Tobacco litter a challenge to a clean India: Environmental experts

Even as the Clean India campaign is making waves with both standalone and coordinated efforts in Kerala as across the country, acclaimed environmental experts  have called for no-holds-barred implementation of the ban on public smoking as a means to keep our cities, towns and villages clean and litter-free.

They contend that callously discarded cigarette stubs found abundantly in public places in violation of the smoking ban poses a challenge to dream of a clean India besides bringing the need for stricter implementation of laws to the fore.

Prof MK Prasad, noted environmental expert and educationist said, “While there are public discourses on the health impacts of tobacco use, its effect on the environment have come up for scant discussion in Kerala and India. Developed countries have woken up to this fact and have undertaken steps to identify the enormity of the problem. According to one estimate, the overall littering rate for cigarette butts in America is 65 per cent.”

“The non-biodegradable nature of cigarette butts, a hazardous solid waste, makes it a challenging area to address. The butts also contain dangerous chemicals such as cadmium, arsenic and lead. Stricter implementation of laws on public smoking will not only improve public health but also restrict the environmental damage caused from cigarette use,” Prof Prasad added.

A paper published in the International Journal of Environmental Research and Public Health cites that an estimated 1.69 billion pounds of butts are littered worldwide a year.

Adv. Harish Vasudevan, environmental law expert said, “Studies point out that tobacco refuse is a major source of litter on the planet. Filtered cigarettes offered as an alternative to reduce the amounts of nicotine and tar consumed are a mainstay with smokers now. Cigarette filters are made of cellulose acetate, a plastic slow to degrade.”

“Presence of cigarette stubs in public places provides cues for smoking. This major environmental and public health issue can be effectively controlled by implementing laws that prohibit smoking in public places. If sufficient multi-stakeholder efforts are not taken on time, it can pose a challenge to having a clean India,” Adv. Vasudevan added.

Indian tobacco control law COTPA, 2003 vide Section 4 prohibits smoking in all public places including public offices, educational institutions, public conveyances, restaurants, hotels, health institutions and all workplaces.

Highlighting how in-flight smoking has been effectively prohibited, Dr CN Mohanan, Retd., Scientist and Head, Environmental Sciences Division, Centre for Earth Science Studies here said that education, awareness generation and enforcement all have equal roles to play while addressing the cigarette litter issue.

“Policy backing, repetitive communication, and punishment for violators have made it possible to curb smoking during air travel. Similar measures will have to be taken to tackle cigarette littering in public places by enforcing laws against public smoking. Having a clean India is a collective dream; cigarette butt littering is something we cannot afford to ignore,” Dr Mohanan noted.

The Centre-State Rs 62,000 crore Clean India campaign launched by the Indian Prime Minister Shri Narendra Modi aims to accomplish the vision of a ‘Clean India’ by October 2, 2019. Among others, the campaign envisages cent per cent collection and scientific processing, disposal, reuse and recycling of solid waste.

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Koolimadu: India's first tobacco free area

Even as dedicated efforts are on to make three districts of Kerala, viz., Trivandrum, Ernakulam and Kozhikode models in tobacco control by following the provisions laid out in Indian tobacco  control law, COTPA, 2003, here's an engaging story of Koolimadu in Kozhikode.

Reproducing the story carried by the India Today on 15 December 1996 that recounts how locals of Koolimadu turned their village into India's first tobacco free area.

While acknowledging that the current status of Koolimadu with regard to tobacco control has not been checked, the story is being carried here for the sheer energy it provides to Kerala's tobacco control efforts.

Weeding out tobacco

Inspired locals turn their village into India's first tobacco-free area

For most smokers, the statutory warning on cigarette packs means only puff and nonsense. But the 2,200 villagers of Koolimadu, 25 km from Kozhikode town, have taken it very seriously.

With the Kozhikode district administration declaring it tobacco-free, smoking has not just been banned in this tiny hamlet, you run the risk of being excommunicated for a day if you flout the ban.

At village gatherings now, tendrils of smoke curl up only from tea glasses. Wizened women no longer chew away at pukayila (tobacco leaves). And the village shops no longer stock the cigarettes or beedis that used to make them richer by about Rs.2,000 every day.

It was a death that sparked the campaign. In 1994, chain smoker Ahmed Kutty, 58, a regular at the popular village reading room, Akshara, died of cancer. And the founders of the reading room, E.A. Moideen and Kader, all smokers in arms, who learnt how cancer is linked to heavy smoking, decided to launch an anti-smoking movement in the village.

Says Kader, a smoker for 30 years: "Kutty's death came as a shock. His sudden demise, caused by smoking, was enough of a deterrent."

It wasn't easy. Die-hard smokers were initially not interested in a fresh lease of life just because it came smoke-free. And a lot of women - like Kader's compulsively pukayila-chewing mother, Ameena - felt they would much rather die than kick their addiction.

But the village elders, whose diktat runs in the 250-odd houses here, ensured that the campaign was a success. Explains Moideen: "We printed no-tobacco pledge cards and went to every house in the village and asked everyone to sign or put their thumb impression on them." Persuasion finally worked. As did Kutty's death.

The promise of a long, healthy life rather than a rasping early death was not enough to wean away smokers from their addiction for good. The supply had to be cut off at source. The campaigners approached the two village stores which sold about 300 packs of cigarettes and beedis every day and asked them not to replenish their stocks.

Says a shop owner, M. Khalil: "They bought whatever was there in the shop for Rs.300 and made a public bonfire. We thought we lost some good business but later realised that a healthy, smoke-free life is much more rewarding in the long run."

Next, the campaigners got in touch with the Kozhikode branch of the Nehru Yuva Kendra (NYK) - established by the Centre in November 1972, to mobilise rural youth for development work in villages - for guidelines on how to systematically eradicate tobacco from the villages.

Placards, festoons and banners ("Stop smoking, save family" and "Koolimadu is tobacco-free zone"), were put up. Banners at the village bus stop entreated travellers not to smoke while they were in the village.

Koolimadu residents who can't help lighting up risk being excommunicated for a day. But this punishment has not had to be enforced yet. 

The inveterate smoker, of course, has only to walk about a kilometre to either Nairkuzhi village in the north, Mavoor village in the south or the banks of the river Chaliyar in the south and east to enjoy a smoke.

This also means that the anti-tobacco campaign has not caught on in any of the other villages. Neither does the district administration have any plans to mobilise such campaigns elsewhere in the area.

But inside Koolimadu, smoking remains strictly a no-no. Says local civil engineer K. Abdullah, 29: "We have groups of youth to monitor the ban." Fortunately, according to Kozhikode NYK coordinator M. Anil Kumar, the punishment of being excommunicated for a day for defying the ban has not had to be enforced as yet.

Ultimately, the effort to banish tobacco may turn out to be the healthiest investment Koolimadu residents have made till now.

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State-level laws banning gutka are impacting product availability and use: WHO

A study by the World Health Organisation to examine the impact of gutka ban in select states of India has found that state-level laws banning gutka are having a positive impact – reduced product availability and a decrease in consumption of gutka. 

The study, 'Examining the impacts of the gutka bans in selected states in India' revealed that the support for gutka bans is very high (92%) and there was an almost universal agreement (99%) that gutka bans are good for the health of India’s youth.

The study was conducted by the World Health Organization Country Office for India in collaboration with Johns Hopkins Bloomberg School of Public Health in seven states (Assam, Bihar, Gujarat, Karnataka, Madhya Pradesh, Maharashtra and Orissa) and the National Capital Region region.

“These findings have a strong message that regulatory mechanisms are effective and can have a positive impact on the consumption pattern,” said Dr Nata Menabde, WHO Representative to India. 

Surveys were conducted with 1,001 current and former gutka users and 458 tobacco product retailers to gain insight into the e ffect of the bans on consumer use and product availability in seven states and the National Capital Territory. 

Observations of 450 retail environments and 54 in-depth interviews with government officials, enforcement officials and citizens working with civil society groups were also conducted to the same end.

The study has recommended the following measures for better public health impact and saving lives:

• Government to expand the Gutka ban to all smokeless tobacco products. The ban should also cover products that can be bought separately and mixed to be consumed as Gutka or a product similar to Gutka (by whatever named called).
  
• Enforcement mechanisms need to be strengthened to ensure complete compliance of the ban
  
• Provision for tobacco cessation services to be scaled up to cater to the unmet need for cessation after the ban
  
• Products like pan masala are used as a base for making products akin to Gutka and also are produced and marketed by the same manufacturers under the similar brand names. These pan masala products are blatantly advertised and act as a surrogate advertising medium for smokeless tobacco.
  
• Therefore, the Government needs to take urgent action to stop advertisements of pan masala to protect the vulnerable sections of society including the youth.

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Kerala, the first Indian state to become tobacco advertisement free

Kerala has become India’s first state to be free of tobacco advertisements after the southern state completely did away with giving publicity to the nicotine-laden material at its points-of-sale.

Tobacco advertisements from 95.3 per cent of points-of-sale across 14 districts were successfully removed in an 18-month-long campaign spearheaded by the Public Health wing of the Kerala Health Services Department. The state police joined forces in this mega effort.

Tobacco control champion and Kerala Home Minister Shri Ramesh Chennithala declared Kerala as tobacco advertisement-free at function held in the presence of State Health Minister Shri VS Sivakumar in the Kerala capital of Thiruvananthapuram on November 14.

Dr AS Pradeep Kumar, Additional Director of Health Services (Public Health) who coordinated this massive effort, said a three-phase activity plan was developed with District Medical Officers at the core. “Sensitisation programmes were conducted with emphasis on Section 5 of COTPA for district officers at the state capital,” he added. “District officers in turn trained and authorised personnel attached to the Primary Health Centre.”

Section 5 of Indian tobacco control law called COTPA, 2003 bans all forms of advertisement, direct or indirect, of tobacco products.

The districts were given the freedom to customise according to their local needs. “This, in turn, raised the level of commitments and ownership taking,” pointed out the medical doctor who has a PhD in tobacco control. “At the state level, we supported the districts by framing guidelines, monitoring and advising course corrections,” said Dr Kumar who is among the few in India to have completed the Global Tobacco Control Leadership Program of the Johns Hopkins Bloomberg School of Public Health, USA.  

The process that started during World No Tobacco Day 2013 saw both integrated and intensive drives that effectively pooled the services of health personnel from district to primary health centre level. In drives integrated with regular activities during the first phase from June to December 2013, over 23,500 notices were issued to shops that violated the provisions of Section 5. 

Intensive weeklong drives in January and May 2014 marked the second leg of the campaign. As many as 32,566 shops and 62,365 eateries were inspected during the period 10 to 17 January 2014. While the January round revealed violations in 48.8 per cent of sites, field assessments conducted by personnel of Primary Health Centres in May showed that 90 per cent of points-of-sale were free of tobacco boards. 

In October 2014, teams led by District Medical Officers at the district level and Programme Officers at the Panchayat and Primary Health Centre level certified that tobacco advertisement boards were surfaced out. 

As many as 22,344 points-of-sale in 84 wards across Kerala were observed during 28 October to 7 November. Dr Pradeep Kumar says, “A civil society group with nearly four-decade-long experience in research and field implementation in Kerala conducted the evaluation study.”

The evaluation reported an overall compliance of 95.3 per cent – 98.5 per cent of points-of-sale are free of any advertisement hoardings and 96.7 per cent of points-of-sale are free from stickers and print advertisements. International standards prescribe that 90 per cent of sites have to be free of advertisements to become eligible for the tag of tobacco advertisement free. 

Noted head and neck cancer surgeon Dr Pankaj Chaturvedi of Mumbai’s Tata Memorial Centre and an internationally acclaimed tobacco control proponent said, “Tobacco is the only consumer product in the world that has not a single beneficial use apart from causing death and disability. Industry spends billions in advertising this killer product to lure youngsters. Ban on advertising will save innocent youths from initiating this habit. I congratulate the Kerala Government.”

The Global Adult Tobacco Survey (2009-10) said 44.2 per cent of adults above 15 years in Kerala had noticed advertisements or promotions on cigarettes and 70.9 percent and 72.3 per cent had noticed advertisements on bidis and smokeless tobacco respectively. 

Bangalore-based senior head and neck cancer surgeon and tobacco control advocate Dr Vishal Rao said, “This is a significant step that Kerala has achieved in its efforts to improve public health of Keralites, especially the youth of Kerala. Youth between the age of 10 and 18 fall prey to the advertisement of tobacco and lured into addiction. Today we are seeing cancers in age group of 20s and 30s, which we earlier saw in the 70s. A healthy society should have less illness, less hospitals and less doctors and this can only be achieved through preventive health.” 

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Oral cancer not the only risk for those who chew tobacco

Contrary to the prevailing notion that chewing tobacco only increases the risk of oral cancer, a study that looked at different researches conducted in India has shown that smokeless tobacco can also cause oesophageal, throat and even stomach cancer.

The findings are critical. While one-third of the country’s population takes tobacco, 21% of them consume smokeless tobacco, such as gutkha and khaini, according to the Global Adult Tobacco Survey released in 2010.

“While reviewing various studies, we found the incidence of oesophagal [foodpipe] cancer was higher in the north-east, while in the south we found pancreatic cancer was prevalent in those who consumed smokeless tobacco,” said Dr Pankaj Chaturvedi, head and neck cancer surgeon at Tata Memorial Centre and co-author of the review study.

He added that researches in Madhya Pradesh have showed that throat cancer is common among smokeless tobacco users.

The study, titled A Review of Indian Literature for the Association of Smokeless Tobacco with Malignant and Pre-malignant Diseases of Head and Neck Region, was published last week in the Indian Journal of Cancer.

Researchers said the review exposed the risk of developing throat, stomach, oesophageal, pancreatic, cervical cancer as a result of chewing tobacco.

“It depends how and where you are consuming tobacco. There is a difference in the incidence of tobacco-related cancer between India and the western world. Those who place the tobacco mixture under the lip are more prone to cancer in that region. Those who also consume areca nuts are increasing their risk of two cancers, as areca nut itself is carcinogenic,” said Dr Chaturvedi.

Researchers said apart from the way tobacco is consumed, the ethnicity of the consumer is also a factor in determining the type of cancer he or she is prone to develop.

Unlike in western countries, smokeless tobacco use is far more common than smoking in India. “Unfortunately, there is nobody regulating the use of smokeless tobacco. It is easy to grow tobacco crop anywhere. It is sold loose and also not taxed. A person who stops consuming smokeless tobacco is at the risk of developing cancer for at least a decade after giving up the habit. This itself shows the impact of the habit,” said Dr Chaturvedi.

Source: Hindustan Times

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Ban on loose cigarettes: An open letter from a cancer survivor to PM Narendra Modi

After the announcement of amendments of COTPA (such as ban on  sale of loose cigarettes), a cancer survivor has sent an open letter addressed to PM that he as addressed to PM Narendra Modi. He expresses his views about the ban on loose cigarettes and urges Modiji to reconsider its implementing the amendments it with full vigour.

Respected Modi Ji,

It was with great sense of pride and satisfaction that I learnt from the Newspapers reports that Government of India has decided to ban sale of loose cigarettes as it constitutes over seventy percent of its sale. 

However, the joy was short lived as today it has been announced that the amendments of COTPA (such as ban on  sale of loose cigarettes) is going to be deferred. Although I did not believe in the paper published by the Congress party with caption U-Turn, it immediately occurred to me that the decision not to implement ban on sale of loose cigarettes is likely to be dubbed as another U-Turn. 

However, the joy was short lived as today it has been announced that the amendments of COTPA (such as ban on  sale of loose cigarettes) is going to be deferred. Although I did not believe in the paper published by the Congress party with caption U-Turn , it immediately occurred to me that the decision not to implement ban on sale of loose cigarettes is likely to be dubbed as another U-Turn. 

Sir, I am a tobacco victim and cancer survivor. After having smoked cigarettes made attractive by constant  advertising with inciting slogans like, ‘Made for Each Other’ by ITC , I was detected with Throat Cancer in 2008. It resulted in removal of my voice box and now I speak with the help of a prosthesis (machine). Eating and Speaking has become a challenge. As ill lack would have it, I suffered yet another Cancer of the Tongue in 2013 resulting in partial removal of my tongue. It can be thus well imagined that my life has become virtual hell. Please see the attached picture that was taken recently during my discharge from hospital. 

I never wanted any other person to have the same fate which was the reason for my joy on learning that sale of loose cigarettes is going to be banned and loop holes in COTPA are going to be plugged by amendment.

Mr. Prime Minister, the case before Consumer Court filed by me for compensation from ITC could not succeed  as one of the grounds taken in defense was that I could not produce bills for cigarettes purchased by me. 

Can you imagine any person being issued with bills for sale of loose cigarettes by the vendors. Therefore, if at all loose cigarettes are to be sold then issuance of sale bills must be made mandatory for loose as well as packets of cigarettes. The activities of cigarettes manufacturing companies must be curbed as they are nothing but merchants of death. One cannot protect these companies and tobacco growers, vendors etc on the plea that the Revenue of the Government as also employment opportunities of persons shall be affected.

For generation of jobs and revenue at the cost of millions of lives lost due to cigarette smoking and  expenditure on health care cannot be justified on this score. You had tweeted on 31st May (World no tobacco day) for a healthier and Tobacco Free India. You had pledged to reduce tobacco consumption in India. Unfortunately your senior Cabinet Ministers do not support your ideologies and continue to patronage tobacco lobby.

It is, therefore, prayed that the Honourable Prime Minister may kindly reconsider its rethinking on proposed  curbs on sale and consumption of tobacco and implement it with full vigour. Sir, you have evoked high hopes in people of India. It is our cherished desire that the Government shall take decisive steps to make India tobacco free. It would not only save lives but also save enough money spent in health care and loss of economic activity to compensate for the loss of Government Revenue. Surely the Government does not want to earn Revenue by allowing its citizens to be killed by Companies like ITC whose share prices have surged by 6% after the announcement to defer ban on loose cigarettes.

The main beneficiaries of tobacco business aren’t farmers/vendors but few powerful families who run this trade only to make vulgar profits. How can you ignore that these business families are killing one million Indians every year and making the nation lose nearly one lac crore every year on health care expenditure? At the end, it is urged that all the proposed amendments in COPTA and its implementation may kindly be done immediately.

Yours Sincerely,
Deepak Kumar
Commissioner of Customs,Central Excise & Service Tax (Retd)

Courtesy: Healthsite

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Tobacco control measures in Rajasthan: UN mission to visit state

Exemplary work done by the Rajasthan government in tobacco control has attracted the attention of a joint mission of the UN inter-agency task force on prevention and control of non-communicable diseases, which is visiting Rajasthan next month. 

In a letter to state's principal secretary, medical and health, WHO representative to India Dr Nata Menabde mentioned, "The main focus of the visit will be to create a forum for highlighting lessons learned in formulating multi-sectoral coordination for non-communicable diseases (NCDs) and tobacco control and identify challenges in the prevention and control of NCDs at state level." The team of officials will visit the state on December 11. 

The mission members will discuss with the state officials about the distinction of Rajasthan as the first state in India with a mandatory requirement for government job aspirants to file an undertaking for not using tobacco products in any form (smoking or chewing forms), declaration of all educational institutions in the state as tobacco-free institutions as per government of India guidelines and imposition of the highest rate of VAT on all tobacco products.

The team will comprise officials from WHO, UNDP, UNFPA, UNICEF and the World Bank with participants from their headquarters, regional and country office. 

The visit will be coordinated by the WHO country office for India in close collaboration with the ministry of health and family welfare and office of the UN resident coordinator in India. The efforts are being made to intensify fight against NCDs as it is currently leading cause of morbidity and mortality in India. 

Nata pointed out in the letter, "In September 2011, heads of state and government adopted the political declaration of the high-level meeting on prevention and control of NCDs during the general assembly of UN. The declarations called upon WHO, as the lead UN specialized agency for health, and all other UN system agencies and international financial institutions to work together in a coordinated manner to support national efforts to prevent and control NCDs and mitigate their impacts." 

Tobacco control and NCD nodal officer (state) Dr Sunil Singh said, "Rajasthan won two WHO's director general awards in two successive years for its efforts on tobacco control. We have banned gutkha and introduced Pehal, an online counseling for tobacco addict." 

The UN inter agency task force (UNIATF), which will visit the state was established to coordinate the activities of the relevant UN funds, programmes and specialized agencies and other intergovernmental organizations to support realization of the commitments made in the political declaration. In particular, through implementation of the WHO global action plan on NCDs 2013-2020. 

In this regard, a joint mission of the UNIATF is visiting India during December 8-12, 2014. The joint mission is intended to enhance the support of the UN agencies to the government of India to scale up the national multi-sectoral response to NCDs.

Courtesy: Times of India

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Living with a smoker equals breathing the air in world's most polluted cities

Living with a smoker can be like breathing the air in the world’s most polluted cities, according to a new study from Scotland.

According to lead author Sene Semple of the of the Scottish Center for Indoor Air at the University of Aberdeen, smoking in  home leads to really poor air quality and results in concentrations of fine particles. 

Tiny particles 2.5 microns in diameter or smaller, known as PM2.5, can penetrate deep into the lungs and even enter the blood. They’ve been linked to heart disease, strokes and cancer.

“Making your home smoke-free is key to reducing your exposure to PM2.5; for non-smokers who live with a smoker the impact of implementing smoke-free house rules would reduce their daily intake of PM2.5 by 70 percent or more,” Semple said. 

Such tiny particles typically result from combustion. Outdoors, the primary sources are vehicle exhaust, power plants and wildfires. Indoors, wood-burning or coal-burning stoves, gas cooking and heating fires and tobacco smoke are the most common sources of PM2.5 in the air.

For outdoor air, the World Health Organization says the safe exposure limit for PM2.5 particles is an average of 25 micrograms, or 25 millionths of a gram, per cubic meter of air over a 24-hour period, or average annual levels of 10 micrograms per cubic meter.

The U.S. Environmental Protection Agency sets the 24-hour limit at an average of 12 micrograms.

Semple and his colleagues wanted to bring together two scientific communities: those involved in tobacco control work and those interested in outdoor air pollution and health. “We think there is a lot that each can learn from the other,” he said.

Many studies have examined outdoor air pollution or indoor air quality in workplaces. But home is where most people spend the majority of their time, particularly small children and homebound elderly people, the researchers write. By comparing indoor air pollution in the homes of smokers and non-smokers, then comparing that to the most polluted cities, they hoped to illustrate the perils of indoor tobacco smoke over a lifetime.

The study team looked at data from four separate studies that measured PM2.5 levels in 93 Scottish homes where people smoked and 17 homes that were smoke free.

On average, PM2.5 levels in smokers' homes were around 31 micrograms per cubic meter – 10 times greater than the average of 3 micrograms in non-smoking homes.

There was a wide range of smoke concentrations in the smokers’ homes, however, and in one quarter of them, the 24-hour averages were 111 micrograms.

Semple pointed out, “A considerable proportion of smokers’ homes had air pollution levels that were the same or higher than the annual average PM2.5 concentration measured in Beijing,” a heavily polluted city.

The study team estimates that over a lifetime, a non-smoker living with a smoker will inhale about 6 grams more particulate matter than a non-smoker living in a smoke-free home.

Semple said that isn’t much, but this amount is likely to "have a substantial effect on the risk of developing diseases of the cardiovascular and respiratory systems.”

Semple said smokers often express the view that outdoor traffic pollution is a bigger problem than second-hand smoke pollution in the home.

“What this work shows is that, for most people living outside of major heavily polluted mega-cities like Beijing or Delhi, outdoor air pollution is much, much lower than what is measured inside homes where someone smokes,” he said.

Source: Reuters

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Tobacco packets to devote 85 per cent space to warnings

India has made it mandatory for tobacco companies to devote 85 per cent space on packets of cigarettes and other tobacco products to warnings against the ill effects of tobacco consumption.

"We have issued a notification to ensure that in the next few months cigarette manufacturers have 85 per cent space on packets covered with either pictorial warnings or messages warning against the perils of tobacco use," Union Health Minister Harsh Vardhan announced in New Delhi at a function on the occasion of global hand washing day.

The guidelines would come into effect from April 1, 2015. 

As of now, tobacco companies are required to devote only 40 per cent of the space on packets to pictorial warnings against tobacco use.

Mr Harsh Vardhan said, "In my career as a doctor, I have seen smokers and tobacco users die in front of me. We should do whatever we can to make people aware."

With this, India will join Thailand where 85 percent of space on packs of cigarette and other tobacco products is covered with warnings. 

India will now rank first in the list of 198 countries that warn smokers about the hazards of smoking through graphic pictures on cigarette packets.

In Australia, it is 82.5 per cent and in Uruguay, it 80 per cent. 

India's ranking had dropped down to 136 out of 198 among countries, which include pictorial health warnings on cigarette packets.

According to the notification issued: "The specified health warning shall cover at least 85 per cent of the principal display area of the package, of which 60 percent shall cover pictorial health warning and 25 percent shall cover textual health warning and shall be positioned on the top edge of the package".

For packages containing smoking forms of tobacco, the pictorial warnings would be of throat cancer, and for chewable tobacco products, they would be of mouth cancer.

The notification said the health warnings shall be expressed in English or any Indian language. 

"The specified health warning on tobacco product packages shall be rotated every 24 months from the date of commencement of these rules or before the period of rotation as may be specified by the central government notification," it said.

"The size of all components of the specified health warning shall be increased proportionally according to increase in package size to ensure that the specified health warning covers 85 percent of the principal display area".

Source: NDTV

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TFK stall at Clean Campus Trivandrum Regional Meet

TFK's stall set up at the venue of Trivandrum Regional Meet of Clean Campus, Safe Campus on 10 October 2014 evinced enthusiastic participation of students and bureaucrats alike.

Visitors thronged our stall and eagerly wrote their comments in the 'Have Your Say' wall. 

Posters were specially designed wherein key stakeholders could write their views on implementing the ban on sale of tobacco products around schools.

Under Section 6 (b) of Indian tobacco control law, COTPA, 2003, sale of tobacco products is prohibited in an area within a radius of 100 yards of an educational institution. 

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Tobacco control: Health custodians congratulate Kerala Police

Senior custodians of health across the state have heaped praises on Kerala Police for their role in preventive health by tightening enforcement of the tobacco control law COTPA, 2003 that is aimed at protecting public from the many harms of tobacco use. COTPA violations check by Kerala Police for the May-July 2014 quarter has gone up by 64 per cent compared to the same period last year.

Dr. Ramdas Pisharody, Principal, Trivandrum Medical College, congratulating the Trivandrum City Police for making the college area smoke-free said,  “This concerted effort by the police force to safeguard the lives of thousands who visit the hospital every day by enforcing COTPA is very laudable. Owing to high literacy levels and penetration of mass media in Kerala, awareness that smoking and tobacco use is harmful to health is very high among our people. Yet, people continue to smoke away causing harm not only to their health but also of others. Tough enforcement of laws together with counselling by doctors is the need of the hour to arrest the preventable damage to public health from tobacco use.”

The Trivandrum City Police, as a part of the collective exercise led by the District Administration to make the district model COTPA compliant, recently declared the Medical College police circle smoke free.

Ernakulam and Kozhikode districts are also in the fray to become model COTPA compliant. Multi-stakeholder efforts in these two districts are led by the District Collectors with active support from the police and other enforcement agencies.  

According to Dr. VP Gangadharan, pioneer medical oncologist and HoD of Medical and Paediatric Oncology, Lakeshore Hospital, Kochi, tobacco induced oral cancers is on the rise in Kerala. “Youngsters are increasingly developing an affinity for tobacco products, which are a definitive causative factor for mouth and throat cancers.”

Complimenting the Kerala Police for their action to curb tobacco use through noble endeavours such as model COTPA compliant districts, he said, “All sections of the society should support the police and other enforcement officials to ensure that no sale of tobacco products happen around any educational institution in Kerala, from primary schools to institutions of higher education.”

Section 6 (b) of COTPA prohibits the sale of tobacco products around 100 yards (91.4 metres) of any educational institution.

Dr MN Krishnan, Prof and Head, Department of Cardiology, Government Medical College, Kozhikode feels that by working to control tobacco use through enforcing the law, police are not just helping to save lives but supporting the state’s economy as well.

“The economic burden to Kerala from tobacco use is very high; a study for the year 2011 found it is the highest for cardiovascular diseases at Rs 226 crores. This is precious resources going down the drain. Police, by acting against tobacco use, are doing a productive service not just to public health but also to our economy’s health.” 

He added that the fine amount collected by the police and other enforcement agencies should be pumped in for tobacco control measures.

From 16,363 challans for COTPA violations during May-July 2013, police have strengthened efforts and have fined/challaned 26,797 persons during May-July 2014, as per Kerala Police website. Fine amount collected from COTPA violators have also increased by 115 per cent in the same period. From Rs 2,270,950 in 2013, it rose to Rs 4,877,550 in 2014. 

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COTPA implementation: Kerala Government authorises Excise Inspectors

The Kerala Government vide GO(P) No. 155-2014/TD dated 20 September 2014 has authorised Excise Department for implementing COTPA, 2003. Officers of the rank of the Excise Inspectors and above can now take action under Sections 12 and 13 of COTPA.

Section 12 of COTPA 2003 states: (1) Any police officer, not below the rank of a sub-inspector or any officer of State Food or Drug Administration or any other officer, holding the equivalent rank being not below the rank of Sub-Inspector of Police, authorised by the Central Government or by the State Government may, if he has any reason to suspect that any provision of this Act has been, or is being, contravened, enter and search in the manner prescribed, at any reasonable time, any factory, building, business premises or any other place,

a. where any trade or commerce in cigarettes or any other tobacco products is carried on or cigarettes or any other tobacco products are produced, supplied or distributed; or 

b. where any advertisement of the cigarettes or any other tobacco products has been or is being made.

(2) The provisions of the Code of Criminal Procedure, 1973, shall apply to every search and seizure made under this Act.

Section 13 of COTPA 2003 reads: (1) If any police officer, not below the rank of a sub-inspector or any officer of State Food or Drug Administration or any other officer, holding the equivalent rank being not below the rank of Sub-Inspector of Police, authorised by the Central Government or by the State Government, has any reason to believe that, 

a. in respect of any package of cigarettes or any other tobacco products, or

b. in respect of any advertisement of cigarettes or any other tobacco products, 

the provisions of this Act have been, or are being, contravened, he may seize such package or advertisement material in the manner prescribed.

(2) No package of cigarettes or any other tobacco products or advertisement material seized under clause (a) of sub-section (1) shall be retained by the officer who seized the package or advertisement material for a period exceeding ninety days from the date of the seizure unless the approval of the District Judge, within the local limits of whose jurisdiction such seizure was made, has been obtained for such retention.

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TFK salutes Union Health Minister Dr Harsh Vardhan

Tobacco Free Kerala salutes Hon'ble Union Minister Dr Harsh Vardhan for championing the cause of tobacco control

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Expert Committee recommends sterner tobacco control measures

An expert committee set up by the Health Ministry for recommending amendments to the Tobacco Regulation Act is likely to recommend that the minimum age for smoking be increased to 25 years from the current 18 years.

The committee is also in favour of raising fines for tobacco related offences, including smoking in public, but has decided that the increase should be at a reasonable level. However, the final report on amendments to the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act (COTPA), 2003, is yet to be prepared.

Former Delhi Health Secretary Ramesh Chandra, who heads the committee, said the report will be ready early next week.

“We are in favour of raising the minimum age for smoking to 25 years. We also want fines for tobacco-related offences to be raised and among the suggestions that we have received is one that says that the fine for smoking in public should be Rs 20,000. We have not taken a call on what that amount should be but we understand that proposing an amount that is not practical will only cause the government to reject that recommendation. We do not want that. We also want the sale of loose cigarettes to be stopped and the size of the pictorial warning to be raised,” said one of the members of the committee.

Members explained that the inputs of the committee are more of a technical nature, delineating international best practices and the health effects of tobacco. “The final shape of the report is being decided in consultation with the ministry representative,” explained a member. 

Among the other offences for which the committee wants fines to be raised are for sale of tobacco products to underage people, advertisements at the point of sale and repeat offenders especially when they are traders or companies violating COTPA regulations.

Source: Indian Express

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Radio Benziger takes up the cause of tobacco control

In the interest of public health, Radio Benziger – India’s first hospital based radio has begun dedicated transmission of tobacco control messages in association with Tobacco Free Kerala – a coalition working for tobacco control in Kerala. 

The transmission, which began on August 30, involves multiple repeats of spots on the harms of tobacco, made available by Tobacco Free Kerala in liaison with World Lung Foundation, the technical partner to the Union Ministry of Health and Family Welfare in tobacco control communications.

Currently, 30-second Malayalam spots titled ‘Artery’ and ‘Dhuan’ are alternately repeated eight times over the radio’s 15-hour daily broadcast period. ‘Artery’ describes how cigarette/bidi smoking clogs up the main artery leading to the heart and ‘Dhuan’ is about the dangers of second hand smoke as a result of smoking which is banned in public places. 

Under the Indian tobacco control law, COTPA 2003, smoking is prohibited in all places where public has access as of right or not; violations can invite a spot fine of up to Rs 200. The law empowers 21 categories of officials including Police, Health and Education to act against violators.

Fr. Ferdinand Peter, Director, Radio Benziger said, “Tobacco is a leading preventable cause of many fatal illnesses, and this current project is part of our efforts to forewarn and save the lives of as many people as possible, especially children, from the maladies of this sinful substance. Though we have tackled tobacco control earlier as well, this is first time we have dedicated specific time slots for this purpose in our community radio.”

Radio Benziger, which began operations in 2010, now reaches over 4 lakh people around a 20 km radius in and around Kollam district.  The major target group of the radio is the coastal population.

A study conducted by Regional Cancer Centre (RCC) and Bhabha Atomic Research Centre in coastal wards of Kollam Corporation last year had brought out that nearly 37% males smoke tobacco – much higher than the Kerala average of 27.9% and national average of 24.3% for males, as per the Global Adult Tobacco Survey (2009-10).

Shri S Jayaraj, State Coordinator, Tobacco Free Kerala said, “We are happy that Radio Benziger readily accepted our proposal for transmitting tobacco control messages through their network. We are looking forward to a strong partnership with this popular community Radio in the fight to save our people, mainly the younger generation from tobacco harms.”

Radio Benziger can be heard by tuning in to FM 107.8 MHz. Programme sharing is possible through ‘Ek Duniya Anek Awaaz’ - a web based free and open audio content and resource exchange platform for community radio broadcasters.

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Economic costs of tobacco use: Kerala surpasses neighbours

Kerala has emerged as a leader of sorts in South India with the huge economic burden it shoulders on account of tobacco use. God’s Own Country has left behind its tobacco cultivating neighbours – Karnataka and Tamil Nadu, reveals the findings of a major recent national study conducted to estimate the economic dimensions of tobacco use.

The study supported by the Union Ministry of Health & Family Welfare and the World Health Organisation brings out that the economic resources lost in treating and managing four major tobacco-induced diseases is nearly 75 per cent more than Karnataka. While Kerala burns out Rs 545.4 crores, it is Rs 314.7 crores in Karnataka.

Monetary resources lost due to tobacco use in Tamil Nadu is nearly 17 per cent lesser than Kerala, at Rs 467 crores.

The report following the study called ‘Economic Burden of Tobacco Related Diseases in India’ developed by the Public Health Foundation of India has estimated the economic costs on persons aged 35 – 69 in the year 2011. It has estimated both direct medical costs and indirect morbidity costs in two categories – all tobacco-induced diseases, and four specific diseases – cardiovascular diseases (CVDs); cancer, tuberculosis and respiratory disease.

Direct medical costs include direct healthcare expenditure for inpatient hospitalisation or outpatient visits such as medicines, diagnostic tests, bed charges and surgeon’s fees. Indirect costs accrue from expenses incurred on transportation and lodging charges for caregivers, loss of household income due to inpatient hospitalisation, besides costs from premature death. 

A similar pattern prevails with regard to economic burden of tobacco use from all diseases, with Kerala facing a greater pinch than Karnataka and Tamil Nadu. The economic cost in Kerala on all diseases is Rs 1513.7 crores, as against Rs 983.1 crores in Karnataka and Rs 1171.3 crores in Tamil Nadu.

In line with consumption patterns, tobacco-induced costs are higher among Kerala males as compared to females. Among males, higher costs – both direct and indirect – accrue from smoking tobacco products as against smokeless tobacco products.

On four diseases specifically, tobacco use among Kerala males causes a loss of Rs 518.9 crores, which is nearly 90 per cent more than in Karnataka and 40 per cent more than in Tamil Nadu. Tobacco induced economic costs among Kerala females is Rs 26.4 crores.

Kerala’s saving grace is Andhra Pradesh, a major tobacco producing state in India, which leads with the highest economic burden due to tobacco use among southern states.

The study, among others, recommends prioritisation of tobacco control measures such as strengthening implementation of Indian tobacco control law, COTPA, 2003; uniform taxes on all tobacco products such as cigarettes and bidis; prohibition on sale and manufacture of all forms of smokeless tobacco products/chewing tobacco and high visibility public awareness campaigns to consistently reach different target audiences.

The Value Added Tax on cigarettes in Kerala is 22 per cent and bidis are not taxed at all.

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Thiruvananthapuram set to become first smoke-free district

By August 31, all government, public sector and private offices in the district are would become 'Smoke-free' as the district collector has issued directives as part of the drive to make the district the first district in the state to comply with the Indian Tobacco Control law - Cotpa. 

"Initially, directions were issued to ensure a smoke-free environment in all public places, government, public and private offices and establishments in the district by August 15. As some had sought more time to implement it, the deadline to ensure a smoke-free district was extended till 31st," district collector Biju Prabhakar told TOI. 

A decision in this regard was taken at a meeting convened by the district collector with representatives of all major departments such as city and rural police, education, excise, local self government, corporation, food Safety, health, RCC, transport and railways on Tuesday. 

The directive states that all workplaces, government, public offices and private establishments in the district should ensure a smoke-free environment according to Section 4 of Smoking in Public Places Rules 2008 of Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act (Cotpa). It has outlined the need to set up warning boards in bilingual template of no less than 60cmx30cm on display at workplaces and public places. 

"Enforcement of the drive to ensure a smoke-free public space in any government, public and private office or establishment will help reduce the menace, even if not 100% eradication. In a workplace or a hotel, smoking should not be permitted in a public space as it will affect others's health. A separate smoker's chamber or room should be there," Biju Prabhakar said. 

With Tobacco-free Kerala, making all workplaces smoke-free is critical to achieving the target of Kerala's first Cotpa compliant district and it will make the state capital a model in the public health arena, he added. 

After the enforcement drive against tobacco products and pan masala, it is almost banned in Kerala with the convergence of various departments including, excise and food safety, he said. 

Courtesy: Times of India

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Kozhikode district to say no to tobacco

The district administration, with the help of the Police Department and various voluntary organisations, is trying to make Kozhikode a tobacco-free district as per the Cigarettes and Other tobacco products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act (COTPA), 2003.

District Collector C.A. Latha said in a press release that the district administration aimed at coordinating various departments and agencies for the purpose. The district would get a ‘public health friendly’ status in three months, she said.

The project was part of the government’s policy to protect the public, especially children, from tobacco and drugs. The Collector had convened a meeting of various departments and agencies on August 7 to discuss the project. The response was favourable, the release said.

The target would be achieved through awareness programmes and strict enforcement of the laws by the police and other agencies, with the help of various institutions and the media, the release said.

The district administration would monitor and evaluate the implementation of the project. The details would be made available on the official website,
Ms. Latha said.

Campaigns would be taken up to make people aware of the harm that tobacco could do. People’s representatives would take part in the project. The plan was to make it a model project for other districts and States to emulate, she said.

As per Section 4 of COTPA, smoking had been banned in public places. Advertising tobacco products in any manner was banned under Section 5. Section 6(a) banned the sale of tobacco products to anyone below 18 years of age.

The section also banned the sale of tobacco products within 100 metres of educational institutions. Section 7 spoke of mandatory health warnings on packets. All these would be enforced strictly, she said.

City Police Commissioner A.V. George and District Police Chief, Kozhikode rural, P.H. Ashraf said the police would cooperate wholeheartedly with the programme.

Police officers in the district had been trained and instructed in this regard. The programme was co-organised by ‘Tobacco Free Kerala.’

Source: The Hindu

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Kerala capital to become model COTPA compliant: City police gears up

The Thiruvananthapuram City Police  are fully geared up for time-bound action to make the capital a tobacco free district that fulfils the provisions of the Indian tobacco control law COTPA, 2003. This follows a multi-stakeholder meeting chaired by the District Collector that decided to make Thiruvananthapuram a model COTPA compliant district.

As part of this, Circle Inspectors and Sub Inspectors attended a half-day workshop in which they were explained the various sections of COTPA and the steps for achieving model compliance status.

Deputy Commissioner Smt S Ajeetha Begum talked about the purpose of the training programme and asked all officers to take strict action against COTPA violations. “We are embarking on a prestigious project that will have positive implications on the health and well-being of our people,” she said, even while calling for strengthening reporting of COTPA violations.

Faculty member Retd.DySP Adv K Mohana Kumar made an audio-visual presentation and explained the various sections of COTPA and the punitive measures prescribed for violation of each. Section 4 of COTPA prohibits smoking in all public places; acts of violation will invite a fine up to Rs 200. Public places have also to put up mandatory no smoking signages in the prescribed size and format at the entrance and conspicuous places inside. Educational institutions, hospitals, restaurants, cinema halls and the like are included in the list of public places, he told.

Section 5 prohibits all forms of tobacco advertisements; Section 6 prohibits sale of tobacco products to and by minors – sale of tobacco products around 100 yards (91.4 metres) radially of an educational institution is banned. Section 7 requires statutory health warnings in all tobacco products’ packages.

Joint Commissioner, Food Safety Shri K Anil Kumar explained that products such as gutkha and pan masala containing tobacco or nicotine have been banned in Kerala as per the 2011 regulation of the Food Safety and Standards Act of India, 2006. As per this, tobacco and nicotine shall not be used as an ingredient in any food product and that the product should not contain any substance that is injurious health.  He also sought stronger coordination between Food Safety and other implementing departments such as Police and Health for effective enforcement of the ban in Kerala.

District Health Officer (Rural) Shri PK Raju presented field-level experiences on implementing COTPA. Highlighting a circular issued by the local self government department in 2011, he pointed out that setting up of ‘no smoking’ boards are a precondition for issue of Factory Licences and Dangerous & Offensive Trade Licences under the Kerala Panchayat/Municipality Acts. Secretaries of Local Government Institutions have been directed to display boards prohibiting smoking at public places and premises of offices under their control, Shri Raju added.

In his opening remarks, Shri S Jayaraj, State Coordinator, Tobacco Free Kerala spoke about smoking in public places which violates Articles 21 and 47 of the Indian Constitution. Article 21 is about protection of life and personal liberty and Article 47 calls upon the State to improve public health.

Tobacco use victim Shri Sukumaran narrated the physical and financial hardships he had to face following tobacco induced oral cancer. The workshop was organised by Trivandrum City Police together with Tobacco Free Kerala – a coalition of like-minded organisations formed for tobacco control in Kerala. More than 30 officers participated in the programme. 

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National Short Film Contest on Tobacco Control: Entries invited

To heighten awareness about the potent dangers of tobacco among the youth and to enhance their involvement in control efforts, a national short film contest is being organised ahead of World No Tobacco Day (WNTD) that falls on May 31.

Entries are invited from youth between the ages of 18 and 25 for this contest being conducted by WNTD Kerala State Organising Committee formed under the leadership of the Department of Health, GoK, Achutha Menon Centre for Health Science Studies of Sree Chitra Tirunal Institute for Medical Sciences & Technology and Regional Cancer Centre.

The entered short films should be in English or Malayalam and may be made in digital camera, camcorder, handycam or mobile camera. The films should have a minimum duration of 30 seconds and should not exceed one minute. Both individuals and groups can participate.

The short films may be made in one of the themes including ‘raise tobacco taxes’; ‘enforce tobacco control laws’; ‘tobacco and health’ and ‘tobacco and youth’.

The last date for submitting entries is May 19; only the first 100 entries received before the deadline will be considered for evaluation. A jury panel of noted filmmakers and medical experts of repute will evaluate the films. The first three winning entries will get a cash prize of Rs. 10,000, Rs. 5,000 and Rs. 3,000 respectively; there are also two consolation prizes of Rs 1,000 each. All winners will get a certificate and memento.

Submissions of not more than 25 MB in ‘.mov’ or ‘mpeg’ formats are to be sent via email to wntdkerala@gmail.com. More details about the contest, its rules and regulations are available here. For further details, contact 0471 – 2524247.

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