Tobacco/ cigarette consumption: India
This is a collection of articles archived for the excellence of their content.
Elusempon village, c1980-
A village in Tamil Nadu’s Villupuram district, which banned the sale and consumption of tobacco products including cigarettes four decades ago, continues to set an example for other villages to become tobacco-free hamlets in the state.
A clear majority of the last three generations of residents of Elusempon village, 20km from Villupuram town, do not use any tobacco products. A few villagers, who use tobacco products respect the elders’ diktat, passed four decades ago, and step out of the village to consume them. There are more than 570 families with over 2,700 population in the village. The villagers request the people visiting the hamlet not to smoke or consume tobacco products within the village limits.
“A fire accident caused by a beedi bud poorly discarded by a smoker razed down a few thatched houses, destroying properties of poor villagers four decades ago forced the villager elders to enforce a ban on selling and consuming tobacco products within the village. Since then the next three generations of people respect the elders’ order and still maintain the tobacco-free identity of the village. You can notice posters in all parts of the village proclaiming that smoking is banned in the hamlet,” said P Pushparaj, 28, who runs a digital weighbridge unit.
The villagers said there were a few people in every generation, who made a hue and cry on the ban on tobacco products. “There will be few people who will not fall in line and follow public discipline. Since we were stubborn not to yield to their tantrums, they started adapting and go out of the village to smoke or consume tobacco products. Most visitors are taken aback when we object to their consuming tobacco products but later appreciate our decision,” said a shopkeeper. And again, there were a few instances that led to heated arguments and villagers and visitors exchanged blows.
Laws, rules, court judgements
Herbal hookahs not completely prohibited: HC
Delhi high court has stayed police’s move to ban all types of hookahs and clarified that those without tobacco or nicotine (herbal) are not completely prohibited.
In a recent order, Justice Navin Chawla granted relief against the circular banning hookah, to an eatery near IGI airport, staying the part where it was not allowed to even sell herbal hookahs.
The court underlined that it is evident from the definition of “smoking” as provided in The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act (COTPA), 2003 that smoking means smoking of tobacco in any form or with the aid of any instrument.
Referring to the direction issued by Delhi Police and the government, the HC noted it “merely directs conducting of raids in all restaurants/ eatery houses /hotels to ensure that in name of herbal hookahs nicotine of tobacco is not served. Prima facie, it does not completely prohibit the use of hookahs in Delhi.”
The HC, however, made it clear that the eatery would be bound by its undertaking given in the court that the hookahs being served would be purely herbal in nature. The restaurant owner had moved HC challenging the direction issued by the DCP/IGI Airport last month, prohibiting serving of hookahs in the restaurants/pubs/bars located at Aerocity.
Death by smoking
Nicotine addiction: the health aspect
FROM THE ARCHIVES OF ‘‘THE TIMES OF INDIA’’: 2008
Chicago: For some people, one cigarette is all it takes to become hooked on nicotine, while others are repelled by it. Researchers in Canada have found a region in the brains of rats that may be the key to these differences.
By manipulating specific molecular doorways into brain cells called receptors, they were able to control which rats in the study enjoyed their first exposure to nicotine and which were repelled by it.
“Our findings may explain an individual’s vulnerability to nicotine addiction and may point to new pharmacological treatments for the prevention of it and the treatment of nicotine withdrawal,” said Steven Laviolette of the University of Western Ontario, who reported his findings in the Journal of Neuroscience.
Several studies have found that certain people are especially responsive to the effects of nicotine.
One, published last October in the journal Pediatrics, found teens who felt relaxed after their first drags on a cigarette were far more likely to become addicted to smoking.
“During the early phase of tobacco exposure, many individuals find nicotine highly unpleasant and aversive, whereas others may become rapidly dependent on nicotine and find it highly rewarding,” Laviolette said.
To explore the difference, Laviolette and colleagues did a series of experiments on rats, which have brain structures similar to humans.
They zeroed in on two areas in the reward circuit of the brain called nucleus accumbens. They found specific receptors of the message-carrying chemical dopamine in the core and shell of the nucleus accumbens controlled whether the rats enjoyed or were repelled by nicotine.
When the researchers blocked two types of dopamine receptors — D-1 and D-2 — with drugs delivered to these areas of the nucleus accumbens, the rats experienced nicotine as a positive, rewarding experience. “We were able to switch nicotine’s aversive effects to rewarding effects,” Laviolette said. Laviolette said “naturally occurring differences” in these receptors may account for why some people are more susceptible to nicotine addiction. REUTERS
India among worst 4
Smoking causes more than one in 10 deaths worldwide (equivalent to 6.4 million deaths), with 50% of these occurring in just four countries -China, India, US, and Russia, according to the latest estimates from the Global Burden of Disease study published in `The Lancet’.
India is also among the top 10 countries together accounting for almost twothirds of the world's smokers (63.6%) in 2015.
The new estimates, based on smoking habits in 195 countries between 1990 and 2015, illustrate that smoking remains a leading risk factor for death and disability despite many countries applying tobacco policies resulting in reductions in smoking prevalence.
Warning that the war against tobacco is far from won, the authors of the study argue that policy-makers need renewed and sustained efforts to tackle the epidemic.
“Despite more than half a century of unequivocal evidence of the harmful effects of tobacco on health, today , one in every four men in the world is a daily smoker,“ said senior author Dr Emmanuela Gakidou, Institute for Health Metrics and Evaluation at the University of Washington, USA. “Smoking remains the second largest risk factor for early death and disability , and so to further reduce its impact we must intensify tobacco control to further reduce smoking prevalence and attributable burden.“
Government estimates show in India over 5,500 youth start tobacco use every day , whereas around 35% of adults consume tobacco in some form or other. Over 25% of females start tobacco use before the age of 15 in the country .
Sin taxes/ 2014-early 2017
Tobacco sale has contributed Rs 19,293 crore in central taxes till January in 2016-17, the government said on. “The figure for 2014-15 and 2015-16 stand at Rs 22,174 crore and Rs 19,977 crore respectively ,“ Health minister J P Nadda said in a written reply in the Rajya Sabha. He said there was no earmarking of funds to the healthcare sector out of the funds collected from taxes on tobacco.
Replying to another question, minister of state for health Anupriya Patel said as per the report on tobacco control, published in 2004, India is the second largest consumer of unmanufactured tobacco in the world, and about 8-9 lakh Indians die of tobacco-related diseases every year.
“As per the report of `Global Adult Tobacco Survey (GATS) India 2009-10', 35% of adults in the age group of 15 years and above use tobacco in some form or the other, whereas 33% adult males and 18% adult females in the country consume smokeless tobacco products,“ she said.
The Times of India, Oct 03 2015
Source: Tobacco Labelling Research Centre, International Status Report, Sep-2014; Research: Atul Thakur
According to the guidelines of the WHO Framework Convention on Tobacco Control, well designed pictorial warnings on cigarette packets are among the most cost-effective ways to increase awareness about the health effects of smoking.On an average, a pack-a-day smoker would look at it 20 times a day or over 7,000 times a year. According to the Tobacco Labelling Research Centre, an organisation developed with the support of the WHO Framework Convention Alliance and the International Union Against Tuberculosis And Lung Disease, pictorial warnings are mandatory in 77 countries. In 2001, Canada became the first country to implement such warnings. Thailand has the world's largest warning size.
Health warnings/ Cigarettes and Other Tobacco Products (Packaging and Labelling) Rules
The Times of India, Jul 6, 2016
Udit Prasanna Mukherji
85% pictorial health warning on cigarette pack to cost govts Rs 7k cr/yr in revenue
The new 85% pictorial health warning on legal cigarette packets may lead to a revenue loss of over Rs 7,000 crore for the Centre and states in this fiscal itself, feels the tobacco industry. The main reason cited is the proliferation of illegal smuggled cigarettes without any pictorial warning. The representative body for tobacco firms, Tobacco Institute of India (TII), and cigarette makers like ITC and Godfrey Phillips have argued that the illegal tobacco trade is on the rise since the new graphic warning rule was unveiled from the second week of May 2016.
According to industry estimates, for just 1% shift in consumption from legal cigarettes to illegal and smuggled cigarettes, there is a revenue loss of Rs 2,300 crore to the exchequer. So, if the industry estimates that there will be up to a 3% smokers' shift to illegal cigarettes, the loss will amount to Rs 6,900 crore. According to a Ficci study, the Central and the state governments are already losing Rs 9,000 crore per year owing to the illegal tobacco trade, which represents a growth of nearly 50% over a two-year period. So the gross revenue leakage may go up to Rs 16,000 crore.
The chairman of Godfrey Phillips, K K Modi, indicated that there has been a fall in the demand of legal cigarettes in the last two months. "It is difficult to quantify the exact fall in demand of legal cigarettes right now. But I think it is 2% or could be even more. In another month, we will be in a position to assess this," he said. "There is evidence that the growth of illegal tobacco will go up from 21% to 23% at least."
According to an independent study conducted by renowned global research organisation Euromonitor International, India is now the fourth largest market for illegal cigarettes in the world. The report estimates the illegal trade — comprising smuggled foreign and domestically manufactured tax-evaded cigarettes — to constitute one-fifth of the cigarette industry in India.
The tobacco-to-hotel-to-FMCG giant ITC, in its latest annual report for the AGM on July 22, echoed Modi's view. It has said that the new graphical health warning will encourage the flow of illegal international brands into the country. That's because such brands are manufactured in many jurisdictions that do not mandate the printing of graphic health warnings on cigarette packages as applicable in India. "The legal cigarette industry in India will be hard-pressed to counter the menace of illegal cigarettes as they will be perceived by the consumer to be safer in the absence of the statutorily mandated health warnings," ITC added.
TII also feels that there will be a spurt in illegal cigarette trade in India. "It has been experienced globally that severe regulations provide an impetus to the illegal cigarette trade. In fact, countries such as Australia and Thailand, are witnessing a huge spurt in illegal cigarette trade following implementation of drastic packaging regulations. India cannot be an exception to this global trend and would, therefore, witness a jump in illegal cigarette trade," TII added.
The institute has claimed that the illegal cigarette trade in the country has grown by more than 40% since 2008, the year prior to implementation of pictorial warning in the country and more than doubled since the enactment of the Cigarettes and Other Tobacco Products Act, 2003 (COTPA) for prohibition of ads and regulation of trade, production, supply and distribution.
2016: India, third largest pictoral representation
The Indian Express, November 11, 2016
After a long and bitter battle for 85 per cent pictorial warnings on tobacco packets, India has jumped from 136th position to third position on pictorial health warnings, according to a report released.
The Cigarette Package Health Warnings International Status Report by the Canadian Cancer Society was released at the seventh session of the Conference of the Parties (COP7) to the WHO Framework Convention on Tobacco Control (FCTC) being held at Greater Noida.
2016: SC sends all petitions against 2014 rules to Karnataka HC
The Times of India, May 05 2016
Amit Anand Choudhary
The Supreme Court directed companies that manufacture tobacco products to comply with the 2014 rules to have pictorial warnings covering 85% of the surface of packets of cigarettes and other commodities till the validity of the law is decided by the court.
Holding that the health warning was meant to educate people about the harmful effects of tobacco consumption and smoking, a bench of Justices P C Ghose and Amitava Roy said the manufacturers had a duty towards society to spread the message and directed the companies, in an interim order, to implement the rules.
The court passed the order on a batch of petitions filed by the manufacturers challeng ing the rules. Taking into account that multiple petitions have been filed in different high courts against the 2014 rules, the bench directed that all petitions be transferred to the Karnataka high court, which would adjudicate on the issue within eight weeks.
“We request all the petitioners that till the disposal of matters by the Karnataka high court, it will be the endeavour of all the parties to implement the rules whatever as amended. This order will not stand in the way of the HC de ciding the matter on merit.Any stay granted by any court shall not be implemented until the final order is passed by the HC,“ the bench said.
The Cigarettes and Other Tobacco Products (Packaging and Labelling) Amendment Rules, 2014 were brought into force by the Centre on April 1. Challenging the rules, Tobacco Institute of India (TII), which represents the interest of cigarette-makers, told the bench that the mandatory warnings were “unreasonable, drastic and impractical“ to implement and enforce. It said the existing graphic health warnings at 40% are adequate to inform and caution a person.
2017: Karnataka HC reinstates 2008 rule covering 40% of packet
In a ruling that will have ramifications across the country, the Karnataka high court struck down a rule mandating that 85% of the principal display area on packets of tobacco products be covered by specified health warnings.
A division bench comprising Justice B S Patil and Justice B V Nagarathna said that the new stipulation under the Cigarettes and Other Tobacco Products (Packaging and Labelling) Amendment Rules, 2014, is unconstitutional. It ordered that the 2008 rule — mandating that the warnings cover 40% of the packet — should replace the existing rule.
The amendment to the rule stipulated that specified health warnings — 60% pictorial and 25% text — should be positioned on the top-edge of the packet. The court struck that down, but provided scope for the Centre to reconsider the matter afresh.
In May 2016, the Supreme Court had transferred all petitions challenging the validity of the new rule to the Karnataka HC to enable expeditious disposal of petitions. Consequently, all related petitions pending before the Rajasthan, Gujarat, Delhi, Bombay and Calcutta HCs were transferred here.
Judges concur amendment is not valid
The two judges wrote separate orders, but concurred on striking down the rule. In his order, Justice Patil noted that the health ministry had unilaterally framed the rules without the concurrence of the other departments concerned. Justice Patil stated that the rules were illegal and ‘void ab initio’ as tobacco control and legislation is not attached to one department or ministry alone.
He further noted that the commerce department had opposed the 85% rule since it would lead to irreprehensible consequences without accruing any benefit. It had suggested warnings comprising only 40% or 50% of the packet. The judge also noted that the labour department had suggested that the beedi industry would be affected, while suggesting an audio-visual campaign instead of a pictorial warning Justice Nagarathna observed that the new rule violated Art19 (1) (g) of the Constitution and the makers of the law had not applied their minds while prescribing an 85% warning. The rule had no basis, she wrote in her order, as it is not in consonance with the parliamentary committee’s recommendation or expert committee. “Rotation of specified health warnings on packages within a short period causes economic and financial loss though the product is legally sellable,” the judge observed.
The new rules were notified on October 15, 2014.
2018: SC allows Big warnings on tobacco packs to stay
SC Stays Karnataka HC Order Reducing Their Size To 40% Of Surface Area
The Supreme Court said that cigarette and other tobacco product manufacturers must continue to display pictorial and statutory health warnings on 85% of the product pack area, while staying a Karnataka high court judgment reducing it to 40%.
“Keeping in view the objects and reasons of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 and the measures taken by the State, we think it appropriate to direct stay of operation of the judgement and order passed by the HC of Karnataka,” said a bench of Chief Justice Dipak Misra and Justices A M Kahnwilkar and D Y Chandrachud.
Tobacco product manufacturers led by senior advocate, made desperate attempts to thwart a stay on HC judgment and even offered to increase the pictorial warning size to 50% of the packet area. But the three-judge bench remained unimpressed while accepting attorney general K K Venugopal’s submission that pictorial warnings conveyed the hazardous effects of tobacco products even to the unlettered.
The bench said: “Though a very structural submission has been advanced by the counsel for respondents that it will affect their business, we have remained unimpressed by the said argument as we are inclined to think that health of a citizen has primacy and he or she should be aware of what can affect or deteriorate the condition of health. We may hasten to add that deterioration may be a milder word and, therefore, in all possibility the expression “destruction of health” is apposite.” It posted the matter for final hearing on March 12.
Venugopal was backed by senior advocates Anand Grover and Rupinder Singh Suri, who appeared for NGO ‘Health for Millions’ and cited a global study which lauded the large pictorial warning on tobacco product packets serving as a dissuasion for many.
Sibal argued that no one can dispute that tobacco is a health hazard. “But, if the government does not ban its trade, then those trading in tobacco products have a fundamental right to do so under Article 19(1)(g) of the Constitution. Unreasonable restrictions cannot be imposed to affect the trade,” he said arguing the 40% pictorial warning should continue till March 31, when the government would take a new policy decision.
The 2008 tobacco product labelling rules mandated that health warning “shall occupy at least 40% of the principal display area of the front panel of the pack and shall be positioned parallel to the top edge of the package”.
2000>2016: smoking declines in India, the world
Smoking prevalence, 2000-16
Since 2000, the percentage of smokers has declined in almost all countries because of anti-tobacco mass media campaigns, mandatory pictorial health warnings, ban on tobacco advertising and heavy taxes on tobacco products. This shows that such measures can also be used to fight other addictions.
Consumption and revenues: 2012-14
The Times of India, Jan 27 2015
According to the WHO, tobacco is one of the world's biggest public health threats as it kills about six million people every year. Raising taxes on tobacco products has been found to be the most cost-effective method of reducing tobacco use. According to the recently released India Statistical Yearbook 2015, for the first time in eight years, excise revenue from tobacco products has witnessed a fall. Product-wise analysis suggests that excise revenue from chewing tobacco and other products has decreased between 2012-13 and 2013-14 while collections from cigarettes and biris have 19,892 14.2% 2012-13 increased. The increase, however, might be linked with the higher taxes imposed in recent years.
2005-16: A decline
The Times of India, Mar 08 2016
Oral cancer among women on rapid decline: National Cancer Registry
For first time, tobacco use is down in country: Family health survey
The use of tobacco, the leading cause of preventable death, has for the first time begun to decline across country . Data from the first phase of National Family Health Survey released by the Union health ministry shows a dip in the use of all forms of tobacco, among men and women, in the past decade.
Doctors are hailing the results as one of the biggest successes in public health.At least 11 of the 13 states in the report have reported a decline in the numbers between 2005-06 and 2015-16. In Sikkim, there is up to 20% dip in tobacco use. The only two states that showed incre ase in consumption were Manipur and Meghalaya.
Ten years ago, nearly half the men and, at least, a quarter of the women in rural areas consumed tobacco. Today , sustained campaign against the use of tobacco -including pictorial warnings on cigarette packets, ban on smoking in public places, complete ban on the sale of pan masala in several states, high taxes, warnings flashed on cinema and TV screens and from doctors -have helped bring down the numbers.
“Every bit of it has helped,“ said Chennai-based senior oncologist Dr V Shanta, who has been campaigning against tobacco manufacturers. “But our war is still not over. We still have a long way to go,“ she said.
The first sign of success is already visible in the national cancer registry . The incidence of oral cancer among women is on a rapid decline. The Madras Metro politan Tumour registry for instance has recorded a 33% drop in oral cancer among young women.
Until 1986, mouth cancer was the third amongst all forms of cancer affecting women with an incidence of 7.8 per 10,000. In 2012, it did not appear in the top five.“It's an indication that fewer younger women are opting for smokeless tobacco,“ said Dr R Swaminathan, head epidemiologist, Adyar Cancer Institute.
The tobacco industry too has also been reporting a consistent dip in production since 2011.
Studies by public health experts show similar trends.A study by Mumbai-based Dr P C Gupta, director, Healis Sekhsaria Institute for Public Health, in the journal BMJ Global Health showed the number of men smoking tobacco in India rising by more than one-third to 10.8 crores between 1998 and 2015.“The increase is only because the population has gone up. We saw no drastic increase in the prevalence of smoking across the country ,“ said Dr Gupta.
NGOs representing the anti-tobacco lobby say cases are being under-reported.“Sale of pan masala is still rampant. Pan masala comes in the form mouth fresheners. On several instances we have found tobacco branded as herbal, organic and spit free being sold to school students,“ said Cyril Alexander, convenor for TN People's Forum for Tobacco Control.
2015, consumption declined
Consumption of cigarettes, 2015
2017, consumption among adults
China, India and major countries: prevalence of tobacco smoking among adults, presumably as in 2017
India next to China in numbers of smokers
India is second to China in terms of number of smokers aged 15 or above accounting for 106 million of the world’s 1.1 billion smokers, according to a new report by the WHO.
Indonesia comes in third with 74 million smokers. As many as 200 million of the world’s 367 million smokeless tobacco users are in India, the report (2016 estimates) highlighted.
The WHO estimates that, worldwide, there are at least 367 million smokeless tobacco users aged 15 years or over. More males used smokeless tobacco products (237 million) than females (129 million).
Although smokeless tobacco is used in all regions, the WHO South-East Asian Region has by far the largest number of users (301 million), representing 82 per cent of all users worldwide.
However, the pace of action in reducing tobacco demand and related death and disease is lagging behind global and national commitments to reduce tobacco use by 30 per cent among people aged 15 and older. If the trend continues on the current trajectory, the world will only achieve a 22 per cent reduction by 2025.
According to the report, tobacco use has declined markedly since 2000, but the reduction is insufficient to meet globally agreed targets aimed at protecting people from death and suffering from cardiovascular and other non-communicable diseases (NCDs).
Tobacco consumption India and comparable countries among those 15 and older in 2023