User:2019RiSK/sandbox

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Gutka, ghutka, guṭkha or betel quid is a chewing tobacco preparation made of crushed areca nut (also called betel nut), tobacco, catechu, paraffin wax, slaked lime and sweet or savory flavourings, in India, Pakistan, other Asian countries, and North America.[1] It contains carcinogens, is considered responsible for oral cancer and other severe negative health effects and hence is subjected in India to the same restrictions and warnings as cigarettes.[1][2][3][4]. Highly addictive and a known carcinogen, gutkha is the subject of much controversy in India. Many states have sought to curb its immense popularity by taxing sales of gutkha heavily or by banning it.[5] Gutka is manufactured in the sub-continent and exported to a few other countries, often marketed under the guise of a "safer" product than cigarettes and tobacco.[6] Reported to have both stimulant and relaxation effects, it is sold throughout South Asia and some Pacific regions in small, individual-sized foil packets/sachets and tins[7] that cost between 2 and 10 rupees each.[8] It is widely consumed in India, Pakistan, Bangladesh, and the Madhesh region of Nepal. Gutka is consumed by placing a pinch of it between the gum and cheek and gently sucking and chewing, similar to chewing tobacco.[9] As with paan and other smokeless tobacco products, there are preventive efforts to encourage users to quit and young people not to start.

Characteristics[edit]

Gutka is a commercially produced form of smokeless tobacco. Manufacturers add sweet or savory flavors, making it more appealing to women and young people in some locations.[10] The combinations of gutka ingredients vary according to local preferences. Spices may include mustard, turmeric, anise seeds, cardamom, saffron and cloves.[11] In addition to areca nut, nicotine, slaked lime, paraffin and catechu, it can be laced with thousands of chemicals.[12] It is a powdery, granular, light brownish to white substance. Within moments of chewing mixing with saliva, the gutkha begins to dissolve and turn deep red in colour. It may impart upon its user a "buzz" somewhat more intense than that of tobacco chewing, snuffing and smoking. [citation needed]

Effects[edit]

Red stains of Gutka on walls due to spitting

Creative advertising by tobacco companies and lack of accessible information for the public leads to many gutka users being unaware of the dangers it can bring. Often users believe that gutka can act as a digestion aid, kill germs, and generally give a sense of well being.[13] In fact 34.4% of smokers have switched to smokeless tobacco use as way to quit.[14] In addition to cancer of the head, mouth, neck, throat, oesophagus, other aerodigestive tract cancers, and dental disease areca nut, the main ingredient in gutka is known to cause severe oral mucosal disorders.[15] Oral submucous fibrosis, one such disorder, is a malignant condition that is severely debilitating and has no cure.[16] Metabolic syndrome, hypertension, diabetes and obesity have also been linked to its use. Use by pregnant women increases the risk of low birth rates in newborns.[17] As of 2015 it was the fourth most common addictive product worldwide.[18][19] Areca nut "quid chewing has claimed to produce a sense of well being, euphoria, warm sensations of the body, sweating, salivation, palpitation and heightened alertness, tolerance to hunger, and increased capacity and stamina to work."[20] When a person chews gutka, the mixture directly enters the system through the oral cavity, which absorbs about 28 carcinogenic chemicals including nicotine.[21]

"Smokeless tobacco use is highly addictive. The nicotine in smokeless tobacco is more easily absorbed than by smoking cigarettes enhancing its addictiveness."[22] Gutka turns saliva bright red, and when it is chewed long and often enough it will stain a user's teeth bright red too. Saliva is generally spat onto a wall or at the ground, causing a red stain that is quite resistant to the elements. Some building owners have taken to combating this by painting murals of gods on their walls, with the idea that gutkha chewers would not spit on a god.[23][24][25]

Usage[edit]

Use of gutka and other forms of tobacco are culturally ingrained and use can begin at a young age.[26] Smokeless tobacco use is most common in India where oral cancer accounts for 30 to 40% of cancer cases.[27] In Mumbai alone reports show that 40% of school students and 70% of college students consume gutkha on a regular basis. Pakistan places second in rankings for smokeless tobacco use. It's use has also been reported in Thailand, Sri Lanka, Bangladesh, Pakistan, Malaysia, Cambodia, China, Indonesia and New Guiana. Immigrants to the United Kingdom, parts of Africa, Australia, North American have brought their habits with them. Gutka is readily available in these locations, especially in neighborhood Asian markets in highly populated areas.[28] Immigrants to the United States where spitting in public is not as socially acceptable, learn to be discreet.[29] Those in the lower socioeconomic populations are especially at risk. It is here that access to education and treatment is limited.[30] Easy access and extremely low cost lead to early addiction and the prevalence of gutka use.[31][32] Precancerous lesions have been observed in young children and symptoms of cancer often appear by high school or college age. Smoking is not allowed in many places, and when done by children, is disapproved of. In contrast gutka use, being all but invisible to others, is the method of choice. A New York Times article reported in 2002 that sales of gutka and the tobaccoless version, paan masala, reached $1 billion a year.[33]

India[edit]

Over 25% of India's population use tobacco products including cigarettes and multiple forms of smokeless tobacco. India has the largest number of smokeless tobacco users in the world. The poorest populations are greatly affected due to the detrimental effects of its use and the subsequent costs of medical care.[34] Many Indian states have sought to curb the use and spread of gutka by taxing sales heavily or by banning it.[35] They have banned the sale, manufacture, distribution and storage of gutka and all its variants. As of May 2013, gutka is banned in 24 states and 3 union territories.[36] The federal Food Safety and Regulation (Prohibition) Act 2011 allows harmful products such as gutka to be banned for a year. This can be renewed annually, resulting in a permanent ban. The ban is enforced by the state public health ministry, the state Food and Drug Administration, and the local police.[37] Enforcement of the law is generally lax and many shops still sell gutka, although it may not be displayed.[38][39][40][41][42] Enforcemnent is stricter in some regions like Mumbai and Delhi, but illegal sale of gutka still occurs.[43]

In 2019, the Delhi government extended the ban for one more year on Gutka, Pan Masala, Flavoured / Scented Tobacco, Kharra and similar products containing tobacco. In September 2012, State of Delhi banned Gutka and Pan Masala containing tobacco and/or nicotine. After the notification, Gutka manufacturers separated the components like tobacco from Gutka and Pan Masala. Since the term ‘Gutka and Pan Masala Containing Tobacco’ was used in the notification. The components like tobacco were manufactured and sold in separate pouches after the ban. The notification was revised in March 2015 to make it more stricter and banned all smokeless tobacco (SLT) products including twin-pack.[44] Offenders can be fined or receive prison sentences.[45] The law has provisions of imposing fines up to 25,000 Indian rupees on the sale of products that are injurious to health.[46]

(table) Research firm Edelweiss estimates the gutka ban will cause the industry 15-20 billion rupees in losses.[47]

Advertising[edit]

Like alcohol and tobacco products, there is a ban on advertisement of gutka. Often tobacco companies advertise gutka as pan masala in order to skirt the ban on advertising tobacco products. Surrogate advertisements often use pan masala ads to promote gutka products with similar name and packaging.[48]

According to the Food Safety and Standards (Prohibition and Restriction on Sales) Regulations, 2011 of the Food Safety and Standards Authority of India, misleading advertisement of such products invites a fine of 1,000,000 rupees.[49]

Notes[edit]

  1. ^ a b "CPAA: Quit Smoking Campaign, Anti Tobacco & Quit Smoking Campaign". Retrieved 30 May 2015.
  2. ^ Ananth, Venkar (1 April 2015). "Thank you for smoking: A brief history of tobacco warning labels". Live Mint. Retrieved 5 October 2018.
  3. ^ "NCI Dictionary of Cancer Terms". National Cancer Institute. National Institutes of Health. 2 February 2011. Retrieved 7 December 2019.
  4. ^ Niaz, Kamal; Maqbool, Faheem; Khan, Fazlullah; Bahadar, Haji; Ismail Hassan, Fatima; Abdollahi, Mohammad (9 March 2017). "Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer". Epidemiology and Health. Us National Library of Medicine, National Institutes of Health. doi:10.4178/epih.e2017009. Retrieved 6 December 2019.
  5. ^ "MP becomes 1st state to ban Gutka products containing tobacco". Hindustan Times. 4 April 2012. Archived from the original on 5 September 2013. Retrieved 16 August 2013.
  6. ^ Mohan, Priya; Lando, Harry A; Panneer, Sigamani (1 January 2018). "Assessment of Tobacco Consumption and Control in India". Indian Journal of Clinical Medicine. Sage Journals. p. 1179916118759289. doi:10.1177/1179916118759289. Retrieved 7 December 2019.
  7. ^ "CDC - Fact Sheet - Betel Quid with Tobacco (Gutka) - Smoking & Tobacco Use". Smoking and Tobacco Use. Retrieved 30 May 2015.
  8. ^ Shaukat, Mohammed. "Tobacco control in India - achievements and remaining challenges" (PDF). WHO. Ministry of health and family welfare. Retrieved 5 October 2018.
  9. ^ "CDC - Fact Sheet - Betel Quid with Tobacco (Gutka) - Smoking & Tobacco Use". Smoking and Tobacco Use. Retrieved 30 May 2015.
  10. ^ "The truth about smokeless tobacco use | Know the truth | TFI". www.emro.who.int. World Health Organization, Eastern Mediterranean Regional Office. Retrieved 7 December 2019.
  11. ^ "CDC - Fact Sheet - Betel Quid with Tobacco (Gutka) - Smoking & Tobacco Use". Smoking and Tobacco Use. Retrieved 30 May 2015.
  12. ^ Banerji, Annie (6 September 2012). "India "gutka" chewing tobacco habit a tough nut to crack". Reuters. Thomson Reuters. Retrieved 7 December 2019.
  13. ^ Niaz, Kamal; Maqbool, Faheem; Khan, Fazlullah; Bahadar, Haji; Ismail Hassan, Fatima; Abdollahi, Mohammad (9 March 2017). "Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer". Epidemiology and Health. US National Library of Medicine, National Institutes of Health. doi:10.4178/epih.e2017009. Retrieved 6 December 2019.
  14. ^ Mohan, Priya; Lando, Harry A; Panneer, Sigamani (1 January 2018). "Assessment of Tobacco Consumption and Control in India". Indian Journal of Clinical Medicine. Sage Journals. p. 1179916118759289. doi:10.1177/1179916118759289. Retrieved 7 December 2019.
  15. ^ Shah, Gunjan; Chaturvedi, Pankaj; Vaishampayan, Sagar (2012). "Arecanut as an emerging etiology of oral cancers in India". PubMed. Indian Society of Medical and Paediatric Oncology : Official Journal of Indian Society of Medical & Paediatric Oncology. pp. 71–79. doi:10.4103/0971-5851.99726. Retrieved 7 December 2019.{{cite web}}: CS1 maint: unflagged free DOI (link)
  16. ^ "The truth about smokeless tobacco use | Know the truth | TFI". www.emro.who.int. World Health Organization, Eastern Mediterranean Regional Office. Retrieved 7 December 2019.
  17. ^ "CDC - Fact Sheet - Betel Quid with Tobacco (Gutka) - Smoking & Tobacco Use". Smoking and Tobacco Use. Retrieved 30 May 2015.
  18. ^ Wu, Fen; Parvez, Faruque; Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Argos, Maria; Levy, Diane; Sarwar, Golam; Ahsan, Habibul; Chen, Yu (25 June 2015). "Betel quid use and mortality in Bangladesh: a cohort study". Bulletin of the World Health Organization. World Health Organization. pp. 684–692. doi:10.2471/blt.14.149484. Retrieved 7 December 2019.
  19. ^ Javed, Fawad; Chotai, Milisha; Mehmood, Abid; Almas, Khalid (1 June 2010). "Oral mucosal disorders associated with habitual gutka usage: a review". Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. Oral Surgery, Oral edicine, Oral Pathology, Oral Radiology, and Endodontology. pp. 857–864. doi:10.1016/j.tripleo.2009.12.038. Retrieved 7 December 2019.
  20. ^ Shah, Gunjan; Chaturvedi, Pankaj; Vaishampayan, Sagar (2012). "Arecanut as an emerging etiology of oral cancers in India". PubMed. Indian Society of Medical and Paediatric Oncology : Official Journal of Indian Society of Medical & Paediatric Oncology. pp. 71–79. doi:10.4103/0971-5851.99726. Retrieved 7 December 2019.{{cite web}}: CS1 maint: unflagged free DOI (link)
  21. ^ Niaz, Kamal; Maqbool, Faheem; Khan, Fazlullah; Bahadar, Haji; Ismail Hassan, Fatima; Abdollahi, Mohammad (9 March 2017). "Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer". Epidemiology and Health. US National Library of Medicine, National Institutes of Health. doi:10.4178/epih.e2017009. Retrieved 6 December 2019.
  22. ^ "The truth about smokeless tobacco use | Know the truth | TFI". www.emro.who.int. World Health Organization, Eastern Mediterranean Regional Office. Retrieved 7 December 2019.
  23. ^ Kolhatkar, Sandip (12 April 2013). "Do not spit here, for god's sake!". mid-day. Retrieved 7 December 2019.
  24. ^ Bearak, Max. "Officials in India are really sick and tired of their country's tobacco habit". The Washington Post. The Washington Post. Retrieved 7 December 2019.
  25. ^ Bhattasali, Amitabha (23 November 2011). "Scheme to save Calcutta's Howrah Bridge from spit". BBC News. Retrieved 16 August 2013.
  26. ^ Mohan, Priya; Lando, Harry A; Panneer, Sigamani (1 January 2018). "Assessment of Tobacco Consumption and Control in India". Indian Journal of Clinical Medicine. Sage Journals. p. 1179916118759289. doi:10.1177/1179916118759289. Retrieved 7 December 2019.
  27. ^ ALI, SYED MUMTAZ; QURESHI, REHAN; JAMAL, SYED. "Shibboleth Authentication Request" (PDF). Pakistan Oral and Dental Journal. Retrieved 7 December 2019.
  28. ^ Niaz, Kamal; Maqbool, Faheem; Khan, Fazlullah; Bahadar, Haji; Ismail Hassan, Fatima; Abdollahi, Mohammad (9 March 2017). "Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer". Epidemiology and Health. US National Library of Medicine, National Institute of Health. doi:10.4178/epih.e2017009. Retrieved 7 December 2019.
  29. ^ Banerjee, Smita C.; Ostroff, Jamie S.; D'Agostino, Thomas A.; Khera, Mitali; Acharya, Sudha; Gany, Francesca. "Europe PMC". europepmc.org. Journal of Immigrant and Minority Health. Retrieved 8 December 2019.
  30. ^ Coelho, Ken Russell (2012). "Challenges of the Oral Cancer Burden in India". Hindawi. Journal of Cancer Epidemiology. pp. 1–17. doi:10.1155/2012/701932. Retrieved 7 December 2019.{{cite web}}: CS1 maint: unflagged free DOI (link)
  31. ^ Balappanavar, Aswini; Mohanty, Vikrant Ranjan; Hussain, Abrar (1 February 2017). "Compliance with Tobacco Promotion and Sale Laws in School Neighbourhoods in India". Asian Pacific Journal of Cancer Prevention. US National Library of Medicine, National Institutes of Health. pp. 563–570. doi:10.22034/APJCP.2017.18.2.563. Retrieved 7 December 2019.
  32. ^ A.H.R. "The nut cracks: Half of all Indian states have banned gutka since April. More may follow". The Economist. Retrieved 7 December 2019.
  33. ^ Waldman, Amy (13 August 2002). "Sweet but Deadly Addiction Is Seizing the Young in India". The New York Times. Retrieved 8 December 2019.
  34. ^ Mohan, Priya; Lando, Harry A; Panneer, Sigamani (1 January 2018). "Assessment of Tobacco Consumption and Control in India". Indian Journal of Clinical Medicine. Sage Journals. p. 1179916118759289. doi:10.1177/1179916118759289. Retrieved 7 December 2019.
  35. ^ "MP becomes 1st state to ban Gutka products containing tobacco". Hindustan Times. 4 April 2012. Archived from the original on 5 September 2013. Retrieved 16 August 2013.
  36. ^ "Cancer centres urge PM to ban gutka across India". DNA India. 21 November 2012. Retrieved 16 August 2013.
  37. ^ "Govt to file caveat in HC today on gutka, paan masala ban". The Times of India. 13 July 2012. Retrieved 16 August 2013.
  38. ^ "Why the gutka ban in Maharashtra won't work". 13 July 2012.
  39. ^ Praveen, M. P. (16 June 2012). "Sale of pan masala thriving". The Hindu. Chennai, India.
  40. ^ "What ban? Gutka still sells". The Times of India. 18 June 2012.
  41. ^ "Gutka ban not satisfactory, admits minister". The Times of India. 20 January 2013. Retrieved 16 August 2013.
  42. ^ "Gutka continues to rustle undercover despite ban". The Times of India. 29 January 2013. Retrieved 16 August 2013.
  43. ^ "Indians want their fix of gutkha & pan masala despite ban". Business Standard. 16 September 2012. Retrieved 16 August 2013.
  44. ^ Siddharth (May 10, 2019). "Fact Check About Ban On Smokeless Tobacco Products In India". The Health. Archived from the original on 25 August 2019. Retrieved September 8, 2019.
  45. ^ Masand, Pratibha (13 July 2012). "Ban implementation may take few weeks". The Times of India. Retrieved 16 August 2013.
  46. ^ "Himachal bans sale of Gutka, Pan Masala, Masheri & Khaini". Hill Post. 13 July 2012. Retrieved 16 August 2013.
  47. ^ Chandramouli, Rajesh (14 September 2012). "Gutka ban loss could be Rs 1500 - Rs 2000 crores". The Times of India. Retrieved 16 August 2013.
  48. ^ "'Ban surrogate advertisements of tobacco products'". 20 June 2012.
  49. ^ "No relaxation on gutka ban - The Times of India". The Times of India.

References[edit]

  • Javed F, Altamash M, Klinge B, Engström PE. (2008). Periodontal conditions and oral symptoms in gutka-chewers with and without type 2 diabetes. Acta Odontol Scand; 66(5):268-73.
  • Javed F, Chotai M, Mehmood A, Almas K. Oral mucosal disorders associated with habitual gutka usage. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:857-64.
  • Javed F, Bello Correa FO, Chotai M, Tappuni AR, Almas K. Systemic conditions associated with areca nut usage: A literature review. Scand J Public Health 2010; 38: 838–44.

External links[edit]


Category:Chewing tobacco brands Category:Tobacco in India Category:Tobacco in Pakistan Category:Herbal and fungal stimulants Category:Desi culture Category:Masticatories

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