![Women and tobacco – The facts and not so pretty figures]()
by iphindia | Jun 21, 2013 | Latest Updates
Women and tobacco is there a connection? Definitely yes!
The bond between women and tobacco goes way beyond the cultivation and manufacture, and is now creeping into consumption as well. As more and more tactics are used by the industry to tap into this vast less explored area of women and tobacco use studies have shown a rapid rise in female tobacco users. In general 6 million people worldwide die due to direct or indirect effects of tobacco usage. By 2030 tobacco is estimated to kill more than 8 million people worldwide each year, with 80% of these premature deaths among people living in low- and middle-income countries.
In India till recently tobacco use among women was not very common. Though rural women do consume tobacco, in various parts of India, generally tobacco use by women is not a socially acceptable norm. Smoking habits, often seen as an act of rebellion usually becomes linked with freedom and equality. In urban India with the increasing number of working and educated women, smoking is picking up among this group as a way to break away from the social constraints and express their freedom. Such circumstances are cleverly exploited by the tobacco industry to gain customers among new target groups such as women and children. Marketing, portrayal in the media, and movies can influence the progression to regular use and addiction. While smoking among women has declined in many developed countries, it is predicted that as women achieve greater spending power, and socio cultural and religious constraints decrease an increase in smoking rates in developing regions is emerging; such is the scenario currently in urban India. Overall, 2.9% of women smoke and 18.4% chew tobacco in India. The prevalence of smoking among women is low in most parts of India, but is somewhat common in parts of the north, east, northeast and Andhra Pradesh.
Smoking by men is somehow considered normal and does not evoke much of a response, but smoking by women does turn heads; more so in India and other neighbouring countries. Hence usage of smokeless and other forms of tobacco such as hookah, tobacco water etc is quite common among women of this region. Smokeless tobacco usage is convenient for women as it can be concealed quite easily and does not attract the same social attention as smoking would. The major concern with this is, smokeless tobacco is shown to contain 3095 chemicals of which 28 are potential carcinogens (cancer causing agents). India presently has the largest number of oral cancers in the world and smokeless tobacco users have a high risk of developing oral precancer and cancer. In the case of smoked tobacco there are more than 4000 chemicals, of which at least 250 are known to be harmful and more than 50 are known to cause cancer. Second hand smoke(SHS) is also equally harmful as the mainstream smoke. SHS causes lung cancer and coronary heart disease. In children, SHS causes sudden infant death syndrome (SIDS) and many other diseases, primarily related to the respiratory tract. Other than tobacco consumption in smoked or smokeless forms even the chemicals used in tobacco farming have hazardous effects on maternal and fetal health.
Few of the reasons for the unique relationship between smoking and the female gender are as follows. Research findings reveal that female smokers derive greater subjective pleasurable effects from nicotine than their male counterparts. Also weight control and reduction of appetite are important aspects of the appeal of smoking for many women and girls. Studies do suggest that cessation may be more difficult for women than for men; one of the reasons could be weight gain and fear of weight gain particularly among women.
Other than the gender neutral effects of smoking such as lung and heart diseases, strokes, cancers etc., women are at an increased risk for female specific reproductive issues, including painful, irregular periods; earlier menopause; increased risk for cervical cancers among women who smoke and have human papilloma virus (HPV) and increased risks among those who use certain birth-control methods.
As tobacco industries are targeting gender specific promotion, increasing efforts should be made to develop gender-specific prevention strategies as well. Women who are very conscious of their looks should not fall prey to such lame excuses of reduction in appetite for weight control as they could end up with much more disfiguring consequences. A change in perspectives is required to consider tobacco use as ‘uncool’ and not a normal behaviour especially among young boys and girls. Women do not need to use tobacco to depict that they are independent and smart. Gender specific tobacco control activities should also take into consideration the millions of women involved in the tobacco farming and production industry that tirelessly roll lakhs of beedis to earn meagre amounts. Such activities should also focus on young girls to help them make well informed choices about their health and life.
![Women and tobacco – The facts and not so pretty figures]()
by iphindia | Jun 5, 2013 | Latest Updates
“He is a caterer, he needs that place to cook and park his vehicle. Therefore he is creating a problem”, it is the opinion of youths from BM layout in KGhalli ward no.30, Bangalore.
KG Halli ward No.30 is located in Bangalore North, with the population of 45000. Findings of baseline survey says 73% of the family do not have tap at home, they depend on other water sources like bore well street tap and tanker etc. To improve water source in this area UHT (Urban Health Team) have planned to strengthen water facility. In consultation with community and local counselor we decided to install 5 Ciston tank each in five areas of KGHalli (AKcolony-1, BM Slum-2, BM layout-1 and Venkateshpura-1). Although we had planned five Ciston, we were able to construct only three Ciston tank.
Construction of water tanks are in progress in identified places. There has been no objection in three places. But team faced problem in two places, we have been asked to stop construction work in both the places namely AK colony and BM layout. Thus any program becomes failure if community does not take lead or if local rowdy element is controlling the community.
Construction of water tank is failure in AK colony
In AK colony the place identified is almost an adjacent to the wall of a house. The house owner objected the construction of water tank. People did not come to our aid or tried to identify another place to install the tank. The point here is how can community let go a basic facility (water) when it has been taken to their door step?
In BM layout we found individual V/S community.
A team of construction workers had already started construction (basement of two feet height) in an identified area in BM layout. When construction is on Nazeer picked up quarrel with the construction workers and did not allow them to continue their work. Nazeer (Caterer) is not an owner of the house but he is a tenant residing in that house. Community member have taken permission from the owner to construct water tank in front of his house.
Despite consultation with community, counselor and permission from the owner, in a public place we could not construct water tank. The reason behind the failure of water tank construction is a local politics. He is being a caterer he wanted to utilize the space for cooking and parking his vehicle. It is hard to fight when the fight is ending on injustice note, few community member especially youths came forward to support the construction of water tank. Their effort became fruitless when Nazeer brought the local rowdies to hush up youths by manhandling them.
We called counselor and BBMP official, everything became futile. None of them want to side the community for an issue of basic amenity.
UHT witnessed the fight between Nazeer and youths, we felt we were helpless when youths were beaten up and construction was stopped. This incidence kept on haunting me for several days, because community has been deprived from basic facility. Is community gullible or do not want to take any effort to protest against injustice happening to them? Is community scared of local rowdies? Is that particular area ruled by local rowdies/unofficial elected leaders? When construction of tank happened in other three areas successfully why not here?
As an outsider we cannot protest on behalf of community, our role is only to facilitate the program. May be the lesson for us is we must have mapped who control’s that area other than counselor or political leader, what is the strength and weakness of the community before the construction of water tank.
![Women and tobacco – The facts and not so pretty figures]()
by iphindia | May 21, 2013 | Latest Updates
Yesterday , we went for our “annual health check up”. After months of being nagged by our teenage children, two fifty-plus year old public health professionals set off on this fairly routine activity, which as doctors we advocate to our nearest and dearest.
The question was where to go. As we well know, distance and affordability are two key factors in making this decision. Of course the comfort of having a GP is non-existent in our present set up, so I was struck by the startling fact that, as a resident of Bangalore city for over a decade, I really did not have ‘someone I could go to’. There exist the ‘annual package services’ at the big centres like Narayan Hridayala and Apollo or Fortis , which apparently are value for money and I thought I would take a leaf out of the book of my net savvy children and do a google search. Now it turned out that the nearest hospital to our house had awful feedback reviews and I was rather concerned.
So at dinner ( the forum for such matters) when we looked at possibilities, given everyone’s crazy schedules ( which is why this event was skipped last year by the way!) we wondered whether we should go directly to the diagnostic lab and give them the list of tests needed. And discovered that some stuff still needed another doc!
So I made a call to the tried and tested “nursing home” , multi speciality private hospital , fairly close by, and reliable. This last conclusion comes from feedback from scores of patients we have referred I the past and our own parents. The very professional voice on the phone told me “ A physician will do this check up between 6.30 pm and 8.30 pm , Monday to Friday , Madam”.
Friday evening saw us waiting our turn out side the young doctor’s cubicle . After a half hour wait, he did the needful and with great professional courtesy did not charge us a fee. A long list of blood and other such sundry tests , unfortunately not all available under one roof , awaited us on the morrow.
Saturday morning ….., and we set out early, undaunted by the seeming impossibility of finishing it in one day!
As we waited in the queue, I was struck by a number of things. One, people always scramble because they are either truly in a hurry or truly believe they are in a hurry. Staff managing the counter were amazing in their grasp of our infinite number of languages, polite and firm. People do not like to sit next to each other while waiting amongst strangers- every odd seat was vacant. People are so anxious and self absorbed that they often do not see others standing, when a seat next to them is available.
We were called to order for the various tests and I slowly transitioned from being me to being roughly seventy kilos of warmish albuminoid matter. They staff were unfailingly polite, extremely efficient ( the technician told me he draws an astonishing 70 blood samples in two hours) and mostly on autopilot.
As the sun grew warmer and we returned for our post breakfast blood tests, all of us were beginning to droop round the edges. Meanwhile, I had stripped , been poked and prodded radiated examined with ruthless efficiency while being carefully guided into rooms with the ubiquitous green curtains!
My husband rallied through the treadmill while I shot across in an auto to get the menopausal ‘must’ screenings done in another hospital!
By lunch we were jubilant….. wondering how to spend three hours waiting for the results. Finally we went home, exhausted and needing the rest. I went back in the evening with my daughter to pick up the results. And she was telling me about our house help who comes from Bihar. They migrated because her father sold three “kheths” or fields to pay for her brother’s dengue treatment in Delhi where he had gone to work. “I think that is probably why you guys work so hard for health insurance”…..she says.
And I think that is why when Pandora’s box flew open, Hope was left behind!
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by iphindia | May 2, 2013 | Latest Updates
The Second regional team meeting for Health Inc Indian partners was held at Mumbai between 24th and 26th April 2013. This meeting was hosted by Tata Institute of Social Sciences (TISS) at Hotel Jewel of Chembur, Mumbai. It was attended by members of Institute of Public Health Bangalore (IPH) and Tata Institute of Social Sciences (TISS) teams, along with representatives from the Institute of Tropical Medicine Antwerp (ITM) and London School of Economics – Health (LSE). In the meeting both the partners shared their findings so far and discussed possible areas and processes for comparision. In addition, the teams discussed further strategies to develop the policy recommendations and dissemination.
![Women and tobacco – The facts and not so pretty figures]()
by iphindia | Mar 29, 2013 | Latest Updates
To create the awareness about the female foeticide, Government of Karnataka is organising sensitation workshop about PC-PNDT act in Governments hospitals. Main focus of the workshop are field health staff. IPH was invited as a resource person for this workshop, which was held at Sira Taluka
![Women and tobacco – The facts and not so pretty figures]()
by iphindia | Mar 20, 2013 | Latest Updates
A training session was conducted for police officials of the Western Range of Karnataka which includes 4 districts on the 14th March 2013. The officers underwent training for implementation of smoking ban in public places and other guidelines regarding tobacco control. The workshop was conducted in Police Guest House, Mangalore. Tobacco control was taken up as an important issue since one tobacco related death happening every eight second in the country! Karnataka presently has around Two Crore consumers, one third of who may die a premature death. Such sensitization and training programs will help in proper implementation of the existing laws.
