Tobacco Use in India – Overview
- India has 42% of men and 14% of women using tobacco (GATS2 data).
- Smokeless tobacco (SLT) is more common than smoking; India houses 70% of global SLT users.
- Bidis are more widely used than cigarettes, especially in rural and low-income groups.
- However, cigarette use is rising, even in villages, due to perceptions of modernity.
Relevance : GS 2(Health)
Health Impact
- India ranks first globally in male cancer incidence and mortality.
- Lip and oral cancers are most prevalent, followed by lung cancer in Indian males.
- Both SLT and smoking are linked to oral, lung, stomach, pancreatic, and head/neck cancers.
- Second-hand smoke exposure continues to be a public health concern.
Economic Burden
- In 2017–2018, tobacco use cost India ₹1.77 lakh crore (1.04% of GDP).
- Smoking: 74% of the cost
- SLT: 26% of the cost
- Rising tobacco use will increase both health and economic burdens.
- Low prices and wide accessibility allow even daily wage earners to afford tobacco.
Affordability Problem
- Low unit pricing:
- Bidis: Median ₹12/pack, as low as ₹5
- SLT: ₹5 median, as low as ₹1
- Cigarettes: Median ₹95, but available for ₹5; single sticks around ₹15
- Tobacco remains affordable due to static taxation, rising incomes, and undershifting by manufacturers (absorbing tax hikes to retain users).
Policy Failures and Industry Tactics
- India hasn’t matched WHO’s recommended 75% taxation of tobacco’s MRP (current GST proposal only 35%).
- The 2024 Union Budget kept tobacco taxes unchanged.
- Single stick sales (banned in 88 countries) are legal in India — evade warnings, encourage impulse buying.
- Vendors near tea stalls fuel the “chai-sutta” culture.
- Tobacco industry influences policy and targets youth and low-income groups through marketing.
WHO MPOWER Framework Undermined
- Tobacco affordability weakens control strategies:
- Monitor use
- Protect from smoke
- Offer help to quit
- Warn about dangers
- Enforce bans
- Raise taxes
Urgent Policy Recommendations
- Regular, steep tax hikes to outpace income growth.
- Ban single-stick sales to enforce warnings and reduce access.
- Allocate tobacco tax revenue to public health (e.g., cancer screening in rural areas).
- Enforce plain packaging and ban sales near schools and tea stalls.
- Strengthen compliance inspections and penalties for violations.
Conclusion
India is at a critical juncture, facing a tobacco-driven cancer epidemic with high health and economic stakes. Robust, evidence-based anti-tobacco strategies are essential to reverse this trend.
