If you walk into a coffee-house and see more women smoking than was the case years ago – that picture may indeed be true, according to a recently released US study on tobacco consumption.

While Indian men are showing signs of snuffing out the habit, tobacco consumption among women remains virtually unchanged, it points out.

“India has more female smokers – over 12.1 million – than any country except the US. In 2012, female smoking prevalence was 3.2 per cent, which is virtually unchanged since 1980,” says the study done by the Institute for Health Metrics and Evaluation (IHME), University of Washington.

But in the same period, between 1980 and 2012, smoking prevalence among Indian men decreased from 33.8 per cent to 23 per cent, said the study, done across 187 countries.

The study further points out that despite a decrease in the percentage of the smoking population, there is an increase in smokers – a paradox arising from the overall increase in population. In fact, smoking leads to nearly one million local deaths each year.

Worrying as that is, local experts say that the ground reality is more “alarming” than the US study outlines, as it does not include the oral consumption of tobacco.

While the numbers are worrisome, Srinath Reddy, a veteran on tobacco-related issues and President of the Public Health Foundation of India, points out that the decreasing percentage of smoking in men did not take into account the substitution to oral and chewing tobacco.

And among women, overall tobacco consumption was as high as 20 per cent, a large part being orally consumed tobacco and beedis, he said, citing an earlier study.

On why women take to tobacco, he said, urban, educated women smoke from a later age, with a sense of freedom and liberation. In rural India, women chew tobacco or smoke beedis to keep hunger at bay, he added.

In fact, India is mirroring the situation in the US, about 20 years ago, says Dr Pankaj Chaturvedi, Professor and head and neck cancer surgeon, at Mumbai’s Tata Memorial Hospital.

Echoing Dr Reddy’s observation, he says the India situation is more alarming than the US study outlines, because of the under-reporting of orally consumed tobacco. Stigma associated with smoking keeps women in rural areas from participating in such studies. And in the urban context, smoking is more of a lifestyle statement, he observed.

According to the Global Adult Tobacco Survey India study (GATS-2010), the estimated number of tobacco users in India was over 270 million, with 163 million being users of only smokeless tobacco, 68.9 million only smokers, and 42.3 million users of both smoking and smokeless tobacco. And the prevalence of overall tobacco use among men was 48 per cent and women was 20 per cent, he said, citing the study.

Health risks

When women smoke it affects their health, and that of future generations too, as it results in birth abnormalities, he said. And similar to the US, increased smoking in urban areas pre-disposes women to the risk of lung cancer. In the rural context, in Maharashtra for instance, tobacco-related cancers in the mouth, oesophagus (the food-pipe) and breast were among the top three cancers diagnosed, he pointed out.

>jyothi.datta@thehindu.co.in

Worrying trend

In 75 countries, smokers consumed an average of more than 20 cigarettes a day in 2012.

Among Indian smokers the average is 8. 2 cigarettes.

The number of cigarettes smoked annually has grown to more than 6 trillion.

Source: IHME study

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