India must stub out attractive packaging of tobacco products

Urvashi Prasad, CNS Correspondent, India
Globally there are one billion people who use tobacco, 80% of whom live in low- and middle- income countries. Tobacco use is estimated to claim the lives of over 6 million people every year. An additional 600,000 lose their lives to second-hand smoke. In fact using tobacco is the single biggest preventable risk factor for non-communicable diseases (NCDs) which are responsible for nearly 63% of all premature deaths globally.

In India, tobacco use related health statistics are extremely grim. As mentioned in a newspaper report, tobacco use alone accounts for about 40% of all cancers in India. About 275 million Indians (35% of adult population and 14.1% of children aged 13-15 years) are tobacco users, mainly smokeless tobacco. Smoking (bidi) and chewing tobacco (smokeless tobacco) are the biggest risk factors for oral cancer. As per another report, India also holds the dubious distinction of having the highest percentage (74%) of smokeless tobacco consumers of the world, as well as it bears three-fourths of the global burden of more than 0.25 million deaths due to smokeless tobacco every year. World No Tobacco Day is observed every year on May 31. This year the theme for this Day is “Get ready for plain packaging”. Plain packaging on tobacco products makes them less attractive and also informs users about the adverse health effects of tobacco with graphic and text health warnings. The use of misleading words such as ‘mild’ and ‘light’ is also banned. Studies conducted in various countries, including Canada and Brazil, have shown that graphic images are effective in warning smokers about the potential harms of tobacco use and encouraging them to consider quitting.

Plain packaging is increasingly being introduced in countries around the world. Australia was the first to implement it in 2012, followed by Ireland, UK and France. The measure has produced encouraging outcomes in these countries. Earlier this year, a report published by Australia highlighted that plain packaging is helping to reduce smoking and exposure to second hand tobacco smoke and is likely to have tremendous public health benefits in the country. It has also been found to be useful in deterring young people from taking up smoking in the first place. In India, the situation with respect to tobacco is quite complex. Firstly, there is little clarity on regulating the production, packaging and marketing of smokeless tobacco products which do not get the same regulation as cigarettes. Secondly, the nature of tobacco products available in the market is constantly changing. For instance, cheap manufactured cigarettes have started to displace small and locally produced bidis. Thirdly, there is tremendous pressure from tobacco companies to thwart efforts of policy makers to kick out tobacco.

Despite these challenges, India has introduced pictorial health warnings that cover 85% of both sides of all tobacco product packets. In a webinar organised by CNS Dr Tara Singh Bam, Regional Advisor, Tobacco Control – Asia Pacific, International Union Against Tuberculosis and Lung Disease, highlighted that the Supreme Court in India has recently issued a notice to the Health Ministry in response to a Public Interest Litigation to immediately implement plain packaging for all tobacco products. It is essential for India to implement plain packaging as the next logical step after introduction of improved graphic warnings on tobacco products. The morbidity and mortality due to tobacco use in India is significant and one of the highest in the world. In order to protect the lives of millions of people who are at risk of suffering the negative health consequences of tobacco use, India must follow countries like Australia and UK in introducing plain packaging and taking all possible steps to deter young people from taking up smoking.

Urvashi Prasad, Citizen News Service - CNS
June 6, 2016