar and nicotine contents of tobacco products and
declaring on tobacco products packages.