Although women in Mizoram are literate enough to understand the ill effects of tobacco, a staggering 60 percent of them consume it in various forms making them the most cancer prone in the country.
Recent figures of the National Family Health Survey (NFHS) shows more than 22 percent Mizo women smoked against a national average of only 2.5 percent, said Jane R. Ralte, principal investigator of the state's Tobacco Cessation Centre.
"It is an alarming statistics," she said.
The reason is all too evident here. Apart from smoking and use of other tobacco products, a unique tobacco smoke-infused water is consumed extensively by Mizo women.
The product, called 'Tuibur', is made locally by passing smoke generated by burning tobacco through water until the preparation turns cognac in colour and has a pungent smell.
Besides this, 'Meizial', another local tobacco product, which comes in the form of 'beedis' (hand-rolled cigarettes), is also popular among women.
The Tobacco Cessation Centre assessed that the annual death rate among women who smoked in the age group of 45 to 74 years was twice as high as that of those who abstained from the habit.
Apart from 'Tuibur', tobacco chewing with betel nut and consumption of 'zarda' (a form of tobacco) are also prevalent among women in the state.
According to D. Baruah, additional director at the hospital and medical education department, community elders, especially in the remote areas of the state, still insisted that smoking was the best insect repellent and this encouraged women to smoke.
Interestingly, an estimated Rs.900,000 is spent every day by the Mizos for buying tobacco and other related products, revealed a survey by the Mizoram Presbyterian Kohhran (MPK), the largest Christian denomination.
"Tobacco users will be doubled if there is a full survey conducted across the state as the MPK represents just about 50 percent of the total population," said Baruah.
"I sell minimum 50 packs of cigarettes and 170 paans (betel leaves laced with tobacco) every day," said 18-year old Nancy Malsawmtluangi from Tuikual area in the capital who goes to different offices and sells various tobacco products.
A study by the Aizwal civil hospital and spearheaded by Eric Zomawia, a senior pathologist and principal investigator, also showed that the risk of stomach cancer among women was significantly prominent in the past three years due to extensive use of tobacco in various forms.
Mizo women also top the cancer list in the country, Zomawia added.
According to the report of the Development of Atlas of Cancer in India (DACI), Aizawl district has the highest Minimal Age Adjusted Incidence Rate (MAAR) - 209.2 - among all districts in India among women, followed by Serchhip district.
"MAAR is obtained by calculating new cancer cases detected in every 100,000 population per year and adjusting it against world standard population," Zomawia said.