The story so far: The Parliamentary Standing Committee on Health and Family Welfare in its latest report about cancer management, prevention and diagnosis recommended that the government institute a ban on the sale of single sticks of cigarettes. It also recommended that the government increase taxes on all tobacco products and utilise the acquired revenue for cancer prevention and awareness.
The Committee observed that there is an urgent need to disincentivise the consumption of tobacco and alcohol in the country. It noted that tobacco consumed in different ways accounts for nearly 50% of all cancers, collectively referred to as tobacco-related cancers — which can be prevented.
What are the proposals and their rationale?
Broadly, the measures endeavour to curb consumption as well as the accessibility of tobacco products, including cigarettes.
The report, pointing to the National Health Policy’s (2017) endeavour for a relative reduction in current tobacco use by 30% in 2025, suggests that it is imperative that the government take effective measures to contain the sale of tobacco products. To this effect, it recommends that the government prohibit the sale of single sticks of cigarettes and lay stringent penalties and fines on offenders.
It also suggests that the government abolish all designated smoking areas in airports, hotels and restaurants in addition to encouraging a smoke-free policy in organisations.
The Committee also foundthat India has the lowest prices for tobacco products and thus, it must look to increase taxes on them. The revenue acquired from additional taxation, it proposes, could be used for cancer prevention and awareness.
These measures flow from the observation that oral cancer accounts for the highest proportion of cancer cases in the country.
Additionally, the committee also sought a ban on gutka and pan masala alongside a prohibition on their direct and indirect advertisement. This is based on the observation that, in India, more than 80% of tobacco consumption is in the form of chewing tobacco with or without areca nut, aggressively marketed as a mouth freshener.
Why the particular concern over single-stick cigarettes?
Single sticks are more economical to acquire than a full pack of cigarettes. This may particularly appeal to adolescents and youth who may have limited money in hand. Single sticks are also preferred by people who may want to take it up for experimentation and have not started smoking on a regular basis.
A ban on single-stick sales would compel a potential consumer to buy the entire pack which may not be particularly economical, thus curbing potential experimentation and the scope for regular intake. Moreover, a potential ban would also mean that the consumer would have to carry around the packet.
The World Health Organisation (WHO) has observed that all forms of tobacco are harmful, and there is no safe level of exposure to tobacco. It also states that smoking cigarettes is the most common way of tobacco use worldwide. Moreover, medical journal, Lancet noted in an editorial in June 2020, that by 2030, 7 million of annual deaths from smoking are expected to be from low and middle-income countries. It said, “The tobacco industry is targeting young people in low and middle-income countries to replace those dying from smoking-related causes.”
Single stick sales, owing to their easier accessibility and affordability, can also work as a disincentive to quit smoking. Nicotine in tobacco products is highly addictive, and without cessation support only 4% of users who attempt to quit tobacco consumption will succeed, according to the WHO. Such support includes professional support and proven cessation medications, which can more than double their chances of successful quitting.
How effective can a ban on single stick sales be?
Cyril Alexander, State Convenor of Tamil Nadu People’s Forum for Tobacco Control (TNPFTC) told The Hindu that notwithstanding that the proposed move would reduce consumption and sales, the government must also consider instituting vendor licensing.
According to Mr Alexander, in the absence of a vendor licensing regime, the ban on single sticks might not be very effective. “If you allow lakhs and lakhs of shops to sell tobacco and then implement the ban on the sale of single sticks of cigarettes, how would you enforce (the ban)?” he asks.
As for tackling addiction, Mr Alexander states that because cigarettes would not be available everywhere, the potential for recurrence of the consumption would reduce. He saidthat while it would indeed be difficult people to rescue people who are highly addicted, those less addicted can be rescued.
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