Young tobacco users

30 Young tobacco users S.G. Vaidya Children who are well informed about the harm done by cigarettes can be powerful agents For reducing tobacco use. Children in India have been found to be the most powerful agents of change in reducing the prevalence and uptake of tobacco smoking, in both adults and children. K was aged 12 and had tried a cigarette once or twice, three of his uncles being smokers. He did not like it much. But soon his parents became worried because his school performance dropped. Three months later they discovered that he had become a victim of pan masala, a product made out of waste tobacco, mid-ribs of tobacco leaf and floor sweepings from cigarette factories. The packets are sold at affordable prices with attractive, shiny coloured wrappings. Since K was consuming three or four packets a day, his pocket money was not enough and he started stealing and lying, so much so that the parents sought medical help. They also warned the trader not to sell the tobacco to children. Some 20% of the Indian popula- tion is aged between 10 and 15 years, and the tobacco industry exploits this fact. The chi ldren are not only the victims, but their poverty leads them to become vendors and to roll ciga- rettes as well. To taste and use what they sell is an easy road to depen- dence. It is estimated that in India almost every second adult has a to- bacco dependence, every 5th child starts experimenting with tobacco and every 1Oth child is hooked on tobacco. The pervasive effect of almost 60% of households using tobacco in the form of chewing paste, pan masala and beedis (primi- tive cigarettes) in rural homes and manufactured cigarettes in urban homes, and of advertisements vaunt- ing smoking as the road to Western sophistication, gives the c igarette industry every reason to believe it can increase cigarette production by some 60% by the year 2000. Already 20 million children are dependent on tobacco, according to a survey by the government's National Sample Survey Organiza- tion . To this astounding figure, about 5500 new users are added every day- a total of two million new users a year. The marketing strategy of the tobacco industry receives powerful backing. The art of dissuasion Fourteen-year-old P ran away from home, leaving behind a note to hi s father, a heavy smoker. "If you don ' t quit smoking, I will not re- turn", he wrote. He stayed with his World Health • 48th Year, No. 4, July-August 1995 uncle until his father arrived with a firm commitment to quit- and he kept his promise. All his previous attempts to quit had failed. A whole class of about 40 chil- dren greeted their headmaster by raising silent but explicit placards reading: "Sir, we love you; Sir, we want you; Sir, smoking causes cancer". The headmaster, a chain- smoker, had no option but to quit. Responsible for 1500 schoolchi ldren, he felt he had to take part in the anti- tobacco education programme, and that meant setting an example. A research project funded by the Indian Council of Medical Research tested the efficacy of anti-tobacco community education. The three participating agencies were 20 000 rural schoolchildren from 74 schools, paramedical workers in primary health centres, and village social workers . All three groups were given anti-tobacco education and motivational training. A positive change in attitude and behaviour towards tobacco use was found not only in children but also among teachers , as compared with the con- trol group. In addition, chi ldren were found to be the most powerful agents of change in reducing the prevalence and uptake of tobacco smoking, in both adults and children . To control the tobacco epidemic in children, a two-pronged attack is necessary. Firstly, strong legislation is needed to ban all pro-tobacco propaganda aimed at converting young impressionable minds into addicts. Secondly, anti-tobacco education in schools should be made mandatory, and it should be comple- mented by nationwide anti-tobacco media campaigns wholeheartedly backed by the government. • Or S. G. Vaidya is Honorary Secretary of the Goa Cancer Society, Den is Apartments, Lake View Colony, Miramar, Panaii, Goa 403 00 I, India.