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Health officials in the US are optimistic that tobacco-use could go down in the coming years and become zero or negligible by 2050. With the current anti-tobacco propaganda, fall in smoking rates and a younger generation averse to smoking, it does seem feasible in the US but will it work in India?
Dr Pankaj Chaturvedi, Professor and Cancer Surgeon at the Tata Memorial Hospital and one of India's most vehement anti-tobacco campaigners points out that cancer, heart disease and lung disease three of the most common ramifications of tobacco use are also three of the biggest killers. He said: 'Tobacco use is responsible for 70% of all heart disease cases, 80% of lung diseases and 50% of cancer cases. Instead of losing crores, battling these ailments we can just remove the root cause of it.'
The anti-tobacco propaganda might seem boring to some people, many complain about the ads they are forced to see before movies or the lines that come up every time someone smokes or drinks onscreen but they've to realise that tobacco is without a doubt the most dangerous weapon of mass destruction conceived. It has killed more people than AIDS, malaria, dengue, natural calamities and wars put together!
Just imagine the lives you could save by ridding the world of tobacco. The fact that it's still available as a product which isn't outlawed by society is sacrilegious but the tobacco lobby has a very strong hold. But the voices against tobacco are being heard and it can be envisioned that our children will grow up in a world which knows nothing about tobacco-use.
The situation in India fire without smoke
In India, it's estimated that smoking killed 100 million people in the last 100 years of which 77 million are beedi smokers. Tobacco also causes:
Shockingly, tobacco is the leading cause of preventable deaths amongst the youth and the only consumer product that has absolutely no use apart from causing death and disease. It comes with a warning sign 'tobacco kills', yet it's available for Rs 2 at every nook and corner. Dr Chaturvedi points out: 'It not only harms the users but also the generation that is yet to be born. It is most important cause of still birth, intra uterine grow retardation, birth anomalies when foetus is exposed to smoke. Tobacco is known to cause mutations in sperms that can be transmitted to the offspring rendering future generation vulnerable to several diseases.'
But smoking is not the main source of tobacco consumption in India that dubious honour goes to smokeless tobacco consumption, particularly among the lower socio-economic groups. Dr Chaturvedi points out that smoking is just the tip of the iceberg. He said: 'Estimates suggest that India has 35% tobacco users of which 21% chew tobacco, 9% smoke and 5% do both. Even amongst the smokers only 3% are cigarette smokers.' He explains how tobacco companies worked very hard to make smokeless tobacco consumption a cool thing in India. 'Tobacco was traditionally consumed in paan and this was never something 'cool' for youngsters. So companies packaged them in gutka packets or as pan masala.'
The step forward
There's no doubt that if we need to strive for a tobacco-free world, the first issue is to make sure that youngsters are not initiated into smoking or consumption. That age is usually 16-18, an age when vulnerable youngsters want to do anything that's forbidden. That's the age Dr Chaturvedi believes we should make sure youngsters don't get hooked. It's obvious that in India, unlike the rest of the world, the problem is smokeless tobacco consumption. The War on Tobacco, believes Dr Chaturvedi, needs to be fought on three fronts. They are:
Implementing existing laws - Cigarette and Other tobacco products act 2003 and Food Act 2006
Steps need to be taken that the laws which ban tobacco advertisements (directly and indirectly) be strictly followed. There should be no ads endorsing any sort of tobacco products, effective pictorial warnings and also reduce the tobacco supply. Currently, several states (Maharashtra, Andhra Pradesh, Goa, Manipur, Mizoram and Dadra Nagar Haveli) have banned all forms of flavoured smokeless tobacco and Assam recently banned all forms of chewing tobacco and other states need to follow this. Enforcement continues to be our Achilles' heel and needs urgent attention. There's also a need to crackdown on the illegal sales of these products. The sale to children needs to be completely prohibited and sales near educational institutions need to be banned. The practice of selling gutka and pan masala separately also needs to be stopped.
If implemented properly, these rules will mean that since smokeless tobacco will no longer be freely available, consumption will go down with time. Also, companies will find it very hard to entice the next generation of tobacco-consumers. Of course, addicts will find a way to smuggle in tobacco from different states but the children will be spared.
Take a stand
The government, both at the Centre and the various states, need to take a stand. While the price of cigarettes continues to go up, cigarette smokers constitute only 3% of the 35% that use tobacco in this country. Beedis and smokeless tobacco products continue to be relatively cheap and even for cigarette users the prices aren't as exorbitant as the developed nations where it's practically impossible to smoke. A packet of cigarettes in India still costs US$ 2.5 compared to the US where it costs US$ 12.
The government needs to take a stand and raise the taxes on non-expensive tobacco products which will deter smokers. There really is no justification for giving subsidies to a product that will kill its users. A study in Euro Monitor Report 2013 actually showed that has been a reduction in volumes 26% among smokeless tobacco and 3% in cigarettes which shows that lack of demand can cut supply.
Big tobacco has been trying hard to tell companies that increase in tax won't result in more revenue but that's simply not the truth, says Dr Chaturvedi who has RTI documents to back up his statements.
The third and most vital step is to increase awareness. Take a stand from a young age; include tobacco awareness in the curriculum. Before companies can target potential users, we need to target them. We as a whole need to de-normalise tobacco use among people, the social gatherings where people smoke needs to be done away with. In fact, religious upbringing could play a major part in this. Dr Chaturvedi points out: 'It's the norm for many Hindus to not eat meats. It won't matter whether they're abroad or not. They just consider it to be part of their morality to not eat it. Similar values need to be passed down to our youngsters, that it's morally wrong.'
Here's more on tobacco use in India:
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