Tobacco: The Silent Killer

Tobacco: The Silent Killer

Tobacco and related issues in India

Note4Students

From UPSC perspective, the following things are important :

Prelims level : GST Council

Mains level : Paper 2- Use of taxation to discourage tobacco use

Context

Tobacco is a silent killer in our midst that kills an estimated 1.35 million Indians every year.

The harm caused by tobacco

  • It is the use of tobacco as a result of which more than 3,500 Indians die every single day, as estimated by scientific studies.
  • It also comes at a heavy cost: an annual economic burden of ₹1,77,340 crore to the country or more than 1% of India’s Gross Domestic Product (GDP).

How price and taxation of tobacco matters

  •  Research from many countries around the world including India shows that a price increase induces people to quit or reduce tobacco use as well as discourages non-users from getting into the habit of tobacco use.
  • There is overwhelming consensus within the research community that taxation is one of the most cost-effective measures to reduce demand for tobacco products.
  • There has been no significant tax increase on any tobacco product for four years in a row.
  • This is quite unlike the pre-GST years where the Union government and many State governments used to effect regular tax increases on tobacco products.
  • As peer-reviewed studies show, the lack of tax increase over these years has made all tobacco products increasingly more affordable.
  •  The absence of a tax increase on tobacco has the potential to reverse the reduction in tobacco use prevalence that India saw during the last decade and now push more people into harm’s way.
  •  It would also mean foregone tax revenues for the Government.

Way forward

  • The Union Budget exercise is not the only opportunity to initiate a tax increase on tobacco products.
  • The Goods and Services Tax (GST) Council could well raise either the GST rate or the compensation cess levied on tobacco products especially when the Government is looking to rationalise GST rates and increase them for certain items.
  • For example, there is absolutely no public health rationale why a very harmful product such as the bidi does not have a cess levied on it under the GST while all other tobacco products attract a cess.
  • GST Council meetings must strive to keep public health ahead of the interests of the tobacco industry and significantly increase either the GST rates or the GST compensation cess rates applied on all tobacco products.

Conclusion

The aim should be to arrest the increasing affordability of tobacco products in India and also rationalise tobacco taxation under the GST.

UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

By Dr V

Doctor by Training | AIIMSONIAN | Factually correct, Politically not so much | Opinionated? Yes!

Tobacco: The Silent Killer

WHO Framework Convention on Tobacco Control (FCTC)

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Framework Convention on Tobacco Control (FCTC), WHO

Mains level : Not Much

The World Health Assembly (WHA) took the historic decision to form a global treaty to “strengthen pandemic prevention, preparedness and response”.

Significance of the launch

  • The launch of putting together this accord is the second such initiative taken under Article 19.
  • The first initiative was the WHO Framework Convention on Tobacco Control (FCTC), which came into effect in 2005.

About FCTC

  • The Framework Convention on Tobacco Control (FCTC) is the world’s first modern-day global public health treaty.
  • It is also the first treaty negotiated under the auspices of the World Health Organization (WHO).
  • The treaty entered into force in February 2005.
  • It was signed by 168 of the 192 WHO member states and more than 180 WHO member states have become parties to the convention.

Highlights of the FCTC

The FCTC provides an internationally coordinated response to combating the tobacco epidemic and sets out specific steps for governments addressing tobacco use, including:

  • Adopting tax and price measures to reduce tobacco consumption
  • Banning tobacco advertising, promotion and sponsorship
  • Creating smoke-free work and public spaces
  • Putting prominent health warnings on tobacco packages
  • Combating illicit trade in tobacco products

 

UPSC 2022 countdown has begun! Get your personal guidance plan now! (Click here)

By Dr V

Doctor by Training | AIIMSONIAN | Factually correct, Politically not so much | Opinionated? Yes!

Tobacco: The Silent Killer

[op-ed snap] India’s vape ban only deprives smokers of safer options

Note4Students

From UPSC perspective, the following things are important :

Prelims level : ENDS

Mains level : Tobacco - India; need to regulate ENDS rather than ban it

CONTEXT

The world has embraced electronic cigarettes, commonly known as vapes, and other electronic nicotine delivery systems (ENDS) as harm-reduction alternatives to combustible tobacco used in cigarettes. 

e-cigarettes

  • Globally, several tobacco control researchers have concluded that e-cigarettes are at least 95% less hazardous than combustible cigarettes. 
  • Studies by Public Health England show that the risk of passive smoking associated with them is also extremely low, as they do not produce tobacco fumes. 

India – Tobacco

  • The country bears 12% of the global burden of tobacco users, has 40% of its adults exposed to passive smoking.
  • We have shown the lowest quit rate among all countries surveyed in the Global Adult Tobacco Survey 2. 
  • Since there is empirical evidence to suggest that countries, which have regulated ENDS, have witnessed a decline in smoking rates, India needs to take note and reconsider its stance on the matter.

Global experience

  • According to a study conducted by The British Medical Journal, as many as 68 countries, including the UK, US, Canada, France, and Japan, are using a range of regulatory mechanisms to enhance the discretionary power of their adult citizens. 
  • These include laws that prohibit sales of ENDS to minors, regulate advertising and promotion, impose limits on nicotine concentration, and place checks on product quality and battery standards. 
  • The UK and France have witnessed a decline in their smoking rates, with the UK marking the lowest at 14.9% in 2017, in comparison to 19.8% in 2011, and a record 1.6 million people in France having moved away from combustible cigarettes over the past two years. 
  • Sweden has achieved the lowest rates of smoking-caused illnesses in Europe, mostly due to a low-risk form of smokeless tobacco called snus. 
  • Japan has reduced cigarette sales by a third in just three years through product substitution. 
  • New Zealand is promoting ENDS by launching a website called Vaping Facts to clarify myths and make the country smoking-free by 2025.
  • Canada, the UAE, and Seychelles have reversed their bans to regulate the product and allow access to adult smokers. 

Ban to regulate

  • Country-wise e-cigarette policies differ and the outcomes of their experience so far could inform a regulatory system in India.
  • These countries have regulatory mechanisms to monitor the manufacture, sale, labeling, and promotion of ENDS products to enable people to switch and deter unintended consequences. 
  • Canada has created a separate provision for vaping products under its existing tobacco control regulations to ensure that the category of modern products is regulated but these are more accessible than old tobacco products.
  • The World Health Organization and the EU have acted in favor of a regulatory framework instead of a blanket ban. They have provided detailed policy suggestions for countries to restrict producing, marketing, selling and using e-cigarettes. 

Course for India

  • With a smoking population at over 100 million, India is not only a lucrative market for e-cigarette players, but also has more to gain from a public health standpoint if ENDS are permitted.
  • A large chunk of India’s healthcare expenditure goes into the treatment and management of preventable diseases, including tobacco-related illnesses. India will not only gain economically but also find better solutions to combat the voluntary inhalation of harmful substances.
  • India needs to think of vaping as part of a solution and learn from the empirical evidence being provided by various countries.
  • The crisis of addiction has not been responsive to various measures adopted over the decades. 
  • India is currently the second-largest tobacco consumer in the world.

CONCLUSION

  • A ban on a widely accepted alternative to smoking regular cigarettes not only prevents consumers from making a less harmful choice, but it may also result in an illicit trade turning rampant. 
  • We need to check the entry of dangerous counterfeits and deny vulnerable groups access to these products via the black market.

 


Back2Basics

Prohibition of E-cigarettes Ordinance 2019

By Dr V

Doctor by Training | AIIMSONIAN | Factually correct, Politically not so much | Opinionated? Yes!

Tobacco: The Silent Killer

[op-ed snap] Public health versus free speech

Note4Students

From UPSC perspective, the following things are important :

Prelims level : Nothing much

Mains level : Benefits of pictorial warnings and challenges

History of the fight against Tobacco

  1. It is ten years since U.S. Congress passed the Family Smoking Prevention and Tobacco Control Act, but now, the Food and Drug Administration issued a rule that pictorial warnings be carried on cigarette packages and advertisements.
  2. At present, cigarette packages in the U.S. carry only text warnings and only on one side.
  3. Canada was the first to introduce pictorial warnings on cigarette packets in 2001. 
  4. By 2018, 118 countries had implemented such warnings in line with the World Health Organisation’s Framework Convention on Tobacco Control that came into force in 2005. 

Importance of messaging

  1. Dut to their small size and placement, text warnings remain invisible and fail to convey the harmful effects of smoking. 
  2. Gory pictures are very likely to be noticed, leave a lasting impression of the varied risks of smoking. 
  3. They also convey the central message immediately and easily.
  4. A 2017 study based on modeling found that pictorial warnings could reduce the prevalence of smoking in the U.S by 5% by 2020 and up to 10% by 2065.
  5. Data from countries that introduced pictorial warnings show how powerful they can be. 
    • In Canada, there was a 12% relative reduction in smoking prevalence in 6 years after graphic images were made mandatory. 
    • Australia witnessed more than a 10% drop in prevalence between 2004 and 2008. 
    • The U.K. saw a 10% relative decline in 2009, just a year after image warnings were introduced. 

Challenges to a stricter tobacco law – lessons from the USA

  1. Stiff opposition from the tobacco industry on the ground that graphic images violate rights protecting free speech.
  2. The biggest threat that pictorial warnings pose to tobacco companies is in reducing the appeal and consumption of tobacco. 
  3. About 30% of young adults in 28 European countries and Canada reported that graphic images made them less likely to start smoking.

CONCLUSION

Pictorial warnings can turn the power of packaging — far from brand building, packages with graphic images will become a mobile medium to spread public health messages at no cost to the government.

By Dr V

Doctor by Training | AIIMSONIAN | Factually correct, Politically not so much | Opinionated? Yes!

By Dr V

Doctor by Training | AIIMSONIAN | Factually correct, Politically not so much | Opinionated? Yes!

Subscribe
Notify of
2 Comments
Oldest
Newest Most Voted
Inline Feedbacks
View all comments