Category: Quitting Tobacco

How to help others quit tobacco. Behavioral 7D intervention to help quit tobacco. Articles to help specialists intervention.

Tobacco and Oral Cancer

The global burden of oral cancer has continued to rise, especially in India, mainly due to the high consumption of tobacco and betel quid. Current research has helped elucidate the relationship between tobacco use and the spread of oral cancer, but more still needs to be understood. Rigorous prevention programs and well-established supportive infrastructure are vital to reducing the number of tobacco-related oral cancer cases.

In light of World No Tobacco Day, join us for a special session, organized in association with SIPHER, on “Tobacco and Oral Cancers” with the renowned Surgical Oncologist Dr. Pawan Gupta on 10th June 2023, 5 PM IST onwards.

Session Highlights:

Tobacco Cessation in Western methodology cannot be copied for Indian patients

What is Chota Dana Campaign?

How can cessation of tobacco cure many lesions in the oral cavity?

https://www.docplexus.com/user/content/webinar/e83ee74d-7d50-487c-8fac-25a005a7815a

Tobacco Cessation Strategies in Lung Cancer

12.5.2023 TOBACCO CESSATION STRATEGIES IN LUNG CANCER – Dr. Pawan Gupta M.Ch.

I was invited to talk about the strategy of tobacco Cessation for lung cancer patients in the Symposium on Management of Early Lung Cancer at Maple Hall, India Habitat Centre on 12.5 .2023.

About 40 young Oncologists from across all Institutes in Delhi NCR gathered for the symposium convened by Dr. Satyapal Kataria and Dr. Anshul Gupta.

These young oncologists are different, they have special bonding, unlike the older oncologists who have compartmentalized themselves in their Institutions and work only to gain patients.

The discussion was rich and educative. I as an Onco-surgeon with in-depth research in tobacco cessation and running a successful tobacco cessation center at MAX gain an insight into the simplified methodology to successful tobacco cessation protocol-based intervention. ICanCaRe protocol is a salable, scalable, and sustainable model to be adopted by all institutions.

Tobacco Cessation, a preventive aspect of oncology is generally not a part of even major conferences but was accepted very well by the young oncologists. Each one felt that they need to do more and get involved for the better treatment and future of their patients. 100% said there is a great need for tobacco cessation in their practice. A cessation expert is needed in all the hospitals.

They were eager to know about the cessation methodology. Each was more than ready to incorporate #advicequittobacco in their practice.

Appreciate #anshulgupta #satyapalkataria for the wonderful meet.

#pawangupta #icancare #icancareacademy

Areca Nut (Betel Nut, Guwaha, Supari) – Agents of Oral Cancers

Introduction:

The use of betel nut in various forms is rampant in India. It is being glamorized by the industry and sold in various forms. Rich and poor, male or female, all age groups are consuming it, almost 30% of the population in both rural and urban India consume it freely across all ages and socio-economic sections of the community. That’s why Oral cancer is very prevalent in India and stands at 30% of all cancer cases reported. Betel nut is one of the significant contributors to this. The market size of areca nut is around 100 billion rupees and it is being sold in India in various forms and advertised as mouth fresheners under various names Rajshree, gutkha, mukhwash, tulsi, rajnigandha, etc. Unfortunately, the young generation is being lured into using this harmful product. It is time we create awareness about the dangers of supari.

Areca (Betel) nut is a seed of the fruit of Areca Palm.  It is a stimulant drug.

The betel nut is used in various ways – fresh, dried, boiled, baked, roasted, or cured.

Betel nut consumption is rampant in the northern and eastern zones of the country. A common way of consuming betel nut is by using it as paan betel quids i.e. betel leaf, slaked lime, and betel nut with any other additives like cloves, elaichi, etc. Nowadays it is available in varieties in the market as part of paan masalas.

In many parts of India and Southeast Asia, it is part of social practice/customs, religious practices, and cultural rituals.

Effects of betel nuts:

It is carcinogenic and used with tobacco it causes cancer of the oral cavity, oropharynx, and esophagus. Betel nut affects almost all organs of the body including the brain, heart, lungs, gastrointestinal tract and reproductive organs, and also the endocrine system.

It is a stimulant drug. Like all drugs, there is no safe limit and one needs to be careful. The effect of the drug may vary according to size, weight, and health of the individual and also on the amount consumed. The variety of betel nut also matters.

As a stimulant the person may experience the following:

  • Mild euphoria and feeling of wellbeing
  • Alertness
  • Increased heart rate
  • Increased blood pressure
  • Sweating
  • Redness on the face and feeling warm
  • Tremors
  • Dizziness
  • Upset stomach, diarrhoea, vomiting
  • Psychosis

Long term effects:

  • Oral cavity and dental –
    • Discoloration of teeth and gums
    • Oral ulcers and gum diseases
    • Submucous fibrosis
    • Oral Cancers
  • Heart diseases – myocardial infarction, cardiac arrhythmias
  • Pulmonary – asthma
  • Gastrointestinal system – Stomach ulcers, hepatotoxicity
  • Reproductive system – infertility, harmful effect on the fetus when being used during pregnancy.
  • Endocrine system – diabetes, hyperlipidemia, hypothyroidism, prostate hyperplasia, central obesity
  • Aggravate immune system- suppressed T-cell activity
  • Cancers – oral cavity, oropharynx, esophagus, liver, biliary tract, and uterus.
  • dependency

Pathology and metabolism

Betel nuts contain 4 main alkaloids – Arecholine, arecaidine, guvacoline, and guvacine

The main alkaloid Arecholine has a systemic effect as well as it is a carcinogen. A number of nitrosamines are formed in the oral cavity mainly methylnitrosaminoproprionitrile which is most carcinogenic in the oral cavity causing cancers and submucous fibrosis.

The betel nut is being glamorized by the industry as mouth fresheners sold as Paan Masalas and fresheners. It is a harmful substance and needs to be banned.

The patient is referred to the Tobacco Cessation Intervention specialist to treat the patient for the smoking and chewing tobacco including betel nut, paan masala, gutkha, khaini, etc. One can Call 011-43077695 or visit www.icancare.in/quittobacco for assistance.

(The Author – Dr. Pawan Gupta M.Ch. is Director of Surgical Oncology at Max Super Speciality Hospital, Vaishali. Patparganj and Noida. He is the author of the book – Win Over Tobacco Made Easy, Be Smart Do Not Start and is highly recognized for his work on Oral Cancer and Tobacco Cessation. He is the convenor for Certified Course in Tobacco Cessation under the Gujarat University)

References:

Garg A, Chaturvedi P, Gupta PC. A review of the systemic adverse effects of areca nut or betel nut. Indian J Med Paediatr Oncol. 2014;35(1):3-9. doi:10.4103/0971-5851.133702