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The evidence of carcinogenic activity was sufficient for the areca nut.
Dr Alok Lathi, a city-based dental surgeon who specializes in oral medicine, along with Dr PC Gupta, Head of Research at Healis-Sekhsaria Institute for Public Health, and Dr Pankaj Chaturvedi of the Tata Memorial Hospital, Mumbai, has started an initiative that aims at spreading awareness about the ill-effects of supari chewing. “While doing my post-graduation in dental studies, we came to know that guthka and paan-masala are the main culprits in the rise of cancer. Further research showed that 80 per cent of guthka is contained of areca nuts, but people are unaware of this. Since childhood we know that tobacco, cigarettes and alcohol are injurious to health, but very few people know that supari too is harmful,” says Dr Lathi.
A lot of youngsters these days are seen chewing guthka and paan-masala with its high percentage of areca nuts. Chewing areca nuts leads to the development of oral submucous fibrosis (OSF), which is a potentially malignant lesion. This is a red alert for patients to stop the habit, because if it is not stopped at that moment, it can lead to cancer. Dr Lathi adds, “OSF was found in 1952 and studies show that 7-25 per cent of people who consume it can be detected with cancer. If awareness is not created, it may turn into an epidemic.” If the habit of chewing supari lasts for many years, it can create serious health problems like limited opening of the mouth, altered speech, burning sensation in the oral cavity, mouth ulcers, etc. Repeated or direct contact with gums can cause them to recede and in turn cause loosening of the teeth. All these symptoms have no effective remedy and can result in horrifying consequences. Moreover, supari is psychoactive, meaning it affects the mental processes of humans. Cigarettes, alcohol, tobacco and narcotic drugs too have similar effects on humans, hence the addiction.
The ‘Food Safety and Standards Act’ states that it is compulsory for all packets of supari and its products to mention a warning on the packets saying ‘Chewing of Supari is injurious to health’ but many supari brands do not follow this mandate. It is also illegal to add tobacco to food products and guthka is a food product. Guthka has been in the market for almost thirty years now, but it is only now that the state government thought of putting a ban on it. “The ban came so late because the government too fails in understanding the crux of the problem. As is the general notion, they too feel that it is the tobacco and not the areca nut that is causing problems. Maharashtra is the only state to have banned guthka as well as paan-masala, all other states have a guthka ban only. Furthermore, due to this lack of awareness, people will shift to chewing supari if guthka or paan-masala is not available,” says the doctor.
“Although guthka has been banned, there is a huge demand still. In such a situation, a black market for these products has come up. Initially, selling of guthka started around school premises, but the government put a ban on sale of guthka around schools so that children, who are of a vulnerable age, do not get into the habit of chewing guthka. The black market caters only to people who are regulars and as a matter of fact, they will get their share of guthka anywhere, but a school going child would not,” informs Dr Lathi. The habit is not easy to give up and people will readily shell out more money if they are addicted. At one point, this addiction reaches a level when the person cannot concentrate if he does not get his daily dose. The public is aware of the ill-effects of tobacco, cigarettes, alcohol, narcotics and even asbestos for that matter, but in case of supari, there is no such awareness. Says Dr Alok, “Once OSF is detected, the complete routine of the patient gets disturbed. He cannot open his mouth; burning sensation is a common symptom. All this hampers their normal life.” Dr Shilpa Lathi, wife of Dr Alok and a prosthodontist herself, adds, “Even the literate people treat supari as a mouth-freshener. They do not know that it causes cancer or OSF. How will you eat if you cannot open your mouth? People should understand this and act accordingly.”
As of today, there are no permanent cures for OSF. At the most a little improvement can be seen in a patient, but research is going on in finding permanent cures. Strikingly, there are some doctors who advise patients to switch from guthka to paan-masala because they too feel it is less harmful, but actually it is equally harmful. Supari is also used by some doctors to help patients get rid of tapeworms. Dr Alok says, “Doctors also need to be made aware of these harmful properties of areca. If there are medicines available that can cure the problem of tapeworm, why advise supari and increase the danger to one’s health?”
Guthka companies are now coming up with a new product called supari mix. “The government’s criterion for banning guthka and paan-masala was that these contained tobacco and magnesium carbonate. But supari mix has neither of these and so the government cannot ban it. What they are not getting is that it still has areca and it still is carcinogenic. The end-user thinks that he is eating a ‘safe’ product, which is not true. This is what we want to change,” stresses Dr Lathi. Dr Shilpa adds, “Supari works as a slow poison. The effects are seen late, but are very hazardous.”
According to Dr Alok Lathi, there is an immediate need to initiate a drive against this slow poison in order to save our oral and general health. He and his team have tied-up with the Mukta Charitable foundation to spread awareness about the cause. The foundation has done widespread work in creating AIDS awareness and is now venturing into this field. Together with the Tata Memorial Hospital, they are aiming to train 1,500 doctors this year. Dr Alok tells us, “We will be conducting dental camps and awareness drives, especially in the areas that have lower income groups like construction labourers, because this guthka and paan-masala chewing in widely prevalent among them. As a team, our aim is to spread awareness and educate people about the hazards of this habit. We hope that people cooperate and make this venture a successful one.”
HAZARDS OF CHEWING SUPARI
? High chance of developing oral and other cancers
? Inability to open the mouth and Oral Submucous Fibrosis (OSF)
? Harmful for diabetic patients
? Low sperm motility in males
? Can lead to low birth weight in babies or can also result in spontaneous abortions in pregnant women
? Presently, there is no effective treatment for these symptoms and hence prevention is the only available method.
By Mihir Bhanage > mihir.citadel@gmail.com
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