Urgency needed in tobacco control in India

According to data, more than 250 million people in India use various tobacco products like gutka, cigarettes and bidis and millions of them die, many suffer with heart and lung diseases because of this habit. The data says one in two Indian men and one in seven women use tobacco in the country. Tobacco causes 40 per cent of all cancer disease in India. An urgent call to take action is needed in India to focus more and more on the issue.

At present, the issue to publish pictorial warnings on tobacco products is being debated in the country. Several researchers of the World Health Organization (WHO) and others stated in a special report in the Lancet medical journal that widespread efforts to cut salt intake, curb smoking and to ensure those at risk of heart disease take needed drugs could prevent millions of deaths each year. They looked at prevention efforts in 23 low and middle income countries including China, India, Russia, Brazil, Turkey, Mexico, Pakistan, South Africa, Poland and Nigeria in which 80 percent of global deaths from chronic diseases like heart disease, cancer and diabetes occur. The study said that implementing tobacco control measures, reduction of salt intake and strengthening public awareness efforts would prevent nearly 14 million deaths over the coming 10 years.

The Government of India has tried to control tobacco use through Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution Bill, 2003. Key provisions of the law include prohibition on direct and indirect advertisements of tobacco products, prohibiting the sale of tobacco products to minors and prohibition of smoking in public places.

The Government is planning to revise its Packaging and Labelling Rules, 2007, wherein grim pictures like cancerous tumours or an ailing infant may be printed on the packet on smoking and non-smoking forms of tobacco. In revised guidelines a tobacco product can now carry the warning ‘tobacco kills’ along with a picture that shows one of the following ‘smoking causes cancer, your smoking kills babies, tobacco causes painful death and tobacco causes mouth cancer.’

But in India the conflict between the tobacco lobby and the government is essentially a conflict between economic interests and health priorities and moves to control tobacco get diluted. This recent move to make pictorial warnings on tobacco products mandatory which was just one of the step has too been stuck in litigation.

Though use of pictorial warnings on tobacco products have been proved to be effective in 15 countries across the world where tobacco consumption has drastically gone down, especially in Thailand, which has now become a model for its success in curbing smoking. But In India this alone may not be sufficient and it needs to be backed up by a powerful public information campaign and many other means. Issue like smoking needs more stress in India. Increasing trend among young generation to get on to smoking in early age too is a matter of great concern. A recent survey conducted on college students in Delhi, showed that two per cent of them smoked their first cigarette before attaining even 10 years of age.

Exposure to smoking activities, easy availability of cigarettes in and around educational institutions, message of smoking getting reinforced in films, advertisements, attracts youths towards smoking. Another survey, carried out among youths with support of WHO and Centre for Disease Control in Madhya Pradesh in year 2003, showed that the tobacco habits including smoking take start at very early stage in life. The survey says that the prevalence of tobacco use in young ones in the Madhya Pradesh was observed to be 12.8%. Out of the total of 1,692 students, which participated in the survey, one in six students (16.5%) had ever used tobacco in any form.

That was the story of year 2003 and now after our years, the ’anti-tobacco’ activists say that tobacco prevalence has increased among young generation. They say it is not only smoking but even use of tobacco has significantly increased. Same survey added that some of the psychological factors mainly leave impact on youths to start tobacco use. They start tobacco habit after watching people surrounding them (Parents and friends) using tobacco. Bidi smoking is one another area, which can be attributed to around 32 per cent of tuberculosis deaths in India, needs more stress.

This is the main reason why several people in IndiaIndia. But how it would be possible is the biggest question, when one gets stuck on every step in this direction. There is a need of multi pronged approach to fight with this problem. But more than this, the issue needs recognition of urgency not only by one person or group but also by large base of people especially who make decisions and influence the process of implementation. advocate for taking different preventive strategies for different target groups if they wish to bring down tobacco use in

Contributed by Anil Gulati