Recently, a Group of Ministers(GoM) appointed by the Indian Government to check the level of tobacco consumption, finally came to a consensus– all tobacco products sold in India will soon have pictorial warnings. The purpose being, to warn consumers of the severity of the health problems associated with smoking/chewing tobacco, thereby scaring them into giving up the habit.
Studies have found that pictorial warnings on tobacco packs lead to greater awareness of health risks and an increased desire to quit. Add to this, the fact that a majority of the tobacco consumers in India are illiterate, and the Government’s decision seems almost commendable. What is questionable is the way this issue has been handled.
Today, around 250 million Indians consume tobacco. When research threw up alarming data on the correlation between tobacco consumption and health risks, Medicos had asked for immediate imposition of pictorial warnings, saying that India was on the verge of a devastating tobacco epidemic. Yet, an issue as serious as this took over a year to resolve, the deadline to introduce these warnings has been extended multiple times in the process. Secondly, the GoM has finally shortlisted the following two images as pictorial warnings – a scorpion depicting cancer or an X-Ray plate of a man suffering from lung cancer. Considering that the primary aim was to inhibit tobacco consumption, these photographs do not hit hard. They possess little shock value and may not even be interpreted correctly. Also, despite recommendations by the WHO Framework Convention on Tobacco Control that warnings cover at least 50% of the principal display areas on tobacco packs, the GoM has decided that warnings will cover only around 30-40% of the pack. It is only after getting to know facts like these, that one is compelled to think whether our country’s priority is public health or formulating namesake policies to keep all policy makers and stakeholders (including the tobacco industry) happy.
Probing the issue a little further, one realises that even though several policies to reduce tobacco consumption have been formulated in the past, India evidently has a disconnect between policy making and implementation regarding government legislation on tobacco control.
Despite a government order three years ago prohibiting smoking in public places, Indians continue to smoke in clubs, restaurants, even educational institutions. The tobacco industry has also found ways of bending the rules. When the Indian government banned advertisements promoting tobacco in public places and media, tobacco companies resorted to surrogate advertising i.e. selling perfumes, CDs, lifestyle products under the same brand name and logo as the tobacco product. There has been no law yet, to combat this.
Today 10 million Indian children below the age of 15 either smoke or consume tobacco. And any misconception that this is limited to the spoiled rich who go ‘clubbing’, will be suspended after a stroll down the lanes of an underdeveloped slum area. Cigarettes and beedis are a way of life and an 8-year-old boy taking a drag is an ordinary sight. But who or what is to blame for this? Is it the film industry guilty of glamorising smoking? The Media? The growing western influence? The vulnerability of adolescence? Peer pressure? Stress? Addiction? Lack of Awareness? Illiteracy? It is difficult to answer this question accurately. But we certainly need to find ways of working around these issues.
The responsibility begins with the tobacco companies to educate their customers and society in general. This initiative needs to be supported and guided by the Government. Public health above everything else should be the key driver. As a part of this drive, tobacco companies can take the initiative to conduct frequent health checks and awareness programmes in schools, colleges, even workplaces, under the supervision of the Health Ministry – this is the positive approach. A decision also needs to be taken regarding the prohibitive measures – the negative approach. Responsible consumption needs to be reiterated. Environmental issues especially with regard to passive smoking need to be highlighted. This will work both ways as it will help spread awareness while simultaneously improving the company’s image in the eyes of the public.
The government, on the other hand, should review and ensure that all the tobacco control policies it has formulated so far are implemented properly. This may even call for amendments to cover loopholes such as surrogate advertising and penalties for those reluctant to adhere to the law.
In my opinion, the pictorial warnings are a very effective way of getting the message across, but the message needs to be “in your face”. At the outset, the government should try and gauge the effectiveness of these warnings via market research surveys. There should also be surprise checks at shops selling tobacco products to ensure that no shopkeeper sells tobacco packs that do not have the stipulated warnings. At the same time, a heavy fine/punishment should be set for defaulters – both manufacturers and sellers.
The seriousness of this issue arises from the fact that tobacco is detrimental to both physical and mental health. In fact, to an extent, it’s addictive and a person under its influence may be incapable of controlling his/her own actions.
Tobacco kills 2500 Indians everyday. A study by the Centre for Global Health Research estimates that the number of deaths caused by tobacco in India will increase to 10 lakh per year by 2010.
It’s time we changed these statistics.