Tobacco products: Their death toll in one grim statistic

Mortality caused by the use of tobacco products in India can be expressed in one grim statistic: one death every eight seconds.

Dr Ulhas Wagh, an anti-tobacco activist, highlighted this grim reality while speaking at a tobacco control event in Mumbai. Dr Wagh said that more than 34 percent of Indian youth are unaware of the negative effects of smoking, which he linked to an increasing number of children indulging in the habit. 5,000 begin consuming tobacco every year, he said.

Dr Wagh took the occasion to commend the World Health Organization’s (WHO) package of global tobacco control measures, commonly known as MPOWER, aimed at facilitating the country-level implementation of anti-tobacco policies. The six provisions of MPOWER include

• Monitoring tobacco use and policies targeted at facilitating prevention
• Protecting citizens from tobacco smoke
• Providing assistance to help tobacco users quit
• Raising awareness of the negative effects of tobacco use
• Banning the advertising, promotion, and sponsorship of tobacco products
• Raising taxes on tobacco

“In many respects, much more work needs to be done. In terms of taxation, the excise duty on tobacco products in India falls below the WHO’s recommended burden. They report a successful enforcement rate of just seven out of every ten bans on indirect advertising and six of every seven bans on direct advertising. Compliance with the ban on advertising is judged by the Tobacco Atlas as “moderate”….Surrogate advertising luring kids to begin smoking continues unchecked.”

India has made progress on some of these indicators. The advertising of tobacco products is banned as per the Cigarettes and Other Tobacco Products Act (COTPA), 2003. Tobacco product packaging is legally mandated to carry health warnings covering 75 percent of the principal display area, as well as a toll-free government quitline. The country has run anti-tobacco media campaigns and enforces a smoke-free environment in many public places (albeit not in bars, pubs, and restaurants).

However, in many respects, much more work needs to be done. In terms of taxation, the excise duty on tobacco products in India falls below the WHO’s recommended burden of 75 percent, sitting at 64 percent for cigarettes and 22 percent for bidis. The Goods and Services Tax (GST) imposes an additional cess of 28 percent on tobacco products.

Compliance with the ban on advertising is judged by the Tobacco Atlas as “moderate”. They report a successful enforcement rate of just seven out of every ten bans on indirect advertising and six of every seven bans on direct advertising. Surrogate advertising luring kids to begin smoking continues unchecked.

“It cannot be understated that India actually has much to celebrate in its tobacco control efforts. The changes to packaging law, in particular, resonate as a major achievement of the government, especially considering the legal challenges brought against such measures by the tobacco lobby. The decline in the number of smokers is also something to celebrate, with 8.1 million fewer smokers in the 2016-17 period compared to 2010…At the same time, India cannot lose sight of the fact that fourteen percent of adults use smoking tobacco and 25.9 percent use smokeless tobacco. As Dr Wagh reminds us, one person dies because of tobacco use every eight seconds.”

Health Issues India has reported before on the efforts of tobacco companies such as Philip Morris International to circumvent the advertising laws in what anti-tobacco activist Dr Kailash Sharma – academic director at the Tata Memorial Hospital in Mumbai – denounced as “a sinister plan to demolish India’s tobacco control efforts.”

One study found a poor rate of compliance with the provisions of COTPA. Surveying 218 stores in Haryana, the study found

• None were fully COTPA-compliant
• 41 percent sold tobacco products to minors
• Ten percent of stores were illegally situated within 100 yards of a school
• 24 percent displayed tobacco products in the open

Based on these figures, the study concluded that “although more than a decade passed since the law was enacted, poor compliance and knowledge was found among participants.” In combination with the unsavoury tactics of members oft the tobacco lobby, future prospects for India’s anti-tobacco drive seem dismal.

It cannot be understated that India actually has much to celebrate in its tobacco control efforts. The changes to packaging law, in particular, resonate as a major achievement of the government, especially considering the legal challenges brought against such measures by the tobacco lobby. The decline in the number of smokers is also something to celebrate, with 8.1 million fewer smokers in the 2016-17 period compared to 2010.

At the same time, India cannot lose sight of the fact that fourteen percent of adults use smoking tobacco and 25.9 percent use smokeless tobacco. As Dr Wagh reminds us, one person dies because of tobacco use every eight seconds.

Tobacco ranks as the fourth leading cause of death in the country. Efforts to control the scourge of tobacco cannot suffer from complacency in the face of progress already made: they must be accelerated, for the good of the health of the country at large.