Despite being a regional leader in formulating tobacco control laws, India is still struggling to curb tobacco addiction among its citizens. At least 94 per cent of tobacco users in the country have no intention to quit, says a report by Tobacco Control Policy Evaluation Project India (TCP India project), which was released on Thursday. The TCP India project is part of the International Tobacco Control Project, a multi-country initiative to evaluate the impact of Framework Convention on Tobacco Control of WHO.
The reports blames India’s failure on a combination of factors, including low levels of awareness of the risks associated with tobacco, poor enforcement of existing laws and affordability of tobacco.
The TCP India project’s findings are based on surveys in Bihar, Madhya Pradesh, Maharashtra and West Bengal, where it interviewed 8,000 tobacco users and 2,400 non-tobacco users on the effectiveness and impact of tobacco control laws in India.
In Madhya Pradesh, only 18 per cent smokers were aware of such laws, while the percentage was higher for Maharashtra (35 per cent), Bihar (54 per cent) and West Bengal (59 per cent). In all four states, there was a lack of compliance with indoor smoking bans in hospitality venues, particularly in bars. The current tobacco uses among adults ranges from 23 to 47 per cent, notes the survey report.
The survey further reveals that in all the four states, the prevalence of tobacco use was high among men and low-income and less-educated adults than women and high-income and more highly educated adults. The World Bank recommends imposing 66 to 80 per cent of tax on the retail price of tobacco products to deter people from consuming tobacco. But in India, taxes account for approximately 38 per cent of the retail price of cigarettes and 9 per cent of the retail price of bidis. Smokeless tobacco products are often sold tax-free.
More than three-quarters of smokers in each of the four states said they were aware that smoking cigarettes and/or bidis can lead to lung, throat, and mouth cancers. At least two-thirds of smokeless tobacco users were aware that tobacco causes throat and mouth cancer, and gum diseases. More than half were aware that using smokeless tobacco causes heart disease. The majority of smokers (63 to 81 per cent) and smokeless tobacco users (64 to 87 per cent) expressed regret for their addiction, but most of them (as many as 94 per cent) have no intention to quit.
“Tobacco use accounts for nearly half of all cancers among men and a quarter of all cancers among women. It is estimated that there will be 1.5 million tobacco-related deaths annually by 2020,” says Bhavna Mukhopadhyay, executive director, Voluntary Health Association of India. There are approximately 275 million tobacco users in India, she adds.