Breaking New Grounds in Tobacco Control - Voluntary Health ...

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issues concerning their rehabilitation
and shifting to economically viable
alternate livelihoods need simultaneous
attention in tobacco growing states.
Like in many other countries, tobacco
control in India has always been led
by the Ministry of Health, although
the issue concerns a large number of
ministries/departments like agriculture,
education, commerce, welfare,
industry, environment, information &
broadcasting, rural development etc.
Lack of cooperation and coordination
among them is also a crucial
challenge.
No progress on the establishment of
tobacco testing labs in the country
hinders regulation of contents and
emissions of a large number of tobacco
products marketed in the country.
The states have failed to effectively
utilize the dedicated funds provided for
tobacco control activities under NTCP in
a timely manner. Non-recruitment
of staff by almost half of the states
has resulted in delay and nonimplementation
of various components
of the programme. States are also
sluggish in the timely submission of
progress reports hindering effective
monitoring.
Conclusion
Despite all odds and setbacks, NTCP has
provided a platform for enforcing and
monitoring implementation of COTPA
provisions and other tobacco control
strategies. During the last four years,
there has been considerable rise in public
awareness on issues related to tobacco
control. Key stakeholders have been
sensitized and trained in tobacco control
and some states have taken initiatives
beyond NTCP by raising VAT on tobacco
products to increase prices and thereby
reduce use. It is also significant to note
that learning from the NTCP and with the
support of partners like the Bloomberg
Initiative and Gates Foundation, many non-
NTCP states have effectively implemented
tobacco control initiatives e.g. Himachal
Pradesh, Kerala, Jammu & Kashmir, Haryana
etc.
Next Steps
The Government on its part has been serious
in integrating relevant health programmes
at different levels to prevent duplication
of efforts and optimal utilization of
resources. Recently, the Working Group
on Non-Communicable Diseases of the
Planning Commission for 12 th Five Year
Plan recommended uniform coverage of all
the districts under NTCP and the National
Programme for Control of Cancer, Diabetes,
CVD and Stroke (NPCDCS). 15 Merging the
components of NTCP with NPCDS will provide
an established platform and requisite
infrastructure for implementing tobacco
control strategies at the grassroot level.
The methodology of the success of the
national mass media campaign under
NTCP can be replicated into strengthening
awareness generation campaigns at the
sub-national level. A large network of
medical, dental colleges and professional
bodies can be involved in these campaigns
for effective outreach and sustainability.
Tobacco control should be incorporated
in the course curriculum of undergraduate
medical and dental education. Capacity of
the states needs to be built to implement
tobacco control efforts through the existing
health care delivery system and multisectoral
coordination. These initiatives
will ensure wider availability of tobacco
cessation facilities.
n 15
January - March & April - June 2012