Even when the ill-effects of alcoholism and consumption of deadly tobacco products are very well evident in our society, citizens continue to reel under the menace of these silent killers.

Commercialism, it seems, has overtaken health interests. The lackadaisical attitude of the people and the administration in particular leaves no doubt that we are not serious at all about this menace which is going to hit us in the long run if steps are not taken now.

We are seeing more of the young addicted to alcohol, drugs and tobacco. Usually, tobacco use is combined with alcoholism or recreational drug abuse.

Unfortunately, data has not been properly documented and no studies have been conducted in this regard except by the Ladakh Institute of Prevention (LIP) under which Ladakh action on smoking and health (LASH) came into being on August 31, 1986.This anti-smoking campaign in the last two-and-a- half decades has achieved formidable success in reducing the prevalence of tobacco smoking adult Ladakhi men from 42% in 1988 to 7.8% in November 2009.

In the year 1986, we had 42% smokers, 36%  non-smokers, 22% ex-smoker. In 1989, 23% smokers, 49% non-smokers and 28% ex-smokers. In 1995, 28% smokers and in 2009, 4.59% smokers, 94.19 %  non-smokers and 1.23% ex-smokers.

Adolescent smoking in 1995 in three public schools survey indicated that by 18 years of age 1 in every 3 boys have experimented with smoking, 1 in 9 boys have smoked at least once a week for three months,1 in 10 boys smoked regularly and 28 % of their fathers were smokers.

Regarding alcohol, it was found that 17.1% of the rural population consumed alcohol, mainly home brewed Chang (about 9-10g alcohol per day) as against 3.5% of urban population. In a study of typical Ladakhi village (Domkhar, 2009) mean SGPT level (liver enzyme) of 306 subjects studied was found to be elevated (44 units/l). HBsAg was found to be positive in 5.7% of the Ladakhi rural population as against 1.6% of urban population. It is, therefore, not surprising that cirrhosis and cancer of the liver is the commonest killer disease in both men and women in Ladakh.

We need to do a thorough study of the changes that have taken place in the last six years. Most of the youngsters start taking alcohol just for fun or under the excuse of being sociable. Many are drawn by peer pressure of friends and relatives. Many adolescents consider under-age drinking a rite of passage to adulthood. Little do they know that they are spoiling some active and vital years of their life.

Restricting easy availability of liquor, demand-reduction programmes and the starting of more counseling arrangements, treatment and rehabilitation centres are the three most effective strategies to counter alcoholism in any society.

The task is indeed made more difficult when smoking and tobacco products already have a firm grip on the public imagination. 

In this issue, the cartoonist tells the readers about the present scenario in Ladakh. Several groups are shown protesting and demand to reduce alcohol and tobacco consumption in society.

But one of the characters is skeptical about the fact whether it will be successful or not in the long run. If not, what is the solution? He wonders and asks the uncle about it. The uncle says it is bad in every sense, and says, “Prevention is better than cure.” The need of the hour is to see that all the concerned people should work together and be determined to get rid of these social evils, forever.