The tobacco epidemic in India

The tobacco epidemic in India


Tobacco is widely acknowledged as the leading preventable cause of disease and death worldwide. It triggers a myriad of health issues, impacting not only consumers but also those involved in its cultivation.

  • After China, India has the second highest number of tobacco users globally, with an estimated 26 crore users in 2016-2017.
  • Additionally, over 60 lakh people working in the tobacco industry face health risks from skin absorption of tobacco, which can lead to various diseases.
  • The repercussions of tobacco extend beyond health, affecting the environment and economy, thus necessitating robust awareness and control measures.

GS-02 (Health, Government Policies & Interventions)

Dimensions of the Article:

  • What is the Topic About?
  • Status of Tobacco Use in India
  • Awareness and Control Programmes
  • Tax Details
  • Key Takeaways
  • Future Prospects

What is the Topic About?

  • This analysis explores the status of tobacco use in India, the measures taken to control its consumption, including awareness programs and taxation policies, and the future prospects for reducing tobacco-related harm.
  • It emphasizes the need for effective implementation of existing laws and highlights the economic and environmental impacts of tobacco production and consumption.

Status of Tobacco Use in India

  • Tobacco consumption in India is surveyed through tools like the Global Adult Tobacco Survey (GATS), Global Youth Tobacco Survey (GYTS), and the National Family Health Survey (NFHS). GYTS focuses on tobacco use among 13-15 year-olds, while GATS and NFHS target individuals above 15.
  • These surveys indicate a general decline in tobacco use, although there’s a concerning increase in usage among women by 2.1% between NFHS 2015-2016 and 2019-2021. However, no comprehensive surveys have been conducted post the COVID-19 pandemic, leaving a data gap in understanding current trends.

Awareness and Control Programmes

  • India is a signatory to the WHO’s Framework Convention on Tobacco Control (FCTC), aimed at reducing global tobacco usage through coordinated demand and supply reduction strategies. The Cigarettes and Other Tobacco Products Act (COTPA) of 2003 governs tobacco sales in India, regulating production, advertisement, distribution, and consumption.
  • In 2007, India launched the National Tobacco Control Program (NTCP) to enhance the implementation of COTPA and FCTC, raise awareness about tobacco’s harms, and support cessation efforts. Despite these initiatives, enforcement remains weak, with many smokeless tobacco products (SLTs) not complying with packaging guidelines and smuggled tobacco products poorly regulated. Fines for violations, unchanged since 2003, are inadequate, undermining the effectiveness of COTPA.
  • Moreover, while direct advertisements of tobacco are banned, indirect or surrogate advertisements through proxy products like elaichi remain a loophole. Notably, the ICC Men’s Cricket World Cup 2023 featured surrogate ads for tobacco brands, indirectly promoting tobacco use through endorsements by prominent cricketers.

Tax Details

  • Efforts to curb tobacco use through taxation have been undermined by tax evasion, smuggling, and illegal manufacturing. Low tobacco taxes in India, which have not kept pace with rising incomes, have made tobacco products increasingly affordable. A 2021 BMJ Tobacco Control study found that cigarettes, bidis, and SLTs became more affordable over the past decade, and the transition to the Goods and Services Tax (GST) regime further reduced the cost of cigarettes and SLTs.
  • Economist and tobacco policy analyst Rijo M. John estimates the tax burden at 51% for cigarettes, 22% for bidis, and 64% for SLTs, significantly lower than the FCTC’s recommended minimum of 75%. The tobacco industry argues that high taxes lead to evasion, but non-tax factors such as weak governance, corruption, poor commitment to combating illicit trade, and ineffective customs and tax administration are equally, if not more, significant.
  • Despite the ban on e-cigarettes under the Prohibition of Electronic Cigarette Act (PECA) 2019, they remain a public health challenge. Surveys indicate a substantial number of adults have used e-cigarettes, questioning their role in tobacco de-addiction.

Key Takeaways

  • Weak Implementation of Laws: The effectiveness of COTPA, PECA, and NTCP is hampered by inadequate enforcement, outdated fines, and loopholes in indirect advertising regulations.
  • Economic and Environmental Impact: Tobacco cultivation depletes soil nutrients, contributes to deforestation, and generates substantial waste, imposing heavy economic burdens on India. The health costs and environmental damage far exceed the budget allocated for health.
  • Need for Stronger Tax Policies: Increasing the tax on tobacco products in line with FCTC recommendations, inflation, and GDP growth is crucial. Addressing non-tax factors that facilitate tax evasion is equally important.
  • Support for Tobacco Farmers: Transitioning tobacco farmers to alternative crops can mitigate livelihood loss, as demonstrated by studies from the Central Tobacco Research Institute.
  • Up-to-date Data: Regular surveys and data collection are vital to understanding and countering tobacco industry strategies effectively.

Future Prospects

  • Enhance Law Enforcement: Strengthen the implementation of COTPA, PECA, and NTCP with updated fines, stricter regulations on surrogate advertising, and robust monitoring mechanisms.
  • Increase Tobacco Taxes: Align tax policies with FCTC recommendations, address non-tax factors contributing to evasion, and ensure taxes rise with income levels to reduce affordability.
  • Support Alternative Livelihoods: Provide support for tobacco farmers to switch to more sustainable crops, ensuring economic stability and reducing environmental impact.
  • Continuous Monitoring and Data Collection: Conduct regular surveys to keep abreast of trends in tobacco use and industry tactics, enabling proactive policy adjustments.
  • Public Awareness Campaigns: Intensify awareness programs highlighting the health, economic, and environmental harms of tobacco use, leveraging media and community outreach.