Last Monday (30 March), when it was declared that sale, purchase, storage and manufacture of all forms of chewable tobacco Rs Gutka and Pan Masala Rs are banned in the Capital, the decision received a mixed response. Many wholeheartedly welcomed the Delhi government’s move as smokless tobacco caused ten lakh death every year. But equally vociferous were those who criticized the decision. Thus, the move pitted tobacco addicts against those who see cancer in a pouch of gutka.

As per the notification of Delhi government, which reads that the manufacture, storage, distribution or sale of tobacco that is flavoured, scented or mixed with any additive going by the name of gutka, paan masala, flavoured tobacco, or kharra, is prohibited for one year. However, what appears to be a well-intentioned move by the government has raised the question whether government is really serious about banning these cancer- prone products or is it just an eyewash. Many wondered if banning was the only solution? Or shouldn’t cultivation of tobacco be stopped completely? Moreover, the Delhi government has banned gutka for just a year. Of course, they have promised to extend the year but there hangs another doubt. Besides, the moot question is, why target only gutka for being dangerous? What about other products like cigarettes, alcohol and other narcotics substances, which are equally, if not more, harmful for the body?

Old debate

Delhi is not the first to ban tobacco products. In fact, several states have either banned these products or heavily hiked taxes on sales of gutka. The predominant forms of smokeless tobacco use in India are chewing tobacco-leaf, khaini, zarda, gutka and paan with tobacco. Among these, gutka is extensively consumed in urban areas. Due to its flavourful taste,easy availability and low price, it is popular with all strata of people. Among them it is the poor or middle class kids who suffer the most as they start at a very early age. Many people use gutka as an alternative to smoking cigarette. "In India, cigarette is costlier. Moreover, smoking is generally looked down upon and so one takes to gutka, which eventually becomes a habit," said a teacher from Delhi University.

Like smoking, excessive use of gutka can lead to loss of appetite, cause unusual sleep patterns and loss of concentration along with other tobacco-related problems and end up in mouth cancer.

According to a survey, in 2008, about 5 million children under the age of 15 were addicted to gutka. A survey in Uttar Pradesh and Madhya Pradesh found precursors of mouth cancers in 16 per cent of the children. Therefore,many states in India have banned the sale, manufacture, distribution and storage of gutka and all its variants.As of May 2013,gutka is banned in 24 states and three Union Territories.

Scary numbers

After China, India is the second largest producer and third largest consumer of tabacco in the world. The most prevalent form of tobacco usage is smokeless tobacco with 206 million users in India. Smokeless tobacco use in India is the highest in the world, according toaccording to Global Adult Tobacco Survey with 25.9 per cent of the adults, 32.9 per cent of men and 18.4 per cent women, using it. In smokeless forms of tobacco, khaini (tobacco with lime mixture) is the most prevalent form (11.6 per cent) followed by Gutkha (8.2 per cent) and betel quid with tobacco (6.2 per cent). Five in ten current smokers (46.6 per cent) and users of smokeless tobacco (45.2 per cent) plan to quit or at least thought of quitting, says according to Global Adult Tobacco Survey in 2009-10.

According to the Tobacco Atlas, almost 10 lakh Indians die annually due to tobacco-related illness. In 2010, about 3,375 women were killed by tobacco every week. For men, the number was more than triple that.With a third of men and almost a fifth of women in India using smokeless tobacco, we have one of the highest prevalence of users in the world.

Inactive government

"Cigarette smoking is injurious to health"
"Tobacco is injurious to health"
"Smoking kills and tobacco causes mouth cancer"

These are some of warnings one usually finds on a cigarette pack or other tabacco products,thanks to stringent government stand on this issue. With growing evidence of hazardous effects of tobacco, the Union government has enacted various legislations and comprehensive tobacco control measures. For instance, Cigarettes and Other Tobacco products Act 2003 (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) seeks to prohibit the consumption of cigarettes and other tobacco products, which are injurious to health. The key features of the Act is ban on smoking in public places, including indoor workplaces, ban on direct and indirect advertisement of tobacco products, ban on sale of tobacco products to minors or ban on selling these products within a radius of 100 yards of educational institution and display of mandatory pictorial health warnings on packages of all tobacco products. With these initiatives India demonstrates a will to curb the menace of tobacco. Not only this the government has hiked the tax on its sale.

"In my opinion, the factories making cigarettes or tobacco should be first banned, as people are blind if they cannot see the warning written on the pack," opined Rajesh Yadav, a property dealer by profession. "Still they go for chewing tobacco or smoke. If the factories are closed then how would anybody smoke and as a result of this there would be less number of cases of mouth and lung cancer."

However, Rishi Rana, a shop owner, has different take: "I totally disagree with the ban on tobacco. We should also impose a ban on cigarettes and liquor. There are many more deaths and health problems from drinking than smoking."

Ban works

No doubt many states in India have declared their cities tobacco-free. But what is the ground reality? Has the ban really worked or is it merely on paper? Despite government’s strict warnings, tobacco products like gutka, zarda, khaini and tobacco-laced pan masala are easily available at public places. Even in restricted areas of Delhi, such as in the vicinity of schools and hospitals, there is rampant violation. This has led many health workers to question government’s seriousness. Government, on its part, seems to have failed to enforce the law properly. For instance, the tobacco industry extensively advertises non-tobacco products under the same name Rs Pan Masala (non-tobacco based). In September 2012, after a series of directions from the Supreme Court to ban gutka in the city, shops started selling raw tobacco and betel-nuts in separate pouches, defeating the purpose of the ban.

"I don’t think banning chewing or smokeless tobacco will curb it," said a paan shop owner in Rohini, who has stocked up these product so that he could sell it at a high rate. "In the past, too, when gutka was banned, companies started giving tobacco and supari (betel nuts) in separate packs."

Agreeing with him, another paan shop owner in East Delhi said, "I don’t think the total ban will have much affect in India. For instance, last time in September 2012, the authorities checked for a couple of days, the cops made some money and then everything was back on track."

However, this time, Delhi health ministry has assured it would strictly implement the law. According to officials of the health department, various citizens’ monitoring committees would be formed in every constituency to educate the masses, appealing to them to report sale of any tobacco product in their area.

Important reason

Now the other important reason for government not taking seriously the anti-tobacco drive is revenue from tobacco products. As per data available, India earns 914.43 million dollars in foreign exchange (2012-13) in tobacco trade,besides accruing 3.65 billion dollars (2012- 13) to the exchequer by way of excise levies on manufactured tobacco. Moreover, the tobacco industry gives employment to nearly 38 million people, who are engaged in various processes of tobacco cultivation, curing, grading, manufacturing and marketing.

Therefore,revenue generation is seen as one of the factors that renders any drive or campaign toothless.However,many experts argue that whatever revenue was generated was spent on health check-ups.The economic burden of tobacco-related diseases highlights that the total cost attributed to this segment among all health problems in the country during 2011, for those in the age group of 35-69 amounted Rs 1,04,500 crore. Of this 16 per cent is direct cost and 84 per cent indirect cost. Direct medical costs amounted to Rs 16,800 crore and indirect Rs 14,700 crore.

"Just for the sake of revenue,permitting sale of tobacco products is inhumane!" said Rajesh Chaurasiya, a students from Delhi University. "It, in fact, leads to a huge loss on human health. Actually, government is losing its revenue by jeopardising human health, which is also a resource."

Major controversies

Dilip Gandhi, head of Parliamentary Panel on subordinate legislation, examining the provisions of Cigarettes and Other Tobacco Products Act, 2003, mainly on increasing the size of pictorial warning on packaging of tobacco products, including cigarettes, had sought deferment of the move. Gandhi stirred up a hornet’s nest when he said there were no Indian studies linking smokeless tobacco to cancer. All studies had come from abroad, he claimed adding that one should consider the Indian angle too. However, Gandhi got a fitting reply from Sunita Tomar, the 28-year old icon of India’s anti-tobacco battle, when she passed away a few days after his statement.

Another controversy which hit the tobacco industry was on 15 October 2014,when Union health minister Harsh Vardhan announced that he had issued a notification mandating text and pictorial health warnings covering 85 per cent of both the front and back of tobacco packages beginning 1 April. Following the intervention of Prime Minister Narendra Modi, the issue was referred to the Parliamentary Panel and now the decision to increase pictorial warning on tobacco packets from 40 per cent to 85 per cent has been kept in abeyance.

-with inputs from Swimmi Srivastava