Consultant Oncologist
Govt T.D.Medical College Hospital, Alappuzha




FAQ ( Frequently Asked Questions)

1. What is smokeless tobacco?

  • Smokeless tobacco is of two forms: snuff and chewing tobacco.
  • Snuff is fine grain tobacco, users pinch or dip between lip and gum
  • Chewing tobacco comes as tobacco leaves.
  • Smokeless tobacco is as dangerous as ’smoking’ tobacco and contains even more additive chemical nicotine.

2. What is passive or second hand smoke?

  • Second hand smoking is a combination of smoke that smokers exhale (mainstream smoke) and the smoke coming out from the cigarette or pipe (side stream smoke)

3. Is second hand smoke hazardous?

  • Yes, it is dangerous. It causes diseases and premature death in nonsmokers.
  • Pregnant women exposed to secondhand smoke have low birth weight babies.
  • Children exposed to secondhand smoke has respiratory diseases like bronchitis, wheeze etc; and growth retardation

So when a person smokes he kills himself, his family and friends (who may be non-smokers).

4. What is smoking addiction or dependence

  • Uncontrollable dependence on tobacco (cigarette) to the point where stopped smoking would cause severe emotional, mental, or physical reactions.
  • Nicotine present in tobacco absorbed quickly into the blood which enters brain and brings about psychoactive changes.
  • Addiction similar to that of cocaine or heroin occurs

5. Is there any safe tobacco product?

  • There is no tobacco product which is “safe”.

6. What all health problems are caused by tobacco?

  • Tobacco harms almost all the organs, causing many diseases and reducing the health of smokers
  • Respiratory diseases- chronic obstructive pulmonary diseases, acute respiratory illness, decreased lung function, worsening of asthma.
  • Heart and blood vessel- Coronary heart disease, early myocardial infarction (heart attacks), stroke, aneurysm, gangrene etc;
  • Cancer and precancerous lesion. (a variety of cancers as discussed above have strong association with tobacco use)
  • Cataract
  • Reproductive disease- Infertility, sudden infant death syndrome, fetal death and growth retardation, preterm delivery, low birth weight babies
  • Peptic ulcer disease
  • Low bone density, increased fractures
  • Premature death
  • Diminished health status, delayed wound healing
  • Non healing ulcers
  • Infection and decay of gum
  • Increased risk of death- 40-80% higher relative risk of death for any type of tobacco use.
  • Overall, smoking causes about 700,000 deaths per year in India.
  • Affects mental health.

7. Will smoking affect sex& reproduction?

  • Tobacco can cause erectile dysfunction or even impotence
  • Men who smoke have lower sperm count and poor sperm quality than non smokers.


8. What is premalignant lesion? What is its significance?

  • Tobacco is associated with certain oral precancerous lesions in the oral cavity which may in future turn malignant
  • Leukoplakia is white patch in the oral cavity which cannot be scraped off. All white patches in oral mucosa are not premalignant. Leukoplakia is the most common precancerous lesion associated with tobacco use.
  • Erythroplakia is reddish patch in the oral cavity. It is premalignant.
  • Oral sub mucous fibrosis (loss of smoothness of the mucosa of tongue and oral cavity) is increasingly seen in youth in India due to the use of gutka and paan masala.

9. What all are the dangerous or warning signs of cancer?

  • Non healing persisting ulcerative lesion in oral cavity
  • White or reddish patch in mouth (Leukoplakia & erythroplakia)
  • Prolonged voice change (hoarseness)
  • Prolonged fever not responding to usual treatment and no other cause found.
  • Sudden unaccountable loss of weight
  • Premenopausal bleeding per vagina
  • Hematuria (blood in urine) were other causes ruled out
  • Chronic cough and hemoptysis (spitting blood) not responding to usual treatment
  • Dysphagia (difficulty in swallowing)
  • Restricted movement of jaw and tongue.

10. What all things we can do to prevent cancer?

  • Avoid tobacco use and quit smoking
  • Eat plenty of fresh fruits and fiber rich food
  • Limit use of fat and oily foods
  • Regular exercise
  • Practice oral hygiene and regular dental checkups.
  • Practice safe and hygienic sex
  • Any unusual body changes and symptoms must be reported to your physician. Do not postpone medical care and follow medical advice.

11. Does quitting of smoking possible?

  • Yes it is possible. Nothing is impossible. After all it is your need and a powerful mind. Meet your doctor he will help you to quit smoking.
  • Earlier the best.

12. What is the penalty against smoking in public places?

  • Offences would be made compoundable with a fine of up to Rs.200/-