Areca nut use in India

HMCH@M INTQM@K NE LDCHB@K RBHDMBDR

206

Indian Journal of Medical Sciences (INCORPORATING THE MEDICAL BULLETIN) ITMD 1//6

MTLADQ 5

EDITORIALS

ARECA NUT USE IN INDIA

Sgd trd ne `qdb` mts `mc adsdk pthc `qd oq`bshbdr ne fqd`s `mshpthsx hm Hmch`- Sgd `rrnbh`shnm ne sgdrd oq`bshbdr vhsg nq`k b`mbdq v`r mnsdc nudq 0// xd`qr a`bj: xds sgd bgdvhmf ne `qdb` mts hm Hmch` v`r bnmrhcdqdc sn ad ` bnlo`q`shudkx hmmnbtntr oq`bshbd sg`s g`c bnlokdsd rnbhnbtkstq`k `bbdos`mbd- Hm qdbdms xd`qr+ gnvdudq+ hs g`r dldqfdc `r ` rhfmh� b`ms otakhb gd`ksg oqnakdl- Bnmudqrhnm ne ` mnql`k btkstq`k oq`bshbd hmsn ` otakhb gd`ksg oqnakdl rs`qsdc oqnaàkx ànts 3// xd`qr a`bj èsdq sna`bbn v`r hmsqnctbdc hmsn Hmch` ax Dtqnod`m sq`cdqr- Hm `cchshnm sn hsr trd enq rlnjhmf+ `r sgd Dtqnod`mr cdlnmrsq`sdc+ sna`bbn rnldgnv fns lhwdc vhsg adsdk pthc `mc adf`m sn ad bgdvdc- Vgdm chc hs `bst`kkx gòodm+ vd cn mns jmnv: ats `rrnbh`shnm vhsg ` btkstq`kkx `bbdosdc rtars`mbd fùd sna`bbn `krn ` rhlhk`q rs`str-Z0\ Ctqhmf sgd rdbnmc g`ke ne sgd 1/sg bdmstqx+ sgd b`tr`k `rrnbh`shnm adsvddm bgdvhmf ne adsdk pthc vhsg sna`bbn `mc nq`k b`mbdq v`r vdkk drsàkhrgdc+ `mc hs bntkc mn knmfdq ad qdf`qcdc `r ` bnlokdsdkx hmmnbtntr oq`bshbd-Z1\ Sgd lìnq btkoqhs v`r bkd`qkx sna`bbn hm sgd pthc: gnvdudq+ oqnaàkx adb`trd ne hsr �dwnshb� òod`k+ `qdb` mts v`r dqqnmdntrkx sgntfgs ne `r ok`xhmf ` lnqd hlonqs`ms qnkd-Z2\

@qdb` mts v`r bnlo`q`shudkx nee sgd gnnj hm rbhdmsh� b vqhshmfr `mc du`kt`shnmrZ3\: `ksgntfg ax 087/r+ hs v`r bkd`q sg`s `qdb` mts bgdvhmf v`r qdronmrhakd enq nq`k rtaltbntr � aqnrhr , ` oqnfqdrrhud cdahkhs`shmf chrd`rd vhsgnts `mx jmnvm btqd+ `mc sg`s v`r drsàkhrgdc `r ` oqdb`mbdqntr bnmchshnm-Z4\ To sn sgd 087/r+ ù`hkàkd c`s` rgnvdc nq`k rtaltbntr � aqnrhr `r ` bnlo`q`shudkx q`qd chrd`rd+ nbbtqqhmf fdmdq`kkx `lnmf nkcdq hmchuhct`kr+ lnrskx adsdk pthc bgdvdqr- Ax 088/r+ sgd rhst`shnm g`c bg`mfdc: sgd onotk`shnm oqdu`kdmbd ne nq`k rtaltbntr � aqnrhr g`c hmbqd`rdc l`mhenkc `mc hs g`c adbnld ` chrd`rd lnrskx nbbtqqhmf `lnmf xntmf hmchuhct`kr-Z5\ @r ` oqdb`mbdqntr bnmchshnm+ lnqd rtaltbntr ehaqnrhr rgntkc ld`m lnqd nq`k b`mbdq: `mc ` rhfmhehb`ms hmbqd`rd hm sgd hmbhcdmbd ne nq`k b`mbdq `lnmf xntmf hmchuhct`kr v`r udqh� dc-Z6\

Sgd qd`rnm enq sghr rtccdm hmbqd`rd hm nq`k rtaltbntr � aqnrhr v`r mns che� btks sn hcdmshex- Ctqhmf 086/r `mc 087/r+ bgdvàkd lhwstqdr bnms`hmhmf `qdb` mts 'fdmdqhb m`ld , pan masala(+ pthsd nesdm sna`bbn `r vdkk 'fdmdqhb m`ld , gutka(+ vdqd hmctrsqh`kkx l`mte`bstqdc `mc l`qjdsdc- Sgd hmctrsqx trdc etkk onvdq ne ldch`+ hmbktchmf sgd dkdbsqnmhb ldch`+ sn Hmch`m I Ldc Rbh+ Unk- 50+ Mn- 5+ Itmd 1//6

2 CMYK

`cudqshrd `mc l`qjds sgdhq oqnctbsr+ rodbh� b`kkx s`qfdshmf xntmf hmchuhct`kr- Sgd hmctrsqx g`c ` ogdmnldm`k fqnvsg+ `mc hs v`r rtbbdrretk hm gnnjhmf `m dmshqd mdv fdmdq`shnmSgd oòdq hm sghr hrrtd ne sgd intqm`k oqnuhcdr rnld mdv duhcdmbd `mc qdhsdq`sdr rdudq`k ne sgd rs`sdldmsr l`cd gdqd-Z7\ Hs rgnvr sg`s ` ogdmnldmnm sg`s rs`qsdc eqnl sgd mnqsgdqm o`qsr ne Hmch` g`r qd`bgdc cddo rntsg `mc dudm odmdsq`sdc hmsn qtq`k `qd`r- Hs rgnvr sg`s ` k`qfd oqnonqshnm+ md`qkx g`ke ne `kk `qdb` mts trdqr+ bnloqhrdr sgnrd trhmf hmctrsqh`kkx l`mte`bstqdc oqnctbsr- Hs `krn rgnvr sg`s lnrs ne sgd trdqr `qd xntmf hmchuhct`kr- Sgtr sgd mdv dohcdlhb ne nq`k rtaltbntr � aqnrhr `mc nq`k b`mbdq `lnmf xntmf hmchuhct`kr rgntkc ad dwodbsdc sn qd`bg `kk bnqmdqr ne Hmch`+ he hs g`r mns `kqd`cx cnmd rn-

mts `r ` b`qbhmnfdmhb rtars`mbd vhsg sgd gdko ne mdvdq c`s`+Z8\ qdudqrhmf hsr d`qkhdq du`kt`shnm 'unk- 26(-Z3\ Sgd rsqdmfsg ne sgd duhcdmbd v`r bnmrhcdqdc rte� bhdms sn bnmbktcd sg`s sgd trd ne `qdb` mts b`trdr b`mbdq `lnmf gtl`mr- Aqhmfhmf `qdb` mts oqnctbsr hmsn sgd `lahs ne �sna`bbn oqnctbsr� @bs hr àrnktsdkx drrdmsh`k sn cdbdkdq`sd sgd qòhckx dunkuhmf dohcdlhb ne nq`k rtaltbntr � aqnrhr `mc nq`k b`mbdq `lnmf xntmf hmchuhct`kr hm sgd bntmsqx

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UNKTLD 50


DCHSNQH@KR

207

Sgd sna`bbn oqnctbsr `qd bnudqdc ax ` qdbdms @bs+ `mc sgd @bs hmbktcdr gutka. Sgdqdenqd gutka b`mmns ad chqdbskx `cudqshrdc mnv- @qdb` mts oqnctbsr+ gnvdudq+ `qd l`qjdsdc ax sgd r`ld l`mte`bstqdqr trhmf hcdmshb`k aq`mc m`ldr- Sgdx `qd mns bnudqdc ax sgd @bs+ `mc sgdqdenqd sgd `qdb` mts oqnctbsr ad`qhmf hcdmshb`k aq`mc m`ldr `r sna`bbn oqnctbsr `qd rshkk `cudqshrdc `mc oqnlnsdc trhmf `kk onrrhakd ldch`+ hmbktchmf dkdbsqnmhb ldch`- Sg`s nauhntrkx etmbshnmr `r rtqqnf`sd `cudqshrhmf enq sgdhq sna`bbn,bnms`hmhmf oqnctbs gutka, vghbg hr sgdhq l`hm oqnctbsSgdqd hr mnv `lokd qd`rnm sn aqhmf `qdb` mts oqnctbsr hmsn sgd `lahs ne sgd @bs bnudqhmf sna`bbn oqnctbsr- Hm ` qdbdms dwdqbhrd+ sgd Hmsdqm`shnm`k @fdmbx enq Qdrd`qbg nm B`mbdq ne sgd Vnqkc Gd`ksg Nqf`mhy`shnm du`kt`sdc `qdb`

REFERENCES

0- Qdccx JR+ Ftos` OB- Qdonqs nm Sna`bbn Bnmsqnk hm Hmch`- Lhmhrsqx ne Gd`ksg `mc E`lhkx Vdke`qd+ Fnudqmldms ne Hmch`9 Mdv Cdkgh: 1//3- 1- Bnmsqnk ne nq`k b`mbdq hm cdudknohmf bntmsqhdr- @ VGN lddshmf- Atkk Vnqkc Gd`ksg Nqf`m 0873:519706,2/ 2- Ftos` OB+ Ohmcanqf II+ Ldgs` ER- Bnlo`qhrnm ne b`qbhmnfdmhbhsx ne adsdk pthc vhsg `mc vhsgnts sna`bbn9 @m dohcdlhnknfhb`k qduhdv- Dbnk Chr 0871:09102,8 3- Hmsdqm`shnm`k @fdmbx enq Qdrd`qbg nm B`mbdq9 H@QB Lnmnfqògr nm sgd Du`kt`shnm ne sgd B`qbhmnfdmhb Qhrj ne Bgdlhb`kr sn Gtl`mr- Unk- 26+ Sna`bbn Gàhsr nsgdq sg`m Rlnjhmf: Adsdk, pthc `mc @qdb`,mts Bgdvhmf: `mc rnld qdk`sdc Mhsqnrnlhmdr- Hmsdqm`shnm`k @fdmbx enq Qdrd`qbg nm B`mbdq9 Kxnm: 0873 4- Ltqsh OQ+ Agnmrkd QA+ Ohmcanqf II+ Cès`qx CJ+ Ftos` OB+ Ldgs` ER- L`khfm`ms sq`mrenql`shnm q`sd hm nq`k rtaltbntr � aqnrhr nudq ` 06,xd`q odqhnc- Bnlltmhsx Cdmshrs Nq`k Dohcdlhnk 0874:02923/,0 5- Ftos` OB+ Rhmnq OM+ Agnmrkd QA+ O`v`q UR+ Ldgs` GB- Nq`k rtaltbntr � aqnrhr hm Hmch`9 @ mdv dohcdlhb> M`s Ldc I Hmch` 0887:009002,5 6- Ftos` OB- Lntsg b`mbdq hm Hmch`9 @ mdv dohcdlhb> I Hmch`m Ldc @rrnb 0888:86926/,2- 7- Ftm`rddk`m Q+ Q`ldrg R+ R`mj`q`khmf`l R-

Hmch`m I Ldc Rbh+ Unk- 50+ Mn- 5+ Itmd 1//6 CMYK 2

rnld @qdb`,Mts,Cdqhudc Mhsqnr`lhmdr- Kxnm- Hmsdqm`shnm`k @fdmbx enq Qdrd`qbg nm B`mbdq 1//3 PRAKASH C. GUPTA

Healis - Sekhsaria Institute for Public Health, Navi Mumbai, India. E-mail: [email protected]


@qdb`mts trd hm qtq`k S`lhkm`ct9 @ fqnvhmf sgqd`s- Hmch`m I Ldc Rbh 1//6:509221,68- Hmsdqm`shnm`k @fdmbx enq Qdrd`qbg nm B`mbdq9 H@QB Lnmnfqògr nm sgd Du`kt`shnm ne sgd B`qbhmnfdmhb Qhrj ne Bgdlhb`kr sn Gtl`mr- Unk- 74+ Adsdk,pthc `mc @qdb`mts Bgdvhmf: `mc

208

ARECA NUT: THE HIDDEN INDIAN ‘GATEWAY’ TO FUTURE TOBACCO USE AND ORAL CANCERS AMONG YOUTH Sgd `qshbkd �@qdb` mts trd hm qtq`k S`lhk M`ct9 ` fqnvhmf sgqd`s� Z0\ hm sghr hrrtd ghfgkhfgsr sgd oqnakdlr qdk`sdc sn vg`s hr bnmrhcdqdc ` admhfm `mc rnbh`kkx `bbdosàkd gàhs `lnmf Hmch`mr- Sgd m`stqd ne `qdb` mts trd hm sgd bntmsqx hr bg`mfhmf hm hsr bnmsdms `mc o`ssdqm `mc gdmbd hr onhrdc sn adbnld ` lìnq gd`ksg sgqd`s+ o`qshbtk`qkx sn sgd hloqdrrhnmàkd `mc gdmbd utkmdqàkd xntsg ne Hmch`Qdbdms khsdq`stqd g`r ghfgkhfgsdc sgqdd hrrtdr- Ehqrskx+ sgd oqdu`kdmbd ne+ `mc cdodmcdmbd nm+ `qdb` mts trd hm Hmch` hr hmbqd`rhmf qòhckx+ hm sgd enql ne bnmrtloshnm ne pan masala, drodbh`kkx ax sgd xntsg-Z1\ Sghr hr hm bnmsq`rs sn d`qkhdq enqlr ne trd vhsg adsdk pthc `mc l`hmkx nm rnbh`k nbb`rhnmr- Pan masala hr d`rhkx ù`hkàkd hm ansg qtq`k `mc tqa`m `qd`r+ `mc sgdqd `qd mn `fd a`qr sn sgd otqbg`rd `mc trd ne sghr rtars`mbd-Z2\

Rdbnmckx+ lnrs pan masala oqdo`q`shnmr+ hm `cchshnm sn `qdb` mts+ gùd sna`bbn hm sgdl `mc `krn hmbktcd nsgdq rtars`mbdr rtbg `r `qdbnkhmd+ b`sdbgt+ s`mmhm- Sgdrd gùd addm entmc sn oqnlnsd dwbdrrhud `mc g`qletk trd `mc `krn kd`c sn cdodmcdmbd-Z3\ Vg`s hr bnmrhcdqdc admhfm `qdb` mts trd gdmbd `bsr `r ` f`sdv`x sn sna`bbn trd udqx d`qkx hm khed- @ rstcx eqnl

Cdkgh qdonqsdc sgd oqdu`kdmbd ne `qdb` mts trd sn ad 00-63$ `lnmf ghfg rbgnnk rstcdmsr- Vg`s hr `krn hmsdqdrshmf hr sgd � mchmf sg`s sgd oqdu`kdmbd ne bnlahmdc `qdb` mts `mc sna`bbn bgdvhmf hm sghr onotk`shnm v`r dpt`k `lnmf fhqkr `mc anxr- Sghr enql ne sna`bbn trd gdmbd rddlr sn ad kdrr ne ` rnbh`k sànn enq xntmf vnldm bnlo`qdc sn rlnjhmf-Z4\ @ qdbdms rstcx nm sdkduhrhnm `cudqshrhmf ne pan masala q`hrdc ` onrrhahkhsx ne pan masala `cudqshrdldmsr adhmf ` rtqqnf`sd enq sna`bbn oqnctbsr-Z5\ Sghqckx+ tmkhjd vg`s hr bnllnmkx tmcdqrsnnc+ sgdqd hr dmntfg duhcdmbd sn rtffdrs sg`s `kk `qdb` mts oqnctbsr+ dudm sgnrd vhsgnts sna`bbn+ `qd `rrnbh`sdc vhsg nq`k rtaltbntr � aqnrhr 'NRE(+ vhsg sgd qhrj adhmf fqd`sdrs enq pan masala. Sgd ctq`shnm ne sgd gàhs hr lnqd rhfmh� b`ms sg`m sgd eqdptdmbx ne sgd bgdvhmf gàhs+ vghbg `f`hm tmcdqkhmdr sgd e`bs sg`s sgd xntmfdq sgd `fd ne nmrds+ lnqd hr sgd qhrj enq NRE- Ansg sgd ctq`shnm `mc c`hkx eqdptdmbx ne `qdb` mts trd hmbqd`rd sgd qhrj ne b`mbdq+ rtffdrshmf ` cnrd,qdronmrd qdk`shnmrgho-Z6+7\ @m hmbqd`rdc qhrj enq sgd cdudknoldms ne nq`k l`khfm`mbx 'nq`k rpt`lntr bdkk b`qbhmnl`( `mc hsr oqdbtqrnqr kdtjnok`jh` `mc rtaltbntr � aqnrhr g`r addm qdonqsdc hm u`qhntr rstchdr Hmch`m I Ldc Rbh+ Unk- 50+ Mn- 5+ Itmd 1//6

3 CMYK

21/

DCHSNQH@KR

ne �`qdb` mts�,nmkx trdqr+ vhsg `cchmf sna`bbn etqsgdq hmbqd`rhmf sgd qhrj-Z6\ @ bgdlhb`k `mc snwhbnknfhb`k du`kt`shnm ne pan masala qdud`kdc sgd oqdrdmbd ne vdkk,drsàkhrgdc b`qbhmnfdmr khjd onkx`qnl`shb gxcqnb`qanmr: mhsqnr`lhmd: snwhb lds`kr rtbg `r kd`c+ b`clhtl+ mhbjdk: qdrhct`k odrshbhcdr khjd CCS `mc AGB: u`qhntr sxodr ne etmfh khjd @rodqfhkktr+ vghbg hr jmnvm sn oqnctbd `� `snwhm+ ` onsdms khudq b`qbhmnfdm- @krn+ `qdbnhchmd+ s`mmhm hm b`sdbgt: `mc rtodq nwhcd hnmr fdmdq`sdc ctd sn `tsn,nwhc`shnm ne onkxogdmnkr `mc hmsdq`bshnm ne b`sdbghm vhsg khld `qd `kk rtrodbsdc sn gùd b`qbhmnfdmhb onsdmsh`k-Z7\ @o`qs eqnl sgd b`qbhmnfdmhb onsdmsh`k+ `qdb` mts g`r addm rgnvm sn ad `cchbshud+ `mc cdudknoldms ne sxohb`k cdodmcdmbd rxlosnlr g`r addm cdrbqhadc-Z7\

bgdvhmf `qdb` mts oqnctbsr vntkc fhud sgdl qdk`w`shnm `mc sgtr vntkc gdko sgdl enqfds sgdhq oqnakdlr- Sgd nkcdq odnokd bnmrhcdqdc `qdb` mts sn ad o`qs ne sgdhq khed `mc vdqd mns `k`qldc ax sgd e`bs sg`s xntmf jhcr hmctkfdc hm ghfg,qhrj adgùhnq- Sgd ldmshnmdc bnlltmhsx rstcx `krn qdud`kdc sg`s rhmbd bgdvhmf `qdb` mts oqnctbsr v`r bnmrhcdqdc ` odqrnm`k gàhs+ sgd bnlltmhsx sgntfgs sg`s mn `bshnm bntkc ad s`jdm `s sgd uhkk`fd kdudk `mc sg`s nmkx rdke, qd`khy`shnm bntkc cdbqd`rd sgd oqdu`kdmbd hm sgd bnlltmhsx- Vghkd rnld edks sg`s hs lhfgs mns ad onrrhakd sn a`m `qdb` mts oqnctbsr vhsg sna`bbn+ vghbg gùd ` k`qfd bnmrtldq a`rd+ eqnl sgd bnlltmhsx+ rnld `cnkdrbdmsr uhdvdc sg`s he sgdrd oqnctbsr vdqd l`cd tmù`hkàkd hm sgd knb`k l`qjdsr+ sgd oqdu`kdmbd ne sgd gàhs vntkc bnmrdptdmskx cdbqd`rd-Z8\


HMCH@M INTQM@K NE LDCHB@K RBHDMBDR

Otakhb odqbdoshnmr òod`q sn gùd ` lìnq qnkd sn ok`x hm l`hms`hmhmf sghr gàhs- Sgd fdmdq`k kdudk ne `v`qdmdrr qdf`qchmf sgd hkk deedbsr ne `qdb` mts trd nm gd`ksg g`r addm entmc sn udqx knv+ `r qdonqsdc ax sgd rstcx hm sghr hrrtd- Qdf`qchmf sgd gd`ksg deedbsr ne bgdvhmf `qdb` mts+ sgd nkcdq fdmdq`shnm adkhdudc sg`s sgd trd ne `qdb` mts oqnctbsr bntkc b`trd mn g`ql `r sgdx sgdlrdkudr gùd addm otqrthmf sgd gàhs enq ` knmf shld vhsgnts `mx gd`ksg oqnakdlr- Nmd rstcx qdud`kdc sg`s sgdqd v`r `v`qdmdrr hm sgd bnlltmhsx qdf`qchmf ftsjg` `mc sna`bbn trd kd`chmf sn b`mbdq+ ats hs chc mns òokx dhsgdq sn `qdb` mts `knmd nq sgd `qdb` mts bnlonmdms ne sgd ftsjg`-Z8\ @ qtq`k bnlltmhsx rstcx rgnvdc sg`s hmhsh`shnm ne sgd bgdvhmf gàhs v`r òoqnwhl`sdkx adsvddm sgd `fdr ne 02 `mc 04 xd`qr+ `mc xntmf anxr vgn vdqd dloknxdc '`r noonrdc sn sgnrd vgn vdms sn rbgnnk( vdqd tmcdq sgd hloqdrrhnm 'oqnuhcdc ax sgdhq oddqr( sg`s

Sn bnmbktcd+ hs òod`qr eqnl sgd ànud duhcdmbd sg`s `qdb` mts trd hm hsr btqqdms enql hr adbnlhmf ` onsdmsh`k gd`ksg sgqd`s sg`s vhkk èedbs sgd xntmfdq fdmdq`shnm hm Hmch`- Dwhrshmf sna`bbn bnmsqnk oqnfq`lr `qd ` fnnc ldchtl sn hmbnqonq`sd dctb`shnm qdk`sdc sn sgd qhrjr ne `qdb` mts trd+ vhsg nq vhsgnts sna`bbn- Vd mddc sn rs`qs xntmf `mc chrbtrr `qdb` mts+ o`qshbtk`qkx sgd trd ne pan masala, vhsg rbgnnk bghkcqdm- Sgd bg`kkdmfd vhkk ad sn l`jd sgd oqdudmshnm oqnfq`lr enq `qdb` mts `mc pan masala `r b`sbgx `mc `ssq`bshud `r sgd `cudqshrdldmsr sg`s oqno`f`sd sgdl

REFERENCES 0- Ftm`rddk`m Q+ Q`ldrg R+ R`mj`q`khmf`l R- @qdb`mts trd hm qtq`k S`lhkm`ct9 @ fqnvhmf sgqd`s- Hmch`m I Ldc Rbh 1//6:509221,61- F t o s ` O B + V ` q m ` j t k ` r t q h x ` R - F k n a ` k Dohcdlhnknfx ne `qdb` mts tr`fd- @cchbs Ahnk

Hmch`m I Ldc Rbh+ Unk- 50+ Mn- 5+ Itmd 1//6 CMYK 3