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Tobacco Control Policies in India Implementationand Challenges
Tobacco Control Policies in India Implementationand Challenges
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Review Article
Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India
Summary
Tobacco use is a major public health challenge in India with 275 million adults consuming different tobacco products.
Government of India has taken various initiatives for tobacco control in the country. Besides enacting comprehensive
tobacco control legislation (COTPA, 2003), India was among the first few countries to ratify WHO the Framework
Convention on Tobacco Control (WHO FCTC) in 2004. The National Tobacco Control Programme was piloted during
the 11th Five Year Plan which is under implementation in 42 districts of 21 states in the country. The advocacy for
tobacco control by the civil society and community led initiatives has acted in synergy with tobacco control policies of
the Government. Although different levels of success have been achieved by the states, non prioritization of tobacco
control at the sub national level still exists and effective implementation of tobacco control policies remains largely a
challenge.
Introduction
Tobacco was introduced in India by Portuguese barely
400 years ago during the Mughal era. Mainly due to a
potpourri of different cultures in the country, tobacco
rapidly became a part of socio cultural milieu in various
communities, especially in the eastern, north eastern and
southern parts of the country. India is the second largest
producer of tobacco in the world after China.1
India is also the second largest consumer of tobacco
in the world, second only to China.2 The prevalence of
tobacco use among adults (15 years and above) is 35%.
The prevalence of overall tobacco use among males is
*Corresponding Author: Dr. Jagdish Kaur,
Chief Medical Officer, Directorate General of Health Services,
Ministry of Health & Family Welfare, Government of India, India.
E-mail: jagdish.kaur@nic.in
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Kaur J and Jain DC: Tobacco Control Policies in India
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District level
i. Training of health and social workers, SHGs, NGOs,
school teachers etc.
ii. Local IEC activities.
iii. Setting up tobacco cessation facilities.
iv. School Programme.
v. Monitoring tobacco control laws.
Inspite of a comprehensive legislation being in place and
implementation of NTCP by the Government, many of the
states are not able to initiate effective measures for tobacco
control. The internal monitoring of implementation of
COTPA in 21 States, where the National Tobacco Control
Programme is under implementation has revealed that
only about half of the states (52%) have mechanisms
for monitoring provisions under the law. Although 15
states have established challenging mechanism for
enforcement of smoke-free rules, only 11 states collected
fines for violations of bans on smoking in public places.
Similarly, a steering committee for implementation of
section-5 (ban on Tobacco advertisements, promotion
and sponsorship) has been constituted in 21 states but
only 3 states collected fines for the violation of this
provision. Similarly, enforcement of a ban on the sale
of tobacco products to minors and bans on the sale
of tobacco products within 100 yards of educational
institutions also remains largely ineffective in many
states. Less than half of the states under the programme
have established tobacco cessation facilities at the district
level. It is largely because of the failure of the states to
recruit manpower under the programme. To facilitate
the implementation of NTCP at state and sub state level,
the Government developed various Training modules,
guides, IEC and advocacy materials.19-23
A well designed public education campaign that is
integrated with community and school based programmes,
strong enforcement efforts, and help for tobacco users
who want to quit, can successfully counter the tobacco
industry. Such integrated programmes have been
demonstrated to lower smoking among young people by
as much as 40%.24 An intensive national level mass media
campaign for awareness generation on harmful health
effects of tobacco and provisions under COTPA has been
a major initiative under NTCP for the last three years.
The anti tobacco TV/radio messages were translated into
18 languages for the national campaign. The World Lung
Foundation provided technical support for development
of well tested and good quality TV/radio spots.
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Figure 1: Mr. Ghulam Nabi Azad, the Union Minister of Health releasing India Global
Adult Tobacco Survey Report on 19th October, 2010 at New Delhi.
Figure 2: WNTD Celebrations led by the State Tobacco Control cell and TCC, at
Hyderabad, Andhra Pradesh
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Conclusion
In view of tobacco control being a major public health
challenge in India, the Government has enacted and
implemented various tobacco control policies at national
and sub national level. The states have implemented the
tobacco control policies and programmes with various
levels of success. Effective tobacco control is dependent
on balanced implementation of demand and supply
reduction strategies by the Government and intersectoral
coordination involving stakeholder departments and
ministries. The implementation of the Government
policies, synergized with tobacco control initiatives by
the civil society and community are pivotal in reducing
prevalence of tobacco use in the country.
References
1.
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Kaur J and Jain DC: Tobacco Control Policies in India
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Cite this article as: Kaur J, Jain DC. Tobacco Control Policies in India:
Implementation and Challenges. Indian J Public Health 2011;55:220-7.
Source of Support: Nil. Conflict of Interest: None declared.
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Indian Journal of Public Health, Volume 55, Issue 3, July-September, 2011