A man lights a cigarette along a road in Mumbai, India. Photo: Reuters/Danish Siddiqui
A man lights a cigarette along a road in Mumbai. Photo: Reuters / Danish Siddiqui

When will India ban cigarettes for its future generations? Are we making sure that young people never start smoking? Young kids, walking around with smokes in their mouth in streets and no has an answer how they’re getting these smokes? Is India taking up any bold proposal, aiming to outlaw tobacco consumption for the next generation and moving the country to be tobacco free within five to 10 years?

No one has any specific answer to these critical questions. According to a government estimate, smoking-attributable annual deaths were about 930,000 in 2020-21 while smokeless tobacco (SLT) accounted for about 350,000. Both smoking and SLT together accounted for about 1,280,000 deaths per year or about 3,500 deaths (mostly horrible ways to die) every day. (The population of India in 2020 was 1.38 billion.)

Tobacco use is a major risk factor for non-communicable diseases (NCDs) such as cardiovascular ailments, cancer, chronic lung disease and diabetes. NCDs are estimated to account for 63% of all deaths in India, and that number is expected to rise further.

Tobacco use is also a risk factor for infectious diseases such as tuberculosis. A total 20% of the global TB incidence is attributed to smoking. The percentage of death is higher (38%) among TB patients associated with tobacco use. 

The author of this article and AF Development Care director Sachi Satapathy presents a copy of his new book Women and Distress Employment to the cabinet minister of labor and employment, Bhupender Yadav, in New Delhi on May 2, 2022. The book is based on research on female beedi (hand-made cigarette) workers..Of the 267 million tobacco users in India, nearly 72 million adults smoke beedi, and beedi smoking is killing 600,000 people (mostly poor) in India annually.

If one examines the disease burden of only  tuberculosis and cancer cases and deaths due to TB and cancer, the Indian government has no option left but to take strong steps to end the tobacco epidemic.

Apart from strengthening anti-tobacco law and increasing tax on tobacco products, there is not much discussion within policy circles on ways to reduce the tobacco burden on such a huge vulnerable population.

Looking at the disease burden (mostly rapid rise of cancers due to SLT) on tobacco consumers and penetration of smokeless tobacco, beedi in rural areas, it is high time for the government to go further on regulating production and retail sales of such tobacco items in the rural areas

The benefits of poverty-alleviation programs, welfare schemes, and direct transfer programs must be preferentially offered to non-tobacco users. Those states reporting above 40% tobacco consumption should abandon their existing tobacco policy and come up with new plans to curb production and supply of such tobacco products to reduce the health risks.

These micro-level interventions would be of more help than current national-level programs. All states (particularly those reporting above 40% prevalence) should implement tobacco censuses and use the census number as baseline (instead of relying on World Health Organization estimates) to monitor the progress of tobacco reduction. 

With a record 3,500 tobacco deaths every day in India, business as usual without any strong steps will make the situation worse. Tobacco is the most harmful consumer product in history and there is no other option but to phase it out. India must plan to go beyond helping people to quit smoking.

With so many deaths from a known source, why can India not adopt a law similar to what New Zealand enacted this year. That country’s new tobacco law says that anyone born after 2008 will not be able to buy cigarettes or tobacco products in their lifetime.

Cigarette, beedi and smokeless tobacco products are available in every nook and corner of India. Will government bring major reform to reduce the number sale of these products by half at least in next two or three years?

Without any further delay, government can bring forward a new plan to allow only the sale of tobacco products in each 30-40-kilometer radius by only approved and licensed shops. This strategy would substantially reduce the existing easy accessibility of tobacco products.

This author doesn’t think tax increases will have any further impact on tobacco consumption. It’s really hard to quit and we feel if we did that, we’d be punishing those people who are addicted to cigarettes even more. Tax measures tend to place a higher burden on lower-income people, who are more likely to smoke. 

Government’s priority must be to bring new legislation to make sure young people never start smoking so it will be an offense to sell or supply tobacco products to young, new buyers. This is the only option to aspire for a tobacco-free India.

Sachi Satapathy is an international development practitioner who has worked on large-scale projects. His interests are in public policy, poverty alleviation and public-private partnerships for development in middle-income and developing countries.