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

Role of Compliance Studies and Opinion
Polls in Strengthening Smoke Free
Legislation in India
Background
Tobacco kills its users or those exposed
to its smoke, prematurely and its use is
recognized by the World Health Organization
as the single most preventable cause of
death. Tobacco-related illnesses account
for 1 in 10 adult deaths worldwide, 1 and if
current trends continue, one billion people
are estimated to die from tobacco use in the
21 st century 2 . More than 80% of the world’s
smokers live in low- and middle-income
countries 3 . Tobacco use currently costs
the world hundreds of billions of dollars
each year and this is borne by individuals,
families and their government 4 .
India is the third largest producer of
tobacco worldwide and ranks second in
total tobacco product consumption. There
are almost 275 million tobacco users in
India; almost 1 in every 2 adult males
and 1 in 5 adult females use tobacco in
some form, 5 . Smokers are not the only ones
affected and killed by tobacco; scientific
evidences have unequivocally established
that exposure to secondhand smoke (SHS)
is as harmful as active smoking and causes
death, disease and disability. SHS is the
combination of smoke from the burning
end of a cigarette and the smoke breathed
out by smokers. Exposure to SHS may lead
to numerous health problems in infants and
children, including severe asthma attacks,
respiratory infections, ear infections and
sudden infant death syndrome (SIDS).
Some of the health conditions caused by
SHS in adults include heart disease and
Dr. Ravinder Kumar, Pranay Lal, Dr. Rana J. Singh
lung cancer 6 . Worldwide, 600,000 people
are estimated to die annually as a result
of exposure to SHS 7 . The toxic mix in
tobacco smoke includes 60 known human
cancer-causing agents. Secondhand smoke
is a complex mixture of more than 7,000
chemicals, including at least 69 known
carcinogens 8 . There is no risk-free level of
contact with secondhand smoke; even brief
exposure can be harmful to health 6 .
India has a high prevalence of exposure
to SHS; 29.9% adults of age 15 years and
above are exposed to SHS in workplaces,
(52.3%) at home and 29% at any public
place including governmental building,
health care facility, restaurant and public
transportation 5 . The Framework Convention
on Tobacco Control (FCTC), negotiated
in 2003 under the auspices of the World
Health Organization (WHO), is the world’s
first public health treaty and mandates
governments of all nations to take specific
steps to reduce tobacco use. Article 8 of
the FCTC binds governments to protect
their citizens from exposure to tobacco
smoke and requires them to adopt and
implement effective legislative, executive,
administrative and/or other measures for
this purpose. In 2008, the WHO developed
and recommended a policy package to
reduce the tobacco epidemic called MPOWER
– this package expanded the measures of
the WHO FCTC that have been proven to
reduce smoking prevalence.
In 2003, the Government of India
enacted a comprehensive legislation for
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January - March & April - June 2012