Even as lobbying continues to reduce pictorial warnings on tobacco products, data released by the Indian Council for Medical Research shows that tobacco-related cancers account for more than 50% of the cases among men in five major cancer treatment centres.

Cancers associated with the use of tobacco account for about 30% of the total estimated 13.8 lakh cancer cases in the country in 2015, the ICMR report said. The medical research body released the consolidated data from the National Cancer Registry, with both hospital-based and population-based data from 2012-'14. Around 14.5 lakh new cancer cases are expected in 2016, with the figure going up to 17.3 lakh in 2017.

The Union health and family welfare ministry had ordered that tobacco products carry pictorial warnings covering 85% of the display area of the packet. The industry was up in arms, with both bidi and cigarette makers stopping production for a few weeks. Among the many arguments made by the tobacco lobby, bidi labour unions claimed that bidi was less harmful than cigarettes.

According to the ICMR data, more than half of the cancers in males at the centres at Nagpur in Maharashtra, Cachar, Dibrugarh and Guwahati in Assam, and Kannur in Kerala, were in organs associated with the use of tobacco such as head, neck and lungs.

Onus on policy

Previously, too, there has been strong evidence of the link between cancer and tobacco products. In 2012, the Million Deaths Study which accessed data on cancer-based deaths, said that tobacco-related cancers represented 42% of the male deaths and 18.3% of the female cancer deaths.

“These figures reinforce the point that we have been making about tobacco control," said Sanjay Seth, from Voice of Tobacco Victims, a campaign that is putting tobacco victims at the forefront of the tobacco control movement in the country. "We need to redouble our efforts to push the government to implement tobacco control policies. The number of people dying is huge and prevention is the only way.”

Seth said that in places such as Goa where tobacco control is enforced, the incidence of cancer is lower. The prevalence of tobacco use in the state is about 9%, as opposed to the national average of 34%. “Goa has a school programme campaigning against the use of tobacco among children running for nearly 30 years, run by an organisation called National Organisation for Tobacco Eradication. That has had a huge impact,” said Seth.

Among males, cancer of the mouth, which is associated with chewing tobacco, is the highest in registries in western India, particularly in Maharashtra and Madhya Pradesh's capital Bhopal.

Most cancer patients sought diagnosis and treatment from the major cancer hospitals of the country only after the disease had spread or was in the advanced stages. The data showed that the overall proportion of patients detected with cancer at the early stage when the cancer is localised is only 12.5%.