Ban gutkha, Centre tells Karnataka; CM unaware of advisory

The Union ministry of health and family welfare has issued a letter advising the state government to ban sale of gutkha (pan masala with tobacco) to prevent its adverse impacts on health due to increasing consumption.

The letter, dated April 25, has been sent to principal secretary, health, EV Ramana Reddy, by the special secretary of Union ministry of health and family welfare, Keshav Desiraju, in the background of growing concern among city oncologists over increasing number of oral cancer cases due to consumption of tobacco in the smokeless form.

Desiraju has said that apart from the risks associated with tobacco, as per the notification by the Food Safety and Standards Authority of India (FSSAI) (Prohibition And Restriction on Sales), in August 2011, food products should not contain any substance that is injurious to health, and therefore, tobacco and nicotine shall not be used as ingredients in any food products.

Studies have indicated that increasing number of youngsters is opting for chewing tobacco in the wake of increasing awareness about the harmful effects of smoking; and gutkha is emerging the preferred choice.

A study by researchers from Indian Institute of Environmental Medicine, on the determination of toxic metals in Indian smokeless tobacco products, published in The Scientific World Journal in 2009, targeted seven different groups of smokeless tobacco products (STPs) for determining eight metals present in them.

The study stated: “It was found that the smokeless tobacco contained considerable levels of metals like lead, arsenic, copper, selenium, cadmium, nickel, chromium and mercury, which if consumed in excess would prove harmful for consumers.”

Referring to a recent Supreme Court judgment, he said pan masala is a food product and, giving due credence to the FSSAI notification, gutkha should not be sold.

The letter also takes into consideration the Global Adults Tobacco (GAT) survey, 2009-10, which states that smokeless/chewing tobacco is one of the most prevalent forms of using tobacco, with over 206 million users.

What is especially worrying oncologists is the age of those affected. “Earlier patients were older, usually past 60, before they could be affected with cancer from smoking tobacco,” said Dr Vishal Rao, consultant oncologist, Head and Neck surgeon, Fortis Hospital.  “But today, we see patients as young as 30 or lesser suffering from mouth/throat cancers due to chewing tobacco, especially gutkha,” he said.

According to the GAT survey, the mean initiation age for daily tobacco users in India is 17.6 years. At least two out of five of daily tobacco users in the age group of 20-34 had started chewing tobacco on a daily basis before reaching 18.
In rural areas, 26% of females and 13% of males started using tobacco before the age of 15. 35% of urban tobacco users started before they were 18. Among half (48%) of tobacco users among students also got into the habit before they turned 18.

The survey also showed that of the overall 35% of the population surveyed, who used tobacco on a daily basis, 21% used it in the smokeless form and 9% smoked it. 5% of the population used both.

Using an average consumption of 10 pouches per day, it was calculated that in these products the levels of lead, arsenic, cadmium, and copper exceeded the daily average values of consumption.

Although several food products have safe limits for heavy metals, in case of smokeless tobacco products (like gutkha), the safe limits for metals is not specified.

Chief minister DV Sadananda Gowda, who is also handling the health portfolio, was not aware of the letter at all. “I have no information on this. I will look into it the matter,” he told DNA.
Whether the state government will take the advice of the Union ministry of health and family welfare seriously or not is yet to be seen.