Tobacco consumption in India

SYLLABUS:

GS 2 > Social justice  >   Health

REFERENCE NEWS:

• World No Tobacco Day, celebrated annually on May 31st and organized by the WHO, emphasizes the health risks of tobacco and promotes policies to reduce its consumption. Tobacco, a leading preventable cause of disease and death globally, poses significant health, environmental, and economic challenges in India.

STATISTICS:

• According to the World Health Organization (WHO), tobacco use in India is responsible for nearly 1.35 million deaths every year.
• As per the WHO, with nearly 29% of adults using tobacco, India is the second-leading consumer of tobacco products after China.
• As per the WHO, for every Rs 100 collected in excise taxes from tobacco products, the Indian economy loses Rs 816 due to healthcare costs, reduced productivity, environmental damage, and social costs.
• A WHO study reveals that India loses 1% of its GDP (2017-18) due to diseases and premature deaths caused by tobacco use.

IMPACTS OF TOBACCO CONSUMPTION ON INDIA:

HEALTH IMPACTS:

• Chronic diseases: 
  • Tobacco use is a major risk factor for many chronic diseases, including cancer, lung disease, cardiovascular disease and stroke.
  • For instance, In India, tobacco-related cancers accounted for 27% of the country’s cancer burden in 2020, according to the Indian Council of Medical Research.
• Health Risks to Industry Workers: 
  • Over 6 million individuals employed in the tobacco industry are at risk due to the absorption of tobacco through their skin, which can lead to various diseases, including skin conditions, respiratory illnesses, cardiovascular diseases, and cancers.

ENVIRONMENTAL IMPACTS:

• Soil Degradation: 
  • Tobacco is a highly erosive crop that depletes soil nutrients at a rapid rate, necessitating increased use of fertilizers. This further deteriorates soil quality and affects long-term agricultural sustainability.
• Deforestation:
  • Processing tobacco requires substantial amounts of wood. Approximately 5.4 kg of wood is needed to cure 1 kg of tobacco, contributing significantly to deforestation.
• Waste Generation: 
  • The tobacco industry generates about 1.7 lakh tonnes of waste annually in India. This includes non-biodegradable waste from cigarette filters, packaging materials, and other by-products of tobacco production.

ECONOMIC IMPACTS:

• Healthcare Costs: 
  • A 2021 study by the World Health Organization (WHO) estimated that the impact of tobacco on health cost India more than ?1.7 lakh crore in the fiscal year 2017-2018. This figure starkly contrasts with the Union Budget allocation for health in the same year, which was ?48,000 crore.
• Waste Management Costs: 
  • A WHO report from 2022 revealed that the cost of cleaning up tobacco-related waste in India is estimated to be around ?6,367 crore annually. 
  • This cost falls on taxpayers rather than the tobacco industry, highlighting the significant environmental and financial burden caused by tobacco products in the country
• Economic Losses from Soil Erosion and Deforestation:
  • Though precise figures are not available, the economic costs due to soil erosion and deforestation caused by tobacco cultivation are significant but excluded from the above estimates.

SOCIAL IMPACTS:

• Addiction and Social Welfare:
  • Tobacco addiction disrupts family and social life, reducing workplace productivity and draining economic resources, especially in lower-income families.
  • For instance, this addiction strains financial resources, particularly in lower-income households, where up to 10% of household income is spent on tobacco products, significantly impacting family welfare and economic stability.
• Impact on Youth:
  • A study by the Ministry of Health and Family Welfare highlights that nearly 14.6% of students aged 13-15 years use some form of tobacco in India. Early initiation into tobacco use is linked to higher addiction rates and long-term health issues, perpetuated by aggressive advertising and media portrayal.

CHALLENGES ASSOCIATED WITH TOBACCO CONTROL IN INDIA:

Legislative Weaknesses and Non-compliance:

• COTPA Packaging Guidelines: Smokeless tobacco products are predominantly non-compliant with the packaging guidelines stipulated by the Cigarettes and Other Tobacco Products Act (COTPA). This includes failures in displaying mandatory health warnings.
• Surrogate Advertising: Despite the ban on direct tobacco advertisements, indirect advertisements, such as those seen during the ICC Men’s Cricket World Cup 2023, promote tobacco use through proxy products like elaichi, endorsed by celebrities.
• Amendment Proposals: Amendments to COTPA were proposed in 2015 and 2020 but were not passed. The 2015 changes included regulating surrogate advertisements, including films and video games in the definition of ‘advertisement,’ and increasing fines for advertisement violations tenfold. The 2020 proposal sought to require licensing for the production, supply, and distribution of tobacco products.

Ineffective Implementation and Enforcement

• National Tobacco Control Programme (NTCP) Effectiveness: A 2018 study in BMJ Tobacco Control reported no significant reduction in bidi or cigarette consumption in NTCP districts, citing reasons like insufficient staffing and poor monitoring mechanisms.
• Excise Duty and Tax Evasion: Tax evasion tactics include purchasing tobacco in lower tax jurisdictions and smuggling. Despite recommendations from the Framework Convention on Tobacco Control (FCTC) to impose a tax burden of at least 75%, the actual tax burden remains 51% for cigarettes, 22% for bidis, and 64% for smokeless tobacco products.
• Prohibition of Electronic Cigarette Act (PECA), 2019: Despite the ban on e-cigarettes, they remain a public health challenge, with 23% of adults in an online survey reporting usage.

Public Health and Industry Interference

• Tobacco Lobbying: Effective lobbying has led to extended cess exemptions for bidis and smaller tobacco manufacturers. Government officials, both active and retired, allegedly engage with the tobacco industry. For example, a retired IAS officer joined the board of Godfrey Phillips, a major tobacco company,  in 2022. 
• Tobacco Interference Index: The worsening score on the tobacco interference index indicates increasing tobacco industry influence in governance. For instance, the Central government holds a 7.8% stake in ITC Ltd., India's largest tobacco company.

Data and Monitoring

• Need for Up-to-date Data: The lack of current and comprehensive data on tobacco usage and industry strategies hinders effective tobacco control policies and interventions.

Cultural Norms and Tobacco Use:

• Tobacco use is often embedded in cultural practices, which can perpetuate its use and complicate efforts to quit. For example, in many communities, pan chewing—a mixture that often includes tobacco—is a traditional offering at social and ceremonial events like weddings and religious ceremonies. 

WAY FORWARD:

• Support for Tobacco Farmers: Studies by the Central Tobacco Research Institute suggest that switching to alternative crops like jowar could be more profitable for tobacco farmers, with a net return per rupee of investment in jowar cultivation at 1.84 compared to 1.48 for tobacco. Government incentives and financial support should be provided to facilitate this transition.
• Increase Tobacco Taxation: Raise taxes on all tobacco products, including bidis, to at least 75% of the retail price, in line with WHO recommendations. This would reduce consumption and generate revenue for health programs. Address tax evasion by implementing digital tracking systems for tobacco products and stricter border controls.
• Enhance Public Awareness: Design and implement comprehensive public awareness campaigns tailored to different demographics, including youth and rural populations. Integrate tobacco control education into school curricula and community health programs, and expand access to tobacco cessation services, including counseling and support groups.
• Strengthen Legislative Measures: Enforce stricter regulations against surrogate advertising and ensure compliance with packaging and health warning regulations for all tobacco products. Revisit and pass the proposed amendments to the Cigarettes and Other Tobacco Products Act (COTPA) to include higher fines for violations and extend the definition of advertisements to cover all media.
• Improve Implementation of NTCP: Increase funding and resources for the National Tobacco Control Programme (NTCP), ensuring adequate staffing and robust monitoring mechanisms. Strengthen local governance and involve community-based organizations in monitoring and reporting tobacco control law violations.
• Address Industry Interference: Enforce transparency in government interactions with the tobacco industry and implement strict conflict-of-interest regulations to prevent industry influence in policy-making. Engage civil society organizations, health experts, and international agencies in tobacco control efforts.
• Enhance Data Collection: Conduct regular, comprehensive surveys to gather up-to-date data on tobacco use, health impacts, and industry strategies. Utilize digital tools and technology to monitor tobacco sales, usage patterns, and compliance with regulations, providing real-time data to address emerging challenges effectively.

PRACTICE QUESTION:

Q. Discuss the multifaceted impacts of tobacco consumption in India. (10 marks, 150 words)