The noose is finally tightening around the manufacturers of one of the most potent killer products in the world — chewable tobacco such as gutka and tobacco containing paan masala. A few States — Madhya Pradesh, Kerala, Bihar, Maharashtra and Rajasthan — have by the stroke of a pen banned the manufacture, storage, distribution and sale of such products. These substances may soon face the same fate in more States where the process of proscribing them has been initiated. Maharashtra has banned all paan masala brands (immaterial of the presence of tobacco) that contain magnesium carbonate above permissible levels. It is highly commendable that State governments have begun to crack down on this dangerous produce just months after the notification of the Food Safety and Standards (Prohibition and Restriction on Sales) Regulation, 2011. The FSS Act prohibits the presence of tobacco in food products. The industry, which successfully scuttled a ban by many States in 2004, is now in the dock. There is inviolable evidence of harm caused by chewing tobacco. A Lancet study published this year highlighted the scale of the problem in India and made a strong case for reducing the consumption of these substances. In 2010, chewing tobacco was responsible for about 20 per cent of the 120,000 tobacco-related cancer deaths. It killed twice the number of people as lung cancer, and was the leading cause of death in men in both urban and rural areas.
The FSS Act provides the much needed teeth for States to act against food items containing tobacco. Unfortunately, the Act has ignored betel nut (areca nut) — a well known carcinogen found in both gutka and paan masala. That the Union government failed to include it despite a voluminous and indisputable body of evidence clearly pointing out its carcinogenic effect is indeed shocking. The International Agency for Research on Cancer (IARC) of the World Health Organisation had in a 2004 monograph stated that “areca nut is carcinogenic to humans (Group I).” There is “sufficient evidence” of the carcinogenicity of betel quid [paan] with and without added tobacco, it noted. Even if eaten without added tobacco, paan causes cancers of the oral cavity and oesophagus; a “positive association” has also been found between exposure to betel quid and liver cancer. Hence banning these products based on the presence of betel nut will result in a sharp fall in oral cancer mortality. So what is preventing the Union government from acting? Betel nut is the “second most consumed” carcinogen after tobacco. But unlike tobacco, there is gross and widespread ignorance of its harmful effects. Hence, increasing awareness levels should be given equal priority.