TOBACCO EPIDEMIC IN INDIA

Source: Hindu

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Context

• Tobacco is the most widely recognized preventable cause of disease and death globally.
• It affects not only those who consume it but also those who cultivate it.
• In India, the tobacco epidemic presents a multifaceted challenge, impacting public health, the environment, and the economy. 

Details

Tobacco Use in India

Prevalence and Demographics

• High Consumption: India has the second-highest number of tobacco consumers in the world after China, with nearly 260 million users as of 2016-2017.
• At-Risk Populations: Over 6 million people are employed in the tobacco industry, where exposure to tobacco can lead to various diseases.

Surveys and Data

• Global Adult Tobacco Survey (GATS)and Global Youth Tobacco Survey (GYTS) assess tobacco use among adults and youth respectively.
• National Family Health Survey (NFHS)also captures tobacco use among those above 15 years.
• Recent Trends: Overall tobacco use has decreased, but use among women increased by 2.1% between NFHS 2015-2016 and NFHS 2019-2021.

Impact of COVID-19

• Data Gaps: No comprehensive survey has been conducted since the COVID-19 pandemic, highlighting a need for up-to-date data to track trends and develop strategies.

Health and Environmental Impact

Health Consequences

• Diseases: Tobacco use causes a wide range of diseases, including cancers, respiratory and cardiovascular diseases.
• Occupational Risks: Workers in the tobacco industry face health risks from dermal absorption of nicotine and other chemicals.

Environmental Damage

• Soil Depletion: Tobacco is an erosive crop that rapidly depletes soil nutrients, requiring more fertilizers, which further degrade soil quality.
• Deforestation: Tobacco production contributes to deforestation; processing 1 kg of tobacco requires up to 5.4 kg of wood.
• Waste Generation: Tobacco production and consumption generate approximately 170,000 tonnes of waste annually in India.

Economic Burden

• Healthcare Costs: Tobacco-related health issues cost India over ₹1.7 lakh crore in 2017-2018, exceeding the Union Budget for health of ₹48,000 crore for the same year.
• Waste Management: Cleaning up tobacco waste costs around ₹6,367 crore annually.

Regulation and Control

Legislation

• Framework Convention on Tobacco Control (FCTC): India is a signatory, aiming to reduce tobacco usage through various strategies.
• COTPA 2003 (Cigarettes and Other Tobacco Products Act): Governs production, advertisement, distribution, and consumption of tobacco.

National Tobacco Control Program (NTCP)

• Objectives: Enhance COTPA and FCTC implementation, raise awareness, and support cessation.
• Challenges: Poor implementation, non-compliance with packaging guidelines, and ineffective regulation of smuggled products.

Advertising and Taxation

• Surrogate Advertising: Loopholes allow indirect promotion of tobacco via proxy products.
• Taxation Issues: Low tobacco taxes and ineffective tax administration keep tobacco affordable.

Control Measures and Effectiveness

Proposed Amendments

• 2015: Regulations on surrogate advertisements, inclusion of digital media, increased fines.
• 2020: Licensing for tobacco production, supply, and distribution.

NTCP and Taxation

• Effectiveness: Studies show no significant difference in tobacco consumption between NTCP and non-NTCP districts.
• Tax Measures: Inadequate taxation and issues with tax evasion and illicit trade.

Tobacco Affordability

• Economic Analysis: Tobacco products have become more affordable over the years, undermining public health efforts.
• FCTC Recommendations: Current tax rates are below the recommended 75%.

Lobbying and Industry Influence

• Government Stake: The government holds a 7.8% stake in ITC Ltd., India's largest tobacco company.
• Policy Interference: Effective lobbying has led to exemptions and influenced tobacco control policies.
• Prohibition of Electronic Cigarettes Act 2019: Banned e-cigarettes, yet their use remains a public health challenge.

Recommendations

• Implementation: Stricter enforcement of existing laws and increased fines for violations.
• Taxation: Increase taxes in line with FCTC recommendations, inflation, and GDP growth.
• Crop Diversification: Help tobacco farmers switch to alternative crops, enhancing livelihood sustainability.
• Surveys: Conduct regular and comprehensive surveys to gather up-to-date data on tobacco use trends.
• Research: Invest in studies to understand and counter the tobacco industry's evolving strategies.

About Tobacco

• Tobacco is a product prepared from the leaves of the tobacco plant by curing them. The main types of tobacco products include:
• Smoking tobacco: Cigarettes, cigars, pipe tobacco
• Smokeless tobacco: Chewing tobacco, snuff

History of Tobacco Use

• Ancient Use: Indigenous peoples in the Americas used tobacco in religious and medicinal practices.
• Introduction to Europe: Christopher Columbus brought tobacco to Europe in the late 15th century.
• Commercialization: Tobacco became a major trade commodity in the 17th century.

Global Production and Consumption

• Top Producers: China, India, Brazil, and the United States
• Consumption Patterns: Vary widely across regions, with high rates in some Asian and Eastern European countries.

Primary Chemicals in Tobacco

• Nicotine: The addictive substance found in tobacco.
• Tar: A mixture of chemicals found in tobacco smoke.
• Carbon Monoxide: A harmful gas produced by burning tobacco.

Nicotine and Its Effects

• Stimulant: Increases heart rate and blood pressure.
• Addictive Properties: Causes physical and psychological dependence.

Additives in Tobacco Products

• Flavorings: Enhance taste and appeal.
• Humectants: Keep tobacco moist.
• Ammonia: Increases nicotine absorption.

Sources:

Hindu