Total ban on smokeless tobacco may soon be a reality in India

On the 26th April, Dr Balram Bhargava, the newly appointed director general of Indian Council of Medical Research (ICMR), the apex body for medical research in India, said that the government must take steps to contain the growing consumption of tobacco through measures as aggressive as those used to fight tuberculosis in the country. He also suggested that all medical colleges must have tobacco cessation clinics – small set up with doctors from surgery, cardiology, psychiatry and dentistry – and those which don't have such clinics, must be de-recognised and higher taxation should be imposed on tobacco, along with sugar and trans fats. He also highlighted the burden of the problem in India and neighbouring countries in South East Asia such as Bangladesh, Myanmar, Sri Lanka and others.

“I am planning to raise these issues with the prime minister, I have sought an appointment with him. I will probably be meeting him next week,” Dr Bhargava said, speaking at the National Institute of Cancer Prevention and Research (NICPR) for the release of a report brought out by the WHO Framework Convention for Tobacco Control and NICPR, recommending the ban on manufacturing, selling and importing smokeless tobacco products which include pan masala, gutka, and khaini. The report also throws light on the global progress made in implementing smokeless tobacco control policies as these products have posed a grave challenge to public health in the country.

Dr Bhargava, a former professor of cardiology at AIIMS, said that heart attacks have hit those in their early 40s too, "even when there is no history of diabetes or hypertension, and it is all because of tobacco use.” Dr Ravi Mehrotra, director, NICPR, spoke about the opening of India’s first tobacco testing laboratory next month. The laboratory will be the first-of-its-kind set up which will be equipped to detect and quantify tobacco content in products sold in the market, he said. Other such laboratories are in Netherlands and in Atlanta. NICPR is also now a global hub for smokeless tobacco research.

According to the latest Global Adult Tobacco Survey India Report 2016-17 (GATS), which is a global standard for systematically monitoring adult tobacco use (smoking and smokeless) and tracking key tobacco control indicators, 199.4 million of all adults currently use smokeless tobacco in India and 49.6 per cent of current smokeless tobacco users are planning or thinking of quitting smokeless tobacco use. A 2010 study estimated that more than 36,800 deaths were attributable to smokeless tobacco use in the country. To address the issue, the government has joined hands with WHO-FCTC Secretariat and set up a global knowledge hub on Smokeless Tobacco (KH-SLT) at the ICMR-NICPR, Noida.

Source: The Week

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Sale Of Gutkha In Maharashtra Will Become A Non-Bailable Offence, Says Govt

The Maharashtra government on Wednesday told the Legislative Council that sale of gutka, banned in the state, would be made a non-bailable offence.

Punishment for the offence would be enhanced to three years in prison, the government said.

Leader of Opposition Dhananjay Munde alleged through a calling attention motion that though anti-gutka laws are in place, gutka -- a scented tobacco mix -- is smuggled from neighbouring states.

Smuggling happens with connivance of corrupt officials in the Food and Drug Administration (FDA), the NCP leader alleged, demanding an inquiry by the Criminal Investigation Department (CID).

In response, Minister of State for FDA Madan Yerawar said gutka is manufactured in other states where it is not banned, and the Maharashtra FDA, since 2012-13, has seized gutka worth Rs 114.2 crore.

Munde said Maharashtra has the highest number of youth falling prey to cancer due to chewing of gutka. He demanded inquiry into continuing sale of gutka despite the ban.

FDA minister Girish Bapat said that currently the sale of gutka is a bailable offence with a punishment of a maximum of six months in prison.

The government has held discussions with the Director General of Police and the Law and Judiciary Department, and will make the offence non-bailable, he said.

"The Centre has given us the permission to do so. Once the technicalities are sorted out (and the amendment made), those found guilty will have to face a rigorous imprisonment for three years," the senior minister said.


An inquiry by the vigilance squad of the FDA is underway into illegal sale of gutka, and the government will order a CID probe if the Leader of Opposition is still not satisfied with its report when it comes out, Bapat assured.

Courtesy:Outlook India

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20 countries to unite in Delhi to fight against smokeless tobacco

Around 20 countries are coming to Delhi to form guidelines against the smokeless tobacco. The first meet in this regard will take place in Delhi from August 16 to 18 this year, said the reports. 

Due to lack of proper uniform policy against these SLT products consumption such as snus, snuff, gutka, tambaku, khaini, qiwam etc which are very harmful to health the countries are coming together to form guidelines.

The World Health Organisation Framework Convention on Tobacco Control in Noida in collaboration with the Union Health Ministry is already on the path to form a policy against this SLT product consumption.

Now, according to the health ministry officials, it aims to impose heavy taxes and form strict guidelines for the advertisement on the SLT products. 

Dr Ravi Mehrotra, director of WHO FCTC said that it is the first time that a global policy is being looked at for SLTs and it is important to take a stand considering that India is currently one of the biggest exporters of SLT products. 

According to reports, 90.4 per cent of SLT users lives in 11 countries such as India, Bang, Myanmar, Pakistan, United States, China, Indonesia, Nepal, Madagascar, Germany and Uzbekistan. 

Harmful health effects due to consumption of SLTS causes cancer, pre-cancer, cardiovascular effects, adverse pregnancy outcome, respiratory infection, addiction and poor oral health that can lead to death at an early stage in life. 

According to 2015 report, 352 million people in 121 countries were said to be the consumers of SLT products. Among these 352 million people 95 per cent live in developing countries.

Source: OneIndia

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Why not ban chewing tobacco, HC asks authorities

Why should chewing of tobacco not be banned as such a step would end the problem posed by ‘gutka’ and ‘pan masala’, the Delhi High Court asked.

The court asked the Food Safety and Standards Authority of India (FSSAI) whether such a step has been taken by the Centre or any of the state governments.

While ‘gutka’ is a mild stimulant made of areca nut, tobacco and other intoxicants, ‘pan masala’ is a mixture of betel leaf with lime, areca nut and other items.

“Have you considered banning it? If you say that chewing tobacco is per se harmful, has anyone banned it? You know, if you (authorities) ban it the whole problem would be over,” Justice Sanjeev Sachdeva said.

The FSSAI, represented by advocate M Pracha, said there was no need to separately ban chewing of tobacco as the notifications banning ‘gutka’ covers this aspect as well.

However, the ban is not being enforced or implemented, the lawyer said.

The court, on the other hand, observed that the notification only appeared to ban mixing of chewing tobacco with any eatable item or ‘pan masala’ and banned ‘gutka’.

The FSSAI did not agree with the observation and said that as chewing tobacco is an “unsafe food”, its sale would attract penal provisions.

The court was hearing an application moved by a tobacco manufacturing company seeking to amend its main petition challenging the notification banning ‘gutka’.

The company wanted to amend its main plea to also challenge the 2017 notification banning ‘gutka’ as the Delhi government comes out with such orders every year.

The court issued notice to the Delhi government and FSSAI seeking their replies to the plea before the next date of hearing in the main petition on May 11.

Source: State Times

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Smokeless tobacco is chewing up India

Many people, especially in rural areas consume various forms of smokeless tobacco such as khaini, pan masala, gutkha etc which is directly linked to cause different kinds of cancers,doctors say.

While health organizations across the world are struggling to curb smoking, India continue to face a big challenge of tackling the menace of smokeless tobacco. While India remains one of the largest consumers of smokeless tobacco such as Pan Masala, Gutkha and Khaini, Ministry of Health and Family Welfare's main agenda in the upcoming Seventh Session of the Conference of Parties (COP7) to World Health Organisation (WHO) Framework Convention on Tobacco Control (WHO FCTC) would be to focus on the problem.

"Our main agenda in the COP7 would be to focus on smokeless tobacco. India consumes smokeless tobacco more than cigarettes so we will be pushing international community''s attention towards it," said C K Mishra, Secretary, Ministry of Health and Family Welfare.

"Tobacco control is a movement we need to work on. We have been doing a lot of work for curbing smoking in India and we have achieved success also but smokeless tobacco needs special attention," he said.

Many people, especially in rural areas consume various forms of smokeless tobacco such as khaini, pan masala, gutkha etc which is directly linked to cause different kinds of cancers,doctors say. As per ministry's directions, tobacco companies in India are required to display pictorial warnings up to 85 per cent on both sides of the packet.

Recently, the Supreme Court banned the sale of all forms of chewable tobacco and nicotine, and directed authorities, including the Food Safety and Standards Authority of India (FSSAI) under Union Health Ministry, to strictly enforce its directions.

Government of India has set up a Global Knowledge Hub on Smokeless Tobacco at National Institute of Cancer Prevention and Research (NICPR). This hub serves as a repository of knowledge related to smokeless tobacco.

The Global Adult Tobacco Survey – India (GATS) conducted by the Ministry of Health & Family Welfare shows that 35 per cent of the adults in the age group of 15 years and above consume tobacco in some form or the other, with 48 per cent men and 20 per cent women consume tobacco in some form.

GATS found that more than 20 crore Indians use smokeless tobacco. Union Health Ministry has been focusing on creating awareness for smokeless tobacco. The audio and visual advertisements, in Hindi and English, along with the posters are being be used to create awareness regarding the harmful effects of tobacco use through TV, radio, at schools, community spaces, railway compartments, and social media.

Source: DNA

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Chewable Tobacco Major Health Threat, Needs Regulation: Doctors

Chewable tobacco is emerging as a major threat in India when it comes to causing cancer that affects 11 lakh people a year, top doctors today said while urging the government to increase taxation on it to reduce its consumption.

Over 700 delegates from around 15 foreign countries have gathered in Delhi for a four-day global conference on head-neck cancer, organised by International Federation of Head and Neck Oncologic Societies (IFHNOS) and Foundation for Head-Neck Oncology (FHNO).

They also urged the government to remove tobacco and cigarette vendors from near school and college premises. There are 11 lakh incidences of cancer every year in India, as per the estimates of Indian Council of Medical Research (ICMR). And 2.5-3 lakh cases are of head and neck cancer. Over 80 per cent of head and neck cancer are caused by tobacco alone.

"Head and neck cancers are emerging as the major killers now, and if the sale and consumption of chewable tobacco like beedi-khaini, tambaku, gutka and zarda are not regulated, it will increase the country's health burden dramatically," said Dr Alok Thakar, professor of head-neck surgery and otorhinolaryngology at the AIIMS.

Dr Thakar, Organising Chairman of the conference, and a host of other oncologists from India's top cancer-cure institutions like Tata Memorial Centre, addressed a press conference here on the opening day of the conference today.

"27 per cent male population is affected by head-neck cancer while its incidence is 10-12 per cent in women. In foreign countries, lung cancer is more prevalent, as people smoke more tobacco than chew it, unlike in India, where every nook and cranny sell chewable tobacco in the open," he said.

"The incidences have increase in the last decade or so. 10-15 years ago, the incidence was about 8 lakh. People today consume gutka and zarda like saunf and that is very dangerous, more so the youth are consuming chewable tobacco from very early age," he added.

Dr Anil D'Cruz, Director of Mumbai-based Tata Memorial Centre, said, "I have operated on a cancer patient as young as an 8-year-old boy. He was chewing tobacco from time when he was four."

"Tobacco consumption has begun in schools and so it is important that law is properly enforced and tobacco and cigarette vendors found violating the stipulated minimum distance rule should be removed," he said.

Dr D'Cruz said, "After increasing tax burden on cigarettes, its consumption has gone down. Tax serves as a major deterrent, and therefore, we hope the government will increase the tax on it."

Countries like France and South Africa have decreased tobacco consumption in one decade for which the US took four decades, just by increasing the taxation, the doctors said.

Source: NDTV

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From a smoker to a smokeless tobacco user: Study

Even as the state and the country is preparing for the next round of the Global Adult Tobacco Survey (GATS), a recent study based on the current edition of this globally followed survey has found that switching to equally harmful smokeless tobacco use is the most common smoking cessation method.

The study by Achutha Menon Centre for Health Science Studies of Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum shows that more than a third of the former smokers in India reported switching to smokeless tobacco for quitting smoking. The study has been published in a recent edition of the international peer-reviewed journal ‘Public Health’.

GATS 2009-10 posed a question to all 2035 successful quitters on the method they used for cessation. Among the options given to the respondents were smoking cessation clinic; nicotine replacement therapy; a quit line or a smoking telephone support line; and switching to smokeless tobacco. The majority 44.4 per cent of total successful quitters including 50.8 per cent men and 8.7 women reported switching to smokeless tobacco use. 

The GATS was conducted covering all the 29 states and two union territories in the country. This nationally representative household survey covered 69,296 individuals aged 15 years and above using a standardised methodology.

Highlighting the policy implications, Dr KR Thankappan, Prof and Head, Achutha Menon Centre and principal researcher of the study said, “Switching to smokeless tobacco is not a safer option as it is equally harmful as smoking. Coordinated measures including high levels of taxation on all tobacco products, strict enforcement of 85 per cent graphic warnings, and concerted awareness generation on harms of smokeless tobacco products is very important.”

Specifically for Kerala, he called for strict enforcement of the ban on pan masala and gutkha containing tobacco or nicotine, steps to combat smuggling of these products and targeted awareness building for the migrant population who are among the prime users of smokeless tobacco products.

Senior Project Fellow, Achutha Menon Centre and co-author of the study Dr GK Mini said, “Across the country, smokeless tobacco use surpasses smoking. If switching over is also added, the disease burden from smokeless tobacco use will be compounded. Studies have shown that smokeless tobacco users have a more than three-fold higher risk for cancer.”

As per GATS 2009-10, the number of adult current users of smokeless tobacco in India is 206.0 million, much higher than the number of current tobacco smokers of 111.2 million.

GATS is conducted once in five years; the next round is slated for 2016-17. In India, it is conducted under the coordination of the Union Ministry of Health & Family Welfare with technical assistance from the World Health Organisation.

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