Sir, tobacco use is one of the major preventable causes of health damage and death in India. It is estimated that tobacco will kill 6 million people annually from 2010, 80% of which will happen in low and middle income countries like India.1 The most susceptible age for initiating tobacco use in India is during adolescence and early childhood with most users starting use before the age of 18 years, while some start as young as ten years. Studies show that if people do not begin to use tobacco during adolescence, there is a good chance they never will. Each day about 5,500 children in India start using tobacco and join about 5 million children under the age of 15 years who are already addicted to tobacco. Adolescent tobacco use is characterised by being driven by relationships, activities, positive and negative emotions and social ramifications while adult tobacco use is defined by nicotine dependence.

According to the Global Youth Tobacco Survey (GYTS) (2000-2004) including students from grades 8-10 in India, 17.5% were current users of tobacco in any form, 14.6% were using smokeless tobacco and 8.3% were current smokers.2,3,4 The survey reported the misconception in many youths that smoking is good for teeth and health and nearly half of smokeless tobacco users needed the tobacco first thing in the morning. The survey also reported that 68.5% of students who smoked wanted to stop and 71.4% had tried during the past year. This is a strong indicator of common quit attempts in youths and they should be provided with help to quit.

Dentists and other oral health professionals are recognised as ideally positioned to counsel against the use of tobacco products and should be encouraged to do so in India and other low and middle income countries.