Umesh Sharma, a resident of Assam's Nalbari district came to Guwahati's B. Borooah Cancer Institute (BBCI) accompanied by his wife. However, this time it was not for treatment. It was for an interactive session titled "Listening to the voice of the tobacco victims", organized by B. Barooah Cancer Institute (BBCI), Guwahati and Voluntary Health Association of Assam (VHAA) and supported by the Voluntary Health Association of India (VHAI), New Delhi. The objective of the interaction was to create public awareness, mass media campaign, to encourage school based education.

Sarma narrated his sordid tale. He runs a small betel nut shop. He became a tobacco addict inspite of his family forbidding him. After 2-3 years he was detected with cancer. After initial treatment in Nalbari, he was referred to BBCI where he was operated upon. "It was an ordeal for me. I could not even swallow my food properly but I am better now," he narrates.

A.C Kotoky, Director BBCI informed that there is an alarming rate of cancer patients in Assam as well as the entire Northeast. He had himself has taken the pledge since Auguest 5 to visit two schools per day to see whether there is any outlet selling tobacco products in the vicinity. As per the Anti-Tobacco Law there should not be any such outlet within 100 yards of the educational institution. But he finds that almost near every school there are such outlets.

According to reports, 39% of adult population in Assam consume tobacco, 32% take smokeless tobacco products, 40% smoke bidis or cigarette, 52% exposed to second hand smoke, 23% at public places. The consumers are victims of diseases like oral and throat cancer, chronic respiratory disorder, cardio-vascular diseases. In 2011 it was found in India that 63% male population and in female 27% of the cancer patients suffer because of tobacco. The highest rate of cancer patients are found in Mizoram, in per lakh of population 190 people and in Assam 180. He urges all the states to join hands to form public opinion. The anti-tobacco law should be implemented in proper manner. BBCI provides a holistic treatment of the victims, taking into consideration their psychological and mental aspects.

The Government of India has paved the way for banning the sale and manufacture of products like Gutka, Khaini & other smokeless tobacco products by issuing the Food Safety and Standards Authority of India (FSSAI) regulation no 2.3.4 that prohibits the addition of tobacco or nicotine in food, from 1 Aug 2011. In 2011 chief ministers of 11 states, including Assam signed a pledge. In 2011 Food Safety and Standards Association of India which is a statutory body of the government to handle food related issues said that nicotine in any product must be banned.

Binoy Mathews, the media officer, Voluntary Health Association of India (VHAI), said it is the first of its kind venture. "We have pleaded to the states of India to ban tobacco, and eight states have already banned gutka," he said. Chief Ministers of Assam, Goa, Punjab, Kerala, Karnataka, Maharashtra, Arunachal Pradesh, Uttrakhand, Chhattisgarh, Rajasthan and Gujarat have signed pledges on behest of victims of oral cancer, doctors and tobacco control advocates of their states.

Dinesh Baruah, another victim urges the younger generation not to indulge in such habits. He got the habit from his friends. He was afraid of cancer and when he was detected with the disease, he thought his life was over, but now in BBCI he is struggling to survive. He had almost lost his voice, now he can talk. He was addicted to alcohol mainly the local brew.

The victims, doctors and tobacco control advocates also presented a Charter of Demands on the occasion. Their demands included urging the government to support the ban on these products, to live up to their commitment and act in time to save the lives of millions of people who are suffering from the impact of these products.

India has the highest prevalence of oral cancer globally, with 75, 000 to 80, 000 new cases of oral cancers being reported every year. Nearly 80% of all oral cancer cases are due to the consumption of tobacco products like Gutka, pan masala, betel quid with tobacco and khaini. According to a study released in March 2012, by Tata Memorial Hospital, about 1.2 lakh deaths in 2010 occurred due to tobacco alone and most number of deaths--nearly 84,000 in men and 36,000 in women were from oral cancer due to smokeless tobacco.

India spends approximately Rs 300 billion annually in both public and private spending on treatment of tobacco related illness, accounting for roughly one fourth of all health spending. According to the WHO, the total economic cost of tobacco use in India for 2004 amounted to $1.7 billion, which is 16 percent more than the total excise tax revenues collected from all tobacco products in India in the financial year 2003-04 ($1.46 billion).

Assam has got one of the highest incidences of cancer in the country due to rampant habit of tobacco consumption. While the revenue from Gutka will be few hundred crore, the health care losses run in thousands of crore. As per the FSSAI 2011, the Government of Assam should enforce ban on Gutka and Pan Masala at the earliest. "It is well known that the Gutka Industry targets Kids and Youth as their new consumer base. The Governments have to stop this trade of this cheapest poison available", said Ruchira Neog, Executive Secretary, Voluntary Health Association of Assam.

Suren Rajkhowa, another victim broke down while talking. "I am now afraid of dying. Its been three months since I am undergoing treatment in BBCI. My life is over but I pray that young innocent lives are not lost to tobacco."

Prevalence of Tobacco Use in Assam

• 39.3% adults (52.6% of males and 25.3% of females) currently use some form of tobacco
• 32.7% adults (39.8% of males and 25.3% of females) currently consume smokeless tobacco like gutka, khaini, zarda & other chewing tobacco products
• 8.8% of adults (17.0% of males and 0.1% of females) currently consume cigarettes
• 5.3% of adults (10.2% of males and 0.1% of females) currently consume bidi's.
• Average age at initiation of tobacco use: 19.0 years in adults, 19.2 years in males, and 16.2 years in females.