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Innumerable Indians are addicted to nicotine (one of the most habit-forming substances known to man) in various forms.  Some smoke it while others sniff or chew it. Many harbour the misconception that chewing gutka or smokeless tobacco is less harmful than smoking. Most are not aware that gutka is literally ‘a pinch of poison’ that can cause severe ailments and lead to a slow death. Specialists, especially oncologists, say consumption of gutka is more harmful than any other form of tobacco.

What is gutka?

Gutka is a smokeless variety of tobacco that is not burned when chewed. It is consumed by placing it between the gum and the cheeks. In India, it’s a common sight to come across people who chew tobacco and spit out a red coloured juice. While this juice is desecrating our walls, monuments, and streets, gutka is slowly killing our countrymen.

Gutka, also known as mawa or kharra, is a combination of crushed arecanut, slaked lime, paraffin and katechu and has sweet or savory flavourings. This mixture, which is promoted and sold as a mouth freshener, has about 4,000 chemicals of which at least 40 are carcinogenic (potential to cause cancer) compounds.

Remember, use of chewing tobacco is not restricted to rural India. Colourful packaging, stylized advertising (both direct and surrogate) and endorsements by mainstream actors including one from Hollywood, have pushed many towards it. 

Health hazards of smokeless tobacco

Smokeless tobacco is more hazardous than smoking because the chewed mixture directly enters the system through the oral cavity whereas with smoking, only 20% of the harmful chemicals reach the lungs. Cancerous chemicals cause a non-healing ulcer in the mouth, oral cavity, food pipe and voice box. When untreated, this can lead to cancer of the mouth or oral cavity.

According to Global Burden of Disease Study (2010) and Global Adult Tobacco Survey in 2010, smokeless tobacco resulted in more than 62,000 deaths due to cancers of the mouth and food pipe. According to a BBC report, India is the oral cancer capital of the world. Data suggests that our country continues to have the highest prevalence of oral cancers globally with 75,000 to 80,000 new cases of such cancers reported every year. Most of these can be attributed to the use of chewing tobacco.

Also, it leads to other conditions like hypertension, heart disease and stroke.  Consumption of gutka during pregnancy can result in low birth weight babies. Other effects include loss of appetite, unusual sleep patterns and loss of concentration. Despite the astounding public health impacts caused by this deadly product and a Supreme Court directive (2016) to completely stop the sale of gutka, companies still sell pan masala and tobacco in separate pouches to circumvent the gutkha ban. The crackdown has been unsuccessful, and some states like Maharashtra has also revoked gutka ban this year.

The solution

A complete ban on gutka and its allied products like pan masala is the only way to curb this deadly menance. The government and legal authorities must unite to tackle this major health problem.  No addict wants to live the life of an addict. Nicotine dependency is a difficult habit to overcome but a combination of motivational therapy, nicotine substitute (like nicotine gums or 24-hour nicotine patches) and anti-craving medicine will offer the best outcome. Government should impose 50% GST on it.

-The writer is a medical director at Suasth One Step, a de-addiction and wellness clinic in South Mumbai.