(Bhavna B Mukhopadhyay is Executive Director, Voluntary Health Association of India)
The Public Health Fraternity of India expresses deep shock and disappointment over the new notification issued by the Government of India on 1 April 2015, which puts on hold, the implementation of 85% pictorial health warnings on the front and back of all tobacco packages w.e.f. 1st April, 2015. We believe this was done following the recommendations of the Committee on Subordinate Legislation to the Ministry of Health and Family Welfare (MOHFW).
Some members of the Committee represent the bidi industry and therefore their opinion presents a clear case of conflict of interest. They have requested the MOHFW to keep implementation of the Specified Health Warnings, notified vide GS.R. 727 (E) dated 15th October, 2014, in abeyance till the final report of the Committee is submitted. They have primarily raised doubts about the link between tobacco and cancer and stated that this needs to be examined further in the context of India.
It is sad that despite numerous existing studies and recent petitions and representations submitted to the Government by public health experts, national and international organizations, the MOHFW has chosen to place public health on the backburner and the revised pictorial health warnings on hold.
Hard facts about tobacco use and why it needs to be regulated
1) The Government of India has published several evidence-based reports and studies in collaboration with other agencies, which include:
a. Report of Tobacco Control in India 2004
b. Bidi Smoking and Public Health, 2008
c. Global Adult Tobacco Survey, India 2010
All these establish the close link between tobacco and cancer as well as other tobacco-related diseases. There are several other studies available in the public domain.
2) Each day 5500 youth initiate tobacco use, 2500 Indians die daily due to tobacco-related diseases and 10 lakh Indians die annually due to diseases caused by tobacco.
3) Economic Burden of Tobacco Related Diseases in India (2014) commissioned by Ministry of Health & Family Welfare states that the total economic costs attributable to tobacco use from all diseases in India in the year 2011 for persons aged 35-69 years amounted to Rs. 1,04,500 crores. The total revenue from all tobacco products in the same year constituted only 17% of the estimated costs of tobacco.
Why large pictorial health warnings on tobacco packages?
- The WHO Framework Convention on Tobacco Control (WHO FCTC), a global convention enlists key evidence based strategies for reduction of demand and supply of tobacco. The Government of India ratified the WHO-Framework Convention on Tobacco Control in February 2005, and hence is legally obligated to take systematic legal, administrative and policy steps to reduce the demand and supply of tobacco. Article 11 of the WHO FCTC calls for signatories to implement large health warnings with strong pictures as they are more effective and should be positioned on both the front and back of each product package.
- The Cigarettes and other Tobacco products (Prohibition of Advertisement and Regulations of Trade and Commerce Production, Supply and Distribution) Act (COTPA, 2003) has been enacted by the Government of India to discourage the use of tobacco products. Section 7 and 8 of the Act, mandate depiction of specified, rotational warnings including pictorial warnings, which are legible, prominent and conspicuous.
- Graphic health warnings are very effective in creating awareness about the hazards of tobacco usage, especially among the youth, children, illiterate and semi-literate persons. They also encourage users to quit and prevent new users from initiating use. Picture health warnings do not affect the livelihoods of the farmers or bidi rollers. This is merely a myth created by the tobacco companies to circumvent the law and mislead policymakers and the Government.
- The current health warnings of 40% size on one side of tobacco packages are weak and ineffective. They do not communicate the desired message to users and non-users. As per Cigarette Package Health Warnings - International Status Report (2014) published by Canadian Cancer Society, India is ranked 136, much below countries like Pakistan, Nepal, Thailand which have 85%, 90% and 85% warnings respectively. It is to be noted that countries ranked beyond 133 have no pack warnings on tobacco packages, thus making India's status amongst the bottom 10 countries in the world. India also ranks last among other SAARC/SEARO nations who have stronger graphic health warnings.
Appeal for urgent action from Government of India to review decision and implement 85% picture health warnings
India has received immense support for implementation of 85% pack warnings from victims of tobacco use, doctors, cancer hospitals, national and state levels health organizations, well-known public health experts, bidi workers unions, women and youth groups and over 36,000 signed petitions from general public. Some eminent MPs from across different political parties such as Ms Supriya Sule, Rajeev Chandrasekhar, PK Sreemathy, Baijayant Jay Panda, Prahlad Joshi, among others, have also written to the Health Minister, Shri JP Naddaji in favour of 85% larger pack warnings in public interest. There is immense public support for our campaign on social media "LivesBachaoSizeBadhao".
Article 5.3 of the WHO FCTC sets clear guidelines and recommendations for protection of public health policies with respect to tobacco control from commercial and other vested interests of the tobacco industry. It states that Parties should "Avoid conflicts of interest for government officials and employees. Clear rules regarding conflicts of interest for government officials and employees working in tobacco control are important means for protecting such policies from interference by the tobacco industry".
In view of the above, therefore, we urge the Government of India not to accept the recommendations of the Committee on Subordinate Legislation as they may be biased and desist from negotiating on people's health. We appeal to the leaders of our country to stand committed to India's goal of implementing 85% pictorial health warnings on all tobacco product packages at the earliest. This will save millions of lives of the citizens of this country, who die daily due to tobacco use.
With best wishes,
Bhavna B Mukhopadhyay
Executive Director
Voluntary Health Association of India
Disclaimer: The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.