Sir, Why this Foot-Dragging on Banning Gutka?

A Cancer Surgeon’s Open Letter to CM Akhilesh Yadav…


Shri Akhilesh Yadav

Chief Minister of Uttar Pradesh

Fifth Floor, Lal Bahadur Shastri Bhawan,

Uttar Pradesh Secretariat, Lucknow.

Dear Akhilesh ji,

Greetings. At the outset, let me congratulate you for being the youngest Chief Minister of Uttar Pradesh, and probably the youngest CM in the whole country. The eyes of the entire nation are on you. We have high hopes that during your rule, the government of Uttar Pradesh will be progressive and dynamic, as befits your youthful personality.

I humbly introduce myself as a Consultant Surgeon at Tata Memorial Hospital in Mumbai – a hospital renowned for diagnosis and treatment of cancer. Every Tuesday and Thursday, I examine dozens of new patients waiting for admission. I am saddened to see among them a very large proportion of people who have contracted cancer of the mouth or throat because of their addiction to tobacco in its various forms.

These patients come from various states all over India. But I wish to tell you with great sadness that a very large proportion of them come from your state. In the last couple of weeks, about 5 out of 20 cancer patients were from the proud state of Uttar Pradesh.

Allow me to introduce them to you:

Rajkamal Prajapat – Jalaon Dist, Orai, UP

1) Sir, this is 28-year-old Rajkamal Prajapati of Orai, near District Jalaon, UP. He was addicted to both gutka and cigarettes. To save his life from the spreading cancer, part of his tongue and inner parts of his lower jaw were removed on 28th August.

Rakesh Ranjan Singh – Jaunpur, UP

2) Rakesh Ranjan Singh of Jaunpur is a 47-year-old school teacher and father of two. He was diagnosed with cancer of the cheek. Today, he can’t even open his mouth sufficiently to insert a finger. So he eats roti and milk ground up in a mixer, using a spoon and fingers to pry open his mouth. As his cancer is at an advanced stage, surgery may not be useful for saving his life. He tells us that a few months ago, his pan-chewing friend was operated in Banaras for cancer.

Mohammad Azazur Rahman of Uttar Pradesh’s Basti District

3) The lips of 51-year-old Mohammad Azazur Rahman of Uttar Pradesh’s Basti district constantly tremble. He is qualified as an electrical engineer and works for the municipality. Despite the advanced cancer of mouth and cheek that is visible, he continues to smoke 10 Pehelwan chhap bidis a day, and finds himself helpless to quit his addiction to tobacco.

Major Janardhan Lal Srivastav – Maharajganj dist UP

4) Retired Major Janardhan Lal Srivastav, age 62, is jilla adhyaksh (district president) of Lok Dal in Maharajganj district. In mid-August 2012, after he developed a hoarse voice, a cancerous tumour was detected at the back of his mouth. Still, he habitually continues to smoke 5-6 cigarettes per day.

Dinesh Chand Sharma – Bawar, Mainpuri Dist UP

5) Dinesh Chand Sharma, aged 42, hails from Bawar, Mainpuri district in UP. He is a motorcycle mechanic and garage owner, and fond of eating khaini – a tobacco and lime mixture. He started eating this only two years ago, and that too only 2-3 times in the evening. Unfortunately, 8 months after he started having khaini, a small tumour appeared on the inside of his cheek where he kept the tobacco quid. Now this cancer is fast spreading on his tongue, and he has great difficulty speaking clearly. Surgical removal of his tongue is a distinct possibility that looms before our team of doctors and surgeons.


Sir, my colleagues and I could introduce you to many more patients who come to Tata Memorial Hospital from Uttar Pradesh every week. But I hope these five will suffice.

Responding to the urgency of this matter, no less than 13 states have recently banned Gutka and Pan Masala following directions issued by central government’s Health department. This includes Delhi, Madhya Pradesh, Kerala, Bihar, Maharashtra, Himachal Pradesh, Rajasthan, Haryana, Jharkhand, Chhattisgarh, Gujarat, Mizoram and Punjab, and the union territory of Chandigarh. Surely they are not all wrong?

The notification issued by Ministry of Health and Family Welfare (Food Safety and Standards Authority of India) on 1st August, 2011 is clear. It says, “Product not to contain any substance which may be injurious to health: Tobacco and nicotine shall not be used as ingredients in any food products.” Hence all smokeless tobacco products such as gutka, khaini, etc stand banned. This is as per Food Safety and Standards Act, 2006, and under the authority of Food Safety and Standards Authority of India, Ministry of Health.

The report submitted by the National Institute of Health and Family Welfare (NIHFW) to the Supreme Court gives evidence of fatal diseases caused in millions of people in India by the deceptively named “smokeless tobacco”. Please read this report:

Sir, You have the undisputed power and the mandate to implement this ban in Uttar Pradesh. But I am saddened to see that your government is wasting time debating whether Gutka and pan masala may be described as food. In the Godawat Pan Masala Case, the Supreme Court has stated that pan masala or Gutka is food. The high court of Kerala, Bihar and other states have also independently held that Gutka and pan masala are “food” as defined under this Act. Surely, all these learned judges cannot be wrong?

We will be saddened if the government of Uttar Pradesh is seen to care so little for its citizens that it drags its feet on a settled matter of law.

Akhilesh ji, while your FDA Commissioner and other bureaucrats engage in legal debates over imaginary issues, people in your state are dying. The tobacco industry is making lakhs of innocent people its addicts, leaving thousands of people crippled and disfigured after surgery, and killing hundreds. Every passing month, lives are lost and families are ruined.

Sir, Please don’t delay. Ban Gutka and Pan Masala now.

Yours Sincerely,

Dr. Pankaj Chaturvedi

Consultant Surgeon,

Tata Memorial Hospital, Mumbai


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