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TOBACCO WATER - HIDDEN KILLER IN THE NORTH EAST INDIA!

Abstract

Usage of tobacco is a global epidemic regardless of age and sex, and all the nitty-gritty of its harmfulness has been documented, taught and spread to every nook and cranny, it is still being considered a social status as a ‘cool quotient’ especially in youth. While, 8-9 lakh deaths every year in India are attributed to have caused by tobacco in varied forms, having a significant implication in the nation’s public health, the use of smokeless tobacco, highly prevalent in India - accounting for 74 percent of the global burden, and exceeds cigarette smoking in both men and women, is to be worried much about too.

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Iti Kaushik DPCN. TOBACCO WATER - HIDDEN KILLER IN THE NORTH EAST INDIA!. ijmhs [Internet]. 6Dec.2018 [cited 13Dec.2018];8(12):214-6. Available from: http://innovativejournal.in/index.php/ijmhs/article/view/2365
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Usage of tobacco is a global epidemic regardless of age and sex, and all the nitty-gritty of its harmfulness has been documented, taught and spread to every nook and cranny, it is still being considered a social status as a ‘cool quotient’ especially in youth. While, 8-9 lakh deaths every year in India are attributed to have caused by tobacco in varied forms, having a significant implication in the nation’s public health, the use of smokeless tobacco, highly prevalent in India - accounting for 74 percent of the global burden, and exceeds cigarette smoking in both men and women, is to be worried much about too.

As acceptance for smokeless tobacco, which is consumed without heating or burning is high as it is less stigmatized and easy to conceal, making it even more popular amongst the youths. People usually tends to ignore the fact that smokeless tobacco is still tobacco, and contains cancer causing chemicals called nitrosamines and is as deadly as its immediate cousin – tobacco in smoking form.

One such usage of smokeless tobacco has been stumbled upon in 2003, while conducting the Global Youth Tobacco Survey, Sinha et al . in the form of then an undescribed tobacco product called tuibur in Mizoram and hidakphu in Manipur.

Tuibur and hidakphu are a form of tobacco water mainly popular in the North-eastern states of India. Tobacco water has been in use since 19th century and has been imbibed as part of the social customs accounting to its widespread acceptance in the region. In this, water impregnated with tobacco smoke in water receptacle is poured out through the mouthpiece of a pipe into a tobacco water flask and preserved for personal use. Studies have shown that people have misconceptions that tobacco water can help prevent insect bites, and can act as an antiseptic, protects the teeth and has anti- snake venom properties which ultimately makes it all the more popular in the region.

Once introduced to it, people don’t realize they soon become addicted to tobacco water and that the persistent use of tobacco even in low amount can lead to a habitual use leading to addiction which adversely affects their health. Since its use is socially acceptable and, in fact, is looked upon as pride, both men and women irrespective of their socio- economic background consume it.

Sinha et al. in their study found that 36.7% of the users in Aizawl district of Mizoram and 92.1% in Churchandpur were using tobacco water more than five times a day. He also hypothesized that the widespread cultural acceptance of tobacco water is the reason for high prevelance of tobacco use in the area ( D.N Sinha, 2004 ). Time and again tobacco use has been stated as the main cause of cancer in the Northeast. Another study done by Phukan et al also suggested that Tuibur use seems to increase the risk of stomach cancer especially when it is consumed in conjunction with other forms of tobacco ( Rup Kumar Phukan, 2005 ) which supports the finding of Mahanta et al. that the incidence of stomach cancer was found to be highest in the Aizawl district ( Jagdish Mahanta, 1998 ). In his study he showed that a tuibur user has three times more risk of stomach cancer than a tuibur non-user. Another study summarised that the presence of polyaromatic hydrocarbons and carbonyl compounds present in the tar phase of Tuibur may also contribute to the increased incidence of cancer when inadvertently consumed by the tuibur users ( Rebecca Lalmuanpuii, 2016 ).

People also have a misconception that water reduces the toxic effect of tobacco. Though, there is no proof that water or any accessory can make tobacco intake safer. The flavour and sweet nature makes tobacco water more appealing but not any safer. To make it more accessible Tuibur is sold in the open market (stationary shops, daily markets or weekly markets) in used glass bottles.

Mathadil et al suggested that use of Tuibur is deeply rooted in culture of North East and it is highly addictive too. They also pointed out that the production of Tuibur is also hazardous for the environment & climate which may compound with the health impacts ( Sreenath Madathil, 2017 ). For a small production unit, a space of 8 feet by 8 feet is sufficient near a source of water with a setup cost of only Rs. 3000 approx. and in return it fetches a monthly income of Rs. 7000 approx ( D.N Sinha, 2004 ). Despite of these findings not much has been done in terms of monitoring and regulating the production of tuibur and hidakphu in the Northeast.

A more thorough understanding of tobacco water as a potential means of tobacco use is needed. There is a need to conduct nationwide studies in order to understand the risks, health effects, and the toxic nature associated with tobacco water. Documentation is needed on how the chemical properties of tobacco water are different from other forms of tobacco and what trend is followed nationwide.

Since the consumption of tobacco water is attributed to the cultural practices, it would be important to study the influence of social and cultural practices on its initiation and maintenance. The studies will help in building prevention and cessation strategies to reduce the use of tobacco water and educate people regarding its harmful effects. Stricter laws might be imposed on its production and availability in the region. This will definitely act as an important step towards the sustainable development goal 3 of ensuring healthy lives and promoting the well-being for all, at all ages. 

Bibliography:

  1. Tobacco use among medical students and surrogate control of tobacco in India Singh Virendra. Lung India.2011. [ CrossRef ] [Google Scholar]
  2. Tuibur: tobacco in a bottle-commercial production of tobacco smoke-saturated aqueous concentrate Madathil Sreenath, Kumar NachimuthuSenthil, Zodinpuii Doris, Muthukumaran RajendraB, Lalmuanpuii Rebecca, Nicolau Belinda. Addiction.2018-jan;:577-580. [ CrossRef ] [Google Scholar]
  3. Fourier Transform Infrared Spectroscopy Dutta Aastha. Spectroscopic Methods for Nanomaterials Characterization.2017;:73-93. [ CrossRef ] [Google Scholar]
  4. Tobacco Use and Stomach Cancer in Mizoram, India Phukan RK. Cancer Epidemiology Biomarkers & Prevention.2005-aug;:1892-1896. [ CrossRef ] [Google Scholar]
  5. Tuibur: tobacco in a bottle-commercial production of tobacco smoke-saturated aqueous concentrate Madathil Sreenath, Kumar NachimuthuSenthil, Zodinpuii Doris, Muthukumaran RajendraB, Lalmuanpuii Rebecca, Nicolau Belinda. Addiction.2018-jan;:577-580. [ CrossRef ] [Google Scholar]

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