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Tobacco: Ending lives but selling incessantly throughout Pakistan

Photography and Videography by Pyar Ali

Ahmad Shah’s hands move with quickness, certainty and precision as he goes about making a beetle nut or as many call it paan in the local language. From two pots filled to the brim with flavoured liquid, he spoons a generous helping and applies it to the betel leaf, before throwing in a mix of small, crushed sweets and nuts. Before proceeding to wrap the delicacy of sorts into a tiny newspaper cutting and handing it out to an eagerly awaiting hand, he sprinkles a pinch of tobacco into the paan and exchanges it for cash. Several customers line up at his small cabin in hopes of availing paan or another form of smokeless tobacco, gutka.

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Smokeless tobacco: Does damage nonetheless

When asked as to why people consume so much of tobacco on a daily basis, given its obvious harm, the old man gave a wry smile and commented:-

“Bhai, ye cheez esi hai. Iska istemaal bi pareshaani phelaata hai aur iska istemaal naa karna bi pareshani phelata hai.” (Such is the nature of tobacco, its use causes anxiety and worry, whereas refraining from it also causes trouble for the addicted).

Pakistan has one of the highest rates of mouth cancer in the world and yes, it is due to the fact that thousands of items containing smokeless tobacco, are sold throughout the country on a daily basis, in huge quantities. Pakistanis love to consume smokeless tobaccos in the form of gutka’s, paan, naswar and other edible items. Judging by the hundreds who flock to Shah’s cabin on a daily basis and from all walks of life, to trade cash for potential mouth cancer, is a dismal state. For a country whose 60% population lives below the poverty line and earns up to $2 per day, expensive medications to cure dental woes or seek treatment against a menace such as mouth cancer, is totally out of the question. However, in an uneducated country such as Pakistan, medical warnings regarding tobacco are bound to be unnoticed.

Other forms of smokeless tobacco which are quite popular in Pakistan (yet proving troublesome for health purposes at the same time) are gutka and naswar. Naswar is made from fresh tobacco leaves, calcium oxide and wood ash. According to facts provided by the Pakistan Tobacco Company, naswar has an estimated market of Rs.6 billion in Khyber Pakhtunkhwa, annually. Since naswar is made from tobacco leaves, it affects the kidneys, heart and causes bronchitis. It is also the cause of lung, mouth and stomach cancer. gutka is a preparation of crushed areca nut (also called betel nut), tobacco, catechu, lime and sweet or savory flavorings.

Whilst gutka’s riveting taste might provide relief for those savour the taste of powdered tobacco, it must also be kept in mind that gutka is the leading cause of oral cancer in Pakistan and South Asia.

Smoking, despite its commonly known health risks, is one of the most popular habits in Pakistan. Dangerously enough, Pakistan is part of the top four countries in the world in which tobacco use has significantly increased. Cigarettes, sheesha, pipes and cigars are common among not only adults but disappointingly in students as well. In order to better grasp the understanding of smoking and its hazardous effects, we had a sit-down with Dr. Javaid A.Khan, Professor, Pulmonary and Critical Care Medicine and Consultant Chest Physician Department of Medicine, at the Agha Khan University.

“My message to anyone who smokes on a regular basis would be to stop immediately,” said Dr.Javaid. “People tend to ignore advice on smoking and take it as a non-serious issue. Smoking is a serious health risk which is likely to have grave repercussions in the future.”

According to the doctor, people viewed smoking as something heroic or macho, after which they could accomplish herculean feats. Also, lack of awareness and education contributed towards the lack of adherence people displayed towards health risks of smoking.

According to the doctor, people viewed smoking as something heroic or macho, after which they could accomplish herculean feats. Also, lack of awareness and education contributed towards the lack of adherence people displayed towards health risks of smoking.

“Passive smoking is a proven cause for lung cancer and heart disease. It is more harmful than smoking as you are inhaling all the toxic chemicals of another smoker nearby. So you’re health is being affected through passive smoking, even if you choose not to,” warned Dr.Javaid. The doctor also had plenty to say about sheesha, the popular hookah whose flavored tobacco is specifically adorned by Pakistani youth.

“According to a research conducted at AKU, 60% of the youth, school and college going children make use of Sheesha,” he revealed. “One hour of sheesha use is equal to smoking 200 cigarettes.”

Dr.Javaid cautioned against the use of tobacco, stating that both smoking tobacco as well as making use of smokeless tobacco can have grave health consequences. He also disclosed that tobacco attacks lungs, causes pneumonia, COPD (a lung disease) and also causes various cancer types (cancer of pipe, cancer of pancreas, cancer of breast and neck cancer.

In conclusion, the government of the day must take notice of the alarming increase in tobacco use and make sure that strict law are passed to prohibit smoking as well as use of smokeless tobacco. The cost of such nefarious products should be raised significantly so as to make them inaccessible for the common man. Strict regulations and laws must be passed in order to contain passive smoking, by banning smoking at public places such as restaurants, malls, cafes, parks etc.

The harsh reality remains that smoking is death by choice and a slow poison, one which Pakistanis opt for willingly.

Tobacco, in any form, contributes to cancer and… by arynews

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Tobacco: Ending lives but selling incessantly throughout Pakistan

by Shahjahan Khurram