Gul(Chewing Tobacco) the Untold Horror Story of Rural Bengal

Estimated reading time: 2 minutes

The effect of chewing tobacco in women in West Bengal is an observational study.

It’s seen that the habit of Gul chewing is common in districts of Malda and Murshidabad. The effect includes foreign body sensation, persistent ear discharge in those with chronic otitis media, earache, reflux, headache, myalgia, low energy and overall malaise. On examination pallor, submucosal fibrosis, post nasal drip is common. There’s also an association with concurrent betel leaf, areca nut chewing with or without bidi(indigeneous cigarette) making habits.

The Gul habit appears either at a young age in presence of elder women in the family, or past middle ages when the women is a mother-in-law. The most common symptoms is usually that of persistent something stuck in throat syndrome which often causes distress at night especially after a heavy meal of meat and rice. This is often a symptom reported with chronic reflux, early supraglottic malignancy and even globus pharyngis.

While this sounds like an easy enough diagnosis, what I found interesting is in the big cities and Medical College there lacks an awareness about this form of addiction, particularly tobacco chewing. Since our Medical Text books are often reflecting the Western viewpoint, this local habit is missed and rarely asked while taking history.
Let me correct that. I wasn’t trained to ask that since we were not aware women took tobacco in that form. Plus, when I ask “do you have any addictions?” Many times for both men and women it’s no. While I dig deeper I get to know more about tobacco and its impact.

For women
They use Gul for their rotting teeth
They take betel nut,supari for reflux,plus khayer/jarda with varioy forms of liquids mixed with chewable tobacco.

For men
They smoke cigarette few times  a day if someone offers (depends on socioeconomic status):
bidi a pack a day .
Alcohol :Only on weekends and special occasion or when feeling low and betel leaf /paan occasionally.
Khaini/Gutkha :If a user,they will say things like I drive, do heavy work so that helps.
I understand .But I also try to sensitize them about – the problem of increasing addictions including the current problem not getting better unless they stop the addictions and invest wholeheartedly in their own health, especially tobacco chewing which is very prevalent.

Hoe to give up chewable tobacco addiction.

Stop .

Visit a registered Psychiatrist for help with de-addiction.

Use a nicotine patch under medical supervision.

Exercise ,go for a run when you feel the urge.

Don’t be around addicts.

It’s never going to be easy giving up,but you have to try.

Reference :
WHO:NO TOBACCO https://healthwealthbridge.com/tobacco-cancer-responsibility/

https://healthwealthbridge.com/truths-about-chewing-tobacco/

https://healthwealthbridge.com/cancer-preventionliving-life-meaningfully

https://healthwealthbridge.com/gulchewing-tobacco-the-untold-horror-story-of-rural-bengal/