Title: An observational analysis regarding factors contributing to tobacco usage among patients diagnosed with tobacco associated malignancies: a study from the Kumaon region of India

Authors: Lalit Mohan, Aradhana Arya, Kailash Chandra Pandey, Nirdosh Kumar Pant, Swaroop Revannasiddaiah, Rajan Yadav, Soorej Balan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.06

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 1st April 2017 to 31st 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.

References

  1. Bhawna G (2013). Burden of smoked and smokeless tobacco consumption in India - results from the Global adult Tobacco Survey India (GATS-India)- 2009-2010. Asian Pac J Cancer Prev, 14, 3323-9.
  2. Hoffmann D, Hoffmann I and El-Bayoumy K. (2001). Chem. Res. Toxicol., 14, 767 – 790.
  3. Marron M, Boffetta P, Zhang Z-F, et al. Cessation of alcohol drinking, tobacco smoking and the reversal of head and neck cancer risk. International Journal of Epidemiology. 2010;39(1):182-196. doi:10.1093/ije/dyp291.
  4. National Centre for Disease Informatics and Research; National Cancer Registry Programme (NCDIR) (Indian Council of Medical Research) Hospital based Cancer Registry 2012 to 2014 report.
  5. Pandey KC, Revannasiddaiah S, Pant NK, Bhatt HC. Stage-wise presentation of non-metastatic head and neck cancer: an analysis of patients from the Kumaon hills of India. Asian Pac J Cancer Prev. 2014;15(12):4957-61.
  6. Pant NK, Pandey KC, Madabhavi I, Pandey V, Revannasiddaiah S. Evaluation of the knowledge and perceptions with regards to pictorial health warnings on tobacco products among tobacco users diagnosed with head and neck carcinoma: a study from the Kumaon Hills of India. Asian Pac J Cancer Prev. 2014;15(18):7891-5
  7. Petros WP, Younis IR, Ford JN, Weed SA. Effects of Tobacco Smoking & Nicotine on Cancer Treatment. Pharmacotherapy. 2012;32(10):10.1002/j.1875-9114.2012.01117. doi:10.1002/j.1875-9114.2012.01117.
  8. Sanner T, Grimsrud TK. Nicotine: Carcinogenicity and Effects on Response to Cancer Treatment A Review. Frontiers in Oncology. 2015;5:196. doi:10.3389/fonc.2015.00196.

Corresponding Author

Dr Aradhana Arya

Assistant Professor, Department of Anaesthesiology, Govt Medical College, Haldwani, Uttarakhand, India

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