India Has The 2nd Largest Tobacco Using Population In The World With 27% Adult Users: Report

A recent report by KPMG Assurance and Consulting Services LLP, in collaboration with ET Edge titled, ‘Human-centric approach to tobacco control’, revealed that India ranks the 2nd largest tobacco using population in the world with 27 per cent of Indian adults engaged in tobacco consumption. The report states that it is imperative and critical to have a holistic roadmap towards tobacco control that is entwined to reduce tobacco induced harm. Offering tobacco users a diverse array of less harmful alternatives will aid in an individual’s journey towards quitting tobacco, leading to a 50 per cent estimated reduction of annual deaths globally due to tobacco related diseases by 2060.

India’s Tobacco Landscape

The report reveals that there were 7+ million tobacco related deaths globally in 2019 & 1.35 Mn deaths in India alone. According to the report, 66 per cent of the respondents started consuming tobacco between 20-25 years of age. 45 per cent of the respondents can’t quit smoking or chewing tobacco, due to lack of alternatives. It further claims that only 8 per cent of the overall tobacco consumed is from legally produced cigarettes, while the remaining 92 per cent of the consumption is in the form of cheaper tobacco products such as bidis, chewing tobacco, khaini, among others. The survey revealed psychological factors, such as stress, anxiety, and emotional distress are the key motivating factors for tobacco use in tier I cities.

The persistence of tobacco consumption underscores the necessity for India-specific policies which are based on regulations and science. Helping a largeeconomically weak tobacco using population, while trying to enforce globally prescribed tobacco control measures in India is a predicament that the Indian policy makers consistently face. India faces a dual challenge with both, smoking and oral tobacco use rampant according to this report.

Tobacco’s Impact on Health And Economy

Health and economy are intricately interrelated when it comes to the impact of tobacco consumption. As per the report, 25 per cemt of the male population surveyed in tier II and III cities faced health issues of which 29 per cent were severe cases; while 50 per cent male respondents in tier I cities mentioned health issues of which 44 per cent were serious cases.

Yet, 81 per cent of the male respondents in tier I cities with serious health issues refrained from quitting tobacco, primarily due to lack of awareness and unavailability of alternatives. The report states that by the year 2030 more than 80 per cent of tobacco-related deaths are likely to be among the low and middle-income countries (LMICs). On a macroeconomic level, it highlights that India loses 1 per cent of its GDP every year due to diseases and early deaths from tobacco use. To safeguard from this, India may look at adopting an effective tobacco control policy that will help reduce harm & disease burden & support cessation.

India’s Strategies for Tobacco Control

India has been actively implementing stringent regulations aimed at controlling tobacco consumption and safeguarding public health. The country enacted tobacco control laws to align with the provisions of the WHO prescribed laws aiming to regulate the production, sale, and consumption of tobacco products as well as protect non-smokers from exposure to passive smoking. To deal with the challenges of tobacco consumption, India has taken several steps to test tobacco products for toxicants and constituents.

While nation-wide regulations play a crucial role, state-level regulations in India have also emerged as a vital aspect of the country’s comprehensive tobacco control framework. The introduction of Nicotine Replacement Therapy (NRT) in the National List of Essential Medicines (NLEM) by the Union Ministry of Health and Family Welfare was a welcome move that offered harm restriction to the tobacco users. The act of using NRT products, such as chewing nicotine gum or using inhalers, replicates the behavioral rituals associated with smoking, helping individuals break the habit and reduce the psychological dependence on cigarettes.

Global Policies

Global policies and programs designed towards controlling the tobacco usage have scaled up owing to the interventions undertaken by countries. While many countries have complied with the WHO Framework Convention on Tobacco Control (FCTC), some have adopted a tailored approach.

The report revealed that the fall in smoking rate is higher with a high access to less harmful alternatives with countries like Japan, UK, New Zealand & Sweden as compared to countries with a limited access to less harmful alternatives like India, Australia & Singapore.

Key recommendations- What more can be done The report advocates for a shift in approach, referred to as ‘Tobacco Control 3.0’ to achieve a healthier India, investing in science-based solutions for tobacco control is crucial.

According to the report, individuals who are unwilling to quit smoking, should be encouraged to switch to less hazardous alternatives, minimising their overall health risks.

Enhanced focus on making Nicotine Replacement Therapy (NRT) affordable and accessible can further support these individuals to quit. The report suggests enforcement authorities to develop & maintain an exhaustive database of listed & unlisted manufacturers and retailers of tobacco products. Additionally, focus on investing in technology such like blockchain to track illicit trade of cigarettes, gutka & other banned tobacco products.

The report further recommends investment in an innovation fund to support research, data collection and impact monitoring. An increase in investment for a nationwide mass media campaign, supported by targeted regional media, to educate smokers, dispelling myths about tobacco use and encouraging their support for cessation will also play an important role.

On the policy front, the report emphasizes on evaluation of less harmful alternatives that align with the government’s goal of reducing tobacco-related harm and encourage smoking cessation. Hence, consumers, industry players and the government should together come forward to facilitate realistic & scientific tobacco control policies for a healthy future.

Key Survey Findings

66 per cent respondents started consuming tobacco between 20 -25 years of age 45 per cent of respondents can’t quit tobacco use due to lack of alternatives Only 8 per cent of tobacco consumed are legally produced cigarettes, 92 per centof the remaining consumption is in the form of cheaper tobacco products

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