New Delhi:
Tackling tobacco dependence through sustained cessation support, alongside effective control of high blood pressure, is crucial to reducing India’s stroke burden, medical experts have said, calling for a stronger public health strategy that goes beyond awareness campaigns.
On the eve of World Stroke Day, experts stressed that tobacco use remains a significant risk factor for cardiovascular diseases and strokes, and that people struggling with nicotine dependence require sustained medical and counselling support to quit.
A 2024 analysis of Global Burden of Disease data estimated that tobacco use contributed to 12 per cent of stroke deaths in India, while high systolic blood pressure accounted for 56 per cent.
The findings underline the need for a comprehensive approach addressing multiple risk factors rather than focusing on individual lifestyle changes alone.
Dr Yashpal Singh Bundela, Director of Neurosurgery and Neurosciences at Medanta Super Speciality Hospital, Noida, said simply advising people to quit tobacco was not enough.
He pointed out that nicotine dependence makes quitting difficult, even when users are aware of the health consequences.
According to him, tobacco cessation must be supported through practical and sustained services, including counselling and clinically established treatments such as nicotine replacement therapy (NRT).
The World Health Organisation estimates that tobacco use accounts for nearly 1.35 million deaths annually in India.
Tobacco consumption in the country extends beyond cigarettes to include bidis and smokeless products such as khaini, gutkha and zarda. Experts said cessation programmes must take into account these different patterns of consumption.
They also stressed that nicotine dependence should be treated as a public health challenge rather than simply a question of individual willpower.
Tobacco use can contribute to strokes by damaging blood vessels and promoting processes that increase the likelihood of blood clot formation. This can interrupt the supply of blood to the brain and cause serious neurological damage.
Dr Bundela said access to cessation services should be expanded to help tobacco users quit and prevent relapse. Public health programmes should also focus on discouraging tobacco initiation among young people.
Dr Sonia Lal Gupta, Senior Consultant Neurology and Joint Managing Director of Metro Group of Hospitals, said stroke was increasingly becoming a concern among younger people, even though the risk generally increases with age.
She identified uncontrolled hypertension, diabetes, obesity, smoking, sedentary lifestyles and delayed recognition of symptoms as major risk factors.
A stroke occurs when blood supply to a part of the brain is interrupted either because of a blocked blood vessel or bleeding in the brain. Brain cells can begin suffering damage within minutes when they are deprived of adequate blood flow.
Dr Gupta emphasised that recognising the warning signs and obtaining emergency medical attention without delay were essential.
Sudden facial drooping, weakness in one arm, difficulty speaking, loss of balance and unexpected vision problems should not be dismissed as temporary discomfort, she cautioned.
Delays in identifying these symptoms can reduce the chances of receiving timely treatment and increase the risk of lasting disability.
Dr Vikas Mittal, Director of Respiratory Medicine at CK Birla Hospital, Punjabi Bagh, said India needed to examine evidence-based approaches to tobacco prevention and cessation.
Referring to international experiences, he called for an open discussion on whether existing tobacco-control strategies and newer approaches could deliver better public health outcomes.
He stressed that the priority should remain reducing tobacco consumption, preventing young people from taking up the habit and making it easier for existing users to quit.
Experts also referred to a nationally representative Japanese study published in 2026. It found that cigarette use among people aged 15 to 64 declined from 20.7 per cent in 2017 to 12.3 per cent in 2025. However, heated tobacco use increased from 5.3 per cent to 11.7 per cent.
The study does not establish that the increase in heated tobacco use caused the decline in cigarette smoking or reduced long-term cardiovascular and stroke risks.
Doctors said India’s efforts to reduce stroke deaths must combine tobacco cessation, blood pressure management, diabetes control, healthier lifestyles and public awareness of emergency symptoms.
They called for stronger access to preventive healthcare and sustained support for tobacco users, emphasising that early intervention can help reduce the burden of stroke and other tobacco-related diseases.