LAUSR

Background: Cancer incidence in northeast India including Assam state is higher than the Indian national average. The incidence of hypopharyngeal cancer mainly pyriform sinus is high in (14.7/100,000) Assam and other northeastern state like Meghalaya (East Khasi Hills). Recently published Global Adult Tobacco Survey (GATS 2) report has shown that there is a decrease in tobacco consumption in India from 34.6% to 28.6%. However, in Assam the rate has increased from 39.3% to 48.2% mainly in the form of smokeless tobacco. Cigarette smoker reduce from 8.8% (GATS 1, 2009-10) to 6.1% (GATS 2, 2017), but smokeless users increase from 32.7% (GATS 1, 2009-10) to 41.7% (GATS 2, 2017). By now in India we only have gutka and pan masala (Prohibition) act 2015, by which there is ban on gutka but not other smokeless tobacco product. Because of COTPA (Cigarettes-and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, there is reduction of smo...