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Tobacco is one of the most common agents responsible for morbidity and mortality across the world. The adverse effects of tobacco extend beyond individuals who consume it; it also affects individuals who cultivate, produce, or are exposed to it. With 253 million tobacco smokers, India has one of the world's highest rates of tobacco use.1 This epidemic has caused significant health, economic, and environmental concerns, with the poor bearing the brunt of the consequences.
Synopsis
Why Is India Leading in Tobacco Use?
Tobacco usage is strongly rooted in Indian culture, making India the world's second-largest user and third-largest producer of tobacco. The higher demands have led to a wide variety of tobacco products available in the market, ranging from cigarettes and bidis to smokeless forms like gutkha and khaini. Indian women frequently use oral tobacco products, including betel leaf and areca nuts, which are proven carcinogens. These products are inexpensive, accessible, and often perceived as socially acceptable, especially in rural areas.
The implications are staggering: tobacco usage causes over a million fatalities in India every year. It significantly increases the risk of mouth and throat cancers, respiratory illnesses, and cardiovascular diseases, while also placing a heavy burden on families and the national healthcare system.
Tobacco Consumption in Indian Youth
According to the Global Youth Tobacco Survey (2019) findings, 8.5% of school pupils in India aged 13 to 15 years ingested tobacco in various ways. Among them, 5,500 youngsters were estimated to have started consuming tobacco every day. More than 55% of the tobacco users have started the habit before the age of 20. Therefore, there is an urgent need to raise awareness about the harmful effects and long-term health impacts of tobacco use amongst students.
Benefits of Quitting Tobacco
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Helps restore normal carbon monoxide levels in the blood, improves breathing, and reduces coughing and shortness of breath.
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Significantly lowers the risk of heart disease, stroke, and various forms of cancer.
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Reduces the likelihood of developing respiratory illnesses, especially in children exposed to secondhand smoke.
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Lowers the risk of fertility issues, pregnancy complications such as miscarriage or premature birth, and improves birth weight in newborns.
Tobacco Prevention and Treatment
An effective approach to tobacco prevention must start by organising local events to educate youths about the harmful effects of tobacco. School-based programmes can be conducted to raise awareness about smoking and make campuses tobacco-free.
On the tobacco treatment side, India has launched several initiatives, including Tobacco Quitline Services (1800-11-2356). These offer free therapy and assistance through mobile platforms and telephone. This initiative, which was expanded in 2018, now provides services in 16 languages and other local dialects through four centres.
Other measures like displaying large warning signs that cover 85% of the area on tobacco products, combating the menace of e-cigarettes through policies, and regulating the display of tobacco products in films or television can help curb tobacco usage.
Tobacco Control Programmes in India
The Cigarettes and Other Tobacco Products Act (COTPA) of 2003 was a significant milestone in India's war against tobacco, which began in 1975. This act aimed to regulate the production, distribution, advertisement, and consumption of tobacco products. It banned smoking in public places, restricted advertising, and mandated health warnings on packaging.
Building on this, the government developed the National Tobacco Control Program (NTCP) in 2007. The NTCP aimed to:
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Raise public awareness of tobacco’s dangers
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Enforce tobacco control laws more effectively
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Promote cessation services to help individuals quit tobacco (counselling, nicotine-based therapies, and community-based support groups)
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Tailoring cessation programs to meet the unique needs of a specific population
In a landmark move, India became the first nation in 2023 to legislate anti-tobacco warnings on OTT services such as Netflix and Amazon Prime—a bold step in keeping up with digital media consumption trends.
Despite these advancements, effective implementation remains a significant challenge. Loopholes and poor enforcement have allowed continued advertising through surrogate marketing, widespread smuggling of tobacco products, and unregulated sale of smokeless tobacco. Furthermore, pressure from the tobacco industry continues to obstruct significant reforms.
Challenges to Tobacco Control in India
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Inadequate metrics: Insufficient data on tobacco quit rates and consumption of tobacco are available, making it difficult to design policies to curb tobacco use
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High taxation: India’s high tax rates for tobacco products have driven consumers towards cheaper alternatives like bidis or unregulated smokeless tobacco products. This trend has led to the rise of the illicit tobacco business.
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Lack of cessation support: India’s rural population is culturally ingrained in using tobacco; unfortunately, there is a lack of cessation services in these areas, making the services inaccessible.
Conclusion
Tobacco use in India is a serious public health concern. While India has taken commendable steps through legislative reforms and public health programmes, the fight is far from over. A sustained, multi-sectoral approach is essential to curb tobacco use and protect future generations from its devastating impact.
If you or a loved one is looking to quit smoking or seek support for tobacco-related health issues, visit Manipal Hospitals, Broadway, for expert guidance, counselling, and comprehensive treatment options from an experienced doctor.
FAQ's
Tobacco includes nicotine, a highly addictive chemical. Tobacco use can have physical and psychological effects. When tobacco is used, dopamine gets released in the pleasure pathways of the brain, producing a physical effect. A psychological addiction may develop based on the activities a person engages in while using tobacco.
Seven FDA-approved medications can break your nicotine addiction. This list includes over-the-counter nicotine replacement therapies such as nicotine patches, lozenges, and gums; prescription nicotine replacements; and nicotine spray. Non-nicotine medications like bupropion and varenicline can also help with de-addiction.
Available medications are safe to use and can help you quit the habit of tobacco use. These medications do not have the toxic elements that cigarettes or tobacco contain.
No evidence supports e-cigarettes being a safe and effective alternative for people to quit smoking. There are reports of adverse health effects from using e-cigarettes.
Some people do gain weight after quitting tobacco. However, following a healthy eating plan and increasing physical activity can help you manage an optimal weight.
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