Tobacco & Health

1. Tobacco & Health MDIndia Healthcare Services (TPA) Private Limited ISO 9001:2000 Certified Dr Sachin Kasat MBBS, AIII., FIII MDI Confidential Proprietary Information

2. Fact Sheet • Smoking tobacco is deadly • Tobacco causes a range of cancers, as well as heart disease, stroke and emphysema. • One in two lifetime smokers die from smoking, half of those in their middle age. • Tobacco causes more illness and death than any other drug. • Smoking harms nearly every organ of the body. Smoking causes many diseases and reduces the health of smokers in general • Smoking causes cancer of lung, throat, mouth, nose, larynx, esophagus, pancreas, liver, kidney, bladder, bowel, ovary, cervix, & bone marrow(myeloid leukemia) MDI Confidential Proprietary Information

3. Smoking & Increased Health Risks • Smoking causes an estimated 90% of all lung cancer deaths in men and 80% of all lung cancer deaths in women.1 • An estimated 90% of all deaths from chronic obstructive lung disease are caused by smoking • Compared with nonsmokers, smoking is estimated to increase the risk of— • coronary heart disease by 2 to 4 times,1,2 • stroke by 2 to 4 times,1,6 • men developing lung cancer by 23 times,1 • women developing lung cancer by 13 times,1 and • dying from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times.1 • Reference: • 1.The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 • 2.Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1989 • 3. Ockene IS, Miller NH. Cigarette Smoking, Cardiovascular Disease, and Stroke: A Statement for Healthcare Professionals from the American Heart Association. Circulation 1997;96(9):3243–7 MDI Confidential Proprietary Information

4. Tobacco Constituents • Tobacco contains 43 known carcinogens i.e. cancer-causing chemicals. (Anything that is known to cause cancer is also called a carcinogen.) • Cigarettes also contain all of the following chemicals: • Ammonia – used for toilet bowl cleaner • Arsenic – used for rat poison • Carbon Monoxide – found in car exhaust pipe • Tar – used for roofing and waterproofing • Nicotine – used as a poison in bug sprays • It is no wonder that smoking kills more Americans every year than murders, fires, alcohol, HIV, and car accidents combined. • Would you want to lick a toilet bowl or drink bug spray? • Nicotineis the most addictive known drug! • It narrows the blood vessels making it difficult for the heart to get oxygen to the body. This can really mess up your game, or even worse it can cause heart disease! • Tar will turn a smoker’s lungs BLACK • It damages the cilia, reducing their ability to keep dirt and germs out of the lungs. Because of this, smokers have more coughs, colds, and other lung diseases than non-smokers. MDI Confidential Proprietary Information

5. Withdrawal Symptoms • One reason why smokers continue to smoke is to avoid withdrawal symptoms which can be very unpleasant. • Cravings • Irritability, frustration, depression &/or anxiety • Restlessness • Difficulty concentration • Changed sleeping patterns • Increase in appetite & weight gain • Withdrawal symptoms are all signs that the body is recovering and getting used to living without nicotine. On average, most symptoms are gone within two to four weeks. Heavy smokers may have symptoms for a few more weeks. MDI Confidential Proprietary Information

6. Quit Smoking • Help is available for quitting in form of: • Counseling or coaching • Education and information • Nicotine patches, gum, tablets • Prescription medicines such as bupropion • People who have best chance of quitting are those who get some sort of counseling & use quitting medications. • Where to get help? • Your doctor • Pharmacist • 104 Help lines • Internet • Sponsored seminars & Health talks organized by employers, insurers, etc. MDI Confidential Proprietary Information

7. Success Steps to quitting • Make a Plan • Set aside time every day to practice. • Take action by setting your "quit date"—the day you will start (being) a former smoker—and telling people about it. • Think about why quitting is important to you. (Write a list) • Plan what to do at times and places that could be challenging when you become a former smoker. • Practice coping with the urge to smoke and choosing, on occasion, not to smoke. • Change behaviors around what you eat, how you exercise, how you cope with stress and strong feelings, and getting support from others. • Choose Your Quit Date • Midnight on a Thursday or Friday is the best time for most people. That way, you'll be through the hardest part of withdrawal by Monday morning. • Your quit date should be about 2 weeks after you begin learning and practicing • the strategies and skills described. MDI Confidential Proprietary Information

8. The Day You Quit • Throw away all your cigarettes, lighters and ashtrays. • You will feel the urge to smoke, but it usually passes in 2-3 minutes. • When you feel the urge, do something else. • Take deep breaths and let them out slowly. Drink a glass of water. • Carry things to put in your mouth, like gum, hard candy, and toothpicks. • Keep busy: Go to the movies, ride your bike, walk the dog, play video games, call • a friend. • Go to places where you're not allowed to smoke, like the movies. MDI Confidential Proprietary Information

9. The First Few Days • The first few days after you quit, don't hang around people and places where you used to smoke. • If your family or friends smoke, ask them not to: • Smoke around you • Offer you cigarettes • Leave cigarettes where you can find them • Tease you about not smoking • Turn your home into a "no smoking zone," especially if your family smokes • Spend a lot of time in places where you're not allowed to smoke • Drink lots of water and fruit juice, but limit your intake of drinks like soda, coffee and tea that contain caffeine MDI Confidential Proprietary Information

10. Coping with Cravings • Notice the craving. Don't ignore, suppress or fight it • Stop and think about it. Take a moment to experience the craving • Make a conscious choice not to smoke • Wait. The urge will pass after a minute or so, whether or not you choose to smoke • Do anything to delay the urge • Get up and do something • Call someone and talk about it • Congratulate yourself each time you have an urge to smoke and choose not to • Plan Alternatives • Drink water, especially out of a sip bottle • Play with "worry stones" or other small objects • Take a walk • Chew gum • Take a shower • Go someplace where smoking isn't allowed, such as the movies or the library • Call a friend, or be with others who don't smoke • Learn to identify what you need at that moment—to be alone or to talk, for example • Stay positive. When you wake up, promise yourself that you won't smoke a cigarette today. MDI Confidential Proprietary Information

11. Celebrate your success • Mark each milestone you reach in some way • Calculate the amount of money you haven't spent on cigarettes. You may want to use a glass jar to save the money you would have spent on tobacco, then spend it on something special • Treat yourself to something fun, such as a movie or coffee with a friend • Each day, watch for the best thing that happens to you because you're not • smoking. Maybe you can walk up the stairs without getting winded, or eat in the nonsmoking section of a restaurant • Ask your family and friends to celebrate with you • Within 20 minutes of smoking that last cigarette, the body begins a series of • changes that continue for years. MDI Confidential Proprietary Information

12. Quit Tobbaco Thank You MDI Confidential Proprietary Information

13. About Us • Founded in November 2000……. IRDA TPA License (No. 005) • Headquartered in Pune, Maharashtra • Financially Stable since inception, with FYE 2011: • 2.5 Cr members; • Annual premiums of INR 1400 Cr • FYE 12 Provisional: • 3.5 Cr members; • Annual premiums of INR 1800 Cr • Annual Fund Management exposure of INR 1400 Cr • Pan India footprint • 3000+ Employees strong • End to End TPA Solution Suite “IATROS” • Support across channels Voice, Email, Web Based Services • ISO standards, Six Sigma and proactive Business Analytics (BI) • Providing Health checkups (annual, pre employment) to corporates & Insurers MDI Confidential Proprietary Information

14. Contact us For Health Checkups ( Pre Employment, Annual or Pre Policy ) pims@mdindia.com For Third Party Administration Services for corporates and Corporate Policies bd@mdindia.com For General queries on Health insurance claims and enrollment customercare@mdindia.com Toll Free Number : 1800 11 233 11 66 MDI Confidential Proprietary Information