Dr. Rubi Kataki
(rubikataki65@gmail.com)
The tobacco epidemic is one of the biggest public health threats the world has ever faced. Tobacco in any form adversely affects health, causing chronic and debilitating diseases like heart disease, stroke, oral and other cancers, respiratory diseases, and other non-communicable diseases, as well as complications of pregnancy such as preterm delivery and low infant birth weight.
All forms of tobacco are harmful, and there is no safe level of exposure to tobacco. Cigarette smoking is the most common form of tobacco used worldwide. Other tobacco products include water-pipe tobacco, various smokeless tobacco products, cigars, cigarillos, roll-your-own tobacco, pipe tobacco, bidis, kreteks, etc.
Worldwide, tobacco-related deaths kill 560 people every hour, 13,440 people per day, and 49 lakh people per annum. It has been projected by the World Health Organisation (WHO) that globally by 2050, if the focus is only on prevention and not cessation, there will be an additional 160 million deaths. The Indian government too acknowledges that the country is facing a smoking epidemic that is likely to cause up to 1 million deaths every year. Recognition of associations between tobacco use and oral health, as well as the benefits of tobacco cessation on oral health outcomes, makes it imperative for national oral health programmes to actively support tobacco control efforts at both clinical and community levels.
Oral health is integral to both general health and a better quality of life. Good oral health is extremely important for the overall wellbeing of an individual. Some common oral health diseases are dental caries, periodontitis, and deleterious changes of the oral cavity, including halitosis, caused by various forms of tobacco consumption by mouth, which affect nearly sixty percent and eighty percent, respectively, of the Indian population. Oral health has been neglected over the years, especially in underprivileged areas. Among many reasons, the low level of awareness among the population and the care providers has even led to continued neglect of dental care. Oral diseases have also been linked to bacterial endocarditis, atherosclerosis, chronic obstructive pulmonary diseases, low birth weight, etc. Periodontal health has direct links with diabetes as well. As per the Dental Council of India, there are about 1.5 lakh registered dentists for a population of about 1.3 billion, out of which 72% live in villages that remain deprived of dental care. The primary objective of the National Oral Health Programme (NOHP) is to render promotive, preventive, and curative services for oral diseases, particularly in rural and underserved areas, through existing public health facilities. NOHP has been launched to support the states and UTs in strengthening their infrastructure and facilities for better oral healthcare. The programme also aims at increasing awareness and capacity building at various levels of healthcare in the country. The Government of India has envisaged the NOHP as an affordable, accessible, and equitable oral healthcare delivery system in a well-coordinated manner where tobacco cessation is one of the major components.
Taking into account the oral health situation in the country, the Government of India has initiated a National Oral Health Programme to provide integrated, comprehensive oral healthcare in the existing healthcare facilities with the following objectives:
To improve the determinants of oral health.
To reduce morbidity from oral diseases.
To integrate oral health promotion and preventive services with the general health care system.
To encourage the promotion of the public-private partnership (PPP) model for achieving better oral health.
The National Oral Health Cell also helps in imparting training to the oral health workforce as well as the general health workforce for a better integrated approach to better oral health. In order to increase the level of awareness, the Government of India helps in the preparation of prototype information, education, and communication (IEC) materials and behaviour change communication (BCC) materials for the dissemination of information. A public-private partnership can be utilised with the dental colleges, various dental associations, and community-based organisations to promote community-based oral health awareness and service delivery wherever feasible. The National Oral Health Cell (NOHC) monitors the implementation and progress of the programme from time to time through established mechanisms.
The National Oral Health Programme (NOHP) is a part of health system strengthening under NRHM (also known as Mission Flexible Pool). Approvals given to the states in NOHP under Health System Strengthening by NHM Therefore, oral health care delivery in the country is strengthened for the overall health of the population.
Today, as we celebrate World No Tobacco Day, let us recommit ourselves to a future free from the devastating consequences of tobacco. Let us stand together as a global community and declare our determination to quit. By doing so, we contribute to the well-being of ourselves, our loved ones, and generations to come. Let us pledge to protect the youth from tobacco industry manipulation and prevent their use of tobacco.
Let us not smoke, consume smokeless tobacco, or spit in public.