When we asked Ramrati Sahariya whether she chewed tobacco, the 25-year-old mother of two from Kishanganj Block,Baran, smiled and looked away. She then confessed that she had gutka throughout her pregnancy and even while breastfeeding her 5-month old infant. Her mother-in-law took frequent breaks during our conversation to smoke beedis and her sister-in-law too chewed tobacco despite being in her early teens.
Ramrati and her family are not anomalies. The National Family Health Survey-5 reports that about 6.9% of women above the age of 15 have tobacco in Rajasthan. The figure is as high as 19.3% in Baran. Anecdotal evidence from RajPusht’s Block Programme Managers and POSHAN Champions suggests that many women continue to smoke or chew tobacco during pregnancy and while breastfeeding.
This harms not only mothers, but also children. Harmful substances from cigarettes are passed onto the foetus through the bloodstream and to infants through the mother’s milk. According to the World Health Organization, maternal smoking during pregnancy is linked to a doubling of the risk of sudden infant death and birth defects. Exposure to second-hand smoke during pregnancy is linked to a 23% increased risk of stillbirth and 13% increased risk of congenital malformation. Nicotine, the addictive substance in tobacco, also suppresses one’s appetite. This is dangerous for pregnant women and new mothers, as they need extra calories to support their growing child.
Divakar Jharbade, Block Programme Manager, Salumber, Udaipur District, says, “There are several reasons women take up tobacco. One woman I talked to said she had picked up the habit from her friends. Another said that she had heard that tobacco is good for digestion. She had started when she was suffering from stomach ailments, but then could not give up the habit. But for many women, tobacco helps them deal with stress or kill their hunger when they have to work for long.”
RajPusht’s Social & Behaviour Communication strategies seek to promote positive behaviours, such as abstaining from tobacco. The first stumbling block is the lack of knowledge regarding the harm tobacco does to mothers and children. Our POSHAN Champions counsel the mother and her family so that they are aware of its dangers. They also motivate the family members to give up tobacco as one is more likely to have it if others around one are having it too and to support the mother by letting her take breaks and naps and making sure she has frequent meals.
Tobacco is an addictive substance, so it’s hard to let go of the habit. But with constant counselling and motivation, we hope to see a shift in behaviours.