CANCER. Mere thought of the word sends shivers down one’s spine. Oral cancer is most common among men in India. Tobacco addiction continues to be the primary cause of oral cancer. To understand the root cause of oral cancer and ways to prevent tobacco addiction ‘The Hitavada’ spoke to Dr Akshay Dhobley, Professor, Department of Oral Pathology, Government Dental College, Nagpur. He has been working in field of oral cancer diagnostics, prevention and public awareness since last 18 years. Talking about the root cause, Dr Dhobley says, “In Maharashtra, specifically Vidarbha, smokeless tobacco, kharra, is rampant and easily available. E-cigarettes and hookahs are proving to be silent killers in the urban society. Sellers claim that they are tobacco-free but it has cannabinoids.

 

Despite ban, e-cigarettes are being sold fearlessly. One hour of hookah session is equivalent to 60 cigarettes. In rural areas, people use betel nuts with tobacco. It is equally addictive. Betel nut is graded as Grade One carcinogen by the Cancer Association. Cigarette and other tobacco products come under COTPA Act. Complete ban on it is difficult but prevention is in our hands. It is always better than cure.” Being an oral pathology specialist and trained counsellor, Dr Dhobley reveals that on an average, there are 15-20 cases of oral cancer starting from 28 years of age on daily basis. “Not just men, even women also complain of pre-cancer symptoms. Oral submucous fibrosis (OSMF) is common among women in Vidarbha.

 

It cannot be cured and stays for life. Average age of first time users of tobacco in urban and rural population in Maharashtra is 8.5 years,” he adds. So, the statutory warnings on TV, theatres and pictorial warning on cigarette packets are proving ineffective to stop the menace? Dr Dhobley tells, “Tobacco industry has evolved so much over the years that all the preventive measures and efforts prove tiny. It indicates that there are lacunas and loopholes which need to be plugged at the right time.” Dr Dhobley adds, “Tobacco cultivators should be given an alternate crop at subsidised rates with proper package. They have to be identified, counselled and supported financially. More people should be working on prevention because once the disease sets in, then it is only in the hands of the medical professionals.” Dr Dhobley is currently working on behaviour therapy of tobacco cessation. He and his team have a tie-up with the Indian Dental Association and NGOs.

 

They run awareness drives, social media campaigns and informative seminars. Talking about the other causes of oral cancer, he states, “There are first hand smokers, second hand smokers or passive smokers and then there are third hand smokers too where a ‘so-called’ aware person smokes when alone. The smoke particles get deposited on his hair, collar, nails or surface of the car and then he picks up his little one or is with his family. Then the young ones complain of breathing problem or asthma. This leads to respiratory issues among children and often leads to carcinogenic tendency. Hence, the reason oral cancer age is reducing consistently and rising also among non-smokers.” Despite awareness, prevention and regulation the graph is rising, to this Dr Dhobley mentions, “Not just one day but every day should be ‘No Tobacco Day’ and awareness towards Cancer Day.n