Why in News

• India faces a very high health and economic burden due to tobacco use

• As per 2017 estimates:

  • Annual economic cost of all tobacco products for people aged 35 years and above was ₹1,773.4 billion (1.04 percent of Gross Domestic Product)

  • Second-hand smoking added ₹566.7 billion (0.33 percent of Gross Domestic Product) in annual healthcare costs

• These costs include:

  • Direct medical and non-medical expenditures

  • Morbidity and mortality losses

• Urgent need to strengthen the tobacco control framework to achieve the vision of a tobacco-free India

Gaps in Existing Legislation

Cigarettes and Other Tobacco Products Act, 2003 (COTPA)

• Strong legislation but implementation is weak in many states

• Contains several shortcomings that need urgent attention

Inadequate Coverage of Smokeless Tobacco

• Smokeless tobacco is:

  • Cheaper

  • Culturally accepted

  • Less stigmatized

• More carcinogenic compared to smoked tobacco

• Food Safety and Standards (Prohibition and Restriction on Sales) Regulations, 2011 attempt to control it, but enforcement remains weak

Surrogate and Indirect Advertising

• Direct tobacco advertisements are banned, but companies use surrogate advertising

• Examples:

  • Mouth fresheners packaged similar to tobacco products to build brand recognition

  • Movies, over-the-top platforms, and social media indirectly promote tobacco

Weak Fiscal Measures

• Cigarettes and Other Tobacco Products Act does not include direct provision for fiscal measures

• Excise taxation is the most effective way to reduce tobacco consumption, yet taxation in India is inadequate and uneven

• Taxation scenario:

  • Tax burden on bidis is only 22 percent

  • Tax burden on cigarettes is about 50 percent

  • Both are below the World Health Organization benchmark of 75 percent

• Since Goods and Services Tax introduction in 2017:

  • Overall tax hikes increased tobacco taxation by only 4 percent

• Rising income and low taxation have made tobacco products more affordable

Ineffective Warning Labels

• India mandates 85 percent health warnings on tobacco packaging, but effectiveness is limited

• Warnings rely mainly on fear-based messages like oral cancer and early death

• Unlike European countries, Indian packaging does not highlight the broad range of harms

• Need for:

  • Regular evaluation

  • Adoption of plain packaging to reduce appeal

Poor Implementation of Electronic Cigarette Ban

• Prohibition of Electronic Cigarettes Act, 2019 bans e-cigarettes, but enforcement is weak

• E-cigarettes remain easily available online

• Adolescents continue to be vulnerable to this threat

Need for a Holistic Approach

National Tobacco Control Programme (NTCP)

• Focuses mainly on:

  • Awareness generation

  • Enforcement of the Cigarettes and Other Tobacco Products Act

• Does not address social drivers such as:

  • Poverty

  • Unemployment

  • Stress

• Cessation clinics have limited coverage compared to the large number of users

Weakness of Tobacco Free Education Institute (ToFEI)

• Currently promotes awareness in schools through posters and occasional activities

• Lacks:

  • Scientific rigour

  • Continuous engagement

• By contrast, United States Centres for Disease Control and Prevention recommends:

  • Enforcing tobacco-free school policies

  • Integrating prevention education from kindergarten to grade twelve

  • Training teachers and involving families

  • Supporting cessation for students and staff

  • Regular evaluation of programmes

Towards Better Regulation and Control

Challenge

• Tobacco industry has access to real-time sales data and uses it to adjust sales strategies

• Public health researchers lack timely data on tobacco consumption

Policy Recommendations

• Adopt a Tobacco Endgame Strategy through collaboration of multiple ministries:

  • Education

  • Finance

  • Health

  • Law

  • Social Justice

  • Commerce

  • Information and Broadcasting

  • Consumer Affairs

• Increase investment in research institutions to:

  • Produce updated and reliable data

  • Design and implement control measures

• Establish an independent oversight body to monitor and expose interference by the tobacco industry

• Use a combination of:

  • Demand-side measures (taxation, awareness, cessation support)

  • Supply-side measures (regulation, strict enforcement)

Conclusion

• India requires a comprehensive and multipronged strategy to reduce the tobacco burden

• The strategy must combine:

  • Strict laws

  • Higher taxation

  • Effective awareness programmes

  • Social and community support

  • Strong school-based interventions

  • Independent oversight mechanism

• Long-term collaboration between policymakers, researchers, and implementers is essential to achieve the vision of a tobacco-free India