Tobacco: Culture and legislature worldwide.

Oral cancer affects as many as 274000, people worldwide annually. Tobacco use is one of the major preventable cause of premature death and disease in the world. TSNAs are considered the most potent classes of carcinogens with N-nitrosonornicotine (NNN) and 4- (methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). Risk Factors for Smoking includes family factors, school factors, peer factors, community factors, stress and domestic violence. Tobacco is an integral part of the culture and tradition in many countries of the South-East Asia Region. Tobacco use resulting in 5.4 million deaths every year. A new term, "thirdhand" smoke, has been proposed to describe the particulate residual toxins deposited in layers all over the home furniture after a cigarette has been extinguished. Many countries are putting ban for smoking in public places. Half measures are not enough, when one form of advertising is banned; the tobacco industry simply shifts its vast resources to another channel. Governments are urged to impose a complete ban to break the tobacco marketing net. An effort is made to comprehend articles on tobacco by searched from journals through Google and Ebscohost.

Compliance to Gutka ban and other provisons of COTPA in Mumbai.

BACKGROUND: Cigarettes and other tobacco products act 2003 (COTPA) is the principal law governing tobacco control in India. Government of Maharashtra in one of its landmark decisions also banned manufacturing, sale and distribution of gutka and pan masala since July 2012. The desired impact and level of enforcement of the COTPA legislation and the gutka and pan masala ban in Maharashtra State, however, needs assessment. Among the many provisions within COTPA, the present study seeks to assess compliance to implementation and enforcement of Section 5 and 6 of COTPA including compliance to gutka and pan masala ban in Mumbai, India. METHODOLOGY: Six educational institutes (EI) within the Mumbai metropolitan region were selected in a two stage random sampling process. Area around each EI was manually mapped and all the tobacco products selling outlets with in the 100 yards distance were listed by trained Field Social Investigators and were observed to determine compliance for Section 5 and Section 6 of the COTPA legislation and for gutka and pan masala ban. The vendors/shop owners manning these outlets were also interviewed for their personal sociodemographic details, self‑tobacco use, awareness and perception about ill‑effects of tobacco and existing tobacco control legislation in the country. RESULTS: A total of 222 tobacco retail outlets were listed within 100 yards of the EI in violation to the provisions of Section 6 of COTPA, of which 72 (32.4%) were selling tobacco products on mobile structures. About 53.2% of the tobacco vendors were also users of some form of tobacco. Whereas, nearly 217 (97.7%) vendors were aware about the gutka and pan masala ban in the State, only 48.2% were aware about the existence of COTPA legislation. None of the EI had a display board prohibiting the sale of tobacco products within a radius of 100 yards of their EI. Only 56.3% tobacco outlets had complied with the mandatory warning display boards indicating tobacco products will not be sold to people below 18 years of age. With regards to point of sale advertisement only 25.2% compliance was noted for display of health warning boards at the point of sale. Nearly 48.6% tobacco outlets exhibited >2 display boards and another 43.2% exhibited hoardings with brand pack photo, brand name in violation to the provision under Section 5. Violation by visible stacking and open display of tobacco products for sale was observed at 51.3% of tobacco outlets. While 41% of tobacco outlets were found displaying gutka and pan masala packets in violation to the ban. CONCLUSIONS: Enacting of the law without robust measures for enforcement has led to widespread noncompliance to the provisions with in the tobacco control legislation in the metropolitan city of Mumbai. Strong and sustainable measures needs to be incorporated both by civic administration and public health departments for its forceful implementation.

Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala State.

Context: Tobacco consumption initiated during the adolescent period is a major contributor to the pathogenesis of fatal diseases in adulthood. Information on tobacco use and awareness regarding tobacco legislation and hazards among adolescents in rural Kerala is limited. Aims: To assess the prevalence of tobacco use among adolescent students in a rural district in Kerala state and to understand the extent of awareness about the prominent legislative measures against tobacco and tobacco hazards. Materials and Methods: Data on awareness regarding health hazards due to tobacco use and legislation against tobacco consumption were collected from students of 15 randomly selected high schools in an educational sub-district in Kerala, using a cross-sectional study design. Chi-square and Fisher's exact test statistics were used for statistical analysis. Results: A total of 1473 students participated in the study, of which 79% were males (mean age 15.4 years, SD 1.5). The overall prevalence of 'current tobacco users' was 8%. A significant association between age and tobacco use was noted among tobacco habitues (P<0.05). Awareness regarding legislation against smoking in public places was more in the higher age-groups (P<0.05). Females were more aware of the 'smoking ban' than males (P<0.05). Our survey of the awareness regarding the hazards associated with tobacco use revealed that 41.5% of the students knew about the link between oral cancer and tobacco, with the awareness being greater among females than among males (64.3% vs 35.4%). Conclusion: The finding that tobacco consumption increases with age is a matter of concern. In addition to their clinical work, dental professionals should also educate the public on the hazards of tobacco and conduct tobacco cessation programmes for adolescent groups to control the tobacco epidemic.