Indian Tobacco Control Act

8/8/2019 Indian Tobacco Control Act

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CIGARETTE SMOKE CONTAINS

4000 POISONS


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1 tobacco related death1 tobacco related deathevery 6 secondsevery 6 seconds

WHAT IS AT STAKE?

=10 million annual=

10 million annualdeaths by 2030deaths by 2030

1 Billion deaths in 21st Century


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Global Tobacco Tolly Tobacco toll rising globally: 5 million in 2002 to 10 million

in 2030- WHO

y

Developing Countries increasingly vulnerable: 7 milliondeaths in 2030- WHO

y 700 million children worldwide are forced to passivelybreathe tobacco smoke

y 1.69 million due to cardiovascular diseases

y 1.47 million due to all tobacco related

(0.83 million due to lung cancer)

y 1 million due to chronic obstructive pulmonary disease.


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Health Consequences of Tobacco Usey Tobacco chewing in its various forms is directly responsible for cancersof the oral cavity, oesophagus, pharynx, cervix, penis.

y Beedi and cigarette smoking cause oral, pharyngeal, oesophagael,laryngeal, lung, stomach, gallbladder, urinary bladder and penile

cancers.y Tobaccouse is a major known risk factor for cardiovasculardiseases.

y Tobacco smoking is responsible for over 82% of chronic obstructivepulmonary disease.

y Tuberculosis is a major cause of death in India and it is three times as

great among smokers than non smokers.y Men who smoke have a lower sperm count and poorer sperm quality

than non smokers

y Tobacco use is also associated with oral precancerous lesions such asleucoplakiaand other oral mucosal lesions.


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TOBACCO AND CANCERSTOBACCO AND CANCERS

LungLung

Mouth (oral)Mouth (oral)

Throat (Pharynx &Throat (Pharynx &Larynx)Larynx)

Food Pipe (Oesophagus)Food Pipe (Oesophagus)

Urinary BladderUrinary BladderOther SitesOther Sites


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CARDIOVASCULAR RISKS OF SMOKINGCARDIOVASCULAR RISKS OF SMOKING

100% Increase in Risk

300% Increase in Risk

Stroke; CHD; Impotence

Death from undiagnosed CHD

> 300 % Increase in Risk

Peripheral Arterial Disease

400 % Increase in Risk

Aortic Aneurysm


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OTHER DISEASESOTHER DISEASES

Chronic BronchitisChronic Bronchitis

EmphysemaEmphysema

AsthmaAsthmaCataractCataract

TuberculosisTuberculosis

DiabetesDiabetesStill Birth and Low Birth WeightStill Birth and Low Birth Weight

> 25 Diseases> 25 Diseases


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PASSIVE SMOKING (ETS)PASSIVE SMOKING (ETS)

Second Hand Smoke increase risk ofSecond Hand Smoke increase risk of

Cancer by 30%Cancer by 30%

Heart attack by 25%Heart attack by 25%

in spouse of the smokerin spouse of the smoker

Increased risk of asthma and lungIncreased risk of asthma and lung

disease in childrendisease in children


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Economic

Effects of Tobacco Use

y The total social costs of tobacco products exceed the direct outlay onthem, owing to morbidity, mortality and negative externalitiesassociated with the consumption of tobacco products.

y The costs inflicted by tobacco consumption extend much beyondthe direct users to cover secondary smokers as well as non-users.

y The recognition of the costs of tobacco has been obfuscated andmade opaque by the unethical tactics and practices by the tobaccolobbies.

y Worldwide recognition of the perils of the pandemic of tobacco haveled to the recognition of tobacco as a demerit good, i.e. a public bad.


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ECONOMIC COSTS OF TOBACCOECONOMIC COSTS OF TOBACCO

Health Care: Just for 3 diseasesHealth Care: Just for 3 diseases

(Coronary Heart Disease; Cancer;(Coronary Heart Disease; Cancer;Chronic Lung Disease)Chronic Lung Disease)

Health Care cost in 2002Health Care cost in 2002 2003 was2003 wasRs. 308.33 Billion (USD 7.2 Billion)Rs. 308.33 Billion (USD 7.2 Billion)

Tobacco also has: Environmental costsTobacco also has: Environmental costs& Social costs& Social costs


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PrevalencePrevalence Of Tobacco Use AmongOf Tobacco Use Among

The YouthThe Youth -- INDIAINDIA

Global Youth Tobacco Survey (GYTS) conducted amongGlobal Youth Tobacco Survey (GYTS) conducted among

school going youth (aged 13school going youth (aged 13--15) during 200015) during 2000--2004 in2004 in

India:India:

Ever tobacco use :Ever tobacco use : 25.1%25.1%

Current tobacco use:Current tobacco use: 17.5%17.5%

Current smokeless:Current smokeless: 14.6%14.6%

Current smoking:Current smoking: 8.3%8.3% Current cigarette smoking:Current cigarette smoking: 4.2%4.2%

Results support the need to prevent youth from initiating tobacco

habit and provide the evidence base for the provisions of Indian

Tobacco Control Act, 2003


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Sixth gradeSixth grade

(n=6165)(n=6165)

Eighth gradeEighth grade

(n=5477)(n=5477)

RatioRatio pp

Ever use to tobaccoEver use to tobacco

Chewing tobacco %Chewing tobacco % 19.019.0 6.86.8 2.8:12.8:1


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Government Initiatives towards Tobacco

Control Laws to Curb the Problem Cigarettes Act is passed with first statutory health warning, 1975

States like Delhi, Goa and a few more had created their own tobacco controllaws

Kerala High Court and Supreme Court had given momentous decisions infavour of tobacco control policies

Prevention and Control of Pollution Act included smoking in the definition ofair pollution, Motor Vehicles Act of 1988 made it illegal to smoke in a publicvehicle and Cables Television Network Amendment Act of 2000 prohibited thetransmission of tobacco commercials on cable TV across the country.

The Cigarettes and other Tobacco Products (Prohibition of Advertisement andRegulation of Trade and Commerce, Production, Supply and Distribution) Act,2003 (COTPA), a comprehensive tobacco control legislation, comes into forceon 1st May 2004

India ratified FCTC on 5th February 2004.


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The Cigarettes and Other Tobacco Products

Act, 2003: Significance to Public Healthy Section 4: Ban on Smoking in Public Places

Secondhand smoke (passive smoking) of smoke causes manydiseases like lung cancer, respiratory diseases, heart disease,breast cancer, asthma, bronchitis. In some cases, it can triggersevere, even life-threatening reactions in individuals.

Children are the worst affected. It causes sudden infant deathsyndrome.

People working, especially in the food service industry areaffected.

Ban on smoking in public places would prevent damage to thehealth of non smokers and smokers


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Contd..y Section 5: Ban on Advertisements of Tobacco Products

In India children and the youth have been greatly influenced by tobaccoadvertisements, especially those for cigarettes and gutka which definitelyharms their health.

Advertisements and placing of the product at a low height and next to candiesat points of sale is a strategy they use to give undesirable exposure and access tochildren.

A study found that children who had seen sports events being sponsored by a

tobacco company were more likely to start smoking. This was during the periodwhen a cigarette company sponsored cricket matches.

Many tobacco industries are promoting tobacco products to target women.

This provision would prevent women and children from being influenced byglamorized advertisements of tobacco products.


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TRENDS IN WEIGHTED CIGARETTE CONSUMPTION

PER CAPITA IN COUNTRIES WITH A

COMPREHENSIVE BAN COMPARED WITH NO BAN

1450

1500

1550

1600

1650

1700

1750

1981 1991

r

A

r

r

B

N B

Source: World Bank Report, 1999


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Contd..

y Section 6: Prohibition of Sale of Tobacco Products toand by Minors

Many children in India experiment with tobacco at an early age andbecome addicted thereafter.

Individuals who use tobacco from a young age are more likely to sufferfrom serious diseases earlier than others and die prematurely

Sale by a minor gives a message to that child, as well as to other

children, that it may be all right to use tobacco. Adolescents out of school are more likely than other youth to sell

tobacco.

This would restrict access of tobaccoproducts to youth and children


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Contd..y Section 7: Specified Health Warning Labels on all

Tobacco Products Images help smokers visualize the nature of tobacco-related diseases

and convey health messages in a clearer way. Pictorial health warnings are intended to serve as visual cues to prompt

smokers to take action to quit. They are designed to shock people intorealizing that smoking kills and causes serious illness.

Pictorial warnings also make the health warnings accessible to those

who are illiterate. They are effective tool in conveying health risks to the tobacco users. It

also has an impact on intentionand ability to quit.

In countries like Brazil, Canada and Thailand many pictorial warningshave helped in decreasing consumptionof tobaccoproducts


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Contd..y Section 7(5): Every tobacco package to have nicotine

and tar contents along with the maximum permissible

limits

Nicotine and tar are carcinogens

Nicotine and tar contents along with permissible limitsshould mentioned on the packages

Having them on the package would help people making aninformed choice


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Contd..

y Increasing Tax and Price of Tobacco Products

Price and tax measures are an effective and important means ofreducing tobacco consumption by various segments of thepopulation, in particular young persons.

Implementing tax policies and price policies, on tobaccoproducts would contribute to the health objectives aimed at

reducing tobacco consumption. This measure acts as a demand reduction measure for tobacco

products.


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IMPACT ON SMOKERS ALIVE IN 1995

Change in Change in

Grouping number of smokers number of deaths

(millions) (millions)

Low/middle -36 -9

Income

High Income -4 -1

World -40 -10

Source: World Bank Report, 1999

PRICE INCREASE OF 10%


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POWER OF POLICY

FOR CHRONIC DISEASE PREVENTION

TOBACCOTOBACCOEvidence is available from manyEvidence is available from many

countries (including LMIC) thatcountries (including LMIC) that

TaxationTaxation

Ad BansAd Bans

Smoke Free PoliciesSmoke Free Policies

Health WarningsHealth Warnings

ARE EFFECTIVEARE EFFECTIVE48.1% of mortality averted in UK (198148.1% of mortality averted in UK (1981--2000) is attributable to2000) is attributable to

reduced smokingreduced smoking (Unal B et al. Circulation 2004)(Unal B et al. Circulation 2004)


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TOBACCO CONTROL POLICIES WORKTOBACCO CONTROL POLICIES WORK

Ban on smoking in bars: 80% reduction in salivaryBan on smoking in bars: 80% reduction in salivarycotinine levels of bar staffcotinine levels of bar staff

(BMJ 2005; 331:1117(BMJ 2005; 331:1117--22)22)

Graphic warning labels have impact on smokingGraphic warning labels have impact on smokingcessationcessation

(Tobacco Control 2003; 12:391(Tobacco Control 2003; 12:391--95)95)

Reduced incidence of admissions for myocardialReduced incidence of admissions for myocardialinfarction after public smoking baninfarction after public smoking ban

(BMJ 2004; 328:977(BMJ 2004; 328:977--80)80)


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Documents

Indian Tobacco Control Act