STRIVING FOR A TOBACCO FREE INDIA

by - Dr. Anbumani Ramadoss

Tobacco is evidently the most common preventable cause of morbidity and death in India. Its consumption has increased over the years. Why so? We need to look at the answer to address the problem. The estimates from the latest round of NFHS-3, 2006-07 indicate an increasing prevalence of tobacco consumption in India, with 57% males and 10.9% females reportedly consuming tobacco in some forms or the other.

The findings of the Global Youth Tobacco Survey (GYTS), 2006 are equally alarming.
 Approx. 14% children in the age group of 13-15 years are consuming tobacco in some form. The majority consume chewing tobacco.
 The age of initiation into tobacco has also come down.
 15% of the ‘never-smoker’ are likely to start initiate smoking in the next year.
 40% of them are exposed to second hand smoke in public places.
 74% of the students are in favour of banning smoking in public places.

According to another study published in ‘New England Journal of Medicine’ in Febuary 2008 smoking will cause one million deaths every year in India during the 2010’s. The WHO-Empower Report of 2007 estimates that tobacco kills a third to half of all people who use it, on an average 15 years prematurely. Today tobacco use causes 1 in 10 deaths among adults worldwide - more that five million people a year. By 2030, unless urgent action is taken, tobacco’s annual death toll will rise to more than 8 million.

Tobacco is perhaps only available product that kills its consumers in such large number and yet gets a fresh stock of consumers. Hence the tobacco companies are always on look out for new consumers. The youth becomes the primary target of these companies. In order to attract the children, youth the potential customer’s, tobacco companies have launched huge mass media campaigns throughout the globe. Indian laws prohibit advertisement, but there are instances of indirect and surrogate advertisement.

The Problem of Tobacco consumption in India is also more complex than probably in any other country in the world with a large consequential burden of tobacco-related disease and death. Presence of large percentage of youth in the total population adds a new dimension to the whole issue.

India shows the Way
India is one among the front-runner countries to sign and ratify the WHO-Framework Convention on Tobacco Control (FCTC), which enlists key strategies for reduction in demand and supply of tobacco products. India ratified the FCTC on 5th February 2004. Even before the World Health Assembly adopted the WHO FCTC. A comprehensive Tobacco Control Act was enacted by the Government on May 18, 2003. This Act encompasses most of the FCTC provisions.

Anti Tobacco Act, formally known as The Cigarette and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production Supply and Distribution) Act, 2003 is one of the most comprehensive Tobacco Control Act in the world.
The rules to implement the Law have been framed. The smoke free rules were notified by the government in May 2004, these rules have further been revised in May 2005 and the definition of public places has been elaborated to include all workplaces, shopping malls, cinema halls etc. Those who are in-charge of these public places will also be liable to be fined with effect from on October 2, 2008 for the failure on their part to enforce rules. Unfortunately the law is not getting implemented. Most State Governments are not fully sensitized and have kept this as a low priority item on their agenda.

National Tobacco Control Programme
The Government has now launched the National Tobacco Control Programme (NTCP) in the 11th Five Year Plan to implement the Anti-Tobacco Laws and bring about greater awareness about the ill- effects of Tobacco. The objectives of NTCP is to build up capacity of the States at the District Level to effectively implement the Anti-Tobacco initiative; train the health and social workers; take up appropriate IEC and awareness campaign including School Health Programme; set up a regulatory mechanism to monitor/implement the Anti Tobacco Laws. Approximately, Rs. 450 crore will be spent in the 11th Five Year Plan. This program will be launched in September-October 2008 in at least 100 districts. Components are field tested in 18 pilot districts.

School Programme is one of the prime focus of the National Tobacco Control Programme targeting school children as well as the college going youth to protect their health and well being and make them more wiser citizens about anti-tobacco laws and their right to life without tobacco etc. and also make them advocates of their right.

It is well known that tobacco has no benefit yet many consume it, for pleasure as well as for reasons not known. Now things are changing and global opinion is turning against tobacco consumption. India with its huge youth population needs to be at the forefront of the movement against tobacco menace.

*(Adapted from the speech of Union Minister for Health & Family Welfare, Dr. Anbumani Ramadoss at the Delhi University on 22nd July, 2008)