World No Tobacco Day 2024: E-cigarettes and vapes are also injurious to health

Tobacco in cigarettes or its smokeless form has a direct link to cancer. Around 15 kinds of cancers are caused by tobacco. In India, two in five cancers in men and one in five in women are due to tobacco. Tobacco can affect almost any part of the body. It leads to cardiovascular problems, chest infections, cholesterol disorders and also impacts fertility and is the leading cause of preventable diseases.

May 31 is observed as World No Tobacco Day.

Interview: Dr A.K. Dewan, Director, Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi.

Q: How are tobacco and cancer linked?

A concoction of harmful chemicals (carcinogens) in tobacco and nicotine not only induces addiction but also plays havoc on cellular structures leading to mutations and thus cancer. The International Agency of Research on Cancer (IARC) classified both cigarette smoke and smokeless tobacco as Group I carcinogens.  

Q: What are the different kinds of cancers caused by tobacco?

Smoking causes multiple kinds of cancers that include mouth/throat; voice box; blood cancer; cancer of the kidney, urinary bladder, oesophagus, lungs, liver, pancreas, stomach, colon and rectum.

Q: How prevalent are such cancers in India? What is the geographical spread?

In India, nearly 40% of male cancers and 20% of female cancers are due to tobacco use. Meghalaya has the highest proportion of cancers for both genders; 65% in males and 42% in females. Naharlagun (Arunachal Pradesh) records the lowest among males (24%) while among females the lowest (6.9%) is at Pasighat.

One marked cultural variation is the six times greater use of smokeless tobacco, as compared to cigarettes by women. Female smokers are twice as likely as men to develop lung cancer.

Q: Is vaping effective in quitting cigarettes?

E-cigarette is an effective tool for quitting smoking in adults. While 10% of smokers are likely to quit smoking by changing to e-cigarettes; with other methods, this number is seven per cent. Aggressive marketing of e-cigarettes has led to an explosion in their use by adolescents and young adults. The addiction potential of nicotine (also present in e-cigarettes) may mean that kids who vape are more likely to become cigarette smokers. We might be causing the next smoking epidemic through young people getting addicted to e-cigarettes early in life.

Q: What are the ill effects of vaping?

Vaping is less harmful than smoking but unsafe. One cigarette requires 10-15 puffs and lasts five to eight minutes. One vape offers 600 puffs, which equals 50 cigarettes, though with lesser nicotine. Vaping burns nicotine at very high (350 degrees) temperatures. This produces water-retaining excipients like propylene glycol and glycerine which cause pulmonary irritation. Metals in the heating coil might leach metals; while flavourings could cause bronchitis. E-vap-associated lung injuries (EVALI) are also a possibility.