The War Against Tobacco: Better Late Than Never

The Chief Ministers of 12 states of India (Arunachal Pradesh, Assam, Bihar, Chattisgarh, Goa, Gujarat, Kerala, Karnataka, Maharashtra, Punjab, Rajasthan and Uttrakhand) have recently pledged their support to fight the growing menace of tobacco products like gutkha and khaini .
According to a release issued by the non-government organization Voluntary Health Association of India, “The Chief Ministers of these states were prompted into action when approached by doctors and victims of oral cancers in their respective states. They assured the victims of their commitment by signing a pledge which says --I will raise my voice against this issue and support all initiatives to rid India of this menace of gutka and khaini and help save millions of lives”.

This project was conceptualized and initiated by oral cancer victims to promote awareness about the harmful effects of tobacco, and appeal for a complete ban on chewing tobacco.
“It is heartening that custodians of health of the State have come out openly against tobacco and have pledged their support for tobacco control. We salute all those Chief Ministers who have come out openly to support this initiative to rid India of this menace,” said Dr. Pankaj Chaturvedi, Associate Professor in the Head and Neck Department of Tata Memorial Hospital, Mumbai.

Despite intense lobbying by tobacco companies and other vested interests, some states have indeed taken stringent measures to curb the menace of tobacco. Goa has banned gutkha and pan masala. The state has the lowest tobacco consumption rate in India and the lowest incidence of tobacco-related cancer.

 Kerala has banned tobacco sale within 40 yards radius (instead of the mandated 100 yards) of educational institutions. Its Chief Minister has sought the support of school principals for a government drive to free school neighborhoods from pan masala and other tobacco products.

Arunachal Pradesh has increased the taxes on tobacco. A Tata Memorial Hospital study shows that with every 10 per cent increase in taxes on tobacco, there is a 9 per cent decrease in tobacco consumption. However, according to another study, led by two Concordia University economists, price increases only prompt low-and middle-income earners to quit. Wealthy smokers and/or those in the middle age group of 25 to 44 years are largely unresponsive to taxes.

The Mayor of Delhi has sought strict implementation of anti-tobacco measures in and around all Municipal Corporation of Delhi offices, schools and hospitals. Delhi University is making renewed efforts to make its campus a smoke free zone, by conducting seminars for the freshers with the help of World Lung Foundation, organizing no-smoking talks, and imposing fines on offenders.

The Chief Minister of Maharashtra has tied up with cancer specialists from Tata Memorial Hospital to start a state-wide anti-tobacco drive, educate legislators on the ill effects of tobacco consumption, and also lead by example.

Are these just politically correct populist measures, or do they mean serious business?
 "Ministers are always making statements but nothing real is happening. Hookah parlors are mushrooming all across the city - school children are having hookahs because the fine is only Rs 200. We have caught Ministers smoking inside the Mantralaya and Corporators smoking inside BMC," said Bharat Kumar of Crusade Against Tobacco, Mumbai.

The Ministry of Health has estimated that 27 crore Indians use some form of tobacco and that is killing 9 crore Indians prematurely, every year.
Involving the legislators in this fight against the poison called tobacco is the right step, but the challenge is also in reaching out to new smokers, and that includes children. The World Health Organization (WHO) estimates that 6% of 10 to 15 years old take some form of tobacco. It should be the top priority of the government to  deter them from this toxic addiction.

It does seem ironical that the political will to enforce the rule of the anti tobacco law has taken a pretty long time to manifest itself. But then, it is better to be late than never. At last, the administration seems to be waking up from its deep slumber, to fight the menace of tobacco.

 Ahmedabad and Mumbai have come down heavily on hookah bars/ parlours, and banned them despite a lot of opposition by the owners as well as their generally young clientele. Hookah bars should be shut down, everywhere, not because they have no place in a conservative society, (as reportedly remarked by the police chief of Ahmedabad), but because they pose grave health hazards, and are far from being harmless as made out to be. It is not unusual to see large scale smoking going on unabated in such lounges, in direct contravention of the anti smoking law. Also there is no check on the age of the visitors, who very often are school children.

More and more cities are joining the smoke free band wagon, at least on paper. But, the ground reality may be very different. We need more proactive school authorities, and committed police/administrative personnel to simply ensure that cigarette and other tobacco products are not consumed by anyone within the premises of their work place during duty hours. As socially responsible citizens we need to have the courage to protect ourselves from second hand smoke by politely asking the offender not to smoke. Believe me; it has worked very often. The existing fine of merely Rs 200 for smoking in a public place cannot be a strong deterrent by itself. It needs to be increased. Stringent action will have to be taken by law enforcers against those found selling tobacco products to children. It is not uncommon to find boys in their school uniforms, smoking near roadside joints within school hours. Girls, are no better, but perhaps are more secretive about it.  Here I am tempted to one mention one small initiative taken jointly by a group of tobacco activists and the local Hindustan Times newspaper in Lucknow, with the help of the DIG Police, which has resulted in the removal of paan/tobacco shops from the vicinity of a few city schools. Such actions need to be replicated elsewhere too.

The nation is currently in the grip of an alarming addiction to chewing tobacco, which is having serious health repercussions. It comes very cheap, is socially more acceptable (than smoking), highly addictive and often misleadingly advertised as a harmless mouth freshener. Men, women and children, from all strata of society, are consuming it in various forms, like gutkha, khaini, paan masala, mishri, gul, etc. It is a big money churner for its manufacturers. The common public is still largely unaware of the near fatal dangers of this form of tobacco. It is high time the government takes up this issue seriously and curbs its sale as well as consumption. Certain tooth powders/pastes, popular in parts of north India, are said to contain tobacco. This needs to be investigated.

 Government initiatives backed by efforts of doctors, media, civil society, and, above all, victims of tobacco themselves can go a long way in having a clean, healthy and tobacco free India.

Shobha Shukla - CNS
(The author is the Editor of Citizen News Service (CNS). She is a J2J Fellow of National Press Foundation (NPF) USA. She is also the Director of CNS Gender Initiative and CNS Diabetes Media Initiative (CNS-DMI). She has worked earlier with State Planning Institute, UP. Email:, website:

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CNS Tobacco Control Initiative, India
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