Exclusive: Health Ministry eyes smoking patterns as India ranks 2nd in world smokers list

New Delhi: The Health Ministry is eyeing smoking patterns in India in an effort to change smoking habits. The ministry is worried because India ranks number 2 in the world for smokers in the 16-64 age group.

The basic idea is also to shape tax patterns and draw up a roadmap for reducing tobacco consumption, a top health ministry official said on conditions of anonymity.

India has one of the lowest quit rates for smoking. The Ministry, claim sources, has tried hard to curb smoking but it has not worked. “Ministry officials have sent out circulars to understand smoking patterns, also what would work and what would not in India,” a senior official of the ministry told this reporter.

The ministry, which issued a circular last month to constitute an expert group on tobacco taxing, feels tax and price policies in India are widely recognised as one of the most effective means of influencing the demand for and thus the consumption of tobacco products.

The Expert Group will have representatives from the health ministry, Niti Aayog, department of revenue, GST Council, CBDT and WHO.
The group will analyse the current tax structure of all forms of tobacco, both smoking and smokeless.

India has 250,002,133 smokers and tobacco prevalence in India is three times higher among men than women.

The official said the ministry officials are also studying patterns of various types of smoking tobacco, cigarettes, beedis and e-cigarettes, the last remains banned in India.

“The ministry officials have been studying various global reports and also decisions taken by various countries in dealing with all forms of cigarettes, including vaping.

Last month, the United Kingdom’s Department of Health said e-cigarettes could be prescribed on the National Health Survey in a world first to help people stop smoking tobacco products. The move follows a similar decision taken by the Food and Drug Administration of the United States which said vaping products – it is scientifically proven – helps cut down smoking. Clinical trials have repeatedly proved that it is more effective than nicotine patches for smoking cessation and it has positive effects on blood vessels when tobacco smokers switch to e-cigarettes

Prof Jacob George, Professor of Cardiovascular Medicine and Therapeutics, University of Dundee, said in his reaction: “This is very welcome news for millions of people who are trying to quit tobacco cigarettes..”

The International Commission to Reignite the Fight Against Smoking says China and India are home to more than 500 million tobacco users between the ages 16 and 64 years. India also accounts for some of the highest rates of smokeless tobacco use and oral cancer in the world, it said.

The report further said nearly 37 per cent of Indian respondents showed a desire to change smoking behaviour, some even planned to quit smoking.

“The Ministry is working with an open mind relating to tobacco. The Expert Committee is open to receive proposals from various bodies who believe their products will help Indians quit smoking. This is for the first time the Health Ministry is trying to understand the entire tobacco business and how it operates in India. The Ministry is trying to gauge if one section of the tobacco market is benefitting at the cost of others,” the official said.

“There is too much focus on cigarettes, virtually no focus on beedis and no thoughts on vaping. There are eight beedis to a single cigarette consumption in India. There is little implementation of a ban on chewing tobacco products in some states. The Expert Committee is slated to look into these issues,” the official further said.

The ministry is alarmed that India is among those countries with the lowest quit rates for smoking. The quit rates for men are less than 20 per cent, said a recent report.

Worldwide, an estimated 1.14 billion still use tobacco, which kills nearly eight million people. Tobacco consumption eliminates nearly 200 million disability-adjusted life years annually.

“The cost to the world is nearly $2 trillion a year. The drastic socio-economic impact makes it urgent to reignite the fight against smoking,” data collated by the International Commission to Reignite the Fight Against Smoking said.

Worldwide, there are various stages of ban in the marketing and direct sales of tobacco products to children. But it is rarely implemented and prohibitions are not rigorously enforced, especially in low-to-middle income countries.

Data collated in 2019 said despite prohibitions, a study of areas around 243 schools found nearby vendors displaying tobacco products appealing to children and the youth.

The Ministry wants to change it, stop it, and adopt best practices to combat misinformation, reduce harm from tobacco by leveraging multi-national, multi-disciplinary and participatory foresight studies. “The ministry wants to make it easier for smokers to quit, it wants to increase access to tobacco-harm reduction products,” the official said.

E-cigarettes, claim experts, are much less risky than smoking and help smokers quit. Experts feel smokers are more likely to benefit from e-cigarettes if they can select flavours, strengths and products that they like, rather than being limited to whatever becomes licensed. The ministry wants to take a balanced approach, it wants to help smokers to stop smoking. “The ministry believes in a discussion on public health and why it is important to include an objective assessment of potential harm. The ministry is also aware of the fact that smokers have concerns about safety and misperceptions about the relative risks of e-cigarettes compared with tobacco,” the official said. Ministry officials are studying the practice in the US and UK, where numbers of smokers quitting have increased and there has been negligible take-up of e-cigarettes by non-smokers.