Nagpur: Kharra, a tobacco product commonly sold, is hardly highlighted in the national policies concerning restriction on the sale of tobacco outside educational institutes. “India is a global leader in making policies but not implementing them. Despite rules, we have paan stalls right outside schools and colleges, said Dr Stuti Bhargava, assistant professor of Oral Medicine and Radiology at VSPM Dental College.Dr Bhargava was invited for World Cancer Congress held recently at Kuala Lumpur, Malaysia, where she emphasized the need for structured awareness and prevention of programmes to meet the enormous challenge of cancer control in mid and low income regions.A fellow of Cancer Awareness Fellowship Programme, National Institute of Health, USA, Dr Bhargava said, “A general awareness exists about association of tobacco with cancer but at the same time this is riddled with many misconceptions. Awareness about other forms of cancers such as cervical and breast and their causative factors is even lesser.”It is assumed that smokeless tobacco and other products such as supari or betel nut are harmless, she said, adding, “In theatres, the screens flash messages all the time about tobacco being harmful. It is creating desensitization through repetition.” Re-designed public service announcements, which are not boring or repetitive, will provide a better result, she observed.The challenge of cancer in India differs from international disease and lifestyle patters and programs are to be developed according to local needs. Talking of probable solutions, she shared, “Identification of gaps in existing policies, their stringent implementation and routine revision, need of trained manpower for tobacco cessation counselling, awareness programs including pre-cancer awareness are some ways to tackle the challenge.”There is no public awareness about pre-cancer, especially oral pre-cancer which can be easily identified by the patient themselves and help in early detection and prevention.Oral Cancer is among the top three cancers in India, number one among all cancers in men and number three among female cancers (breast cancer and cervical cancer are the other most prevalent cancers).

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