A study assessing data from 130 countries found that point of sale advertising bans is significantly associated with reduced smoking experimentation among youth.
By Dr Binod K. Patro, MBBS, MD, MAMS, DFID, DCMH, PGDHHM
The COVID -19 catastrophe has laid bare the fragility of India’s health care system. The public healthcare system particularly has been overburdened irrespective of a pandemic. With close to 4 million covid-19 cases, over 65000 deaths and counting as of September 01, India is expected to cross the USA and Brazil in the number of infections. About 82% of those who succumbed to the virus, were suffering from co-morbidities like hypertension, diabetes, cancer, and cardiac ailments. The patients could have fought the virus much better if not for their comorbidities. This reiterates the importance of living healthy and preventing lifestyle diseases to reduce the pressure on an overburdened healthcare system.
Prime Minister Modi has emphasized the importance of good health with him pioneering initiatives like Yoga day and the Fit India Movement – encouraging people towards adopting healthy lifestyles. As a next step, it is time to consider policy decisions that would limit access to products with detrimental effects on one’s health like tobacco.
According to Global Adult Tobacco Survey-India (GATS2), India is home to over 27 crore tobacco users and globally is the second largest producer and consumer of tobacco products. Estimates available in India show that smoking-related annual deaths were about 930,000, while the smokeless tobacco (SLT) attributable annual deaths were pegged at 350,000, together accounting for 1,280,000 deaths per year or 3500 deaths every day. The use of tobacco is a major risk factor for four main Non-Communicable Diseases (NCDs) — cardiovascular disease, cancer, chronic lung disease and diabetes. NCDs are estimated to account for 63% of all deaths in India and these are expected to rise further.
A case against tobacco has always been a compelling one. Under the current circumstances, it has become a necessity. The government must ensure that it increases the cost of access to tobacco for smokers and at the same time reduce access to it. It is time that the government amends the COTPA to tighten the noose on tobacco even further. COTPA in many ways aligns with the international treaty, the WHO Framework Convention on Tobacco Control (WHO FCTC). However, the act needs to go further and plug some of the gaps in the legislation to make it an effective tobacco control law. Every two years, WHO releases a report on the Global Tobacco Epidemic (GTCR) which cites country level compliance with key policy areas. The 2019 report noted that India is yet to meet the best practice standard in two key policies that are covered under COTPA: smoke-free environments and tobacco advertising.
To achieve that, here’s what needs to be done:
Abolish all designated smoking areas in airports, hotels, and restaurants
Comprehensive smoke-free laws that include workplaces, restaurants, and bars are estimated to reduce the risk of heart attack by 85%, improve the respiratory health of workers, and may also reduce the risk of stroke. Many of India’s State Health Acts do not allow for designated smoking areas in their tobacco control provisions. At least 61 countries have comprehensive bans on smoking in indoor public places, and at least 42 countries completely ban smoking in airports. Brazil, Canada, and Moldova are notable examples of countries with these policies
Ban all point of sale advertising and point of sale tobacco product displays
A study assessing data from 130 countries found that point of sale advertising bans is significantly associated with reduced smoking experimentation among youth. A study reviewing data from 77 countries estimated that having a point of sale display ban reduced daily smoking prevalence by about 7%. At least 42 countries comprehensively ban TAPS including point of sale advertising. 21 of these countries also ban tobacco product display.
Prohibit sales of single stick cigarettes
Evidence suggests that availability of single cigarettes facilitates smoking among youth and people with fewer resources, and that having greater accessibility of single cigarettes reduces the likelihood that smokers will make a quit attempt. It is therefore important that sale of individual cigarettes be outlawed with heavy penalties.
The Union Health Minister Dr Harsh Vardhan has led the way as a champion of tobacco control. I am hopeful and sure that with his expertise and the leadership of PM Modi, India will drastically cut down on its tobacco consumption leading to healthier lives and reduced burden on the health system.
(The columnist is Additional Professor & Addl Medical Superintendent, Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar.)