Youth at crossroads: Rise in tobacco use alarms doctors as India witnesses surge in lung cancer cases

World No Tobacco Day is observed every year on May 31. The day aims to raise awareness about the effects of tobacco use. However, there has been a resurgence in the rise tobacco use among the youth. Read on as doctor links the increase in tobacco use to the surge in lung cancer cases in India.

New Delhi:

India is currently facing a unique conundrum; on one hand, there are the decades of public health campaigns that have been raising awareness about the perils of tobacco use, while on the other, a worrying resurgence and rise in tobacco consumption among the youth can be seen, fuelled by social media, which seems to deliberately glamourise smoking, chewing tobacco and vaping.

Rise in tobacco use

Dr Anil D’Cruz, Director, Oncology & Senior Head & Neck Oncosurgeon at Apollo Hospitals Navi Mumbai says that the demographic patterns in relation to tobacco use and related cancers cannot be thought of as statistics; they are stories of people and families in distress, their futures hanging in the balance. The Apollo Hospitals Health of the Nation Report 2025 as well as the National Cancer Control Programme (NCCP), paints a stark picture: mouth and lung cancers are now among the top three cancers in Indian men, and its biggest contributing factor is tobacco use.

The report also reveals something more concerning: the median age of lung cancer diagnosis in India is 61 years, a number significantly lower than that of most developed countries. Besides the fact that India is a younger country population-wise, this represents the earlier onset due to initiation at younger ages and heavier exposure to carcinogens (via non-refined forms like beedis) that Indians face and highlights the systemic issues hampering awareness, early screening and intervention.

Social media influence on tobacco use

For the Indian youth, especially men, the association with tobacco (and later disease) used to start with a seemingly harmless encounter with tobacco, be it at school or college, sharing gutka, vapes or cigarettes with friends. Now, the digital age has redefined how tobacco is perceived and promoted. The days are gone when cigarette advertisements on billboards were the only source of temptation. Nowadays, youth are consistently exposed to so-called influencers and celebrities on social media platforms like Instagram, YouTube, etc., who consume tobacco as part of their content. On these platforms, vaping and smoking are portrayed as symbols of style, rebellion, and even sophistication. Despite laws banning advertising of tobacco, surrogate promotion and influencer-driven content subtly normalise its use.

Adapting swiftly to the dynamic digital landscape, tobacco companies have updated their messaging, packaging and flavouring to target young adults and even adolescents. Many loopholes are exploited to do this as well. E-cigarettes and vapes, which were initially touted to be harmless tools to quit cigarettes, have transformed into gateways for nicotine addiction. Now, we know, from data from India and abroad, that vaping introduces newer and newer generations to nicotine dependency. Vapes are also exposing them to harmful chemicals that compromise lung function and, in fact, raise cancer risk.

It is important to understand the distinction when it comes to the burden of responsibility for this. It doesn’t just fall on individuals. The consequences are borne by families, communities and the nation’s healthcare system.

Impact of tobacco use

The effects of this phenomenon are multifaceted. For one, treatments for head and neck cancer involve extensive chemotherapy, radiation and surgery. Two, they face effects that affect them throughout their life, like losing the ability to speak or eat normally. Three, they lose their productive years because of the financial, physical and emotional toll, making this one of the most devastating public health challenges. The fact that this is all preventable makes the situation somehow worse.

Ways to prevent tobacco use among youth

Nonetheless, this crisis is surmountable. From the Cigarettes and Other Tobacco Products Act (COTPA) India, to tobacco taxes, to pictorial warnings on cigarette packaging, India has had a strong set of actions against tobacco use. Yet, there is more required now. We need youth-specific digital interventions, recalibration of messaging, and educational campaigns that can meet young people where they are - on their screens. For instance, things like short, evidence-based, emotionally resonant content shared by trusted voices (including influencers, educators, and physicians) can help.

Moreover, healthcare professionals should be empowered to enable them to play a proactive role in addressing the issue. As early as in primary care and school, screening for tobacco and health visits should be integrated to build the foundation. Parents, teachers, and community leaders should receive training to recognise the early signs of tobacco use and intervene with compassion, not stigma.

World No Tobacco Day should not just be a day of remembrance – it is a call to action. India is marching toward becoming a healthier nation, and its greatest asset—its youth—must not be left vulnerable to addiction masked as freedom. The crossroads is here, and the direction we choose will determine not only the health of a generation but the very future of our nation.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.