• 3/3/2005
  • New Delhi, India
  • Tribune de Genève (Geneva Tribune)

India, which accounts for one-sixth of tobacco illnesses worldwide, faces an uphill battle to crack down on the use of the product as a global anti-smoking treaty takes effect, officials say.

India, one of the early ratifiers of the tobacco control measure that came into operation last weekend, has already passed a law to tackle tobacco use in the country where 2,200 people die daily from tobacco-related diseases. But the government has found it tough going to implement the legislation that includes measures banning smoking in public places.

“Only a holistic approach can work. The campaign should combine coercive methods with education,” said Sajeela Maini, president of the Tobacco Control Foundation of India.

At the moment people in the country of over one billion flout the law, smoking nearly everywhere they please. Shopowners have also paid little heed to the law forbidding them from selling tobacco products near schools.

Authorities have been relying on an overstretched police force to enforce the anti-tobacco legislation which contains fines of 200 rupees (4.50 dollars) for smoking in public places, a sizeable sum in a country where up to 400 million people live on less than a dollar a day.

But with corruption rampant and major crimes to tackle, cracking down on tobacco miscreants has been low on the police’s priorities. So for the moment, the main thrust is educational.

“Our plan is to focus on information, education and communication with the help of social groups. It will help to discourage the use of tobacco,” Health Ministry Joint Secretary Bhavani Thyagarajan told AFP.

A health activist said education would play a key role as it would help the more educated, younger generation make an informed choice.

“It’s important as it will draw away those who are not yet addicted,” said Monica Arora, director of the non-governmental group Hirday (the Heart).

The financial imperative for curbing tobacco use is clear in India. Treating tobacco-related illnesses impose an annual financial burden of over 300 billion rupees (seven billion dollars) on India’s emerging economy. While there is no state-provided health system, many patients seek treatment in heavily subsidised government hospitals.

Globally, tobacco kills five million people every year, according to the World Health Organisation (WHO), with deaths expected to hit 10 million a year in two decades and with 70 percent of those in developing nations.

Health officials add one of the most urgent needs in India is to combat the habit of chewing tobacco. Indians account for over 90 percent of the world’s oral cancer patients. A report on tobacco control by the government and the WHO says the tobacco scourge is more difficult to check in India as the pattern of consumption differs from the rest of the world.

“Global literature is only of limited help in assessing the problem … since the dominant and the most researched form of tobacco use globally is cigarette smoking,” it said.

Tobacco rolls called beedis and chewing tobacco are the most widely-consumed, while cigarettes are smoked by a small number of the elite. Flavoured chewing tobacco is so popular entire families eat it after meals. One in every two males in India uses tobacco, while use among women varies from region to region from between two to 21 percent.

In a bid to crack down on smoking in public places, the health secretary said the government planned to “empower different types of government employees to take action.”

“All will be asked to help — from bus ticket collectors to school teachers,” Thyagarajan said. But just exactly what powers they will have still are being decided.

“They will definitely be told who to contact if they see smoking in an illegal place,” said a government official, who did not wish to be named.

“The idea is not to fine people but to make them aware they are wrong. It may be baby steps but if even 50 percent of people stop using tobacco, the job is done.”

India has already banned all direct tobacco advertising as well as tobacco sponsorship of sports events. It also plans, in line with the global treaty, to slap strong health warnings on tobacco packages. Activists detect some progress.

“The heartening thing is awareness is growing among people — at least in cities. Non-smokers are standing up and asking people to ‘stub that thing out’,” said Arora.