Eliminating Tobacco in India: A New Approach

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Source: Making Beedis (cigarettes) in Karnataka, India

In India, tobacco accounts for 800-900,000 deaths a year and more than 40% of cancer cases.  India has proven dedicated to tobacco reduction and was the first country to ratify the Framework Convention on Tobacco Control (FCTC) in 2004.  In 2007, the government launched the National Tobacco Control Program (NTCP) to reduce environmental tobacco smoke. The program seeks to meet these objectives through four components including population-based community interventions, policy, counter-marketing, and surveillance.  

This initiative has benefitted from multisectoral support.  Using Karnataka as an example, control was a top-down initiative, beginning with the State Anti-Tobacco Cell,  representing the commitment of the government. The perspective of the patients is represented through the Voice of Tobacco Victims (VOTV)  and other organizations dedicated to spreading an anti-tobacco message. Enforcement is carried out through the police force, which  has so far been effective in this role. Of concern is the continuing high level of financial support for politicians from the tobacco industry.

These efforts have successfully reduced the smoking prevalence in India; however, with an average of 8.2 cigarettes smoked per day, there is still room for improvement. Policy banning smoking in public and for minors is in effect, but the tobacco industry is a strong economic force in India. Further efforts should involve policy that decreases tobacco supply by offering tax incentives to expand tobacco companies’ profiles to non-tobacco products. Incentivizing the development of non-tobacco products will reduce tobacco availability and use by Indians and should be the priority moving forward.

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2 Responses to “Eliminating Tobacco in India: A New Approach”

  1. zhuolusun Says:

    This initiative has proved to be very successful in India. I’m wondering if such initiatives would also work in China. Currently, China has more than 300 million smokers, leading to a largest population of smokers in the world. Unlike India and other countries that have established related regulations to ban smoking, China’s efforts to reduce or to ban smoking remain to be complimented and improved. I think the first step is to set up a National Tobacco Control Program as India did in 2007. The actions implemented in other countries may not perfectly suits the situation in China. However, Chinese government could learn from these methods. Like the initiative in India, the Chinese tobacco control program could also be operated based on a top-down initiative. From the commitment of the government to the implementation by anti-smoking groups and organizations, the program will make a big difference. Also, the enforcement could be carried out by police, which has been proved effective in India and other countries. Other actions that could be taken may include the elimination of advertisements associated with smoking, the presentation of graphics illustrating bad outcomes of smoking on packs of cigarettes and higher taxes on cigarettes. I’d like to emphasize the effect of graphic ilustration of harmful effects from smoking. Currently, the only thing that illustrates the hazards of smoking is a setence — Smoking is bad for health. Smokers can’t fully understand what hazards there would be so they don’t care much. Everyone knows smoking is bad for health, but they havn’t realized how bad it would be. What we need is something like a black lung or more descriptive pictures.

  2. ymdoffice Says:

    This post gives a very selective and, probably, unrealistically optimistic success narrative on the tobacco control efforts in India. I travel to India often, and I am always bothered by prevalent public smoking at all locations totally disregarding a few no-smoking signs, and almost no enforcement of the policy. People very rarely protest against a smoker in a non-smoking zone to avoid confrontation. In addition, the use of smokeless tobacco (e,g tobacco chewing either as pure tobacco or in a variety of products such as Pan-Parag) seems to be on the rise. A recent report in Time of India (http://timesofindia.indiatimes.com/city/pune/94-tobacco-users-dont-want-to-quit/articleshow/24501747.cms) points out that 94% tobacco users in India do not wish to quit tobacco use. In addition, a 2013 International Tobacco Control Project (ITCP) report shows that over 1.5 million deaths annually may be attributed to tobacco use (http://www.reuters.com/article/2013/09/12/us-india-tobacco-idUSBRE98B08K20130912). The same report points out that ” the legislation currently in place is not delivering the desired results – in terms of dissuading tobacco use and encouraging quitting.” The low percentage of people wanting to quit combined with poorly enforced laws, inconsistent regulations covering smoke-free zones, and relatively cheap tobacco prices means deaths from tobacco use are destined to stay high. The picture is far from rosy. According to Geoffrey Fong, a co-author of the ITPC report “If there is any single indicator of the urgent need for continued and strengthened efforts for strong, evidence-based tobacco control in India this is it’(the lack of inclination to quit tobacco use)”.

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