Tobacco Epidemic in India, Awareness and Control Programs

Context: Tobacco is the leading preventable cause of disease and death globally, affecting both consumers and cultivators.

Tobacco’s Impact in India

• India has the world’s second-highest number of tobacco users (26 crore), and the health of 60 lakh tobacco industry workers is at risk.
• Environmental Degradation: Tobacco farming depletes soil, contributes to deforestation (5.4 kg wood per 1 kg tobacco), and generates 1.7 lakh tonnes of waste annually in India.
• Economic Burden: Tobacco-related health costs exceed ₹1.7 lakh crore in India, dwarfing the ₹48,000 crore health budget in 2017-2018.
  • Cleaning tobacco waste costs ₹6,367 crore annually, excluding soil and deforestation costs.

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Status of Tobacco Use in India

• Surveys such as the Global Adult Tobacco Survey (GATS), Global Youth Tobacco Survey (GYTS), and India’s National Family Health Survey (NFHS) show a decline in tobacco usage among the surveyed demographics, except for a slight increase among women from 2015-2016 to 2019-2021.
• No surveys have been conducted post-COVID-19, which leaves a gap in current data.

Awareness and Control Programs

• Legal Framework: India has been a signatory of WHO’s Framework Convention on Tobacco Control (FCTC) since 2005 and has the Cigarettes and Other Tobacco Products Act (COTPA) 2003 governing tobacco sales.
• National Tobacco Control Program (NTCP): Launched in 2007 to implement COTPA and FCTC, raise awareness, and aid quitting efforts.
• Taxation: Tobacco is taxed, but implementation is weak, with non-compliance of smokeless tobacco products (SLTs) with COTPA guidelines, poorly regulated smuggled products, and outdated fines.
• Surrogate Advertising: While direct ads are banned, indirect ads (surrogate advertising) persist, promoting tobacco brands through proxy products.

Affordability and Implementation Challenges

• Failed Amendments: Proposed COTPA amendments in 2015 and 2020, addressing surrogate ads and licensing, were not passed.
• NTCP Ineffectiveness: A 2018 study found no significant difference in bidi or cigarette consumption reduction between NTCP and non-NTCP districts due to insufficient staffing, resources, and monitoring.
• Tax Evasion: Tobacco taxes remain low due to evasion, smuggling, illicit manufacturing, and counterfeiting. Transition to GST further increased affordability.
• Lobbying Power: The tobacco lobby influences policy, with exemptions for bidis and smaller manufacturers, government officials engaging with the industry, and the central government holding a stake in ITC Ltd.

Additional Challenges and Opportunities

• E-Cigarettes: Banned by the Prohibition of Electronic Cigarette Act (PECA) 2019, yet remain a challenge with 23% reported use and 8% daily use in an online survey.
• Farmer Support: Government support for tobacco farmers to switch to alternate crops like jowar, which can be more profitable, is crucial.
• Data Needs: Up-to-date data on tobacco use trends is needed to counter the industry’s evolving strategies.

Way Forward

• Strengthen Implementation: Stringent implementation of COTPA, PECA, and NTCP.
• Increase Taxation: Align taxes with FCTC recommendations, inflation, and GDP growth.
• Support Farmers: Aid tobacco farmers in transitioning to alternate crops.
• Gather Data: Collect up-to-date data to track tobacco use trends.

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