Authored article By Dr. Manjunath Doshetty, Nephrologist, NephroPlu

We live in an era where there is a strong emphasis on global health awareness campaigns, and Anti-Tobacco Day serves as a timely reminder of the ongoing issues faced by rising tobacco smoking among individuals. While the dangers to respiratory health are well-known, the impact on vital organs like the kidneys remains less discussed yet is equally concerning.

Understanding the Impact of Tobacco on Kidney Health                                                       

Tobacco is a significant risk factor for chronic kidney disease (CKD). The World Health Organization (WHO) helps to point out the direct link between smoking and an increased risk of CKD and end-stage renal disease (ESRD). A report by the National Kidney Foundation further reveals that smokers are more susceptible to proteinuria, a sign of potential kidney damage. The relative risk of Proteinuria / CKD ESRD with smoking ranges between 2.0 to 3.2 which is alarming. Further, smoking is not only an independent risk factor but also a risk amplifier for CKD in patients with diabetes and hypertension. Interestingly, cessation of smoking reduces the risk of progression to end-stage kidney failure. Thus, raising awareness about this issue is crucial.

India's Tobacco Production and Diversification Effort

In addition to being a major consumer of tobacco, India stands as the second-largest producer globally, manufacturing 761,335 tons. The majority of this production is concentrated in three states, employing nearly 25 million people across the production value chain.

Recognizing the health and economic implications, the Indian Ministry of Agriculture, Cooperation, and Farmers Welfare introduced a Crop Diversification Scheme under the Rashtriya Krishi Vikas Yojna program. As of 2018, the government reported a diversion of 67,512 hectares, or 8.7% of designated tobacco-growing land, since 2015-2016.

In 2022, India's unmanufactured tobacco production stood at approximately 2 thousand tons, representing 13.4% of the global production of 5.78 million tons. This marks an 11.9% increase from the 690.0 thousand tons produced in 2010. Moreover, India utilized an estimated 3 thousand hectares for tobacco cultivation in 2022, a 4.3% decrease from 2010.

The Need for Anti-Tobacco Initiatives                                                                                           

Despite increasing awareness, tobacco-related illnesses, including kidney diseases, continue to rise. WHO report on the global tobacco epidemic, 2023 exposed the tobacco industry's tactics to undermine smoke-free regulations. From discrediting evidence on second-hand smoke to promoting Electronic Nicotine Delivery Systems (ENDS) as "clean" alternatives, these tactics demand vigilance from policymakers and the public alike. The industry also influences policy-making through lobbying, aiming to weaken tobacco control measures and undermine existing laws by promoting ENDS (Electronic Nicotine Delivery Systems) through traditional and social media. Regulators must remain vigilant against these tactics to protect public health.

Driving Change through Awareness and Education                                                                           

 In the last 15 years, there has been significant progress in implementing smoke-free measures globally. In 2007, only 15 countries were believed to have 100% smoke-free cafés, pubs, and bars, a number which rose to 88 by 2022. Despite this, these venues remain the least protected under national laws. Meanwhile, in 2007, 81 countries had smoke-free healthcare facilities and 78 had smoke-free educational facilities. By 2022, these numbers increased to 142 and 149 countries, respectively. This significant increase underscores the growing global commitment to creating healthier environments by reducing exposure to second-hand smoke in crucial public spaces.

Sensitisation about the ill effects of smoking in schools and colleges is pivotal. Cigarette and tobacco products manufacturers need to be more explicit in displaying the hazards of smoking.

Embracing a Smoke-Free Future                                                                                                                

 I believe, that there's a growing trend to extend smoke-free laws across various public venues and outdoor spaces globally. Also, as a doctor, I feel that we must empower people with information on the ill effects of smoking and the benefits of quitting.  Hence, by providing accessible and effective smoking cessation support services such as counselling, medications, and hotlines one can ensure that these materials are widely available and cheap to all those who want to quit smoking.

Therefore, it is essential to create a smoke-free world that demands collaborative efforts and robust policies. As we mark Anti-Tobacco Day this year, we can renew our commitment to safeguarding public health and fostering a tobacco-free environment for future generations.

Source:

• WHO report on the global tobacco epidemic, 2023
• State Of Smoking And Health In India