Why smoking prevails over it’s awareness in India
New Delhi, June 3: Tobacco kills more than 1 million people each year in India (home to the second greatest number of smokers in the world behind China). Additionally, tens of millions use deadly smokeless tobacco products. These are harsh realities. There is nothing positive about tobacco consumption. In fact, approximately 130 million people ages 15 and older in India currently smoke and roughly half of all adults are exposed to second-hand smoke at home.
While no organ is immune to the destructive effects of tobacco, it has the worst impact on the lungs. What may start as an innocuous cough can soon evolve into asthma, and eventually fatal and disabling diseases such as tuberculosis, pneumonia, emphysema, chronic bronchitis and lung cancer. Tobacco smoking is the leading cause of deadly lung and respiratory diseases, says Dr. Villoo Morawala-Patell, Founder &CMD, Avesthagen Limited.
According to a Global Burden of Disease study by the Institute for Health Metrics and Evaluation, of the more than 8 million deaths attributed to tobacco use in 2017, 2.88 million of those deaths were from chronic respiratory diseases; tracheal, bronchus and lung cancer; and tuberculosis. Up to 60 percent of total cancers among males in India are tobacco-related. The 20th annual edition of the World Health Organization's (WHO) global tuberculosis report revealed India had more deaths from tuberculosis (423,000) in 2017 than any other country in the world.
WHO, governments and health NGOs use May 31, World No Tobacco Day, as an opportunity to urge smokers to quit and to encourage their loved ones to provide them with the needed support to succeed in quitting.
Why does tobacco have such a strong hold on the Indian population?
Poverty and economic burden of tobacco
Tobacco consumption thrives in India's poor communities and incurs social and economic costs. Women, men and children in these communities consume some of the world's cheapest and most readily available smokeless tobacco products and bidis.
The Cigarettes and Other Tobacco Products Act (COTPA) 2003 banned the sale, use and advertisement of tobacco and tobacco products, including: cigarettes, cigars, bidis, cheroots, pipe tobacco, hookah, chewing tobacco, pan masala and gutka near educational institutions. It also mandated statutory warnings be displayed on all tobacco products. Laws on the books though do not translate into laws on the streets!
Tobacco control policies don't address the realities of India
Pack warnings don't work. Most cigarettes in India are sold singly. Bans on sales of bidis to children are not effective when a significant percentage of the sellers are kids seeking cash for food. Tax increases on combustible cigarettes drive cigarette smokers to cheaper bidis. The guidelines developed by the WHO are based on the experiences of countries where sophisticated and well-funded enforcement structures exist. They need to be adapted to the reality of India's streets.
Awareness about the negative effects of tobacco consumption is weak
Public awareness that smoking is harmful is lower in India than in 12 other countries surveyed in 2017. Just less then 70% of smokers thought their habit was harmful compared to 85-95% in other countries. Further awareness of the potential benefits of e-cigarettes was also lowest by far with 57% of people believing e-cigarettes were more or equally harmful as cigarettes. It's important to address these misperceptions. Health professionals have the responsibility of communicating the real risks to their patients. India needs to push for comprehensive policies that truly reflect the realities of the smoking population and the tobacco ecosystem we have here.
Lack of support for innovations in cessation and harm reduction solutions
Supporting smokers in quitting or switching to reduced-risk products is the most effective way to cut rates of tobacco-related deaths and diseases. Indian governments and organizations need to further support and fund the research and development of additional smoking cessation and harm reduction methods. The innovation pipeline for new smoking cessation products is sparse. There's a great opportunity to better leverage today's technology to develop solutions that will help smokers quit.