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iii) Economics of Tobacco in India by Voluntary Health. 

                iv)    Article on Cancer Mortality in India




                                                       
                v)     World Health Organisation's Monographs on evaluation of
                       carcinogenic risks to humans

                vi)    Review of Areca nut and tobacco use in Pacific-A technical




                                            
                       report

                vii)

27. By an order dated 7 December 2010 in SLP No. 16308 of 2007 (Ankur Gutka v. Asthama Care Society & Ors.), the Supreme Court had directed the Central Government "to undertake a comprehensive analysis and study of the contents of gutka, tobacco, pan masala and similar articles manufactured in the country, and harmful effects of consumption of such articles." The Report of National Institute of Health and Family Welfare submitted, pursuant to the above analysis and study, reveals that more than one-third of adults in India use tobacco in some or other form, more than 16 crore people are users of only smokeless tobacco and 4 crore people are users of both smoking and smokeless tobacco. Several studies in India have reported SRK 25 of 48 wp-1631-12-19.9.12-FINAL.sxw a strong association between smokeless tobacco use and oral pre-malignant / pre-cancerous lasions. The risk increases with the duration and frequency of smokeless tobacco use. There are consistent results of an increased risk of oral cancer with the use of different forms of smokeless tobacco used in the country. There is also strong association between smokeless tobacco and pancreatic cancer, throat cancer, oesophagal cancer, renal cancer and higher mortality rate. The use of smokeless tobacco also causes non-cancerous diseases/ conditions including nervous system diseases, metabolic abnormalities, reproductive complications and other diseases like gastrointestinal and respiratory diseases The study further reveals that areca nut or supari causes harmful effects like oral pre-malignant lasions, oral cancer, throat cancer, oesophagal cancer, liver cancer and non-cancerous diseases/conditions like hypertension and cardiovascular diseases, nervous system disease, metabolic abnormalities, reproductive abnormalities, liver and kidney diseases.

35. It is an admitted position that pan masalas being manufactured by the petitioners contain magnesium carbonate. It is specifically urged in paras 2.3.2 and 2.3.3 of the petitions (W.P. No. 1631 to 1635 of 2012) that magnesium carbonates occurs naturally in tobacco, lime, arecanut and cardamom and that therefore, pan masala necessarily contains magnesium carbonate.

36. Dealing with the above submission of the petitioners, the Joint Food Commissioner has pointed out in his affidavit dated 14 August 2012 that "lime does not contain magnesium carbonate and that the magnesium carbonate in betel nut and lime is in miniscule scale. Betel nut does not contain SRK 31 of 48 wp-1631-12-19.9.12-FINAL.sxw carbonate but it only contains inherent and natural magnesium which is 2.8 nanogram per gram dry weight. The exact percentage of magnesium in betel nut/areca nut and slaked lime and catechu is as under:-

37. We may also refer to the report placed by the intervenor on record wherein the survey indicates that out of 3896 children surveyed, 1054 children take areca nut and that 854 out of them use sweetened areca nut and that only 36 children used unsweetened betel nut alone. Most of the children used one packet of areca nut per day. The average age at which the people start consumption of gutka and pan masala is 17 years. It is also found that those who chew areca nut were not aware of the health hazard. Out of the school children chewing areca nut, 19% claimed it to be harmless and 70% did not know about the health hazard. Only 10% were aware about the health hazard of chewing areca nut. It is, thus, clear that in Ghodawat case, the material SRK 32 of 48 wp-1631-12-19.9.12-FINAL.sxw about harmful effects of magnesium carbonate and the large scale on which it is being consumed and the fact that people and particularly children are unaware of health hazards does not appear to have been brought to the notice of the Supreme Court. In fact, the Supreme Court had indicated that if magnesium carbonate had injurious effect on health, it could be prohibited.