Awareness of Harmful Effects of Tobacco –Misinterpretation or Misrepresentation
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Debilitating effects of tobacco on health are established but its awareness among its consumers is questionable. Despite aggressive steps in advertising and enforcement of laws to print statutory warnings in the packaging of tobacco products by the health ministry, the habit is still on the rise. A survey was conducted to evaluate the awareness of acute and long terms effects of tobacco on the body and the ability to comprehend the pictorial warnings in packaging of tobacco products in the district of Salem and Namakkal.
The deleterious effects of tobacco on the health of its consumers are established but the due to delayed clinical manifestations, its consumers are misled that they may be exempt from the inevitable consequences. Despite the imposition of increased tax on tobacco products and aggressive advertising, to highlight the harmful effects, tobacco consumption is still on the rise in our society. Awareness by advertisements, target the population that are either early into the habit or on the edge of addiction as once addicted to any form of tobacco, its consumers require aggressive rehabilitation to break away from its dependency1,2. During the period of our undergraduate course in our college, we have come across patients with oral premalignant lesions and conditions unaware that the lesions were because of the tobacco habit even with statutory warnings on the packaging. The present survey was taken to study the awareness of the harmful effects of tobacco habits from the patients reporting to our college, VMSDC, Salem and the rural population of Namakkal district.
2. Materials and Methods
A total of 200 patients from the age group of 15 to 70 years were taken with 123 patients reporting to the department of Oral Medicine and Radiology, VMSDC and 77 patients from the rural population of Namakkal district. History and informed consent were obtained from all patients, including questions pertaining to nature and type of tobacco habits. Patients with any clinical lesions and patients below the age group of 15 years were excluded. All patients were asked to answer a questionnaire (Figure 1) with questions drafted to obtain information of the knowledge of the harmful effects of tobacco. The questions and the options were read to illiterate patients and patients not familiar with English language.
61 of 123 individuals from Salem district and 22 of 77 individuals from Namakkal district were tobacco users. The details regarding the awareness and nature of habit have been tabulated in Table 1 and 2 collected from the two districts.
|Total no. of individuals||77||122|
|No. of individuals with habit||22||61|
|No. of individuals without habit||55||62|
|No. of individuals with habit aware of effects.||13||32|
|No. of individuals without habit aware of the effects.||36||33|
|No. of individuals without habit who are unaware||9||30|
|No. of people without habit, who are unaware||19||28|
|FORM OF TOBACCO||SALEM||NAMAKKAL|
|Tobacco habit with alcohol||7||10|
|Beedi, Cigarette and Hans||3||----|
|Cigarette and Hans||7|
Marketing of tobacco products is currently challenging as the products the companies that vend them must display statutory warnings with photographs on the packaging as mandated by the health ministry. These photographs do not accurately represent the reality that may educate the population on the acute and chronic effects on the body especially on the respiratory system. Majority of the population are not able to interpret or understand the pictures. In our survey, most of the participants were able to read the warning but unable to comprehend the photograph on the packaging. The dire effects of tobacco habits and its constituents did not reach the population or bring any significant effect on the users.
Among 200 individuals, 83 individuals had some form of tobacco habit, of which 45 were aware of the harmful effects of tobacco consumption which accounts to around fifty percent of the tobacco users were unaware of the effects. The individuals from the low socio economical class did not realize the extent of damage that tobacco had on the respiratory system. The other long terms effects of smoking on the cardiovascular system, such as atherosclerosis, were not known among all the participants. Among 117 who do not have any form of tobacco habit, 69 were aware of harmful effect of tobacco on the respiratory system. The source of awareness on the development of oral cancer was cited to be recent credited to the mandatory advertisements in theatres and television by the health ministry. Rarely, did participants cite the warnings given on the packaging of tobacco products3.
Among the various forms tobacco consumed, beedi was prevalent comparing with other forms, commonly preferred by older men from rural population because of the nominal cost and availability. This form of tobacco when compared with filtered cigarettes can cause severe irreparable damage to the lung alveolus with diseases such as Chronic Obstructive Pulmonary Disease (COPD) with scarring and difficulty in breathing4.
Oral cancer was seen to follow lung cancer as a potential consequence of tobacco habits. Other effects on the lung and cardiovascular system were not known among the individuals.
Some of the cigarette smokers in our survey when explained about the effects of tobacco on the oral cavity, the acute and chronic effects on the respiratory and cardiovascular system showed willingness to gradually quit the habit. The knowledge of the deleterious effect of tobacco on organ systems, affecting future generations by inheritable diseases, and the picture of a morbid line of treatment with poor prognosis proved to be effective in discouraging its use and to view the habit as a temporary relief with permanent consequences. Recent initiatives made by the health ministry such as aggressive advertisements through media have brought about considerable awareness among the population especially development of oral cancer by tobacco products. Campaigns to educate the population on the acute and long terms effects on health can reinforce the knowledge, discourage the habit, encourage rehabilitation of the users, and curb the habit at its roots among the oblivious.
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