Gutkha and pre- cancerous lesions: An empirical study in “twin city” of Odisha

Tobacco and its products have been a household entity since a long time specially in Indian houses either as a pride to be snuffed through the pipes or the traditional hookahs by the Rajas and Maharajas, or if not through the smoke, it took place in many untowardly customs and rituals associated. It has spread through the subcontinent, and even to the other countries. Promoted by a slick and many temptating advertising campaign, gutkha, an indigenous form of smokeless tobacco, has become a fixture in the mouths of millions of Indians over the last two decades. The emergence of newer, chewable flavoured forms of tobacco along with several other ingredients, called gutkha has changed the trends in the tobacco market. Gutkha contains areca nut, slaked lime, catechu, condiments, and powered tobacco. It was originally available custom-mixed from paan vendors and commercially available since 1975.(Kumar S: 2006). According to Global Adult Tobacco Survey 2010, about 35 per cent of adults in India consume tobacco in some form or the other. The estimated number of tobacco users in India is 27.5 crore, with 16.37 crore users of smokeless tobacco, 6.9 crore smokers and 4.23 crore users of both smoking and smokeless tobacco. Further, a report released in 2014 by the Centre for Disease Control and Prevention and the National Cancer Institute found that users in India and Bangladesh make up 80 per cent of the total smokeless tobacco users in the world. Another report by the Health Ministry had estimated the total economic cost attributable to tobacco use from all diseases in 2011 amounted to Rs 1,04,500 crore in India, equivalent to 1.04 per cent of the country's gross domestic product. Gutkha use in India is mainly by youth and adults <40 years of age, mostly males. (Dongre A 2008) Gutkha has been available in several brands for the last few decades and is exported to 22 countries worldwide, which shows its spreading usage. (Bhurgri Y: 2006). This study aims to find out the health risk associated with gutkha with special reference to oral cancer.