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 Tobacco Epidemic in India

Context:

Tobacco is the most widely recognized preventable cause of disease and death globally. India has the world’s second-highest number of tobacco consumers, following China, with nearly 26 crore (260 million) people using tobacco products.

Relevance:

GS II: Health

Dimensions of the Article:

  1. Reports on Tobacco Consumption in India
  2. WHO Framework Convention on Tobacco Control (FCTC)
  3. Government Initiatives
  4. Hidden Costs of Tobacco Beyond Health Risks
  5. Challenges to Effective Tobacco Control in India
  6. Way Forward for Tobacco Control in India

Reports on Tobacco Consumption in India

Global Adult Tobacco Survey (GATS):

  • Indicates a general decline in tobacco use among people aged above 15 years, except for an increase among women between 2015-2016 and 2019-2021.

Global Youth Tobacco Survey (GYTS):

  • Shows a reduction in tobacco use among students aged 13-15 years.

National Family Health Survey (NFHS):

  • Aligns with GATS findings, showing a decrease in tobacco use among individuals above 15 years, with the exception of an increase among women.

WHO Framework Convention on Tobacco Control (FCTC)

Overview:

  • The FCTC is an international treaty adopted by the World Health Organization (WHO) in 2003 and is legally binding.
  • Countries that ratify the treaty are required to implement the measures within their national jurisdictions.
  • The treaty addresses global health risks related to tobacco use and provides a framework for effective tobacco control policies and strategies.
Government Initiatives

Regulations:

  • Cigarette and Other Tobacco Products Act (COTPA) 2003: Regulates advertisement, promotion, and sponsorship of tobacco products, prohibits smoking in public places, mandates pictorial health warnings on tobacco packaging, and sets rules for selling tobacco products to minors.
  • Media Awareness: India is the first country to implement warnings on OTT platform content when actors are seen using tobacco products.
  • Product Awareness: Implementation of prominent and graphic pictorial health warnings on tobacco packaging.

Hidden Costs of Tobacco Beyond Health Risks

Environmental Impact:

  • Tobacco cultivation rapidly depletes soil nutrients, requiring more fertilizers, which further degrade soil quality.
  • Tobacco production contributes to deforestation; processing 1 kg of tobacco requires up to 5.4 kg of wood.
  • The production and consumption of tobacco generate massive waste, amounting to 1.7 lakh tonnes annually in India.

Economic and Health Costs:

  • Tobacco use leads to significant healthcare costs, with an estimated loss of Rs. 1.7 lakh crore in India (2017-18), surpassing the national health budget of Rs. 48,000 crore.
  • Over 6 million people working in the tobacco industry are at risk of health issues due to tobacco absorption through the skin.
  • Cleaning up tobacco waste incurs substantial additional costs, estimated at Rs. 6,367 crore annually in India.

Challenges to Effective Tobacco Control in India

Regulatory Challenges:

  • Smokeless tobacco (e.g., gutkha) and smuggled products often evade Cigarettes and Other Tobacco Products Act (COTPA) regulations, complicating control over their production, sale, and marketing.
  • Fines for COTPA violations are low (maximum of Rs. 5,000 for first-time violations) and have not been updated since 2003, providing inadequate deterrence.

Advertising and Promotion:

  • Surrogate Advertising: Tobacco companies use advertisements for other products (e.g., elaichi) to indirectly promote their brands, making regulation difficult. The ICC Men’s Cricket World Cup 2023 featured surrogate advertisements for at least two tobacco brands.

Policy and Implementation Issues:

  • The Indian government has not passed proposed amendments to strengthen COTPA in 2015 and 2020, which could have addressed existing regulatory gaps.
  • The National Tobacco Control Programme (NTCP) lacks the necessary staff, resources, and monitoring systems to fully implement COTPA across the country.

Industry Influence and Governance:

  • Effective lobbying by the tobacco industry impacts policy-making and regulation enforcement.
  • Despite the ban, issues with enforcing the policy on e-cigarettes persist.
  • Tax breaks for small tobacco companies result in unequal taxation, making harmful products more affordable.
  • The government’s 7.8% stake in ITC Ltd., India’s largest tobacco company, raises concerns about conflicts of interest and commitment to tobacco control.

Way Forward for Tobacco Control in India

  • Update Legislation:
    • India’s Cigarettes and Other Tobacco Products Act (COTPA) and the National Tobacco Control Programme (NTCP) need revisions to enhance tobacco control efforts.
  • Increase Taxes:
    • Current taxes on tobacco products, particularly bidis and smokeless tobacco, fall short of the WHO-recommended target of 75%. Raising these taxes would reduce consumption and generate revenue for public health initiatives.
  • Enhance Monitoring:
    • Regular monitoring is essential to track tobacco use trends, identify violations of COTPA, and evaluate the effectiveness of anti-tobacco campaigns.
  • Support for Farmers:
    • Implement public programs to assist tobacco farmers in transitioning to alternative crops, minimizing economic hardship due to reduced tobacco cultivation.
  • Data Collection:
    • Timely collection of data on tobacco use patterns is crucial to understand changes and identify new strategies employed by the tobacco industry. This data is vital for formulating effective tobacco control policies.

-Source: The Hindu


June 2024
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