NICOTINE

People smoke tobacco all over the world to lessen fatigue, to concentrate more on work, to relieve tension, to remove boredom. These are some of the unjustified reasons .which are argued to justify one's smoking when addicotion has already taken deep roots. Tobacco addiction poses serious health risk to the smoker as well as the people living with the smokers. About 4000 chemicals have been detected in the mixture of gaseous and terry droplets that comprise tobacco smoke. Of these have been singled out to be the most harmful and responsible for various diseases. These are Carbonmonoxide, Nicotine, and Tar..

Carbonmonoxide is a colorless and odorless gas constituting 3-5% of a cigarette smoke and produced, during incomplete combustion. It is highly toxic and easily binds with haemoglobin in the blood to form carboxy-haemoglobin. It has 2000 times more affinity for haemoglobin than oxygen.

Nicotine is a dense oily alkaloid and highly toxic. As little as 4mg can produce symptoms of toxicity in a subject whose body is not used to the drug and 60mg proves to be an absolutely lethal dose.

Nicotine also stimulates the release of 'adrenaline and nor-adrenaline 'which influence blood pressure and heart rate. Excessive smoking leads to increase in heart rate, blood pressure and cardiac arrythmias.

Tar is brown, viscous material composed of condensed particles from cigarette smoke after moisture and nicotine are removed. Tar has carcinogenic properties.

PREVALENCE

In India tobacco smoking is widely prevalent and is associated with social religious, cultural and agricultural activities. According to a survey, 1.84 crore people in India smoke tobacco. Base on per capita consumption, bidi smoking has risen substantially during the last three decades. Use of tobacco in other forms such as pan masala, gutka chewing and smutting is also on the rise.

MORBIDITY AND MORTALITY FROM TOBACCO USE

Tobacco is responsible for significant amount of morbidity among middle aged adults. According to a WHO report, 2.8 million people die each year from tobacco related diseases all over the world of which 20% are Indians. Recent surveys reveal that 11000 people die each day during tobacco related problems all over the world. Clinical observations have revealed that 60% of heart dis¬ease patients under 40 years of age are tobacco users; over half of the patients aged between 41 to 60 years are also smokers. Smokers are exposed to the risk o f meningitis 4 times than those who are non-smokers. Even the passive smokers have two and a half times more risk to develop bacteria infection than the non-smokers. -

TOBACCO CONTROL MEASURES

Control on tobacco products:

Tobacco advertising has been banned in state controlled electronic media, but still shown continuesly without restriction in newspapers, magazines, posters, billboards and video cassettes in Indian films. A proposal for total ban on advertising and sponsorship on all tobacco products is under consideration by the Indian Government.

Protection for non-smokers

In 1990, through an executive order, the government implemented a prohibition smoking in all health care establishments, government offices, educational institutions, air conditioned railway cars, chair-car, buses and domestic passenger flights.

Health Education

There is no organization currently working at the national level for tobacco control. Several non-government organizations and committed industrialists at the local levels are involved, by-to day, no perceptible attitudinal change: among tobacco consumers have been found. Therapist should enhance smoker motivation to leave the habit and educate about harmful effects of tobacco or the body.