Cricket, Bollywood, and oral cancer: They’ve all got one thing in common in India!

The slow-motion replay of Jaiswal’s ensured no one missed the gutka brand making an appearance in the background.

That Leap. That Celebration. That Special Feeling 👏 👏

Here’s how Yashasvi Jaiswal notched up his Double Hundred 🎥 🔽

Follow the match ▶️ https://t.co/X85JZGt0EV#TeamIndia | #INDvENG | @ybj_19 | @IDFCFIRSTBank pic.twitter.com/CUiikvbQqa

— BCCI (@BCCI) February 3, 2024

A photograph the Board of Control for Cricket in India, the BCCI, shared of the batter’s jubilation also showcased two gutka brands in the background.

150 up for Yashasvi Jaiswal 🙌🙌

Live – https://t.co/Ne2d0hI6QB #INDvENG@IDFCFIRSTBank pic.twitter.com/MxgKSpPQ18

— BCCI (@BCCI) February 2, 2024

Gutka is commonly used in India, Pakistan, and other Asian countries.

It is chewing tobacco made of crushed areca nut (also called betel nut), tobacco, catechu (an acacia extract), paraffin wax, slaked lime (calcium hydroxide), and sweet or savoury flavourings.

Spices such as mustard, turmeric, anise seeds, cardamom, saffron, and cloves may also be added. Gutka is consumed by placing a pinch of it between the gum and cheek, and gently chewing and sucking the juice.

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The chewing stars

Former cricketers like Virendra Sehwag, Sunil Gavaskar, and Kapil Dev, and Bollywood stars Amitabh Bachchan, Shah Rukh Khan, Ajay Devgan, and Akshay Kumar, too, indirectly promote these gutka brands.

The advertisements are not for gutka, but promoting cardamom. However, they carry the same brand name, and in the market, they are sold as gutka.

Advertisers resort to surrogacy since tobacco and alcohol advertisements are banned in the country. So these brands use stars to advertise their brand of gutka as cardamom or some other product.

Surrogate advertising is a practice where a brand promotes a different product or service as a means to indirectly promote a product that may be banned or restricted by law or regulations.

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Multiple avatars 

The gutka brands use surrogate advertising by promoting a “mouth freshener” or “herbal product” under a similar or the same brand name.

This is done to maintain brand visibility and recognition, while complying with laws that restrict or ban the direct advertising of tobacco products.

On the other hand, these products — gutkas — are highly addictive and carcinogenic, making them responsible for oral cancer and other severe negative health effects.

Interestingly, states in India started prohibiting gutka in 2012, and by the end of 2013, it was banned nationwide. But it’s easily available in any nearby shop.

The surrogate advertisements during the telecast of games not only promote the sale of these products but also kill thousands of Indians as well as burdening lakhs of poor with hefty medical bills.

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‘Promoting death’

In 2022, a staggering 1,99,65,054 cancer cases were reported worldwide, resulting in 97,36,520 tragic deaths. The most prevalent types of cancer globally include lung, breast, and colorectal cancers. Lung, colorectal, and liver cancers top the list in terms of fatalities.

Surprisingly, in India, which documented 14,13,316 cancer cases and 9,16,827 cancer-related deaths, a specific type of cancer, less common on a global scale, emerges as a major concern.

Lip and oral cavity cancer ranks second — behind breast cancer — among prevalent cancers in India. In 2022 alone, 1,43,759 cases and 79,979 deaths were reported.

Chewing of tobacco and pan often manifests as ulcerative lesions, initially presenting with pain.

“Unfortunately, individuals might tend to neglect these early signs, allowing the lesions to grow. If not addressed promptly, these ulcers can develop into more severe conditions, potentially spreading to the neck and even the lungs,” Dr L Rohit Reddy, Consultant Medical Oncologist & Hemato-oncologist at Yashoda Hospitals in Hyderabad, told South First.

“Primarily, oral cancer is associated with habits such as tobacco chewing and the use of gutka. In the case of gutka, individuals place them inside their mouths. This involves holding it with the thumb under the lip. In the past, chewing tobacco leaves and betel nuts were prevalent. The process involved crushing the betel nut leaves and placing them in the mouth, typically between the lip and the lower gum. Cheek cancers were then more common,” Dr AN Vaidhyswaran, Director and Senior Consultant Radiation Oncologist at Kauvery Hospital in Chennai, told South First.

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Invitation to lip cancer

Dr Vaidhyswaran added that in the present scenario, placing a pan or gutka under the lip can lead to lip cancer. Gingival cancers, especially in the lower gingiva (gums), are also prevalent due to the common practice of placing it under the tongue.

“This becomes evident when individuals speak, as they tend to keep it under the lip, contributing to the higher incidence of lip cancer. Overall, oral cancers, including those affecting the head and throat, are more common due to persistent chewing habits,” Dr Vaidhyswaran said.

Lip cancer affects the skin of the lips, primarily the lower lip, and is mostly identified as squamous cell carcinomas originating from the thin, flat cells in the skin’s middle and outer layers.

Oral cavity cancer encompasses cancers occurring in the mouth, including the lips, inside the lining of the lips and cheeks (buccal mucosa), teeth, gums, front two-thirds of the tongue, the floor of the mouth beneath the tongue, and the bony roof of the mouth (hard palate).

The majority of oral cavity and oropharynx cancers are squamous cell carcinomas, originating from the thin, flat squamous cells in these areas.

“Apart from smokeless tobacco, Human Papillomavirus and certain genetic predispositions are also responsible for this lip and oral cavity cancer,” Dr Reddy said.

He added that smokeless tobacco not only causes lip and oral cavity cancer but also oesophagus, stomach, kidney, and intestine cancers as well.

Bolo Zubaan Cancery! pic.twitter.com/I97YZssz9t

— India in Pixels by Ashris (@indiainpixels) October 15, 2023

Also Read: Does tobacco cause cancer in all?

Why do people consume smokeless tobacco?

When an individual chews gutka, the mixture is directly absorbed into the body through the oral cavity. Upon mixing with saliva, it turns a deep red colour and can produce a more intense “hit”.

“This can lead to a false sense of well-being, euphoria, a warm sensation in the body, sweating, increased salivation, palpitations, heightened alertness, tolerance to hunger, and increased capacity and stamina to work,” Dr Rajesh Sharma, Health Economist from National Institute of Technology Kurukshetra, told South First.

He added that when a person is working in brick kilns or similar tough environments where the worker has to suppress the urge to eat food for hours, he consumes gutka. It is easily available and can give a euphoria and tolerance to hunger. Gutka is mostly consumed by lower middle-class or lower-class people.

“One watches their idols, such as cricket stars and Bollywood stars promoting these gutka brands and thinks that they also consume it. That’s the aspiration of low literate, low-income people. And, they consume it. It’s not only bringing death to the people, but also burdening the health infrastructure of the country,” Dr Sharma said.

Dr Vaidhyswaran added that smokeless tobacco advertisements cleverly navigate around the restrictions, promoting a different product while indirectly promoting their tobacco-related products.

“Regulating these advertising practices poses a challenge. Advertisers find ways to circumvent restrictions, making it difficult to prevent them from promoting tobacco-related products under the guise of something else. It becomes a complex issue, especially considering the powerful lobby supporting the tobacco industry,” Dr Vaidhyswaran further stated.

He added that as a doctor, he is aware of the health risks associated with tobacco, but addressing this issue is beyond his purview.

“It’s up to the policymakers. Despite the complexities, the bottom line remains simple: Tobacco is carcinogenic. Individuals must make informed choices and avoid the health risks associated with tobacco consumption,” he added.