The Tobacco Epidemic in India- Explained Pointwise

On the Occasion of World No Tobacco Day, it is pertinent for us to delve deeper into the case of Tobacco Epidemic in India. Through the World No Tobacco Day, WHO aims to raise awareness about the health risks of tobacco use. It also advocates for stringent measures to protect public health, especially among youth.

What is the status of Tobacco epidemic in India? 

1.  After China, India has the world’s highest number of tobacco consumers. There are nearly 26 crore tobacco users in India according to an estimate in 2016-17.

2. The Global Adult Tobacco Survey and India’s National Family Health Survey capture the status of tobacco usage in people above 15 years of age. The Global Youth Tobacco Survey (GYTS) assesses tobacco use in students between the ages of 13 and 15 years of age. According to all these surveys, the usage of tobacco is increasing in India.

3. India has the largest number of Smokeless Tobacco users in the world. India accounts for 66% of world’s smokeless tobacco users.

What are the negative impacts of tobacco epidemic in India?

1. Deleterious Impact on Human Health- Tobacco usage causes a wide range of life threatening diseases like cancer. As per WHO, tobacco use is a major cause of death and disease in India. It is responsible for an estimated 1.35 million deaths annually.

2. Health risk to employees engaged in Tobacco Industry- The health of more than 60 lakh people employed in the tobacco industry is placed at risk because of the absorption of tobacco through the skin. This causes various diseases.

3. Economic Loss- India incurred a loss exceeding ₹1.7 lakh crore as a result of tobacco’s effects on the health of its consumers in the fiscal year 2017-2018, due to a 2021 study. This loss is ~3 times as compared to Union health budget of ~Rs. 48,000 crore.

4. Deterioration of Soil Quality- Tobacco crop is a highly erosive crop that rapidly depletes soil nutrients. The cultivation of tobacco crop requires more fertilizer usage which further worsens soil quality.

5. Deforestation- The tobacco plant is a major contributor to deforestation in India. For ex- ~ 5.4 kg of wood is required to process 1 kg of tobacco.

6. Waste Generation- The production and consumption of tobacco generates ~1.7 lakh tonnes of waste every year in India. Cleaning up tobacco waste has been estimated to cost ~ ₹6,367 crore a year.

7. Social Impact- Tobacco smoking violates non-smokers right to clean air and undermines health of non-smokers. It also affects household welfare as the expenses incurred in tobacco use substitute the basic needs of food and education among disadvantaged population.

What are the Govt Schemes and initiatives for Tobacco Control in India?

1. Cigarettes Act 1975- The Act is largely limited to statutory warnings like ‘Cigarette Smoking is Injurious to Health’ to be displayed on cigarette packs and advertisements. However, it did not include non-cigarettes.

2. The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) Act (COTPA) 2003- The act contains 33 sections governing the production, advertisement, distribution, and consumption of tobacco in India.

3. WHO’s framework convention on Tobacco Control- India is one of the 168 signatories of the WHO’s Framework Convention on Tobacco Control (FCTC). It was launched in 2005. It aims to reduce tobacco usage worldwide by helping countries develop demand and supply reduction strategies.

4. Food Safety and Standards Act 2006- Government of India has issued regulations under the Food Safety and Standards Act 2006 which lay down that tobacco or nicotine cannot be used as ingredients in food products.

5. Cable Television Networks Amendment Act of 2000- It prohibited the transmission of advertisements on tobacco and liquor in India.

6. Prevention and Control of Pollution Act of 1981- The Act recognized smoking as an air pollutant.

7. The Motor Vehicles Act 1988- It made smoking illegal in public vehicle.

8. National Tobacco Control Programme (NTCP), 2008- The objective of the programme was to control tobacco consumption and minimize tobacco consumption related deaths. The activities include- training and capacity building, information, education, and communication (IEC) activities; reporting survey and surveillance and tobacco cessation.

9. Tobacco Cessation- The program provides targeted support to help people overcome the personal challenge of maintaining efforts to quit tobacco use. Tobacco cessation clinics have been set up across the country as part of the program.

10. Tobacco Taxation- According to WHO Report on the Global Tobacco Epidemic 2017, cigarette taxes in India are amongst the highest in the world. Cigarettes are subjected to high and discriminatory rates of taxation, as compared to other tobacco products. As of 2014-15 Government collected 87% of its total tobacco revenue from legal cigarettes

What are the Challenges with Tobacco Control Programmes in India?

1. Ineffective Regulatory coverage- Smokeless tobacco products (SLTs) have predominantly been non-compliant with COTPA packaging guidelines. Smuggled tobacco products- in both smoked and smokeless forms- have been badly regulated in India.

2. Outdated provisions in the COPTA- The fines for violation of COTPA regulations have not been updated since 2003. For ex- First time violation fine of ₹5,000 for violation of packaging restrictions.

3. Unclear Guidelines on surrogate and indirect advertisements- These have been used to sell proxy products like Elaichi. This has to indirect promotion of the sale of tobacco manufactured by the same brand. For ex- The ICC Men’s Cricket World Cup 2023 displayed surrogate advertisements for at least two tobacco brands which indirectly promoted tobacco use.

4. Ineffective implementation of NTCP- A 2018 study there has been no significant difference in the reduction of bidi or cigarette consumption between NTCP and non-NTCP districts. National Tobacco Control Programme (NTCP) suffers from insufficient staffing, insufficient resource allocation and utilization, and lack of effective monitoring mechanisms.

5. Tax evasion- Indian government’s efforts to levy excise duty on tobacco have been marred by tax evasion practices, such as by purchasing tobacco products in lower tax jurisdictions, and illegal methods such as smuggling, illicit manufacturing, and counterfeiting.

6. Increasing affordability of tobacco products- Low tobacco taxes in India, have not matched the rise in people’s income, and have kept tobacco affordable over the years. For ex- A 2021 study in BMJ Tobacco Control reported that cigarettes, bidis, and SLTs have become more affordable in the preceding 10 years. The transitioning to the Goods and Services Tax regime has rendered cigarettes and SLTs more affordable.

7. Govt interference in tobacco Industry- India’s score on the tobacco interference index- which calculates the degree of interference by the tobacco industry in governance– has also worsened since 2021. For ex- Government officials, both in-service and retired, engage with the tobacco industry. A retired Indian Administrative Services officer joined the board of Godfrey Phillips as an independent director in 2022. Moreover, the Central government holds a 7.8% stake in ITC Ltd., India’s largest tobacco company.

What Should be the Way Forward?

1. Effective regulations on surrogate advertisements- The COPTA must be updated to include regulations on surrogate advertisements, inclusion of films and video games in the definition of ‘advertisement’ and increasing the fines for violation of advertisement norms by a factor of 10.

2. Increasing tax on tobacco products in line with FCTC recommendation- Tax burden which is 51% for cigarettes, 22% for bidis, and 64% for SLTs. They must be increased to FCTC’s recommendation of 75% tax. 

3. Effective implementation of Prohibition of Electronic Cigarette Act (PECA), 2019- The PECA must be strictly implemented. We must continue to strive to strengthen the governance framework, reduce the corruption levels and increasing the effectiveness of customs and tax adminstration.

4. Helping tobacco farmers switch to farming alternate crops- According to study conducted by the Central Tobacco Research Institute, helping tobacco farmers switch to alternate crops will help in avoiding loss of livelihood. For Large-scale tobacco farmers, the net return per rupee of investment in jowar cultivation (1.84) is higher than tobacco (1.48).