Does smoking lead to cancer?

The recent comments made by certain parliamentarians on the connection between smoking and cancer in India have generated a lot of heat. These parliamentarians have tried to show that there is no link between smoking and cancer as no such study has been conducted in India.[1] However, there are many such studies which have been conducted at the international and regional levels, which provide empirical evidence for the connection between smoking and cancer.

HARMFUL EFFECTS OF SMOKING

Among all the causes like unbalanced diet, lack of physical activity and exposure to radiation, smoking is the most preventable cause of cancer.[2] It is reported that in the United Kingdom, one in four cancer deaths are because of smoking.[3]  Lung cancer is one of the most common types of cancer caused by smoking, but it is preventable if the smoking is given up on time. Smoking also increases the risk of other cancers like mouth, pancreas, skin and breast cancer.[4] Although merely smoking would not cause cancer, but it does indeed increase the risk of cancer and it also affects the general immunity of the human body. Tobacco smoke contains more than 250 known different substances like nicotine, benzene, cadmium, chromium etc that are thought to cause cancer. When you inhale smoke, these chemicals enter your lungs and spread around the rest of your body. A pregnant woman smoking may cause her unborn baby to get birth defects like internal bleeding, problems with the placenta or the food pipe and low birth weight and men who smoke are at greater risk of erectile dysfunction.

STUDIES ON SMOKING IN OTHER COUNTRIES

Smoking in not only harmful to the person who is smoking, but it also causes second hand effects. It can cause cancer to those who are regularly in contact with first-hand smokers.[5] Approximately 3,000 lung cancer deaths occur each year among adult nonsmokers in the United States as a result of exposure to secondhand smoke.[6] Besides cigarettes, other form of smoking like chewable tobacco, biddi, pipes and cigars are equally harmful. All these products have nicotine, which makes the extremely addictive.

There have been concrete disinformation campaigns to deny the effect of smoking on human body and tobacco industries have spent millions to keep the controversy alive. . In 1973, for example, the Tobacco Institute, a United States tobacco trade industry research group hired AHF-Basico Market Research Co. and Audience Studies, Inc., to measure the impact of its 1972 propaganda film, ‘Smoking and Health: The Need to Know’, shown to hundreds of thousands throughout the America, including high school students. The film had also produced ‘significant shifts’ in attitudes favorable to the industry in other areas, including whether recent reports had ‘overemphasized the dangers of smoking’.[7] In UK also, sustained campaigning was conducted to dent the effect of second hand smoking.[8]

STUDIES ON SMOKING IN INDIA

India has been witnessing a rising debate over the link between cancer and smoking. The government has proposed to increase the size of the pictorial warning on the cigarettes packaging from 45% to 80%. However, this has been met with a strong backlash by tobacco industries and smokers in general. Tobacco industry provides employment to millions and in turn generates revenue for the government.

In India, no national level study has been conducted to determine the harmful effects of smoking. However, we do have research studies conducted at regional levels. A study conducted in South India concluded that smoking biddis increases the chances of lung cancer however other forms of smoking might not do so.[9]

Cancer killed 5,56,400 people across the country in 2010. The 30-69 age group accounted for 71 per cent (3, 95,400) of the deaths. In 2010, cancer alone accounted for 8 per cent of the 2.5 million total male deaths and 12 per cent of the 1.6 million total female deaths in this age group (30 to 69 years).[10]There is a variation in the deaths across region, class and gender. It seems that most impoverished regions, where women are still suffering the shackles of patriarchy are not allowed to smoke. As a result, there are less number of deaths among women due to smoking in states such as Orissa, Bihar and Uttar Pradesh. Northeast States and Kerala have recorded high instances of death among women due to smoking.

A report by The Tobacco Control Policy Evaluation Project India predicts around 275 million tobacco users in India.  Tobacco use accounts for nearly half of all cancers among males and a quarter of all cancers among females and it is estimated that there will be 1.5 million tobacco-related deaths annually by 2020.[11]

Consumption rates are falling in most of the richer countries, but smoking rates remain high or even increasing in many parts of the globe.[12]

If the Indian government is ever going to conduct a detailed research study on the link between smoking and cancer, it would only show that how wrong some of the parliamentarians can be. The government has indeed taken a bold move by proposing to increase the size of pictorial warning to 80% under the provisions of Cigarettes and Other Tobacco Products Act, 2003. If this legislation is amended, it could help to a large extent in reducing the number of tobacco deaths.

[1] Outlookindia.com, No Indian Report Links Tobacco to Cancer: BJP MP (2015), http://www.outlookindia.com/news/article/No-Indian-Report-Links-Tobacco-to-Cancer-BJP-MP/888904 (last visited Apr 5, 2015).

[2] Prabhat Jha et al., 21st-Century Hazards of Smoking and Benefits of Cessation in the United States, 368 New England Journal of Medicine 341-350 (2013).

[3] Cancerresearchuk.org, Smoking and cancer : Cancer Research UK (2015), http://www.cancerresearchuk.org/cancer-info/healthyliving/smoking-and-cancer/smoking-and-cancer (last visited Apr 5, 2015).

[4]  U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004.

[5] U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.

[6] National Cancer Institute. Cancer Progress Report 2003. U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, 2004.

[7] Legacy.library.ucsf.edu, Legacy Tobacco Documents Library: AUDIENCE TESTING OF “SMOKING & HEALTH: (2015), http://legacy.library.ucsf.edu/tid/uqn92f00 (last visited Apr 5, 2015).

[8]Legacy.library.ucsf.edu, Legacy Tobacco Documents Library: NOTE ON A SPECIAL MEETING OF THE UK INDU (2015), http://legacy.library.ucsf.edu/tid/dof53a00 (last visited Apr 5, 2015).

[9] Gajalakshmi V, Tobacco smoking and chewing, alcohol drinking and lung cancer risk among men in southern India. – PubMed – NCBI Ncbi.nlm.nih.gov (2015), http://www.ncbi.nlm.nih.gov/pubmed/14506745 (last visited Apr 5, 2015).

[10] R. Prasad, ‘Cancer killed 5.56 lakh in India in 2010’ The Hindu (2012), http://www.thehindu.com/sci-tech/health/medicine-and-research/cancer-killed-556-lakh-in-india-in-2010/article3251406.ece (last visited Apr 5, 2015).

[11] Uwaterloo.ca, Experts predict 1.5 million smoking deaths in India by 2020 | Waterloo News (2015), https://uwaterloo.ca/news/news/experts-predict-15-million-smoking-deaths-india-2020 (last visited Apr 5, 2015).

[12] Proctor RN. Golden Holocaust: Origins of the Cigarette Catastrophe and the Case for Abolition. Berkeley: University of California Press, 2011

 About the Author

Archit Gupta is currently pursuing his B.A.LL.B. (Hons.) from National Law Institute University, Bhopal. He has also completed a diploma in Cyber Law from Asian School of Cyber Laws, Pune. He has previously interned with various organizations like Central Information Commission and Adhrit Foundation. He has undergone internships with different law firms and has observed the proceedings of various tribunals and courts as well. He is associated with various online law portals and regularly writes articles for them. He has been recognized by various magazines such as Competition Success Review and Pratiyogita Darpan for his writing skills and regularly publishes his essays in these magazines.  His interest lies in Criminal Law and Constitutional Law.