Tobacco Controll Effects

Tobacco Control in West Bengal

Tobacco1 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. In the 12th Five Year Plan the programme would be scaled up as decided by all concerned.
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.
The Context:

High Prevalence

National Family Health Survey-III (2005) indicated that 50.1% males in State of West Bengal are smokers whereas 70.2% are using any kind of tobacco. The Global Youth Tobacco Survey (GYTS) 2009 highlighted that 14.6% of students aged between 13-15 years currently use any form of tobacco and 4.4% currently smoke cigarettes. The Global Adult Tobacco Survey (GATS) India report 2009:10 revealed that in West Bengal 36.3% of adults, 52.3% males and 19.3% of females are currently using any kind of tobacco. It also showed that 21% people of Bengal as against national average of 14% are presently smoking. This data is alarming as Bengal is the second largest home state of smokers after Uttar Pradesh in India.

High Secondary smoke exposure

GYTS 2009 highlighted that 50% students live in homes where others smoke and over two thirds are exposed to smoke in public places in Kolkata. Half of the students have parents who are addicted to tobacco. While 70% students think smoke from others is harmful to them and over three fourth agree that smoking should be banned in public places, an encouraging figure, only fifty percent of the smokers actually want to quit smoking. The GATS India showed that 62.4% of adults were exposed to second hand smoke at home while 29.8% in public places in West Bengal.

High disease burden

The first report of the Kolkata Cancer Registry (2002) mentioned that highest incidence rate of lung cancer in males in India is reported from Kolkata. Smoking (56.4%) emerged as the major risk factor among young (<40 years) patients of ischemic heart disease and lung cancer patients in West Bengal. Again the Population Based Cancer Registry, Kolkata (2006-2007) highlighted that Tobacco related cancer accounts for an overall 44.4% in males and 12.3% in females. The study also found that Kolkata had the highest number of new lung cancer patients in 2007 among the Metros in India - 14.9 cases per one hundred thousand people.

What we are proposing?

MANT proposes to strengthen the mechanisms for enforcing Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act (COTPA), 2003 and its revised Gazette notifications and rules and increase public acceptability and subsequent compliance through comprehensive information campaigns and political advocacy in total five districts of West Bengal. It will have a ripple effect, as expected, on the rest of 15 districts of the State, which is the second largest home of smokers in India as per the GATS report (2009-2010) and where the social acceptability of tobacco use is regarded as proverbially high. The activities as proposed by MANT seeks to extend support and build the capacity of all districts and sub-district level stakeholders to ensure compliance with all provisions of COTPA, 2003.

The Rationale:
Tobacco epidemic poses more daunting challenges than traditional health problems, because it involves a powerful addiction, deeply established social customs and beliefs, as well as a global industry with a history of undermining public health efforts.

Tobacco Control can effectively address the followings:

1. Address the social acceptability of tobacco consumption and thereby reduce the number of new users.
2. Smoke-free policies will lead to reduction of tobacco use as well as a reduction of existing users.

The adverse effects of smoking are particularly marked for low-income groups due to their greater exposure to tobacco. Recent studies found evidence to support the view that effective activities for tobacco control should address ethnic and class differences in smoking/tobacco use behaviour as well as socioeconomic deprivation. Therefore equity considerations suggest that enhanced tobacco control is one approach available to reduce the gaps in health status in our society.
Enhanced tobacco control can also be justified in terms of intergenerational justice. Tobacco use behaviours are to some extent transmitted from parents to children. Moreover, foetuses, infants and children are directly harmed by second-hand smoke.

The Main Provisions of the Law:
Prohibition of smoking in public places. Implement from 2, Oct, 2008 in the hole of India.

1. Prohibition of advertisement, sponsorship and promotion of tobacco products.
2. Prohibition of sale of tobacco products near educational institutions
3. Regulation of health warning in tobacco products packs.
4. Regulation of tar and nicotine contents of tobacco products.