Report on Tobacco Control in India

Tobacco use impoverishes lakhs of individuals in India annually and increases socioeconomic disparities among people. Therefore, tobacco is a major threat to achieving overall development.

The first volume of the Report on Tobacco Control in India was released in 2004 by the Ministry of Health and Family Welfare, Government of India at a time, when India was at a crucial stage in streamlining and accelerating multi-pronged action on tobacco control. 

The second volume of the Report on Tobacco Control in India 2022 is a comprehensive documentation of this remarkable journey that is a testament to the collaborative action of the Government of India, State Governments, academia, researchers, civil society, youth advocates and media.

Ill effects of Tobacco use

• Tobacco smokers have higher risks of early death from any-cause (between 31% and 55% in different studies).
• Smokeless Tobacco (SLT) users who do not smoke or drink also have higher risks of early death (about a 30% excess risk) due to SLT use alone. 
• Tobacco use is a key risk factor for major groups of noncommunicable diseases (NCDs), such as cardiovascular diseases, cancers, respiratory diseases and diabetes. In India, tobacco use results in 1.35 million deaths each year. Deaths and diseases due to tobacco use deprive the Indian economy of an  estimated INR 1773.4 million annually, which is over 1% of the GDP. 
• Tobacco use leads not only to the loss of lives but imposes a heavy environmental, social and economic burden.
• Deforestation for growing and curing tobacco has been adding carbon dioxide to the atmosphere, which is a risk factor for climate change. The use of trees for making paper for cigarettes contributes to deforestation.
• Butts of cigarettes and bidis and wrappers of smokeless tobacco (SLT) products are thrown on the roads; they get washed into the drains, rivers and seas causing seawater pollution, and adversely affect marine life.
• Spitting associated with SLT use results in unsanitary and ugly public spaces.

Summary of Report on Tobacco Control in India 2022

The objective of this report is to provide an update since 2004 on the nature and magnitude of the tobacco problem, on the scientific knowledge about the health effects of tobacco use, on the economics of tobacco and highlighting new challenges posed by new emerging tobacco products / nicotine products /flavoured tobacco products. 

This report encompasses the technical expertise and experience of over 100 authors and peer reviewers from across the country, representing a wide gamut of stakeholders. The content of the report is rich with national, sub-national and grassroots initiatives on tobacco control. The recommendations provide key strategies to realize the vision of a ‘Tobacco-Free India’ and ‘Tobacco-Free Future Generation’.  

The topics covered include

• Tobacco control in India: A multisectoral response (2004–2022) -  highlights the multisectoral approach adopted by various stakeholders in strengthening tobacco control efforts in India
• Tobacco use in India: Practices, patterns, prevalence and trends 
• Health consequences of tobacco and nicotine use - informs readers about the evidence since 2004 from Indian studies on cancer, vascular diseases, lung
  diseases, pulmonary tuberculosis, reproductive health outcomes, oral diseases, green tobacco sickness and mortality attributed to tobacco use in India. It also provides information on the adverse effects of ENDS, and the interactions of tobacco with alcohol, areca nut, cannabis and opium. 
  
  • All-cause mortality and tobacco use in India 
  • Tobacco and cancer 
  • Tobacco and risk of cardiovascular and metabolic diseases 
  • Tobacco smoking and lung disease 
  • Tobacco smoking and pulmonary tuberculosis 
  • Tobacco and reproductive outcomes 
  • Tobacco-induced oral diseases 
  • Green tobacco sickness 
  • Health effects of electronic nicotine delivery systems 
  • Tobacco, alcohol, drugs: Interlinkages 
  • Research gaps in health effects of tobacco in India 
• Economics of tobacco control in India - details various economic aspects related to the cultivation, employment and revenue generation of tobacco as a product as well as the economic burden of tobacco in India
• Ecological and environmental effects of tobacco use 
• Progress in tobacco control: The Indian experience -  provide a detailed account of the progress in tobacco control since 2004 in terms of the  implementation of policies and programmes relevant to addressing TII, tobacco cessation, the ban on gutkha and/or SLT, the prohibition of ENDS, national testing laboratories, alternative livelihoods for bidi rollers as well as public perceptions of tobacco products. It also discusses the legal challenges encountered in developing and enforcing policies.
• Progress in tobacco control: What works? 
• Tobacco control: What is needed?
• Tobacco control: What is possible? A vision for 2040 and beyond

Recommendations and the way forward 

To achieve the vision of ‘Tobacco-Free India’ and ‘Tobacco-Free Future Generation’ by 2040, all stakeholders need to make concerted efforts and adopt the  evidence-based tobacco control policy measures in the following.

• Surveillance
• Policy formulation and implementation 
• Tobacco industry interference
• Monitoring and evaluation
• Tobacco taxation
• Capacity building of key stakeholders 
• Multisectoral and multistakeholder engagement
• Mainstreaming tobacco cessation 
• Developing a robust multi-disciplinary research agenda
• Resource mobilization 

Source : Full Report on Tobacco Control in India 2022