Friday 28 April 2017

Taxation on Tobacco in India - Tool for Tobacco Control

Tobacco is the major factor causing non-communicable fatal diseases in India. Tobacco consumption in India is unique and complex with various forms of smoke and smokeless tobacco. Its use is long-standing and is ingrained among Indians from varying cultural backgrounds. Also its social acceptability poses great challenges for the regulation of tobacco products and the enforcement of tobacco legislation. However, there are other barriers as well that prevent the cessation of this practice such as poverty, illiteracy, lack of awareness, aggressive marketing strategies of giant tobacco companies targeting vulnerable groups, a growing economy and a less than optimal implementation of provisions for tobacco cessation by government agencies. This article focuses on the current state of the Indian population addicted to tobacco use and the various methods used to improve cessation, with a focus primarily on taxation as a crucial measure that encourages abstinence.

Tobacco consumption is the single most important avoidable risk factor in the growth of non-communicable diseases in India (Jha and Chaloupka 1999). Tobacco-accounts for 12% to 25% of the deaths among men in India (Gajalakshmi et al 2003; Gupta et al 2005; Jha et al 2008); one half of tobacco-related deaths occur between the ages of 35 and 69 years—the most economically productive period (WHO 2002).

Tobacco Consumption in India
India is the third largest producer of tobacco and the second highest consumer of tobacco products. There is a broad spectrum of tobacco products, aimed at different socio-economic and demographic categories. Unlike other countries, India is unique in the use of multiple non-cigarette preparations such as beedi (an indigenous form of combustible tobacco) and the extensive variety of oral tobacco products (chewing, quid, and dentifrices). Beedis account for 85% of smoked tobacco (John et al 2010), however, there has been growth in the number of cigarette smokers in the past decade (Joseph 2011) due to a rise in disposable incomes and an increased affordability. Studies have also shown that manufactured cigarettes are displacing beedis (Jha et al 2011). Prevalence estimates vary, with most estimates obtained from the National Family Health Survey–3 (NFHS–3) of 2005–06.

Approximately 10% of the world’s tobacco smokers live in India (WHO 2008). Between the ages of 15 and 49 years, 57% of males and 11% of females consume tobacco in a smoked or non-smoked form. Around 120 million Indians smoke, of these 115 million are males and 5–6 million are females. Fourty percent of rural men and 10% of rural women chew tobacco, 31% of urban men and 5.5% of urban women chew tobacco (John et al 2010). Recent trends in tobacco use are not indicated with certainty. However, the absolute number of male smokers is rising, with male smokers between the ages of 15 and 24 accounting for the largest proportion of the increased consumption (Sharma 2014).

About one million deaths are attributable to smoking-related diseases annually in India (John et al 2010) and on an average, male beedi smokers die six years earlier and female beedi smokers die eight years earlier than their non-smoking counterparts. Male cigarette smokers die an average of 10 years earlier than their non-smoking counterparts. More than half of tobacco-related smoking deaths occur in illiterate sub-populations. Roughly 80% of these deaths occur in rural areas. The risk of death due to chewing tobacco is 15% for males and 30% for females. Healthcare costs are a huge burden for a developing economy like India. Healthcare costs for tobacco-related illness, spent by public and private funds, was about 30,000 crore annually (Reddy and Gupta 2004). Households with a smoker have worse child health outcomes, including lower immunisation rates in children (Rani et al 2004).

Tobacco Control Measures
Cessation is the only practical way to substantially reduce the morbidity and mortality issues associated with tobacco consumption, in the relatively near term. This requires comprehensive tobacco control programmes—including both price and non-price interventions. Although India has ratified the WHO Framework Convention on Tobacco Control (WHO FCTC), implementation of its provisions has been suboptimal. According to the WHO, the six policy measures included in the MPOWER policy, if effectively implemented have the ability to reduce tobacco use, however, tobacco taxes are by far the most effective method of decreasing tobacco consumption especially among the young and lower income sections in emerging economies (WHO 2008, 2014a).

Taxation: Taxation plays a critical role in tobacco control. Tobacco taxation and consumption are inversely related (WHO and IARC 2011); higher taxes are particularly effective with poorer or less educated groups (WHO 2010). Most high-income countries have reduced their overall tobacco consumption, over the years, through increased taxation. France reduced its tobacco consumption by 50%, in a span of just 15 years, from 1990 to 2005 mostly due to a sharp rise in tobacco excise taxation (Hill and Laplanche 2003). Even among several low and middle-income countries of South-East Asia—Bangladesh, Sri Lanka and Thailand—taxes have exceeded 70% on top of the retail price (WHO 2014b).

Unfortunately, India has the lowest taxation rates on tobacco in the Asia–Pacific region—well below the recommendations of the World Bank and the WHO. This creates significant challenges for implementing cessation programmes. Tobacco taxation in India is the most complex tax policies in the world and there is no uniformity. Taxes are based on the type of product, length and quantity of tobacco. Low levels of taxation, with an inefficient tax structure contribute to increased tobacco consumption.

Taxation on cigarettes: A tax of 38% on top of the retail price, is far below the World Bank recommended rate of 65% to 80%, and also it varies with length from less than 65 mm to more than 85 mm. Longer cigarettes are taxed at higher rates, so companies manufacture varying lengths to retain their customer base and consumers shift to the cheaper options.

Taxation on beedi: Handmade beedis are taxed at 12 per 1,000 sticks, machine made beedis are taxed at 30 per 1,000 sticks and an average rate of 9% is applied to the retail price. As a result, nearly 98% of beedis are handmade (Sunley 2008) though mechanisation is available. Also, small-scale beedi manufacturing has been reduced to only 50% of the market with a concomitant increase in household beedi rolling, given that no tax is levied if production is less than two million beedis annually.

Taxation on oral tobacco: There is no set tax on chewing tobacco—this is subject to ad valorem taxes that are based on the value of tobacco products. The literature indicates that reducing oral tobacco consumption through taxes, is not as feasible as reducing smoked tobacco consumption, due to the large and informal market of sub-suppliers, in the case of oral tobacco (Jha et al 2011). This leads to its greater use, and is of particular concern in India due to the disproportionate usage by women and youth and the fact that oral tobacco is a major cause of oral cancer, of which India has become an epicentre. It is of paediatric concern also, because children on the street begin consuming tobacco through chewable forms that are available in sachets (Priya and Lando 2014).

Literature on Tobacco Taxation
Higher taxation of tobacco products is the single most effective intervention to reduce consumption (Jha et al 2008). The following are the consequences of an increased taxation on beedi and cigarette manufacturing, with respect to revenue raise and premature mortality. Raising taxes on beedis to 98 per 1,000 sticks would raise tax revenue of over 36.9 billion and would also prevent 15.5 million deaths in terms of current and future beedi smokers (John et al 2010). Raising cigarette taxes to 3,691 per 1,000 sticks would raise tax revenue of over 146 billion and also prevent 3.4 million deaths in current and future cigarette smokers (John et al 2010). Uniformity in taxation also is indicated. The increased tax revenue could support comprehensive tobacco control programmes, including cessation, and other social and public health programmes such as those in Australia (VicHealth) and Thailand (ThaiHealth) (John et al 2010; WHO 2012).

Economic growth: Taxation policy should be in accordance to income growth, with annual systematic inflation-adjusted increases built into the policy; otherwise increased affordability will lead to an increased consumption. In India, beedis were nearly three times more affordable in 2011 than in 1990, while cigarettes were two times more affordable (Blecher and Van Walbeek 2009). Manufactured cigarettes are also displacing beedis (Jha et al 2011) as a measure of affordability.

In the Indian scenario, high consumption of tobacco is due to easy availability, accessibility and affordability, exacerbated by a lack of health education and awareness as well as, poverty. Tobacco control requires strong political will—to control tobacco production, to enforce strict regulations as stated in the Cigarettes and Other Tobacco Products Act 2003, to be compliant with FCTC regulations and guidelines and to include increased and uniform taxation on smoking tobacco, with an equal consideration on taxing smokeless tobacco.

Commentary by Priya Mohan; Harry A Lando and Panneer Sigamani in the Economic and Political Weekly

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Wednesday 19 April 2017

Impose stricter controls and regulation of bidis: Lancet study

At a time when the Union Health Ministry has called for taxing bidis at 28 per cent along with the highest cess under the new GST regime, a recent Lancet study recommends stricter controls and regulation to combat the health burden caused by this small, but lethal, tobacco product.

Higher levels of severe respiratory impairment, significant cardio-respiratory conditions and follow-up mortality were found among bidi smokers as against cigarette smokers and non-smokers, reports the study in the respected Lancet Global Health journal.

The largest-ever prospective international community-based cohort study of its kind covered as many as 14,919 men across five centres in India, including Thiruvananthapuram besides a centre each in Bangladesh and Pakistan. The other Indian centres covered in this sub-study of Prospective Urban Rural Epidemiology (PURE) were Chennai, Bengaluru, Chandigarh and Jaipur.

Households with at least one member aged 35-70 years were approached for the study, which was coordinated by the Population Health Research Institute in Canada. Baseline data was collected from January 1, 2003, to December 30, 2009, and follow-up data collection took place from January 1, 2008, to December 30, 2013.

Trained personnel administered standardised interview-based questionnaires that surveyed and accounted for demographic, household, behavioural and medical information, including risk factors, symptoms and the occurrence of any multiple disorders. 

Dr Sanjeev Nair, from the Department of Pulmonary Medicine, Thiruvananthapuram Medical College, is one of the co-authors of the study. “The health and economic burden caused from bidi smoking is tremendous, leading to the recommendation of stricter controls and regulation on this product. High levels of taxation to dissuade consumption would be a welcome policy initiative,” he said.

“Collective efforts should be made to provide alternative livelihoods to workers involved in bidi manufacturing in cottage industries that escape other prevailing tobacco regulations and taxes. Such a measure would be in the interest of the health of bidi workers as well. As the Kerala Government is striving hard to achieve the Sustainable Development Goals, tobacco control also has a key role in reducing mortality from cardiovascular diseases, COPD, and cancers, for which all stakeholders must come together,” Dr Nair added.

Another co-author, Dr K. Vijayakumar, Secretary, Health Action by People said, “The study has shown conclusively that there is no safe threshold from the harmful effects of tobacco smoking and even low-intensity, clinically-trivial smoking is associated with respiratory impairment. Our way forward should be to create 100 per cent tobacco smoke-free environments that would benefit the poor and the young significantly.”

Reaffirming existing information on the enormous impact of bidi smoking on the poor, the study has found that heavy bidi smokers were more likely to come from rural communities and from lower socio-economic sections.

Further, in what should be a worrying trend with a fast-aging population, the study pointed to a marked rise in decreased lung function among older bidi smokers.
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Monday 17 April 2017

Higher tobacco taxes can save 35-45 billion lives in South Asia: Study

Higher taxes on tobacco could reduce its consumption by at least one-third and save about 35 to 45 million lives in South Asia, including India, a study said.

The analysis published in The British Medical Journal said South Asia with a population of 1.1 billion adults has about 170 million adult smokers - and mostly from India - and very low rates of cessation.

The analysis calls on the South Asian countries to implement the World Health Organisation's (WHO) global tobacco control treaty, including high tobacco taxes, smoke-free public spaces, warning labels, comprehensive advertising bans and support for smoking cessation services.

The study was conducted by Prabhat Jha, Director, Centre for Global Health Research at St Michael's Hospital in Toronto.

He said the study looked at 140 million current and future smokers, aged under 35 years (about 33 million of whom are current smokers, aged 25-34 years, and 107 million under 25 years who have not yet started) and 100 million current smokers over 35 years (out of 171 million smokers at 15 years or more).

"Unless large numbers of them stop smoking, at least half of the 140 million young and future smokers would die because of smoking. At least half of these 70 million deaths would occur before the age of 70. Not starting smoking or complete cessation before age 40 would avoid nearly all of these deaths.

"In 2010, most of the roughly 170 million adult smokers in South Asia were male and lived in India. A substantial number of people in India smoke cigarettes and bidis (small, locally grown and mostly unregulated form of smoked tobacco)," the analysis said.

It said in India and Bangladesh, cigarettes have gradually displaced bidis, particularly among younger and illiterate males.

"South Asia has large and growing numbers of tobacco users and very low rates of cessation. Effective implementation of the Framework Convention on Tobacco Control, particularly its tax provisions, could reduce tobacco consumption by at least one-third and save about 35-45 million lives," it said.

Jha said a tripling of the excise taxes, designed in particular to decrease substitution from more expensive to cheaper brands would likely reduce smoking in South Asia by at least one-third.

"The benefits of a one-third reduction in the 100 million current smokers over 35 years depend on their age of cessation. 

Conservatively, such a reduction might avoid about 10-20 million deaths, most of which would be before 2050," Jha said.

"Indeed, the loss of life among Indian male cigarette smokers is as extreme as now observed in prolonged smokers in high-income countries," the study said.

It stated that annual increase in tobacco tax has mostly been below the rate of inflation and income growth, thus cigarettes remain affordable.

"In fact, the stock price of the cigarette industry has risen after ineffective budgets such as the February 2017 budget in India, which increased cigarette taxes by well below the rate of income growth," it said.

The analysis also quoted a report by the Asian Development Bank on five Asian countries, including India, which stated that increasing the price of cigarettes by 50 per cent through excise tax increases of 70-122 per cent would reduce the number of current and future smokers by nearly 67 million and reduce tobacco deaths by over 27 million in the five countries.

"Moreover, about USD 24 billion additional revenue would be generated annually," the analysis quoting the report said.

Noting that "most chewed tobacco products are unregulated" and may contain high levels of toxic and carcinogenic substances, the analysis said that chewing cessation is also uncommon and below 5 per cent at ages 45-59 years in both India and Bangladesh.

Jha added that the price of cigarettes, bidis and chewing tobacco is lower in South Asia than in high-income countries in the West because the excise taxes are so low.

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Saturday 15 April 2017

Government wants 28 per cent tax on all tobacco products

In a move aimed at lowering consumption of tobacco products, the health ministry has sought to tax all such products, including bidis, at 28 per cent as well as impose higher cess under the new GST regime.

Greeting the step taken by finance ministry to keep aerated drinks, tobacco products, luxury cars and pan masala in the 'demerit goods' category, the health ministry suggested that the cess levied under the GST should be high enough to make these products unaffordable over a period of time.

In an office memorandum issued by the health ministry recently, it suggested that exemptions from the high taxation norms should not be extended to industries with low turnover such as bidi manufacturers as this will allow them to manipulate norms.

"Taking advantage of this exemption, bidi manufacturers closed bigger units and started producing on small scale under different names in a clandestine manner, resulting in huge tax evasions," the memorandum said.

The ministry, which has favoured higher taxes on all tobacco products for long, also highlighted that tiered tax structure for cigarettes needs to be done away with as these slabs are open to manipulation for products substitution and promotion.

Last year in February, health minister J P Nadda had also written to finance minister Arun Jaitley pressing the need to impose a sin tax or a health cess on demerit goods such as tobacco products and aerated drinks.

Nadda had also suggested considering a proposal to earmark the proceeds from the additional surcharge to fund health schemes like the Rashtriya Swasthya Bima Yojna. Tobacco consumption is one of the leading causes for non communicable diseases including different types of cancer, heart disorders and respiratory diseases.

The rising burden of non­-communicable diseases not only undermines India's socio-economic development at macro level but also has huge impact at household, family and individual level. 

As per government estimates, merely the health cost on account of tobacco consumption is pegged at over Rs 10,40,500 crore in 2011 for people aged between 35 to 69 years. Each year, about 10 lakh Indians die from tobacco­related diseases.

Experts say globally there is ample evidence to show that tobacco tax increases are the most effective policy to reduce tobacco use.

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Friday 14 April 2017

Kerala’s traditional sports shun smoking

The New Year or Vishu in Kerala is a time for celebration, festive re-unions, and good food. It is also a time for resurgence of native sports in street corners and even courtyards of homes.

Not many however, know that the high-energy, hugely-popular indigenous sports, such as Vadamvali and Vallamkali forbid players from smoking as a part of their fitness regimen.

Vadamvali or tug-of-war involves seven to nine member teams showcasing their strength by pulling their opponents across the central line.

Shri Sudhir Sankar Cheppad Alappuzha, Chief Referee, Kerala Vadamvali Association said, “We pick our players after a selection process involving checks for their vital signs, including heart rate and breathing rate, along with endurance. Since smoking leads to decreased lung capacity and increases heart rate, we stop our players from taking in these carcinogenic fumes.”

“Advice against smoking is also part of our efforts to instil healthy practices among our youngsters and help them excel in whichever area they choose to,” added Shri Sudhir Sankar. The Association, in the interest of its players’ health, also prohibits spectators from smoking at the sporting sites.

Professional Vadamvali competitions carry attractive prizes of up to Rs 50,000 and are generally held on weekends. The winning players are also celebrated as community sporting heroes.

Total abstinence from smoking is an essential precondition for rowers in the snake boat race or Vallamkali in Alappuzha. A major tourism event, the stamina and fitness quotient required for this sport is tremendous.

Shri Jameskutty Jacob, winning captain of 2015 and 2016 Nehru Trophy Boat Race said, “The event which lasts for less than 5 minutes requires total contribution of physical and mental energies by the rowers. To ensure stamina levels, we strictly prohibit our players from smoking, right from the period of trials.”

“Youngsters who aspire for success in a sporting career would do well to not initiate smoking,” Shri Jameskutty noted.

Over 4,000 sportspersons assemble to make the Nehru Trophy Boat Race the only sporting event in the world in which teams of 100 or more members participate. The first three winners in the Nehru Trophy Boat Race, held in the Punnamada Lake of Alappuzha, can win cash prizes of up to Rs 7 lakhs.
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Wednesday 12 April 2017

The War Is Far From Over-Smoking Causes 1 in 10 Deaths Worldwide

A new study finds smoking continues to be a challenging public health threat. Nearly one billion people worldwide smoked daily in 2015—one in four men and 1 in 20 women. Of course, this is despite decades of tobacco control policies and more than half a century of unequivocal evidence of the harmful effects of tobacco on health.

Smoking’s impact worldwide
In 2015, smoking was the second leading risk factor for early death and disability worldwide. This addictive habit causes one in 10 deaths throughout the globe, and half of them are in just four countries: China, India, Russia and the United States. Since 1990, smoking has claimed more than 5 million lives each year. In lower income countries, its contribution to disease is growing as the tobacco industry’s pursuit of new smokers is complicated by rapidly evolving social, demographic and economic markets. The tobacco industry is always seeking new customers, and they are now aggressively targeting consumers in these areas of the world.

Results from the study
This study relied on a systematic analysis from the Global Burden of Diseases, Injuries, and Risk Factors 2013 Study (GBD 2013) from 1990 to 2013 of 188 countries where researchers collated diverse data sources and synthesized them to come up with comprehensive, comparable estimates of daily smoking prevalence by sex and age group.

Findings from the study showed that worldwide the prevalence of daily smoking among men was 25 percent and 5.4 percent among women. This means that smoking rates have decreased: In 1990, 28.4 percent of men and 34.4 percent of women were daily smokers. Most countries experienced decline in smoking prevalence from 1990 to 2005 and only four countries had significant increases in smoking prevalence between 2005 to 2015—Congo and Azerbaijan for men and Kuwait and Timor-Leste for women. In 2015, 11.5 percent of deaths worldwide were attributed to smoking and 52.2 percent of took place in China, India, the U.S. and Russia. Smoking was ranked among the five leading risk factors for mortality in 109 countries and territories in 2015, up from 88 countries in 1990.

The number of women who smoke continues to lag behind significantly in comparison to men—roughly only one in every 20 smokers are women.

Challenges faced by continued use of tobacco products
Even though impressive strides have been made over the years in the fight to reduce the number of smokers, there are still challenges, especially in regards to demographic forces poised to heighten smoking’s global toll. It’s important to continue to push for continued progress in preventing people lighting up to begin with and to promote cessation among those who already have.

Smoking is widely recognized as a risk factor for premature morbidity and mortality. It increases risk for numerous health conditions, including lung cancer, coronary heart disease, stroke, high blood pressure, emphysema, chronic obstructive pulmonary disease and chronic bronchitis.

The staggering negative effects of smoking extend well beyond the health of individuals and a country’s population as a whole. The more people there are who smoke in a region of the world, the greater the rise in billions of dollars attributable to lost productivity and the greater the threat on already resource-constrained health care costs.

Getting a handle on snuffing out smoking
Over the past ten years, there has been substantial expansion of tobacco control initiatives that have strategized on using a wide range of effective policies to address the smoking epidemic. Some of the most successful strategies have been the following:

Increased taxation on tobacco products
Banning smoking in public places
Instituting smoke-free zones
Restrictions on marketing and promoting cigarettes
Community-wide and nation-wide smoking cessation interventions

Including both text and pictorial warning labels on tobacco products
To substantially loosen the hold of the global tobacco industry’s grip, there needs to be continued and sustained focus on comprehensive tobacco control policies around the world. To keep smoking prevalence rates low in areas of the that haven’t experienced a smoking epidemic yet, intensified efforts will be required to effectively and aggressively enforce policies and laws. Even though the war against tobacco is far from over, success is possible. We owe it to our children and future generations who have not yet started to smoke and hopefully never will.

Source: Observer
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Monday 10 April 2017

India among top 4 in death by smoking

Smoking causes more than one in 10 deaths worldwide (equivalent to 6.4 million deaths), with 50% of these occurring in just four countries - China, India, US, and Russia, according to the latest estimates from the Global Burden of Disease study published in 'The Lancet'.

India is also among the top 10 countries together accounting for almost two-thirds of the world's smokers (63.6%) in 2015.

The new estimates, based on smoking habits in 195 countries between 1990 and 2015, illustrate that smoking remains a leading risk factor for death and disability despite many countries applying tobacco policies resulting in reductions in smoking prevalence.

Warning that the war against tobacco is far from won, the authors of the study argue that policy-makers need renewed and sustained efforts to tackle the epidemic.

"Despite more than half a century of unequivocal evidence of the harmful effects of tobacco on health, today, one in every four men in the world is a daily smoker," said senior author Dr Emmanuela Gakidou, Institute for Health Metrics and Evaluation at the University of Washington, USA. "Smoking remains the second largest risk factor for early death and disability, and so to further reduce its impact we must intensify tobacco control to further reduce smoking prevalence and attributable burden."

Government estimates show in India over 5,500 youth start tobacco use every day, whereas around 35% of adults consume tobacco in some form or other. Over 25% of females start tobacco use before the age of 15 in the country.

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Wednesday 5 April 2017

Health Ministry Releases New Pictorial Warnings For Tobacco Products

Replacing the existing images, the Health Ministry has released a new set of pictorial warnings for mandatory display on packets of cigarettes, bidis, and chewing tobacco with effect from April 1 this year.

Under the new rules, manufacturers will now need to display graphic pictures of throat cancer on cigarette and bidi packets and pictures of mouth cancer on chewing tobacco packets. According to the public notice on the Health Ministry's website, the government notified the new health warnings on October 15, 2014 and issued a notification dated September 24, 2015 for mandatory display of new health warnings covering 85 per cent of the principal display area on all tobacco products from April 1, 2016.

"As per Rules, during the rotation period of 24 months, two images of specified health warnings as notified in the Schedule, shall be displayed on all tobacco product packages and each of the images shall appear consecutively on the package with an interregnum period of 12 months.

"Further as per notification dated March 24, 2017, all tobacco products manufactured on or after April 1, 2017 shall display the second image of specified health warning," the notice said.

It further said any person engaged directly or indirectly in production, supply, import or distribution of cigarettes or any other tobacco products shall ensure that all tobacco product packages have these specified health warnings.

"Violation of the provisions is a punishable offence with imprisonment or fine as prescribed under section 20 of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act 2003," it said.

India is third among countries with the largest pictorial warnings on tobacco products, according to a recent report.

The Health Ministry has implemented, from April 2016, large pictorial health warnings occupying 85 per cent of the principal display area of tobacco packs and on all forms of tobacco.

Source: NDTV
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Saturday 1 April 2017

Kerala Police strengthens COTPA enforcement

As part of its initiatives for public health through enforcement of Indian tobacco control law COTPA, 2003, Kerala Police has fined over 5.3 lakh persons from 2013 to 2016, bringing more than Rs 10.6 crore in revenue to the exchequer in the process.

Records made available in the official website of the Kerala Police show that there has been a steady increase in the numbers of persons fined over this four year period. From 63,513 in 2013, the numbers have risen to 2.05 lakh in 2016, under various sections of COTPA.

The highest numbers of persons have been fined for smoking in public places, which constitutes a violation of Section 4 of COTPA, 2003. Action under this section alone has yielded Rs 4.17 crore in 2016. 

In 2014, Kerala was declared India’s first tobacco advertisement free state. That this prized distinction is being sustained is reflected in the numbers of cases booked under Section 5 of the Act. From 3,860 cases in 2013, the numbers have fallen to a mere 37 in 2016. Section 5 of COTPA prohibits all forms of tobacco advertisements, promotions and sponsorships. 

The numbers however indicate a worrisome nearly 80 per cent growth in the sale of tobacco products to and by minors, which is prohibited under Section 6 (a) of COTPA. From 358 cases in 2013, it has risen to 642 in 2016.

Section 6 (b) of the Act prohibits sale of tobacco products in an area within a radius of 100 yards of an educational institution. This section, again, has seen an increase in the number of cases from 1,258 in 2013 to 3,065 in 2016.

Kerala Police is vigilant in curbing any sale of tobacco products without the mandated 85 per cent pictorial warnings. In 2016, 328 such cases were charged.

Details are available on http://www.keralapolice.gov.in/public-information/crime-statistics/cotpa-violations.
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