Philippe Boucher's Rendez Vous Sharad Vaidya
Founder of the National Organization for Tobacco Eradication (Note) Goa, India
Rendez-vous with Sharad Vaidya
By Philippe Boucher
Tuesday, July 20 , 1999 Rendez-vous with Sharad Vaidya
Thank you Sharad for accepting our " rendez-vous ".
May I ask you to introduce yourself ? (and NOTE)
I am a surgeon (MS-Master of Surgery of University of Bombay) by training and practice. I am 63 years of age. My wife is a doctor and actively helps me in preparing the educational materials. My son Jayant was one who insisted that our organization should have the word "Eradication of Tobacco"
at the stage of naming the organization in 1992. Thus NOTE was launched and out of four alternates "National Organization for Tobacco Eradication"(NOTE India) was accepted by about 54 participants from all over India in a UICC workshop hosted by me in Goa.
I come from a family of doctors with a long history of 300 years practicing medicine and well known in Goa and beyond its borders for medical and social work. At present there are 20 doctors in the family of Vaidyas spread over different parts of India and abroad. Incidentally five of them are in the UK. My son, Jayant MS FRCS,DNB (firstname.lastname@example.org) is Honorary Lecturer doing his Ph.D in cancer surgery in University College London. He is actively involved in this campaign against tobacco.
With the above background I was groomed to go beyond the call of practice and vocation of surgery (by one of my late uncles- a surgeon) of just doing surgery and fill my coffers. After completing my Post-graduate degree in Surgery I worked as Asst. Prof of Surgery in Goa Medical College for 5 years. I resigned from the government service and founded the Goa Cancer Society in 1968, built a cancer hospital by collecting money and men and was its Executive Director till 1993. Now it has been handed over to a corporate Medical Educational Institution to run. I am a trustee of that Institution, but not actively engaged in day to day operations. All my work against tobacco and as founder of Goa Cancer Society and NOTE India has been without any remuneration.
Of the many awards, the one which I value most is WHO Gold medal awarded on 2nd World No-Tobacco Day in 1989 for my efforts for a Tobacco-Free Society. I have been WHO country representative for 3 Tobacco and Health International Conferences in Buenos Aires (Argentina), Paris (France) and Beijing (China), and presented my research work. I have been a WHO consultant on Tobacco Control for South East Asia Regions for policy formulation in Bangkok and Sri Lanka and many other meetings.
I was given a certificate of appreciation by Goa Government for the services rendered to Goa. This award was given at the hands of the President of India on 19 December, 1986 on the occasion of Silver Jubilee Celebrations of Goa Liberation.
I have been relentlessly campaigning against tobacco for the last 25 years. In 1993, I founded NOTE India. Now NOTE has chapters in 7 States in India and is represented in additional 7 States.
We successfully prevailed upon the President of India not to be the chief guest for the inauguration of WILLS World Cup 1996 in Calcutta.
About 30 of my anti-tobacco letters have been published in a national daily The Economic Times on economic issues from 1996-98.
I organized one day hunger-strike in five cities in September 1996 with Freedom Fighters of India aged 70 and above were sitting for the whole day without even water. Goa can be one shinning example how public participation has been generated in this fight.
In 1997 Goa Government. unanimously passed "The Goa Prohibition of Smoking and Spitting Bill No 22". I was one of the non official members on the select committee while the bill was piloted. This seems to be the direct result of 25 years of endeavor to make the society actively aware of the tobacco menace and pressurize the policy makers.
Q1: Children under 12 are often vehemently against tobacco as well as very afraid their parents could die from their smoking (or chewing). Is that why you rely on them as a medium to push the adults to quit?
I disagree with your presumption that children under 12 are often vehemently against tobacco. My observation is that with more than 50% of adult men and 20% adult women using tobacco a large majority of children are curious and would like to imitate the adults. They want to experiment with tobacco particularly if any elders in the family use tobacco.
We have found them listening with alertness if they are told to carry the anti-tobacco messages to their parents and elders. When they are told to carry the message they are keen to learn the adverse effects of tobacco. Direct 'preaching' is quite ineffective.
We had no intention to generate fear in the mind of the child. The generation of the fear may be spontaneous in response to our education. Secondly fear of death is an enigma in children's mind below the age of 10. When someone dies at home we tell the children that the person has gone to the home of God and may not return. However at a later age of 15-16 it is likely that the fear may crop up.
We have also stressed during the educational campaigns that the children should persuade the smoking (or chewing) parents to quit.
The message through the mouth of the child has a strong element of innocence, love and affection and comes from the heart. The persuasion by this message is much stronger than one by the doctor, which generally comes late in the day. The child is never tired of persuasion once it is convinced of the truth.
Q2. Can you give us some more precision about the curriculum you are using in Goa?
The curriculum during research setting.
We introduced 1 booklet for age group 10-12. This contained lots of pictures and preliminary knowledge about tobacco, particularly smokeless tobacco and its ill-effects.
For age group 12-16 a detailed booklet on similar lines was introduced entitled "Tobacco and its ill-effects" A second booklet of 4 dramas was introduced. The dramas were entitled and depicted "Imitation", "Giddiness"
(immediate effect of tobacco consumption) "Addiction" & "Cancer".
The plays were enacted by the school children with great enthusiasm during annual days and village festivals.
One comic book "Story of Missing Cigarettes" depicting children persuading their father to give up smoking was also introduced.
A lung model made of soft foam 'showing brown staining' of the lung after
"smoking" was introduced and the children were asked to experiment in the class room.
Videos depicting ills-effects of tobacco in a folkstyle called "Kirtan" were also shown in schools and villages.
About 900 teachers were trained to impart the above education and were provided with a Guide Book .
The Government since last 6 years has included in school diary annual
'National No Tobacco Day' on 11th October on lines similar to Independence Day. The students and teachers are thus engaged for about 6 months in preparing posters, placards, conducting rallies, enacting street plays, arrange talks by doctors etc during the scholastic year.
I call this a participatory and motivating curriculum.
The Goa University through its National Service Scheme- (wherein college students are engaged in social work and get credits for the hours of work they put in) has been active participant in our campaign for the last 20 years.
Q3. I read the impact of the children was that "18 per cent of their parents and teachers quit" and "cigarette consumption has fallen 30 per cent in Goa in the last decade". Can you tell us more about the results?
Data from 1990 to 1998 the per capita per year consumption of cigarettes has come down from 440 to 321.
In 1986 parents of 52% of school children were tobacco users. That has come down to 34% in 1998. The chewing habits have not shown the decline as in smoking. It is almost constant. about 10-11 % fathers and about 14% among mothers.
Q3b. I also wonder about the possible conflicts with irate smokers when you nag them about their habit? What about the kids whose parents do not quit, don't they feel they have "failed"?
When we introduced the booklets- we had some reports about irate parents tearing the books. But that hurt the child more. It had just the opposite effect. Some months later the books were accepted. Nagging by children has a gold-gilt of love. One cannot brush it aside easily.
Of course nothing is 100% in this world. Sometimes addiction may be stronger than the love. But it does register in the mind. Children do feel they have failed. We have found children asking us what they should do when the parents don't listen. Our answer was to continue your efforts very lovingly.
We have not done any study to find how many have failed. But results show that more have succeeded than failed.
We found this love and respect extended to the principal of a high school. This convent school Principal was a chain smoker. This school was one selected for research purposes.
After launching the program of education- the students on their own prepared placards. One day as the principal entered the class at 8.00 am. They all stood up and said "Good morning Sir" and sat down with their heads lowered in silence. He did not know what had happened. He asked " What is wrong, my children?"
Without uttering a word every child raised the placard in his/her hand. The placards read- "Sir, we love you" "Sir, we want you" "Sir tobacco causes cancer" "Sir, tobacco causes fatal heart attacks" "Sir, tobacco kills prematurely" and so on -about 40 of them in the class.
The Principal told us that he had no option but to quit and he kept his promise to the kids.
Q4. Often kids who are against smoking at 10, smoke at 15. Does your program make a difference later on, when kids are older?
This does happen and will happen to an extent. That is where a continuous relentless campaign is required. Our latest study of 1996 'Influence Of Sports Sponsorship by Cigarette Companies On Adolescent Mind A National Survey, India' after the WILLS WORLD Cup has shown that despite high degree of knowledge almost 95 knowing that tobacco causes cancer as high as 14 % of children between 13 and 16 in schools had experimented with tobacco as against only 7% among junior college students (17-18)who were exposed to a longer barrage of campaigns against tobacco. Knowledge of "Lowering of life span" seemed most to affect reduction of uptake at this age. However, thorough knowledge about ill effects of tobacco is a strong determinant -
only 5.4% of those who knew all the dangers smoked while 14.5% to 26.9% of those who did not have adequate knowledge. As the knowledge level decreased it went up to 41.9%.
Since the last three or four years college students on their own have been having programs such as street plays in the schools that feed the colleges. We are strengthening this strategy to deploy groups of college students to motivate the school children not to take up the habit. These College and University students have scripted their own dramas and go from school to school and create a further chain of such groups.
Q 5. Do you think such a program could work elsewhere, in other countries?
Why not? I think it can definitely work
Children are the same all over the world. The environment may be different. But parental, grandparental love is universal- at least till the age of 18. In less developed countries it might work better because individualism and revolt against family norms which the industry has been promoting in the west has not yet penetrated in the psyche of the youth in the developing world. Family is still a unit.
In addition, the only chance we have to stop the tobacco epidemic, apart from banning tobacco growing and selling, is to stop children from becoming addicts. Even if we are able to reduce the addiction rate by 25%, we will be saving 3,000,000 (yearly deaths due to tobacco) * 0.25 * 0.5 (half of those who use tobacco die from it) = 375,000 people from dying prematurely, every year. that is 30 times the number of yearly breast cancer deaths in the UK.
Do you have anything else you would like to add?
My philosophy is to get into niche of the minds of politicians and the society that just as we need to eradicate small pox, polio, measles etc, so also we must aim to eradicate the last of the tobacco plant from the face of this earth. We may keep a sample of the plant in a laboratory for the posterity to see and realise how uncivilized the 20th century global society was with all its scientific and technical advancement.
Now I have set the target before the educational institutions in Goa that by 2007 we should bring down the prevalence to tobacco use by less than 10%. I hope I will not be far away from my target. When you aim at Mars, you may land on the Moon. Thank you Philippe for this opportunity.
Thank you Sharad for taking the time to be with us today.
Prepared by Philippe Boucher mailto:IslandErsk@aol.com
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