Abstract

Aim: Despite decades of efforts by the government of India toward tobacco regulation and raising awareness of tobacco induced carcinogenesis, there is a very high incidence of tobacco induced malignancy in Indian subcontinent as well as in the Kumaon region of India. This study will throw light upon factors which prompted tobacco usage by people to the point of carcinogenesis.

Material and Methods: New and earlier diagnosed patients with tobacco associated malignancies (head and neck squamous cell carcinoma (HNSCC) and carcinoma lung) with history of chronic tobacco use of least 5 years; visiting in outdoor patients department of Swami Rama Cancer Hospital and Research Institute, Haldwani, India (SRCH&RI) were asked to read and fill questionnaire, inquiring the details of their tobacco usages. Of the 334 patients of HNSCC and carcinoma lung visited in OPD during 1^st April 2017 to 31^st March 2018; 318 patients were analyzed, 8 patients never consumed tobacco, 4 patients consumed tobacco for less than 5 years and 4 patients were excluded due to ambiguous or self contradictory history.

Results: Of the 318 patients analyzed in the study 269 (84.6%) patients were well aware for the carcinogenic effect of tobacco, for 73 (23%) patients tobacco consumption was a financial burden, 232 (73%) patient noticed pictorial health warning (PHW) over the tobacco products, addiction to tobacco was the most common cause to not to discontinue consumption, 265 (83.3%) patients attempted to quit tobacco and only 12 (3.8%) could ever quit.

Conclusion: Despite high level of awareness of tobacco induced carcinogenesis, PHW and even willing to quit tobacco; patients still continues to consume tobacco to the point of carcinogenesis, this indicates strict implementation of existing laws, new legislation and even gradual cessation of all kind of tobacco production.