• 27 Jul, 2026 - 01:17 PM
• Dr. Durga Acharya

HEAD AND NECK CANCER DAY- KIDS AS SOFT TARGETS?

This year we celebrate our 79^th year of independence on the 15^th of August.

But are we “free” in the true sense? As in “free” from the reigns of Tobacco which was introduced to India by the Portuguese and other European states for trade as early as 1605.¹

We know for a fact that tobacco contains nicotine which is addictive and smoking is associated with significantly increased risks of lung cancer, cardiovascular disease, COPD, and other serious illnesses. Globally, it causes more than 7 million deaths annually, about 75% of which occur in men.¹

But the lesser known facts are of the plant and cultivation itself.

Tobacco cultivation is resource intensive and depletes the soil significantly. These plants absorb massive amounts of essential nutrients, leaving the land severely degraded for cultivation of future food crops. They are high maintenance crops, requiring abominable amounts of water, insecticides and pesticides which degrades the top layer of soil leading to soil erosion and deforestation. Tobacco leaves contain a potent neurotoxin, nicotine which mimics acetylcholine and causes sympathomimetic effects when inhaled. It poses a danger to the grazing herbivores and can cause death. The farmers who handle the processing and cultivating of the leaves develop respiratory illness- GREEN TOBACCO SICKNESS. This farmer goes back home and he exposes his family to the tobacco, even without smoking or chewing them. Poses serious neurotoxic effects to the children and can hamper brain and cognitive development.²

Adults who smoke in the house pose threat to themselves as well as surrounding them i.e., by second hand smoking / passive smoking. The clothes the smokers are wearing, the walls of their house and the surrounding objects all have traces of tobacco i.e., third hand smoke.

The cigarette butt, once it is doused, it is just another poisonous nonbiodegradable pollutant which clog the water bodies i.e., fourth hand smoke.^2,3  

Ironically, tobacco is a ‘cash crop’!!!!?? Causing Environmental Distress and Human Stress!!!

 Nationally, there is a notable decline in overall tobacco use, from 34.6% in 2009-10 to 23% in 2019-21. This decline is more pronounced among men (47.9% to 38.1%) and women (20.3% to 9%) according to the Global Adult Tobacco survey.

The International Classification of Diseases (ICD-10) has recognized that “tobacco dependence” is a disease.

 

 

REWARDING AND REINFORCING EFFECTS OF NICOTINE.

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F Fig 1: REWARDING AND REINFORCING EFFECTS OF NICOTINE ⁴  Loddenkemper R, Kreuter M (eds): The Tobacco Epidemic, ed 2, rev. and ext. Prog Respir Res. Basel, Karger, 2015, vol 42, pp 47–57.

 

•        Nicotine is inhaled- 7 secs reaches, crosses the Blood Brain Barrier

•        Nicotine binds to alpha and beta 4 nicotinic Acetylcholine receptors nAcH receptors in the Ventral Tegmental Area VTA. This stimulates dopamine receptors

•        Dopamine release rapidly in Nucleus Accumbens (NAc)

•        Projections from the ventral tegmental area (VTA) to the nucleus accumbens (NAc) and to cortical structures (CTX) form the Dopaminergic Mesocorticolimbic System.

•        This pathway is activated when inhaled nicotine rapidly enters the brain and interacts with different subtypes of nAChRs (in this example α4β2 nAChRs) located in the VTA.

•         This results in the rapid release of dopamine in the NAc that mediates the rewarding and reinforcing effects of nicotine.⁴

In children and adolescents, the mesocorticolimbic system is still developing, and when is exposed to nicotine there is reduction in the volume of the brain, affects that part of brain responsible for cognitive development, decision making, are more prone to risk taking behaviours i.e., illicit drug addictions.^4,5

To pave a path for their new customers,  and to cause an addiction, the tobacco companies manufactured  “Electronic cigarettes” which do not contain Tobacco contains nicotine, they are attractive , lure the teenagers, as a “cool” device, peer pressure,  small, sleek, innocent looking devices (some look like a pen, some like a candy, a popsicle, featuring kids famous cartoon character, favourite flavours , colours,  are  advertised illegally  on the internet as a stress buster, as a habit breaker or harm reduction substance.

In the year 2019 PECA was introduced and enforced the Prohibition of Electronic Cigarettes Act, i.e.,India banned the production, manufacture,import,export, transport, sale,distribution, storage and advertisement of e-cigarettes.

 

Fig 2: DIFFERENT FORMS OF E CIGARETTES

Vaping risks and dangers during COVID. Kidscentraltn.com

                                                

Fig 3: : DIFFERENT FORMS OF E CIGARETTES- LURING YOUTH

ENDING THE SALE OF FLAVOURED TOBACCO PRODUCTS- Tobacco free kids campaign- U.S. WEBSITE

 

Fig 4: DIFFERENT FORMS OF E CIGARETTES- LURING YOUTH

LATIMES.COM- Los Angeles will clamp down on selling flavoured tobacco products

Fig 5: DIFFERENT FORMS OF E CIGARETTES- flavoured vape juices

Flavored E-Cigs Tied to Continued Teen Vaping. U.S. and world report news 

Stages of adolescent addiction.⁷

•        Initiation of smoking    

•        Urge to smoke more after starting   

•         increased frequency of use

•        Exascerbating Into Dependence   -    RAPID PROGRESSION TO ADDICTION

There has been a paradigm shift in the customers of the BIG TOBACCO companies now.

                    

Fig 6: Karen Evans et al .Tobacco control.  British medical journal.  News analysis. Worldwide news and comment

Fig 7: No smoking school images- getty images.no

CONCLUSION

Whatever we do always should start from the home itself. Parents themselves should refrain from smoking or chewing tobacco as that has deleterious effects on them and on the minds of their children.  Children will learn from their parents.

We have to create awareness in our children, NOT to give in to peer pressure, NOT to ‘TRY’ that 1 time, because that can create a craving for more which can lead to dire consequences of getting hooked onto it.

FIG 8: WHO WEBSITE 2026- KNOWLEDGE ACTION PORTAL ON NCDS. WORLD NO TOBACCO DAY 2026

The World Health Organization has announced the theme for World No Tobacco Day 2026, “Unmasking the appeal – countering nicotine and tobacco addiction,” focusing on how the tobacco and nicotine industry continues to target children and adolescents through increasingly attractive and misleading products such as e-cigarettes, nicotine pouches, and synthetic nicotine. The campaign highlights alarming evidence of widespread youth use and aims to expose industry tactics, advocate for stronger policies to reduce product appeal and marketing, and empower young people to resist addiction.

TAGLINE FOR HEAD AND NECK CANCER DAY IS “SAYING NO, IS THE NEW RICH”!

REFERENCES

1. Bhattacharya et al: A model-based comparison of life expectancy by smoking status. Discover Public Health 2026
2. Tobacco cultivation leads to the accumulation of alkaloids in the soil and causes potential risks. Microchemical journal 2025
3. Sančanin, B., & Penjišević, A. Impacts of tobacco use and exposure to tobacco smoke on health, society, economy, and environment, MEDIS - Medical Science and Research, 3(2), 25-2;2024
4. Loddenkemper R, Kreuter M (eds): The Tobacco Epidemic, ed 2, rev. and ext. Prog Respir Res. Basel, Karger, 2015, vol 42, pp 47–57.(Fig 1 in text)
5. Chaitali Mandal et al. Tobacco trends: An Examination of adult tobacco consumption through GATS and NHS DATA
6. Nicotine addiction: More than just dopamine. Current opinion in neurobiology. 2023
7. Mahajan et al. Multifactorial etiology of adolescent nicotine addiction. Neurobiology of nicotine addiction. Frontiers of Public Health. July 2021;Vol 9