Answer:

Introduction:

The tobacco epidemic in India has profound health, economic, and social impacts, affecting millions across the nation. In 2022, with a population of 1.42 billion, the 2016-17 Global Adult Tobacco Survey (GATS) found that 29% of people aged 15 and over used tobacco, including over 42% of males and over 14% of females – amounting to nearly 267 million users. Smokeless tobacco (SLT) is the most common form, with over 21% of adults using it. 

Body:

Multifaceted Impacts of the Tobacco Epidemic:

• Health Impacts:
  • Tobacco use is a leading cause of preventable deaths and diseases, contributing to cancers, cardiovascular diseases, and respiratory disorders.
  • For example: India has the second-highest number of oral cancer cases globally, with over 90% attributed to tobacco, mainly SLT.
• Economic Impacts:
  • The economic burden includes direct healthcare costs and indirect costs from lost productivity due to illness and premature death.
  • For example: Direct medical costs alone amounted to 5.3% of all health expenditure, significantly outweighing the revenue generated from tobacco excise taxes.
• Social Impacts:
  • Tobacco consumption exacerbates poverty, diverting household expenditure from essential needs to tobacco products, disproportionately affecting low-income families.
  • For example: Nearly 13% of females aged 15 and over use SLT, compared to 2% who smoke, highlighting the social dimension of tobacco use in India. 

Effectiveness of Existing Legislative Frameworks and Control Programmes:

• Legislative Measures:
  • The Cigarettes and Other Tobacco Products Act (COTPA) 2003 includes bans on smoking in public places, restrictions on advertising, and mandates pictorial health warnings.
    For example: The enforcement of 85% pictorial health warnings on tobacco packaging has improved awareness but is inconsistently applied across states.
• Control Programmes:
  • National Tobacco Control Program (NTCP): NTCP aims to create awareness, establish tobacco cessation centers, and enforce tobacco control laws. 
  • However, its effectiveness varies due to challenges in implementation and enforcement.
    For example: In a study of NTCP’s impact in 42 districts, some regions saw significant reductions in bidi and cigarette consumption, while others struggled with enforcement due to lack of resources and public awareness​.

Measures to Strengthen Tobacco Control in India:

• Enhanced Enforcement:
  • Strengthen enforcement of existing laws through regular monitoring and stringent penalties for violations.
    For example: Dedicated state-level enforcement teams can ensure compliance with COTPA provisions.
• Targeted Awareness Campaigns:
  • Implement campaigns focusing on vulnerable populations such as youth and rural communities using mass media and social media platforms.
    For example: Social media campaigns tailored to youth have shown effectiveness in reducing tobacco use initiation.
• Increasing Tobacco Taxes:
  • Raise taxes on tobacco products to make them less affordable, especially for low-income groups and young people.
    For example: Studies indicate that a 10% increase in tobacco taxes can lead to a significant reduction in consumption.
• Comprehensive Support for Cessation:
  • Expand access to tobacco cessation programmes and integrate them into primary healthcare services.
  • For example: Training healthcare professionals to provide cessation counselling can enhance the effectiveness of these programs.

Conclusion:

The tobacco epidemic in India requires a comprehensive approach to mitigate its health, economic, and social impacts. While existing legislative frameworks and control programmes have made some progress, enhanced enforcement, targeted awareness campaigns, increased taxation, and comprehensive cessation support are crucial to strengthening tobacco control. Implementing these measures will help reduce tobacco use, improve public health, and alleviate the economic burden on society, leading to a healthier and more prosperous India.