NEW DELHI, OCT 29 (PTI): Tackling tobacco dependence through sustained cessation support, alongside controlling high blood pressure, is crucial to reducing India’s stroke burden, experts said on the eve of World Stroke Day, calling for a stronger public-health response that goes beyond awareness campaigns.
A 2024 analysis of Global Burden of Disease data estimated that tobacco use contributed to 12 per cent of stroke deaths in India, while high systolic blood pressure accounted for 56 per cent, highlighting the need to address multiple risk factors through prevention and timely intervention.
“We cannot keep telling people to quit and assume the problem is solved. Nicotine dependence can make quitting difficult, even when people understand the health risks. With the burden of tobacco-related diseases continuing to pose a serious public-health challenge, we need to act now,” Dr Yashpal Singh Bundela, Director of Neurosurgery and Neurosciences at Medanta Super Speciality Hospital, Noida, said.
Bundela said that helping people stop smoking must remain the priority, supported by practical, sustained cessation services and access to clinically established aids such as nicotine replacement therapy (NRT).
The World Health Organisation estimates that tobacco use accounts for nearly 1.35 million deaths annually in India. The country’s tobacco consumption extends beyond cigarettes to bidis and smokeless products such as khaini, gutkha and zarda, requiring cessation strategies tailored to different patterns of use.
Experts said nicotine dependence should be treated as a public-health challenge rather than merely a matter of individual willpower.
They argue that smoking can contribute to stroke by affecting blood vessels and promoting processes that increase the likelihood of blood clots.
Bundela said access to cessation services, including counselling and clinically established treatments, should be strengthened to help tobacco users quit and prevent relapse.
He said that public-health efforts must also focus on preventing tobacco initiation, particularly among young people, while improving awareness of the link between tobacco use and cardiovascular disease.
International experiences could offer lessons for India, but experts cautioned that changes in tobacco-use patterns should be assessed carefully before drawing conclusions about their health impact.
A nationally representative Japanese study published in 2026 found that cigarette use among people aged 15-64 declined from 20.7 per cent in 2017 to 12.3 per cent in 2025, while heated tobacco use increased from 5.3 per cent to 11.7 per cent. Overall tobacco-product use declined more modestly, while dual use increased.
The findings do not establish that the rise in heated tobacco use caused cigarette smoking to decline or reduced long-term cardiovascular and stroke risks.
Dr Sonia Lal Gupta, Senior Consultant Neurology and Joint Managing Director, Metro Group of Hospitals, said stroke, once widely perceived as a medical emergency primarily affecting older adults, was increasingly becoming a concern for younger populations as well.
She warned that uncontrolled hypertension, diabetes, obesity, smoking, sedentary lifestyles and delayed recognition of symptoms can significantly increase the risk of stroke.
Experts highlighted the urgent need for greater public awareness, early identification of warning signs and timely access to emergency treatment.
“A stroke occurs when blood supply to a part of the brain is interrupted due to a blocked blood vessel or bleeding in the brain. Without adequate blood flow, brain cells can begin suffering damage within minutes. Although the risk increases with age, stroke can occur at any stage of adulthood, making awareness equally important for younger individuals,” Gupta said.
Medical experts point out that one of the biggest challenges in stroke management is the failure to recognise symptoms immediately.
“Sudden facial drooping, weakness in one arm, difficulty speaking, loss of balance or unexpected vision problems are often dismissed as temporary discomfort. Such delays can reduce the chances of receiving time-sensitive treatment,” she said.
Dr Vikas Mittal, Director of the Department of Respiratory Medicine at C K Birla Hospital, Punjabi Bagh, said, “Improving public health requires us to look beyond conventional approaches to tobacco control and learn from the experiences of countries that have made progress in reducing tobacco use.”
“India must have an open, evidence-based discussion on whether a complete ban on tobacco or newer, more effective approaches to prevention and cessation could deliver better public-health outcomes,” he added.
The priority must be to reduce tobacco consumption, prevent young people from starting, and make it easier for people who use tobacco to quit, Mittal emphasised.
“ Ultimately, our approach should be guided by one measure: what works best to protect public health and reduce the burden of tobacco-related diseases, including stroke and cardiovascular disease.”
Dr Awadh Kishor Pandit, Additional Professor of Neurology, AIIMS-Delhi, said stroke prevention must also include early identification and effective management of hypertension, diabetes and other cardiovascular risk factors, alongside tobacco cessation.
“People should not wait for symptoms to appear before taking preventive action. Regular blood pressure checks, adherence to prescribed medication, physical activity and a balanced diet can help reduce stroke risk. Tobacco users should be encouraged to seek professional support to quit rather than rely on repeated attempts without assistance. A comprehensive approach combining individual risk assessment, sustained cessation services and population-level prevention measures is essential to reducing avoidable strokes and their long-term consequences,” he said.
He stressed that preventing tobacco-related disease requires sustained efforts to discourage tobacco use, support people seeking to quit and address other established risk factors, particularly high blood pressure.
Pandit said evidence-based interventions and accessible healthcare services would be essential to reducing India’s stroke burden.
Thursday, October 29, 2026