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Highest number of smokeless tobacco deaths in India

Also in the article: the health ministry’s efforts to tackle tobbaco

India accounts for nearly three- fourths of over a quarter million deaths worldwide caused by smokeless tobacco while millions more have their lives shortened due to its ill health effects, a new study has found.

“Nearly 85 per cent of the total burden attributable to smokeless tobacco (SLT) use was in South-East Asia, with India alone accounting for 74 per cent of the global burden, followed by Bangladesh (five per cent),” said the study that assessed the impact of smokeless tobacco on adults.The study collected smokeless tobacco consumption figures for 115 countries and estimated burden of disease for 113 of these countries. Smokeless tobacco – including chewing products such as gutkha, zarda, paan masal and khaini – is the most common form of tobacco use in India, with many poorer people and women preferring these over smoking cigarettes or bindis – small, cheap, locally-made cigarettes

In another story on tobacco,  bulging sacks of letters gathering dust at India’s health ministry are the latest obstacle to a push for tougher laws to curb smoking, as more than 100,000 unread messages from members of the public overwhelm officials and stall legislation.

Tobacco  has been linked to up to 900,000 deaths a year in India and the government wants to raise the minimum smoking age to 21 from 18. It also wants ban the sale of single cigarettes, which make up 70 percent of overall sales. Before taking its proposals to parliament, the government in January asked for public suggestions. The result was unprecedented: 45,000 e-mails and more than 100,000 letters delivered by mail.

According to this article,  the sheer volume has left officials stumped, with some fearing that it could take as much as five months to sift through the letters.

Some health officials suspect the letter-writing campaign was orchestrated by the tobacco industry to hold up the process. While there is no evidence to back up such suspicions, there are signs of an organised letter-writing campaign.At least one pack of letters seen by Reuters consisted of dozens of the same printed objections signed by different people. Industry body the Tobacco Institute of India declined to comment.

“Given the number, it is likely to take some time,” said C.K. Mishra, an additional secretary at the health ministry, but he did not estimate how long.

Tobacco inflicts huge damage on the health of India’s people and could be clocking up a death toll of 1.5 million a year by 2020 if more users are not persuaded to kick the habit, an international report said.Despite having signed up to a global treaty on tobacco control and having numerous anti-tobacco and smoke-free laws, India is failing to implement them effectively, leaving its people vulnerable to addiction and ill health, according to the report by the International Tobacco Control Project (ITCP).

Tobacco use alone accounts for about 40 per cent of all cancers in India. “About 275 million Indians (35 per cent of adult population and 14.1 per cent of children aged 13-15 years) are tobacco users, mainly smokeless tobacco,” says a paper by Paul E. Goss of Harvard Medical School, Boston, and others.

Despite bans on advertising, sale to minors and smoking in public places, more than one in three adults use some form of tobacco in India. India has one of the world’s weakest tobacco warning regimes. Currently, official cautions appear only on one side of the package, covering a mere 20% of the entire packet.Hard-hitting anti-tobacco advertisements and graphic pack warnings – especially those that include pictures – reduce the number of children who begin smoking and increase the number of smokers who quit, says the WHO.

The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA) is the principal comprehensive law governing tobacco control in India.  The Act was passed before India became a party to the WHO Framework Convention on Tobacco Control.

Strategies to support the implementation of demand reduction measures contained within the WHO Framework Convention on Tobacco Control (WHO FCTC), such as the “MPOWER” package, have helped save millions of lives in the past decade.India has not yet attained any MPOWER measure at the highest level of achievement, in terms of efforts to curb tobacco use, says a report, adding, complex tax structures are helping to keep people hooked on to the habit.

MPOWER was established in 2008 to promote government action on six tobacco control strategies – one for each letter of the MPOWER acronym – Monitor tobacco use and prevention policies; Protect people from tobacco smoke; Offer help to quit tobacco use; Warn people about the dangers of tobacco; Enforce bans on tobacco advertising, promotion and sponsorship; and Raise taxes on tobacco.  


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