A recent appraisal of India’s tobacco problem by the Union health secretary on the occasion of ‘World No Tobacco Day’ revealed some sobering truths. Tobacco, it suggests, continues to pose a severe threat to public health, claiming about 1.3 million lives annually in the country. Worryingly, children form a significant segment of tobacco addicts. A report by the World Health Organization showed that an estimated 37 million children aged 13 to 15 years were using tobacco in some form. In fact, India’s Global Youth Tobacco Survey 2019 had found that the prevalence of tobacco among the same age group was 8.4%. The survey also showed that 11.4% of children start smoking cigarettes below the age of seven; the figure for bidi users among children is 17.2% while 24% consume smokeless tobacco. The allure of e-cigarettes, promoted as a safer alternative to conventional cigarettes, is believed to be driving up smoking among children. Further, despite interventions to curb their use, products with chewable forms of tobacco, such as gutka, pan masala, khaini and zarda, easily find their way to the young through neighbourhood grocery stores, paan shops, and stationery carts. The consequences are there for all to see. A Lancet study last year highlighted that India along with six other countries contribute to more than half of the global burden of cancer deaths caused by smoking. Ironically, India is a signatory to both the World Health Organisation Framework Convention on Tobacco Control — New Delhi ratified it in 2004 — and the Protocol to Eliminate Illicit Trade in Tobacco Products.

This does not mean that there has not been any progress in the anti-tobacco campaign in India. The tobacco-using population in the country aged between 15 and 17 declined from 35.4% in 2009 to 27% in 2016, according to a survey. But the decline was uneven, with northeastern states such as Assam, Tripura and Manipur registering an increase in tobacco use. Strict implementation of the Cigarettes and Other Tobacco Products Act of 2003 is of utmost importance along with bolstering public awareness programmes and sharpening regulatory mechanisms. There is also a case of sensitising communities where tobacco usage is integral to the cultural ecosystem: the Northeast is a case in point. Special attention must also be paid to measures that could encourage children and adolescents to kick the habit.