Wednesday, February 3, 2010
Photo by Vandana Rajagopalan
Upon return from India, I discover a new poison for our children
The Stain -- On the morning of the first bath of the Maha Kumbh Mela, when we had returned from the ghats just as dawn was breaking, my husband and I ran up the stairs to our hotel, deliriously laughing, shocked that we had submerged ourselves in the Ganges with the other pilgrims, and relieved that we had made it to the crowded site with relative ease. As he peeled off his wet clothing, I moved into the small bathroom and started the shower. I unzipped my long wet skirt, and as I stepped out of the folds, I saw that the bottom of my feet were scarlet-colored. “Honey?” I said, “Please come quickly.” At that moment I thought that I had cut myself, and in the dark of four in the morning, and the delight of the journey, had simply ignored the sensation.
We ran our hands over my feet, their shade a distinct blood-red, and saw no cuts. Then we looked down and saw the stain spreading across the towel. Some substance I had stepped on had stained them so completely that I was to wear this color for days. After it happened I saw several other women on the street with the same red soles, usually the women who worked in the markets, out on the streets with bare feet or light sandals, as working women often seemed to be. I wondered if the powder placed on the agna or sixth chakra by marred women and temple-goers had somehow fallen into the street and had given me my Dorothy-like ruby slippers.
The Sell -- Later, traveling over dusty roads and through small villages, we observed hundreds of small street vendors in everything from wooden stalls, to rolling carts to umbrella-covered boxes. At every stall long silvery streams of small packets were lined up like prayer flags, flying in the sun. They looked just like condom packets sold in America in bathroom stalls and pharmacies. “Do you think it’s a sign of their great family planning education?” I hopefully asked my husband. “I think they’re candies,” he answered.
It wasn’t until several days into our long rural drive, as my husband heaved against thistle bushes – oh, the ravages of food poisoning, -- that I got up the nerve to ask our quiet, polite driver what the packets were. There, littered by the side of the road were hundreds of packets, scattered from the street to the farms. I pointed at one on the ground and he said, “Gutka. Terrible. Like cigarettes. Make people sick.”
The Sickness – Back in America, I google ‘gutka’ and discover that it is the scarlet substance that stained women’s bare feet. Like chewing tobacco, gutka is a stimulant placed in the mouth, where it turns red, and then spit out after its effects have been ingested. Composed of crushed betel nut, tobacco, catechu, lime and sweet or savory flavorings, gutka is manufactured in India and exported to other countries. Costing a pittance --between 1 and 6 rupees apiece, -- even the poor can afford its high, and it is the working people who most prefer the buzz to keep them awake during long shifts.
Cheap, sweetened, and as portable as candy, the deadly substance has also found its way into the mouths of India’s children, sometimes even as far away as England’s South Asian population. The age for initiation to gutka is between eight and fourteen years. Now gutka is so popular amongst the young that doctors say it is causing an oral cancer epidemic.
Called the ‘Indian avatar of tobacco’ – even though the ingredient of tobacco is missing on some packets -- about 5 million children under 15 are addicted to gutka. India has the world's highest incidence of oral cancers, about 30%, compared to the West’s 5%, and over 2,000 deaths a day are tobacco related. A survey in Uttar Pradesh and Madhya Pradesh yielded precursor of mouth cancers in 16 percent of the children.
Indians have long chewed paan, a betel leaf wrapped around a mixture of lime paste, spices, areca nut and sometimes tobacco. Convenience, in the form of shiny packaging available everywhere in India, has made gutka accessible to children and young people, for whom smoking is taboo. Sales of the deadly mix quadrupled in the 1990’s to over one billion dollars, causing Mumbai and other places to attempt a ban on the product, which the High Court later overturned on the grounds of unfair trade practice.
Gutka manufacturers say it was cigarette companies that wanted the ban on their product. Gutka marketing campaigns managed to erase the stigma tied to using tobacco by utilizing glamorous and socially acceptable situations. India's version of the Oscars is sponsored by one of the top-selling brands, and free samples are available at religious festivals, youth events, and some say even outside schools. In television commercials, gutka gives actors the power to perform superhuman feats.
With gutka’s use, tumors bulge from cheeks and jaws; there are holes where larynxes used to be. Dr. A. K. D'Cruz, the lead head-and-neck surgeon at Tata Memorial Hospital says, "most of our cancers come a decade earlier than the West." They’re often preceded by submucosal fibrosis, a hardening of the palate that can make it almost impossible to open the mouth. Gutka’s ‘glamorous’ effects.
The Switch – Enter the Marlboro Man. Philip Morris, who changed its name to Altria in a rebranding effort, is lobbying President Obama, under new FDA laws, to categorize smokeless products as less harmful than cigarettes. No contrite corporate citizen, it was reported yesterday that Altria seeks to add sweet flavorings to its smokeless products and market them in tiny packages. Smell like teen snuff?
“A series of letters that Altria submitted to the F.D.A. as part of that process argues that the government should, effectively, sign off on the notion that smokeless tobacco products are less harmful than cigarettes — and that Altria and other companies should be allowed to market them as such to consumers,” says The New York Times. Not only would indoor smoking laws be bypassed, but just as in India, smokeless ‘candy’ would become popular with children and adults for whom smoking has become stigmatized. With Altria’s control of 55% of the smokeless tobacco market, and its alignment with Kraft Foods, (not to mention its $11 million in bad debt,) it is counting on the ease of access to flavored smokeless products to improve its stagnant cigarette sales and bottom line.
In The New York Times, Christopher Growe, an analyst at Stifel Nicolaus, the investment bank, says smokeless could be a business with strong potential growth for Altria. “There’s an opportunity that, in the long run, the F.D.A. could treat smokeless tobacco differently than cigarettes,” he says. (1) Even without glitzy ads, sponsorships, shiny packaging and the sweetening up of the poison, in the U.S., smokeless tobacco use is growing amongst high school teens. For Altria, repackaging is only the beginning – in its appeal to the FDA, it is seeking to have its ‘American gutka’ designated as safe as smoking cessation products.
“They’re clearly trying to make the product more palatable and more appealing to a broad audience,” says James F. Pankow, a professor of chemistry and engineering at Portland State University in Oregon who was a researcher involved in preparing the journal report. (2)
That audience, public health experts say, includes children. “The flavors are designed to attract kids,” says Kenneth E. Warner, dean of the University of Michigan School of Public Health and a founding director of its Tobacco Research Network. (3) The Journal of Immigrant and Minority Health states that use by immigrants is on the rise. “Smokeless tobacco prevention and cessation research and interventions have not yet addressed the unique sociocultural circumstances of this growing, at-risk community. The medical, dental, and public health communities need to join forces to combat this emerging threat.”
Let India’s lessons teach America. Before our children’s mouths, jaws and lives are destroyed by a deadly toxin masquerading as candy, write the President, your Senator, and please write the FDA at http://www.fda.gov/AboutFDA/ContactFDA/default.htm.
Material from this piece also came from The New York Times, August 13, 2002 “Sweet But Deadly Addiction Is Seizing Young In India” and February 2, 2010 “Where There’s No Smoke, Altria Hopes There’s Fire