Indifference to Smoking Warnings

Recently the World Health Organization (WHO) announced tobacco industry interference as the theme for World No Tobacco Day this year to focus on the industry’s increasingly aggressive efforts to undermine public health efforts across the world. This global discourse warrants an assessment of the industry’s role in India’s tobacco control and larger public health movement. Every year, tobacco use causes one million deaths in India and the industry spends millions of rupees on clandestine marketing and advertising tactics to recruit new users, particularly the youth. Why does the industry need to try so hard? That’s because tobacco slowly and painstakingly kills 5.4 million loyal customers every year. Another 600,000 people die from exposure to secondhand smoke emitted from lethal products sold by the industry. With tobacco control policies and regulations world over, particularly in developed countries, becoming more stringent, firms are turning to developing countries with poorer and vulnerable populations to establish their stronghold. India is among the few countries in the world with myriad forms of tobacco products including smoked forms (cigarettes, bidis, hookahs, etc.) and smokeless tobacco (khaini, gutkha and mawa). For nearly a decade since 2003, when India enacted the Cigarettes and Other Tobacco Products Act, the country has been at the forefront of the global tobacco control movement, setting an example for other developing countries fighting the epidemic. India’s tobacco control law bans any form of direct or indirect advertising with the exception of advertising at points of sale and on tobacco products itself. Therefore, the industry employs ways to overcome this by emphasizing brand loyalty, style, etc. The law also mandates the inclusion of pictorial health warnings on tobacco packs but the tobacco lobby has played a critical role in delaying and diluting warnings, a critical public health measure to warn people against the lethal effects of tobacco use. In fact, the Indian government notified some of the strongest pictorial health warnings in July 2006. This move was met with severe resistance from the tobacco industry. The Packaging and Labelling Rules, 2006, were amended with weaker pictorial warnings without skull and bones being introduced in September 2007. Finally, a group of ministers introduced a set of mild warnings in March 2008. Since 2006, nearly 18 notifications have been issued for implementation of pictorial health warnings in India. In 2010, strong warnings depicting a cancer-stricken mouth were notified yet the tobacco industry coerced the government by announcing a closure of production in their factories and published losses of revenue to the exchequer and weak warnings continued. Finally, comparatively stronger health warnings have been implemented since 2011, but only on smokeless tobacco packaging while smoking forms continue to depict lung cancer.