India: One third of cancer cases attributable to smoking
September 28, 2021
Par: National Committee Against Smoking
Dernière mise à jour: September 28, 2021
Temps de lecture: 4 minutes
According to the latest report published by ICMR - Indian Council of Medical Research, nearly 33% of cancer cases diagnosed in India are linked to smoking. Released on September 24, the report collates data spanning over seven years from 96 hospital cancer registries across India[1].
Cancer is a growing public health problem in India. The number of new cancer cases was estimated at 1.39 million in 2020 in the country. Of the 1.3 million cancer cases registered in hospitals under the National Cancer Registration Programme (NCRP) in 2012-19, 610,000 cases were included in the analysis.
One in two cancers linked to tobacco in Indian men
The National Noncommunicable Disease Surveillance Survey (NNMS) indicates that 32.8 % of adults aged 18 to 69 consume tobacco products, 28 % daily. There is a notable difference between the sexes: 42% of men are consumers compared to 14% of women. However, this gap narrows among adolescents. Thus among 13-15 year-olds, 9.6% of boys are regular consumers and 7.4% among girls. In 2021, the share of cancers associated with smoking, on the rise, represents 48.7% of all cancers in men and 16.5% in women, or on average almost a third (32.6%).
Among these cancers, the most common in men was oral cancer (24.4 %), followed by lung cancer (22.4 %) and tongue cancer (16.6 %). The most common cancer in women was oral cancer (26.4 %), followed by lung cancer (22.9 %) and esophageal cancer (20.8 %). By age group, the highest number of new cases of cancers associated with tobacco use was observed in those aged 60-64. Nearly half of these cancers occur after age 60 in men (44.6%) and women (42.7%).
All these forms of cancer are directly associated with the consumption of tobacco products, a significant portion of which in India is consumed in oral form: 21.4% of adults consume smokeless tobacco (men 29.6%; women 12.8%). Nearly 90% of oral cancers in India are attributable to the consumption of smokeless tobacco.[2].
India's tobacco consumption is increasing at an earlier age
Smoking prevalence (use of any tobacco product in the past 30 days) has declined in India over the past decade among adolescents. It has decreased from 14.6% in 2009 to 8.5% in 2019, from 19% to 9.6% in boys, and from 8.3% to 7.4% in girls. However, the age of initiation has declined significantly, from an average of 12 years and 3 months in 2012 to 10 years in 2019.[3]. According to recent data, 38% of young people who smoke cigarettes, 47 % of young bidi users and 52 % of smokeless tobacco users started their consumption before their 10th birthday.[4].
Recently, the Indian government has proposed amendments to address the shortcomings in the Cigarettes and Other Tobacco Products Act (COTPA). The bill aims to extend the ban on the sale of tobacco products to those under 21 and to strengthen penalties for non-compliance with this ban. Similarly, penalties would also be strengthened for violations relating to the ban on any direct or indirect advertising of tobacco products on the internet and social networks. However, these amendments remain insufficient, particularly with regard to young people. The sale of individual cigarettes and bidis remains authorized, which increases the accessibility of inexpensive products for young people. Plain packaging of tobacco products, which plays a crucial role in improving the visibility and effectiveness of health warnings and reducing the attractiveness of the product, is not included in the new bill. In addition, the application of the provisions of Article 5.3 of the WHO Framework Convention, regarding the protection of public policies from the commercial interests of the tobacco industry remains generally deficient.
Keywords: India, cancer, smokeless tobacco, youth, health
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[1] ICMR-NCDIR, Clinicopathological Profile of Cancers in India: A Report of the Hospital Based Cancer Registries, 2021, Bengaluru, India [2] Siddiqi K et al. Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries. BMC Medicine. 2015;13(194). [3] Priyank Kanoongo, NCPCR Chief Writes: Kids as Young as 10 Using Tobacco Products, COTPA Amendment a Must, News 18, September 20, 2021, accessed September 28, 2021 [4] Generation Without Tobacco, 42% drop in tobacco use among children aged 13-15 in India over 10 years, August 12, 2021, accessed September 28, 2021 National Committee Against Smoking |
