While health activists have lauded the implementation of 85 per cent pictorial health warnings on tobacco packages from today, they have cautioned that this is not the end of the battle against tobacco abuse but merely the beginning. Senior doctors working in the field have urged the Union Health Ministry to ensure proper monitoring of the Cigarettes and other Tobacco Products Act (COTPA) 2003, pointing out that in the absence of adequate monitoring and punishment for violations, the rules and regulations mean little.
Dr. G.R. Khatri, president of South Asia unit of World Lung Foundation, one of the organisations at the forefront of the demand to increase the size of pictorial warnings on tobacco products told The Wire: “In a letter to Health Minister J.P. Nadda, which was being sent by Padma Awardee Doctors Forum, I have demanded that it should be stated that the review of implementation of the COTPA provisions be done at the highest level by both the Centre and the States.”
Khatri, who is a public health expert insisted that the rules were not being implemented properly right now. “Under the existing rules, there is a ban on smoking in public conveyances which includes three-wheelers and taxis. But have you ever noticed this ban being implemented or anyone being punished for its violation?” Similarly, he said, there is a restriction of sale of tobacco products within 100 metres of educational institutions but this ban too is being violated with impunity. He had also filed a PIL on that very same issue in 2010.
Right now, he said, another major problem is the use of surrogate advertising for promoting tobacco products, especially cigarettes. “In almost all pan and bidi shops you now find a big image of a lion with a small warning printed underneath. What is this? It is the ad of a famous cigarette brand. We need to stop such activities.”
Incidentally, following the death of Sunita Tomar, the poster girl of India’s anti-tobacco campaign, who died exactly a year ago on April 1 due to oral cancer, the World Lung Foundation, along with Voices of Tobacco Victims had launched a campaign, called “Answer Sunita”, to demand early implementation of the larger pictorial health warnings. The campaign was necessitated as the Narendra Modi Government had gone back on its word to implement the new warnings from April 1, 2015 after a parliamentary panel headed by BJP MP Dilip Gandhi, had claimed that there was no original Indian research to prove that tobacco use causes cancer.
The “Answer Sunita” campaign was aimed at keeping the pressure on the Prime Minister to implement the decision on new packaging design norms for tobacco products. It asked social media users to reach out to the Prime Minister through Twitter, Facebook and Tumblr, with the message: “#Answer Sunita and put children’s health over tobacco industry profits. Pass 85% pack warnings now.”
Insisting that “the link between tobacco and cancer has been established through a lot of research and statements contradicting that are baseless and hurtful to the people who suffer from tobacco-related illnesses.” Nandita Murukutla, the country director of WLF, had noted that the online campaign would continue till the government agreed to fulfill its promise of increasing the size of the graphic warnings.
As part of the campaign a clock was also started from April 1, 2015 which depicted how a person was dying every 32 seconds – 13,500 every year – due to tobacco abuse in India. The idea was to illustrate that the delay in deciding on the bigger warnings was contributing to more deaths. “The clock depicts the real consequences of tobacco use that Sunita Tomar represents,” Murukutla had said.
Sunita had just two days prior to her death written to Modi about her dismay at Gandhi’s statement as chairman of Lok Sabha’s Committee of Subordinate Legislations.
In her letter, she had written “Recently Dilip Gandhi chairman of a Parliamentary panel wrote to the Health Ministry asking for the notification on bigger tobacco pack warnings to be kept in abeyance. I was shocked that people in such high posts can be so irresponsible. Bigger warnings can probably save some innocent lives like mine. You have started to take people along in your Mann Ki Baat where you recently talked about de-addiction. I hope you will also take up the cause of tobacco.”
Recently, the Indian Medical Association too had urged the Health Ministry to implement the bigger pictorial warnings stating that with 275 million adult users, India is the second largest consumer of tobacco products, globally. Tobacco, it warned, causes a gamut of serious diseases including cancer, cardiovascular diseases, chronic pulmonary diseases and stroke.
Representing over 260,000 doctors, the IMA had stated that the pictorial health warnings (PHWs) were the most effective way of communicating the ill effects of tobacco use, particularly among those with low literacy or no formal education.
With India also due to host the Conference of Parties (COP7) to the WHO Framework Convention on Tobacco Control in November this year, it had said the larger PHWs were essential in keeping with the commitment made by India at COP6 in Moscow.