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Don’t chew, don’t spit!

Chewing tobacco and pan stimulates a desire to spit — an activity that is banned during the pandemic. So why are these products selling despite a ban and the danger to public health?

An addiction which could help spread the Covid-19 pandemic — which has already killed 34,252 people in India and infected 15,35,335 — authorities think, is smokeless tobacco. The red stained walls of street corners, market places, footpaths, and even old government buildings will be party to the propagation of the substance.

As the lockdown began with full force in the country, the central government in April urged states to ban the use of smokeless tobacco pointing out that “Spitting in public places could enhance the spread of the coronavirus”.

Delhi was amongst the over 25 states and union territories which then banned the use of smokeless tobacco products and spitting in public places. 

On the 28th Delhi reported 1,056 new coronavirus infections this puts the total active cases at 10,887. Delhi has so far witnessed a total of 1,32,275 coronavirus positive cases. The death count has now increased to 3,881.

The capital city’s government has now decided to extend the ban on manufacture, storage, sale and distribution of gutkha and pan masala for one more year.

It was Food Safety Commissioner D N Singh who issued a notification on the ban of these products in mid-July.

But unsurprisingly, its sale continues unhindered. Atul Bhargava, the president of New Delhi Traders Association had earlier, before the year-long ban had been announced, pointed towards the opening of cigarette/ pan shops in Connaught place. He questioned the idea behind allowing them to open, which would mean the banned products would continue to be sold and used.

“On one hand, the government says use of gutkha is an offence, spitting is an offence (and) on the other side you allow panwalas to be there. I’m sorry they are doing nothing,” he had accused.

In fact, we met a long-time user of smokeless tobacco; we will call him Akash, as he does not wish to be named. Akash has been using zarda for over 20 years now and cannot go a day without it. He was surprised when we mentioned the word ‘banned’. 

He claimed he did not know anything about it, and that procuring his addiction was as easy as ever. “It is available readily, the only thing that has changed is its cost. During the lockdown a packet which would cost Rs 10 became Rs 35. Now, after the lockdown it is Rs 15, higher than usual, I guess it’s because of the ban”.

Chewing tobacco, like gutkha and paan masala would be kingpins in the spread of the virus that remain airborne, and spreads indiscriminately through an infected person’s spit. The Indian Council of Medical Research (ICMR) and the health department tell us why – because chewing tobacco products, paan masala and areca nut increases the production of saliva followed by a very strong urge to spit.

According to data provided by the Delhi Police a total of 25 challans had been issued for spitting on Tuesday, July 28 till 4 pm. The total number of challans for spitting since the ban is at 1,509.

The Traffic Unit on its part, in the last 24 hours, has issued 45 challans for consuming paan, gutka, tobacco in public places, while the total number of challans for the same is at 555.

The police are however not looking into the sale of the banned products. We spoke with Director of Press and Information North Delhi Municipal Corporation Ira Singhal, who says they have not been notified to carry out any checks.

The notification however, is not the first. Even in April 2019 there was one prohibiting “in the interest of public health for a period of one year…the manufacture, storage, distribution, or sale of tobacco which is either flavoured, scented or mixed with any of the said additives, and whether going by the name or form of gutka, pan masala, flavoured/scented tobacco, kharra, or otherwise by whatsoever name called, whether packaged or unpackaged and/or sold as one product, or though packaged as separate products, sold or distributed in such a manner so as to easily facilitate mixing by the consumer”. 

And before that in April of 2018, and before that in 2016, in 2015, all for a year, and before that in 2012. Despite this, the sales never stopped. 

Is it just spit?

The love of pan and its consequent spitting is so high that last year, embarrassingly, the city of Leicester, in the UK, put up signboards which dissuaded the public from spitting or incur a fine. The message was written first in Gujarati then in English, that ‘Spitting paan on the street is unhygienic and anti-social. You could be fined 150 pounds’.

But other than the current pandemic and how it increases the risk of spreading the virus, smokeless tobacco (SLT) has been quite a big problem in the country, for its users. India is the world’s largest market for smokeless tobacco; a report called ‘Smokeless Tobacco and Public Health in India’ jointly prepared by organisations including Health Foundation of India; World Health Organization (WHO) and the Centres for Disease Control which points out that over the last two decades, the SLT industry in India has grown exponentially, mostly in the unorganised sector. About 14% of land under tobacco cultivation is used for growing SLT varieties, and one-fifth of total tobacco production is used for SLT.

According to the WHO, its 2018 estimates show that tobacco use among people aged 15 years and older, is at an estimated 26.3%, with male users’ percentage at 40.4% and females at 11.3%. Tobacco also causes 1 million deaths each year – this does include second hand smokers.

What’s even more worrying is that Indian smokeless tobacco products are among the most lethal, according to a study by ICMR – National Institute of Cancer Prevention and Research (NICPR). Carcinogenicity of smokeless tobacco products varies from country to country.

The meta-analysis looked at 37 studies and SLT products that are chewed or snuffed orally or nasally, or applied over teeth and gums, or gargled or drunk.

It found: “A study (of SLT and oral cancer link) which included the United States, Sweden, and India together found that the risk of oral cancer from SLT use was due to the inclusion of Indian studies, since when analysed separately excluding India no such risk was found for US and Swedish studies. Most of the studies found no or negligible risks as far as European studies are concerned. Some other studies showed an increased risk for the United States…”

And while authorities seek to ban its use as it’s a major cause for concern in the pandemic, the way the smokeless tobacco gets endorsement through celebrities has not stopped. The joint report we quoted earlier had also pointed to how advertising and marketing of smokeless tobacco had pushed products forwards, especially those endorsed by celebrities. The report pointed to ‘Several television news channels’ which began featuring news breaks sponsored by a pan masala manufacturer.

We tried getting in touch with the major players of smokeless tobacco in India — our emails either bounced back (email address provided on website were incorrect) or remain unanswered. Our calls remain unanswered.  

The use of their products, with or without a ban, continues.

(Cover: Spit stained walls in Connaught Place  PHOTO: Getty images )