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Indian Journal of Community Medicine

Gutkha and Tobacco Consumption and Awareness of their Health Hazards among School and College Students in Gujarat

Author(s): A. B. Pawar, S. Mukherjee

Vol. 29, No. 3 (2004-07 - 2004-09)

Introduction

Tobacco is the main culprit behind oral cancer: approximately 90 per cent of oral cancers in Southeast Asia are linked to tobacco chewing and tobacco smoking. Tobacco is mainly consumed in two forms - chewing and smoking. Oral cancers are mainly attributed to tobacco chewing. In developing countries 2-10 per cent of women and 40-60 per cent men use tobacco. Tobacco use usally begans in adolescence; the time for discovery, challenge and experimentation.

Kheda and Anand districts are the leading tobacco-growing areas of Gujarat3. Tobacco is the major contributor to the agricultural economy in these two district and it is part of their culture and is socially acceptance. Children receive tobacco from their parents, especially women, right from their childhood.

This study was undertaken to know the extent of Gutkha abuse among school & college students of Anand & Kheda districts of Gujarat and to study the perceptions of the students regarding the health hazards of tobacco and Gutkha.

Methodology

A sample-size of 4,000 was decided, constituting approximately 0.5 per cent of the total population of Anand and Kheda district collectively. In actual effect only 3,848 students were involved in the study, out of which 1995 were college and 1853 were school students. 90 per cent students in schools were from aided schools, while 94 per cent students were from aided colleges.

The proforma consisted of 24 questions drawing information relating to tobacco use. Before starting this study, the interns involved in the study were adequatly trained for carrying out the study.

Results and Discussion

The prevalence of tobacco use including Gutkha in school was 24.9% while in colleges it was 25.9%. Among the school students, prevalence of Gutkha use was 6.7% per cent and that among college students was, meaning that one out of every five college students was consuming Gutkha.

This finding provides an important clue that school students after going to colleges prefer Gutkha over other tobacco products. This is an alarming finding since Gutkha is more hazardous to health than plain tobacco.

Almost half of the students, both from schools & colleges were aware about the close association between tobacco/ Gutkha and oral cancer.

The detection of oral cancer in its early stages constitutes an important phase of prevention; because oral cavity is easily accessible body site for visual examination. Oral cavity self examination needs to be promoted which is very simple since it requires only torchlight and mirror. Instead of disseminating horrifying messages on oral cancer, the strategic and sustained health educational efforts should be carried out to arrest tobacco epidemic.

Table I: Place Preferred For Purchase of Gutkha

Place School
Students
College
Students
School Premises 30 (24%) 120 (27.3%)
Shops Near School 57 (45.6%) 155 (35.2%)
Shops Near Home 09 (7.2%) 37 (8.4%)
Shops On Way To School 29 (23.2%) 128 (29.1%)
Total 125 (100%) 440 (100%)

The figures in Table I clearly indicate that Students prefered the pan-shops on the way to school and around the school-premises. These places are the favourite spots of the students for the purchase of tobacco products as being away from their homes there is no fear to be caught by their parents. Primary prevention can be implemented in the form of a community approach where the risk of the entire community is eliminated without the individual's direct participation. Some of these measures include higher taxation on tobacco and tobacco products, changes in the manufacturing process of tobacco products, ban on tobacco sale, alternative crops for tobacco producing farmers etc. Recently, the Maharashtra, U.P. and Rajasthan government have taken an appreciable step to impose ban on production and sale of Gutkha in the states. This could be a major milestone in tobacco control, if implemented properly.

Attitude Regarding Stopping Tobacco:

More than 3/4th of school students and almost 2/3rd of college students expressed a desire to quit Gutkha and other tobacco habits. Thus a large number of habituated students are already motivated to stop their habit. They need to be counselled properly.

The communication media like newspapers, television, radio, cable channels, movies etc. spread the anti-tobacco message.

References

  1. Jayant K, Balakrishnan V, Sanghvi LD, Jussawalla DJ. Quantification of the role of smoking and chewing tobacco in oral, pharyngeal, and oesophgeal cancers. Br J Cancer. 1977; 35: 232-5.
  2. Jayant K. Statistical appraisal of the association of smoking and chewing habits to oral and pharyngeal cancers. Indian J Cancer 1977; 14:293-9.
  3. Bansal RK. Tobacco usage in rural women. Journal International Medical Sciences Academy 1996; 9 : 44-46.

Associate Professor,
Department of Community Medicine,
SMIMER, Surat.
E-mail : [email protected],
Project co-ordinator

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