India also has one of the highest rates of oral cancer in the world, partly attributed to high prevalence of tobacco chewing.

"In all 50 percent of the cancers in India are directly or indirectly related to tobacco consumption," said Sudhir Khandelwal, Head of Psychiatric department, All India Institute of Medical Sciences (AIIMS).
Khandelwal, also the Chief of National Drug Dependence Treatment Center at AIIMS, said, "There are several myths because of which people start consuming tobacco and slowly get addicted to it ending up ruining their life." Noting several myths as the prime reason behind youngsters picking-up smoking or consumption of tobacco in other forms. Khandelwal said many people were under the wrong perception that consuming less amount of tobacco would not cause any damage.
"Every form of tobacco consumption such as gutka, inhaling and the paan causes the same damage that chewing tobacco does. Slowly and slowly there comes a time when people get addicted to it," he said, adding that the youth consuming tobacco in any indirect form was more likely to get into active consumption of tobacco with time.
Sonali Jhanjee, Additional Professor of the Psychiatric Department, said the disturbing trend as earlier age of initiation leads to higher chances of getting addicted to tobacco and greater health damage in the longer term.
The Global Youth Tobacco Survey stated that in India the percentage of students who initiated bidi smoking before 10 years of age has increased from 26 percent to 45 percent.
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She added that the tobacco addiction was now recognized as a chronic medical illness on the same lines as hypertension and asthma. "Treatment in the form of both medicines and counseling is available to treat tobacco use and a psychiatrist may be approached for the same in both government or private setting," she said.
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