The issue in brief:
Tobacco use is arguably one of the greatest public health threats facing the world today. If left unchecked, it will kill 1 billion people this century. The majority of these deaths will occur in developing countries targeted by the tobacco industry after stronger tobacco control laws and higher taxes reduced demand in developed markets. The key to tobacco control lies in prevention. The essential elements of a national tobacco control policy are the same for all countries.
The FCTC And Psychology Of Tobacco Control:
The Framework Convention on Tobacco Control (FCTC) is a promising public health accomplishment, but its emphasis on top-down, command-and-control approaches to tobacco control puts this promise at risk. The World Health Organization’s “Guidelines for Implementation” of the FCTC prescribe restrictive regulation of artistic speech, contributions to popular culture, and even political speech, as well as constraints on promotion of tobacco products. This intrusiveness fails to take account much of what we know, from research in psychology and the neurosciences, about what prompts people to engage in risky behaviours and what empowers them to exercise restraint. The Guidelines (and the FCTC) start from the premise that people smoke either because they become “addicted” (rendering personal choice impossible) or because they fail to comprehend tobacco’s dangers. But recent findings about the workings of the mind suggest a different story, a story of risky behaviour (including smoking, unhealthy eating) as the product of competition between aspects of the self – between systems of perception and motivation that drive indulgence and restraint. We argue in this Essay that the WHO, in its “Guidelines”, should pursue anti-smoking strategies that support individuals’ self-restraint, rather than merely suppressing tobacco use in a coercive fashion. Alliances between governments and myriad actors that shape social and cultural norms and influence people’s behaviour, along with funding for research into the psychological determinants of tobacco use, will prove critical to this approach. Crude coercion, on the other hand, risks cultural backlash and even embrace of smoking as a way to express independence and rebellion.
INDIA AT A GLANCE:
PREVELANCE OF TOBACCO CONTROL IN INDIA-
Information on prevalence of tobacco use in India is available from surveys carried out in general community. As per various surveys carried out during 1980s, the prevalence of tobacco use among men above 15 years of age varied between 46% and 63% in urban areas and between 32% and 74% in rural areas. Among women it varied between 2% and 16% in urban areas and between 20% and 50% in rural areas10.
Major efforts for tobacco control in India:
Even before the FCTC was adopted at the WHA, the Govt. of India initiated and enacted the national tobacco-control legislation namely, “The Cigarettes and other Tobacco Product Act, 2003” on 18 May, 2003. The salient features of this legislation include total ban on direct and indirect advertisements of all tobacco products; prohibition on sponsorship of sports and cultural events which encourage tobacco use; ban on smoking in public places; ban on sale of tobacco products to minors; ban on sale of cigarettes and tobacco products within a radius of 100 yards of educational institutions; mandatory pictorial depiction of specified health warnings and clear indication of nicotine and tar contents on packets and cartons of all tobacco products.
The rules for some provisions of the said Act, 2003 relating to prohibition of smoking in a public place, prohibition of advertisements and sponsorship of cigarettes and other tobacco products and prohibition of sale of cigarette and other tobacco products to a person below the age of 18 years came into the force with effect from 1st May, 2004.
1) Warning on cigarette packages/ advertisements: Recognizing the
health hazards of tobacco, the Government of India promulgated The Cigarette (Regulation of Production, Supply and Distribution) Act 1975.Under the act, all packages and advertisements of cigarettes are to carry a statutory warning, “Cigarette smoking is injurious to health”.
2) Warning on smokeless tobacco products: In India, nearly half of the tobacco users consume tobacco in smokeless form. Realizing the need for a warning on smokeless tobacco products (which are classified as food material), the provisions under the Prevention of Food Adulteration Rules (1955) were applied in 1990, which necessitates that every package and advertisement of smokeless tobacco product should have a warning stating that “chewing of tobacco is injurious to health”.
3) Cabinet guidelines for smoking in public places: Cabinet secretariat by an administrative order in 1990, prohibited smoking in certain places such as hospitals, dispensaries, educational institutions, conference rooms, domestic air flights, A/C sleeper coaches in trains, sub-urban trains, A/C buses, etc. State Governments were also advised to discourage sale of tobacco products in and around educational and health related institutions.
4) Community education on tobacco: In view of the deep-rooted nature, the eradication of tobacco habit would require concerted action resulting into a social change. Community education regarding tobacco and its health hazards would necessarily be an integral component of such an action plan. Anti-tobacco education needs to be targeted at decision-makers, professionals and the general public, especially the youth. Efficacy of educational activities in tobacco cessation had amply been demonstrated by various organizations. The anti-tobacco community education activities have been initiated in about 60 districts through district level projects for control of cancers. Educational programmes on tobacco through television have also been initiated.
