The chewing disaster

Gutka, a bizarre mixture, has become a favourite pastime in underprivileged and middle class localities, mostly in Karachi, Hyderabad, Badin and Thatta. Betel quid with tobacco or without tobacco is widely used in the Indian subcontinent including Pakistan, India and Bangladesh.
It is also used throughout Asia and the Pacific region including Cambodia, China, Indonesia, Malaysia, Philippines, Taiwan, and Thailand. Global estimates report up to 600 million men and women use some variety of betel quid.
A research conducted by Parvez Ahmed Seehar of the Sindh Civil Services reveals that gutka is a preparation of crushed betel nut, tobacco and sweet or savoury flavourings that are used according to local preferences and customs. These include sweeteners, catechu, or spices such as cardamom, saffron, cloves, anise seeds, turmeric and mustard. Gutka can be found in a powdery, granular light brownish or white form that easily dissolves in the mouth and turns into a deep red colour within moments.
It contains tobacco with potent carcinogens including nitrosamines (nicotine), nitrosodiethanolamine, polycyclic aromatic hydrocarbons, nitrosoproline, polonium, thiocyanate, hydrogen cyanide, nicotine and netabolites.
Gutka has become common in the low-income group localities of Karachi, including Gadap, Lines Area and Kharadar.
Most people use gutka as a pastime, style as well intoxicant. Since culture is defined as adopting of a certain practice peculiar among the group or society having certain common characteristics, consuming gutka has also become a culture as it is evident from the research conducted through a random sampling survey in the Gadap village, where most of the people interviewed did not know the reasons for taking it.
A number of studies have been conducted to ascertain the motivation for using gutka and the demography where it is commonly used.
The findings of most of the studies support the proposition that it is being taken because of low price and easy accessibility. Some people also use it while suffering from depression and extreme frustration. The factors behind the use of gutka also include poverty, easy availability, cheapness, illiteracy, lack of awareness, non narcotic item, frustration and anomalies in law.
 According to gutka selling shopkeepers, there are about 122 brands of gutka available in different flavours in the market, including chocolate.
Those consuming betel quid or gutka term it as stimulant with relaxation effects.
Gutka consumption can causes dangerous diseases including mouth cancer and hypertension. These diseases are mainly common in the poor localities of urban and rural areas, where people consuming gutka are unaware of its consequences.
According to medical experts, gutka affects cardiac functions and causes liver cancer, throat cancer and GIT problems.
It also has a hazardous effect of pre-cancerous in the mouth, causing oral lesions and diseases including erythroplakia (a reddened patch in the mouth), leukoplakia (a white patch on the mucous membranes in the mouth that cannot be wiped off) and oral sub-mucous fibrosis (OSF) (a precancerous lesion that stiffens the soft pink tissue lining the inside of the mouth).
OSF may extend into the esophageal tract. OSF is a debilitating and irreversible condition that often results in an inability to open the mouth.
Gutka may also cause heart disease and fluctuation of blood pressure as well as palpitation and stroke. This affects cardiac functions, causing a heart attack.
Besides the physical damages to the body, gutka can also cause many psychological problems including confusion, impaired judgement, euphoria, altered brain chemistry, intoxication, dilated pupils, amnesia and psychosis.
From a societal perspective, gutka causes public nuisance and dirtiness. It has been observed that gutka users always spit over the roads and buildings.
Parvez Ahmed Seehar said that as far as government action is concerned, legislation against the use and spread of gutka is yet to see the light of the day.
Javed Ahmed, a resident of sector 5-A New Karachi, first brought the issue of gutka use and its adverse implications to the notice of the Provincial Ombudsman, especially with reference to presence of a gutka factory in his vicinity, which not only disseminated unhygienic fumes, but also spread gutka addiction among the youth of the area.
The Ombudsman advised the Sindh government to examine and issue a notification declaring gutka and supari as intoxicants within the meaning of ‘Prohibition of Hadd Order’. The home department prepared a summary for the chief minister along with a bill for consideration by the cabinet. The chief minister approved the summary for placing the bill before the cabinet.
According to deputy secretary of the Law Department, the treasury benches have not submitted any bill seeking a ban on gutka. However, one of the members of the provincial assembly submitted a private bill in 2006 that has not been taken up yet because the members of the House do not consider it as a priority issue.
According to legal experts, three sections of the Pakistan Penal Code – sections 269, 270 and 273 – deal with injurious substances.
The text of these provisions of law is as following:
Section 269 PPC – Negligent act likely to spread infection of diseases, dangerous to life.
Section 270 – Malignant act likely to spread infectious diseases, dangerous to life.
Section 273 – Sale of noxious food items.
There is an urgent need for public awareness, effective legislation and implementation against the sale and use of gutka, which is not only causing public nuisance, but also ruining lives with each passing day.