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India's war on tobacco
By Raja M

MUMBAI - Fighting to slay a smoking dragon that kills a million Indians a year, lawmakers have produced anti-tobacco legislation that is long on good intention but short on the necessary specifics to implement it. The new law forbids smoking on public transport and in public places such as airports, railway stations, bus stops, auditoriums, cinemas and stadiums. Tobacco advertising has also been made illegal.

But a month after the law came into effect in May, it's business as usual for vendors in Mumbai. Roadside paan (betel leaf) shops bountifully stocked with cigarettes feed smokers continuing to exhale acetone, arsenic, benzene - just three of more than 3,000 chemicals in cigarettes that are also used in making nail polish remover, toilet cleaner, insecticide, rocket fuel, brake fluid and preservatives for dead bodies.

The earlier, much flaunted, tobacco lifestyle-related advertising has been snuffed by the reality checkers that won the Indian Cancer Patients Aid Association (CPAA) a Gold Lion in Cannes, France, last June. "Cancer cures smoking," said the winning entry. Another entry showed the Marlboro man's horse keeled over dead from second-hand tobacco smoke.

The new law, with its long-winded title - "The Cigarettes and Other Tobacco Products Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution Act, 2003" - shrinks legal tobacco advertising down to three-by-two-foot (90-by-60-centimeter) display boards in retail outlets.

Owners of sales outlets too have to display a 90-by-60cm board at their entrance with such warnings as "tobacco causes cancer" and "tobacco kills". The seller must display a 60-by-30cm board saying "sale to minors is a punishable offence". Sellers are authorized to demand proof of age. Offenders selling tobacco to minors will be fined Rs200 (US$4.40).

"The law is at least a beginning, and it gives us a tool to fight with," says Alka Kapadia of CPAA, which financially supports cancer patients' medical treatment and organizes anti-tobacco campaigns with inputs from organizations such as PATH Canada, a non-governmental organization whose goal is to improve health in developing regions of the world.

"But we are not sure of implementation of the law," adds Kapadia. She says she saw three out of four paan shops with new boards warning against the sale of tobacco to minors. "But when I asked the paanwallahs how they would verify age, they had no clue."

A Health Ministry official informed the media with typical governmental vagueness that these are early days of the ban, and over a period of time, a monitoring mechanism will be put in place.

Meanwhile, in Mumbai's Churchgate Station used by more than 1.8 million suburban railway commuters daily, a cigarette hoarding from tobacco major ITC (Indian Tobacco Co) was transformed into an advertisement for John Players League apparel wear after May 1.

Such surrogate advertising has long made use of soft-drink, apple juice and sports apparel to sell tobacco and alcohol through the media. But the Indian government has promised litigation to tackle surrogate advertising as well.

Other countries that ban tobacco product advertising include Norway, South Africa, Thailand, Ireland, Canada, Australia, New Zealand, Finland and Sweden.

The new Indian law was an outcome of earlier initiatives such as the New Delhi conference on Global Tobacco Control Law in January 2000. The New Delhi Declaration from the conference wanted "the tobacco industry [to] be held publicly accountable at the national and international level through legislation, litigation and other means".

The New Delhi Declaration recognized that "4 million people die each year from tobacco-related diseases and that this number is expected to rise to 10 million deaths per year within the next 25 years, with 70 percent of these deaths occurring in developing countries". 

After the ban, the $7.7 billion (Rs350 billion) Indian tobacco industry (which pays about $1.5 billion worth of taxes) has to find other ways to spend its $55.1 million advertising budget. The ban is expected to badly sting tobacco companies, hoarding suppliers, outdoor ad agencies and charity organizations dependent on tobacco companies for sponsorship.

According to Indiantelevision.com's AdEx India analysis, tobacco companies were among the biggest outdoor advertisers, spending an estimated $134 million in 2003.

Ravi Kiran, managing director of Starcom India (west/south), and part of Starcom Worldwide (one of the world's largest media and marketing companies) told Asia Times Online that print media will lose about $22.4 million in lost advertising. Television will lose $7.7 million.

However, "The advertising ban would not make a significant impact on the advertising business," Ravi Kiran said. "It makes for less than 2 percent of the advertising industry's total ad spend of 8,500 crore [$1.8 billion]. Agencies handling tobacco accounts would be hit, but even they said they knew it was coming and were not shocked."

According to the new law, direct and indirect advertisements for all tobacco products have been made a cognizable offense. First-time offenders will get two years in jail and a fine of Rs1,000, while second-time defaulters can be sentenced to up to five years and fined Rs5,000.

Other than cigarettes, India consumes other lethal forms of tobacco such as gutkha, pan masala, masheri, snuff and tobacco toothpaste. More than 80 percent of Indian smokers puff from beedis (rolled tobacco leaves). Beedi firms hardly ever advertise.

A leading Indian anti-tobacco activist, Dr Kalyan Gangwal, has demanded that tobacco be classified as a narcotic substance. He says about 4 million Indian children aged less than 15 years consume tobacco products. The New Delhi-based South Asian Coalition on Child Labor says the beedi industry widely uses bonded child labor, with children forced to roll an average of 1,500 beedis a day on daily wages of Rs9 (19 cents).

Shifting its anti-tobacco war strategy to developing countries, the World Health Organization (WHO) has begun fighting tobacco use on economic grounds. The World Bank estimates that smoking costs the global economy $200 billion a year in health costs and man-hours lost. About one-third of this financial loss occurs in developing countries.

WHO launched this year's campaign for "World No Tobacco Day" on May 31 with the slogan "Tobacco and poverty: A vicious circle" that stressed the huge economic bill from tobacco use and cultivation to families, communities and countries.

"It is the poor who bear most of the economic loss and disease burden of tobacco use," says Samlee Plianbangchang, formerly an adviser to Thailand's Public Health Ministry, and current regional director of WHO Southeast Asia.

Releasing a WHO report in New Delhi on May 31, he said, "Tobacco consumption and poverty form a vicious link." The WHO report said that of the 4.9 million global deaths every year attributed to tobacco use, 1.1 million are in Southeast Asia. India, Indonesia, Bangladesh and Thailand are among the top 20 tobacco producers in the world.

"There has been a tremendous progress on tobacco control thanks to the efforts made by many governments and civil society," said Dr Lee Jong-wook, director general of WHO. "Every 6.5 seconds one person dies, and many others fall ill or suffer diseases and disability due to tobacco use. The world cannot accept such easily preventable human and economic losses."

Adding life-or-death urgency to the anti-tobacco war, the latest report from the US Surgeon General linked smoking to four more serious diseases and five new cancers: acute myeloid leukemia, cancers of the cervix, kidney, pancreas and stomach.

Smoking harms nearly every organ of the body, the May 31 US Surgeon General report said. More evidence that the anti-tobacco war may logically evolve from merely banning advertising and smoking in public to banning the tobacco manufacturing industry altogether.

Raja M is an independent writer based in Mumbai, India.

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Jun 5, 2004



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