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RF_PH_10_SUDHA

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Since tobacco production and consumption
influences various sectors of society in several
ways, some negatively and others positively:
Rajesh Kumar
implementation of the policy should take
into account its effects on various sectors.
More than six million people.arc.cstimated
A comprehensive long-term policy, giving due consideration to
to.be employed in tobacco farming jlpne.
all sectors which will be affected, needs to be evolved.
Many "thousand more are employed in
manufacturing, distribution and advertise­
TOBACCO abuse has assumed epidemic
ment of tobacco products. Sales promotion
Rise in tobacco-related diseases will
proportions in India. Population-based surveys
increase the economic burden on scarce
activities includeevensponsorships ofseveral
have found that 70 per cent to 80 per cent of resources of ministry ofhealth. Social security
cultural and sporting events. The state earns
men and 15 per cent to 30 per cent of women
substantial amount (3.5 percent) ofitsrevenue
costs of employees and workers covered by
use tobacco. The burden of diseases caused
Central Government Health Services (CGHS)
from tobacco. Ministry ot agriculture gives
by tobacco is relatively small at present as
subsidiestoloEaccogrowers.Tobaccocontrol
and Employees State Insurance Corporation
compared to many other communicable
(ESIC) will rise. Higher sickness rate and
actions are likely to be opposed notonly
diseases but considering the trend in tobacco
pre-mature death in smokers is not only-a
by tobacco growers and tobacco companies
consumption in last decades tobacco-related
lossTo ’productivity but to. the.productive
but also” by some" ofThe government
workforce as well. Considerable part of
diseases such as heart attacks, asthmatic
departments.
bronchitis, cancers of lung, lips, mouth, food
Although' most of tobacco-related
income in poor smoker’s household is
and windpipe, etc, will increase in future.
Consumed to buy bidis or cigarettes or khaini.
activities, i e, production taxation, trade.
Government action for tobacco control such
etc, and consequently less money spending
etc, are controlled by other ministries and
as ban on promotion oftobacco through official
on food adds to pre-existing rrialnufrition
departments (ministry of agriculture,
mass media Akashvani and Doordarshan;
industry, commerce and~finance)~ but
problem. In addition to adverse effects on
printing of health warning on cigarette packs
health, smoking habits are responsible for
ministry of health being custodian of
and on cigarette advertisements: prohibition
peoples health'and committed to the goal
large numbers of fires in industrial
on smoking in public transport; health infor­
of ‘health for all’ should take the leading
establishments as well as in agri cultural sector.
mation and education campaign; and tax
Tobacco farming uses many more
role for formulation of tobacco control
increase on tobacco products have succeeded
pesticides and fertilisers as compared to other
policy and for monitoring its imple­
in reversing the trend to some extent but
crops putting heavy pressure on fanning
mentation. As a first step, therefore, the
considering the enormity of this problem a
land. The leaf of tembumi plant which grows
ministry should have its own working group
f
comprehensive long-term policy is needed.
on tobacco control. In ordeTTfogenerate- f
in wild is used in making bidis. Collection
Tobacco is used in various forms: for
consensus wftfidtheTministries on the policy
f
of this leaf from forest provides seasonal
smoking (cigarette, bidi, chutta, dhumi,
of
tobacco
control
a
cabinet
sub-committee
f
employment to hundreds of thousands of
should be constituted?Since the problem is
t
'
chillum and hooka), for chewing alone or in
tribal people in central India but at the same
betel-quid or in pan masala, mishri, and
very complex and involves so many sections
I;
time it is responsible for causing great strain
of thesociety, implementation should be step
f
snuff. The per capita cigarette consumption
on environment.
has declined from 190 to 160 between 1970
Most ofthe religious faiths in India prohibit
by step in phased manner.
and 1985 but only one-fifth of the total 120
smoking butsome are more strict than others.
Replacement of tobacco farming to other ■ 8
cash crops is a difficult proposition since/ f
million smokers buy cigarettes. The
Smoking in public places not only causes
net returns per hectare are three times higher
8
’-■ consumption index with base of 100 set in
inconvenience to those who are not used to
for tobacco as compared to other crops. I f
1973-74 has reached only 111 for cigarettes
inhaling tobacco smoke but also hurts the
by 1986-87 while in same period index for
religious sentiments of some people and at
Resources generated by increasing taxation I j
bidis reached 265 mark. The production
times leads to religious strife. In general people
can’be used to give technological as well as
8
figures fortobacco leaf show annual increase
consider tobacco as social evil and many
financial assistance to farmers encouraging
S
■ ' of 0.1 per cent. Total leaf production was
social organisation may take active part in
them to change cropping pattern away from
f
4,60,000 metric tonnes in 1987. Percentage
anti-tobacco campaigns if the concept of
tobacco. Similarly anti-tobacco media
J
consumption of leaf in 1982/83 was 34 per
public good is accepted in relation to tobacco
campaign be financed to re-employ
u
"
cent for cigarettes and smoking mixture for
use since smokers are a health hazard not
professional advertisers in public and private
o
A pipes and cigarette, bidis26percent. chewi ng
only to themselves but also to non-smokers.
sectors who are likely to become surplus due
s
" products 9 per cent, hookah 5 per cent, cigar
In view of the enormous adverse effects
to the policy ofban on tobacco advertisement.
8'
.and cheroot 2 per cent, snuff 1 per cent, and
of tobacco use not only on health but also
Indian export market of tobacco products is
■?
miscellaneous 26 per cent. Tobacco used in
on decline due to anti-smoking campaigns
5
on economy, environmentand social relations
cigarette and bidis is of high tar content
in the industrialised countries. Therefore, it
?
the tobacco control programme needs to be
(range from 19.4 mg to 28.3 mg in cigarettes
accelerated by adopting following measures.
is wise to give incentive to tobacco industry
j
S / and 23.0 mg to 40.7 mg in bidis).
(a) Legislation: Ban all tobacco-related
to shift over to other export-oriented
Ij
consumer
products.
Revenue
generated
I
S:
The consequences of tobacco use are well
advertisements; Smoking in public transport
■> known for several decades in the west.
and in specified public places be declared
from tax increases on tobacco be invested
5>; Tobacco-caused diseases in the west are
as an offence; Printing of statutory warning
in potentially profitable enterprises so as
■>
Btr virtually all related to smoking whereas in
‘tobacco chewing and smoking is injurious
to compensate for the eventual decline and
K
India cigarette consumption is low. But all
ultimate depletion of this source of revenue.
to health’ be made compulsory for every
£ other forms of tobacco use have also been
tobacco product including bidis; and Ban
Tobacco control programme is essentially
»
anenterpnseof economic readjustment which
if
K- found harmful in Indian studies. Age-adjusted
sale of tobacco products to minors, (b)
K, relative risk (of overall .mortality) among
I believe can be done without any financial
s'
Taxation: Increase tax on tobacco sale, higher
L,. smokers_(mostLy.bid£smokers) was 1,5 and
tax on more harmful brands: and stop
loss to the country. "All the gains in health
K among chewers (mostly betel-quid chewers)
subsidies fortobacco farming, (c) Administ­
can be attained Without any extra cost. A
i
g>. was 173 in a cohon study of 10218'7 individuals
comprehensive approach as outlined will
fl
rative: Set up a tobacco control authority to
g. followed up for 10 years in a district ofKerala.
monitor implementation of tobacco control
reduce both demand and supply by antiS
gj' A similar study on reverse chutta smoking
policy; (d) Education: Launch a multimedia
tobacco campaigns and by tax increases and
II
g?- m a district of Andhra Pradesh found relative
campaign against tobacco to educate public
rapid decline in tobacco abuse will be
:>
k"- r'slc._0LL'?.in.r5cn as well as in women.
about the harmful effects of tobacco.
achieved.

Controlling Tobacco Use

^Economic and Political Weekly

July 16, 1994

1841

COVER STORY

ADDICTIONS

Smoking and Health
risk data
Taken from US Surgeon Generals’
and Royal College of Physicians
Reports. Data derived from US
and British sources.
Overall Deaths From Smoking

• Currently, the overall excess
death rate in a year from all
causes, irrespective of the quan­
tity of cigarettes smoked, is 70°/o
higher than that for non-smokers.
This means that for every 100
non smokers who die during a
^^year, 170 smokers will die.
'^’Smoking deaths are greater in

Heart Disease

• Smoking is a major risk factor for
myocardial infarction, sudden
cardiac death and arteriosclerotic
peripheral vascular disease; This
last disease can result in gan­
grene and loss of a limb. The effect
is greater the more cigarettes
smoked,, if other risk factors are
present (high blood cholesterol,
high blood pressure, &c) and is
more pronounced at younger
ages.
• Death from heart attacks is 3
times more common in smokers
than in non-smokers; For'those
smoking more than a pack a day,
the risk is about 5 times greater.
□nee a smoker quits, risk of heart
attack tends to fall fairly quickly to
that of the non-smoker.
• Among men aged 40-50, deaths
from coronary heart disease are
nine times more common in
smqkers than in non-smokers.
• Smoking nicotine and carbon
monoxide aggravate exercise induced angina.
• Women smokers who use oral
contraceptives are at significantly
greater
risk
of
myocardial
infarction.

those who have smoked longer,
from earlier ages and who inhale.
• 4O°/o of heavy smokers now aged
35 (more than 25/day) will die
before reaching the age of 65,
compared to only 15°/o of nonsmokers.
• The average loss of life for a
20/day smoker is about 5 years.
For the 40 a day smoker, life
expectancy is eight years less.
This means the average habitual
smoker's life is shortened by
about 5.5 minutes for each Cancers
cigarette smoked — not much • When 12 people die from lung
less than the time it takes to
cancer, 11 will have been smok­
■ smoke it.
ers, Smokers who consume two
• Between 2.5 and 4 out of every
or more packs a day have lung
10
smokers will die because of cancer death rates 15-25 times
M their smoking.
greater than non-smokers.
► 15

fall in
smoking
and the related
mortality. In India, the laudable
example of Maharashtra, which has
banned smoking in public places such
a"s buses,Trains; waiting halls etc has
to be accepted and followed in other
states too. What else can be done in
this direction?
The following suggestions and
strategies will
help in combating
the menace of smoking.
• Spread the message: If you
smoke, stop!
• Spread the message: If you are a
nonsmoker, never start!
1B • HEALTH ACTION NOVEMBER 19B8

• Since the early 1950s, lung
cancer has been the leading cause
of cancer death among males. The
rate among females is accelerat­
ing and should pass that of breast
cancer in the 1980s.
• Cigarette smoking is the major
cause of laryngeal, mouth and
oesophageal cancer and a con­
tributory factor in the develop­
ment of many bladder, kidney and
pancreatic cancers.
Respiratory Diseases

• Smokers are 6 times more likely
to die from the crippling ..respira­
tory diseases, emphysema and
chronic bronchitis?
Birth Weight and Foetal Growth

• Babies born to women who smoke
during pregnancy are on average
200 grams lighter than babies
born to non-smoking women. The
more the mother smokes, the
greater tends to be the drop in
birth weight. Reductions in babies’
body length, chest and head cir­
cumference have been observed.
• There
are
indications
that
retard.e.d__foetal--growth from
smoking may affect physical
growth, mental development and
behavioural characteristics ofchildren up to the age of 11.
— The Lung Goodbye, Simon Chapman

How Zooti AfTzR 'YOU
QUIT 5MoKlbl& UJILL.
YouR 0Opy &EGIU TO
HEAL ITZZLF 2

Provide health workers working at
grass root levels with health
information about smoking.
Ban smoking in all public places.
Antismoking campaigns by volun­
tary agencies like Rotary, Lions
etc.
The pathway to a society free of
smoking may have many barriers and
the going will be uphill, but every
civilized society should follow it.
Otherwise there is scant hope of
reducing the enormous suffering and
death that is being caused by the
'small white Devil'.
■

A0LE, PuTYoUR. 0OPY
To HEAL—
\Te>FlF APouT 12 HoiJRZ
AFTER. You quit
Times of India

J)15
rm riMts of w*
tauaatt

1 0 MAR I9W

CANCER ASSOCIATION TO
TAKE ON TOBACCO LOBBY
Pay for the damage says CPAA
Smtta Deshmukh
TAKING Inspiration from the land­
mark legal battle In the US, after
which the tobacco Industry agreed
to pay $365 billion towards the treat­
ment of tobacco-related diseases,
the Mumbai-based Cancer Patients
Aids Association (CPAA) has
worked out a,comprehensive plan
to launch a similar offensive against
. the Indian tobacco Industry.
The CPAA will be supported by
an international organisation deal­
ing with ecology, whose legal group
.In New Delhi will frame a draft leg­
islation asking the tobacco compa­
nies to pay for cancer care. Together
they will seek the supporttof the new
MPs once the next Parliament is
formed to pass legislation on the
lines of that being worked out In the
US with regard to tobacco con­
sumption.
'3'
The Indian legislation would for­
bid smoking and use of tobacco In
public places and ban advertise­
ment of these products In media,
films and TV serials. The CPAA will
approach companies ma'nufacturJng_cigarettes, beedls and gutka to

pport the project and accept the
social responsibility of preventing
the Increased use of their products.
Manufacturers' will also be per­
suaded to contribute financially
towards the management of cancer.
Titled 'Project Control Cancer
Epidemic India - 2010,' the Initiative
will launch a multi-pronged attack
against tobacco, which Includes a
media blitz on the adverse Impact
of tobacco. "We are planning to have
a tie-up with a major advertising
agency which will work out a strat­
egy for targeting different segments
of society which are Inclined to use
tobacco. Several ad people, Includ­
ing Alyque Padamsee, have agreed
to co-operate,” said Y K Sapru,
founder chairman president, CPAA
and vice-president, ortho-clinical
diagnostics, Johnson & Johnson.
As part of this project the CPAA
will conduct awareness pro­
grammes In colleges and schools.
Several celebrities from filmdom
have agreed to participate and to
explode the myth that smoking Is all
with glamour and pleasure.
"We will establish clinics In alt'

|O|3
“
major towns to wean away people
from tobacco. These clinics will use
psychological and medical tech­
niques to help addicts give up tobac­
co and a pilot clinic Is already oper­
ating In Mumbai,” explained Sapru,
adding that people who have given
up smoking are being contacted to
create a vast network of volunteers.
India has the dubious distinction of
being rated third among the 25 lead­
ing producers of unprocessed
tobacco. Besides, there are more
than 100 brands of cigarettes pro­
duced in 20 factories.
“Thanks to strong legislation,
there Is a marked reduction In the
tobacco intake In the developed
countries." said Vijl Venkatesh,
director, diagnostic services, CPAA,
who believes that the US legislation
Is a comprehensive model for the
rest of the world to follow. “We are
not looking for a confrontation. We
want the companies to know that
cancer will be the biggest killer dis­
ease in India in the coming years
and to do something about it," she
added.

WORLD NO-TOBACCO DAY OBSERVED

MAKING SOCIETY TOBACCO-FREE
HE Central Health Education
Bureau in collaboration with

T
the

Govt

of National

Capital

Territory of Delhi observed the
World No-Tobacco Day on 31st
May 1993.

The venue was Nehru

Homoeopathic Medical College
and Hospital, New Delhi. Emi­
nent people from the World Health
Organization, Govt, of India and
representatives
from
voluntary
organizations
participated. The

theme of the symposium ■ was
"Health Services: our window to a

tobacco-free world.”
Inaugurating the symposium. Dr
D.B. Bisht, Director, Programme
Management, SEARO, WHO said
that tobacco “is an intoxic drug
which leads to cancer and other
respiratory diseases. It is hazar­
dous to consume tobacco through
pan and pan masala, particularly by
the young people. Mortality and
morbidity rate in the country is very
high due to the use of tobacco
and smoking.”

,

Dr Bisht stated that “65 per cent
cases of cancer are avoidable and
preventable if use of tobacco is
given up.” The theme for the next
year of the World No-Tobacco Day
would be “The media against
tobacco" which would enforce total
ban on the use of tobacco in the
U.N. buildings and buildings fun­
ded by UNO, he added.

Dr Bisht said that legislation
alone was not sufficient to stop peo­
ple from smoking or consume
tobacco. Indeed, the “enactment
should come from within by the
people and not from without,” he
added.

178

Dr Bisht said that the “know­
ledge of the art of communication
is essential to convince people to
quit smoking. Each health pro­
fessional should also become a
communicator to make the society
tobacco free,” he said.

Death from smoking rising
Dr
V.P. Varshney,
Director,
Health Services, staled that smok­
ing was killing 2 million people a
year — three times as many as is
the 1960’s — and the death toll was
rising
steadily. Of these,
1.5
million people died in India every
year, he said.

Dr Varshney said that there were
about 30 brands ofpan masala now
on sale in the country: They con­
tain tobacco which was extremely
harmful especially for children and
pregnant women. e.

Delhi Administration has ban­
ned smoking in hospital premises
and workplaces that fall under its
jurisdiction. Similar action should
be taken by the Central Govt, and
other deptts., he said.
Dr Varshney emphasised the
need of health education of the
people to persuade them to quit
smoking.
Indicators

Dr Narendra
Bihari.
OSD,
DGHS, said the ICMR study has
indicated that the “prevalence rate
of smoking among males above 15
years of age is 90 per cent in a rural
community in Meerut district of
UP.” According to another study
undertaken in 1981-82 in an urban
situation, the prevalence of smok­
ing was found to be 59.5 per cent

among males of above 15 years of
age. These indicators show the pre­
valent situation in the country.
Smoking is
responsible for
deaths due to cancer, cardiovas­
cular diseases, respiratory diseases,
peptic ulcers, pregnancy-related
complications
while
passive
smokers, with ill-health conditions
like asthma, bronchitis, cold and
other allergies are prone to more
serious reactions of Environmental
Tobacco Smoke (ETS).

The ETS causes sudden, infant
death syndrome. Irritant effects
on eyes, nose and throat, res­
piratory tract infections had in­
creased the risk of death from lung
cancer and coronary heart diseases
by 20 per cent. Such revelations
make it imperative for the health
profession to strive for making
non-smoking a social norm which
would eventually lead to the goal of
a tobacco-free society, he said.

Dr Narendra Behari exhorted
the health personnel, particularly
medical doctors to set an example
and abstain from smoking in order
to protect their patients and their
colleagues
from
the risks of
passive smoking.

Non-communicable diseases rising'
Dr I.C. Tiwari, Adviser (Health)
Planning Commission, said that
India has made many achieve­
ments in the field of health. The
life expectancy has gone up from 31
years in 1947 to 58 years today.
Many
communicable
diseases
have either been eradicated or con­
trolled. Smallpox and plague are
non-existent Malaria is under
control. Leprosy is to be con­
trolled by 2000 AD, he said.

SWASTH HIND

Bui.

non-communicable

dis­

eases. he said, arc causing a great

alarm. As we control communic­

able

diseases

we

to

have

SWASTH HIND

fight

against the non-communicable dis­
eases right from the time a mother

wastii Hind. May

window to a tobacco-free world was released by Dr Narendra
Bihari, O.S.D., DGHS.New Delhi. The issue was hailed by
all with a thunderous applause. It has been “brought out
very well” and itcarries “informative and thought-provoking
articles” was the opinion of a cross section of the VIPs, pro­
fessionals and others who were present during the sym­
posium on the theme that was organised at the Nehru
Homoeopathic Medical College and Hospital,NewDelhi on
31 May, 1993.

For. passive smoking of tobacco

among women carries the risk of
cancer of the cervix.

Besides, oral

cancer closely follows it. Dr Tiwari
said.
Beedi smokers, he said, carried 6

to 8

times higher risk of tobacco

related

diseases

compared

1993, devoted the theme of the World

S No-Tobacco Day — 31 May, 1993 Health Services — Our

is carrying a baby in the womb.

to

cigarette smoking, he said.

The practitioners of the Indian

Systems of Medicine who being

that

non-governmental

closer to community, especially in

said

rural areas, could help a great deal

organizations

in health education of the people

parallel programmes with the Govt.

by presuading them against smok­

lhe

were

running

the

in this field.

ing. he said.

Screening in the north-east part
of the country has revealed that 15

Parallel programmes

per cent of cancer is contributed by
the lifestyles adopted. Beedi smok­

Dr Suraj Varma, a surgeon rep­
resenting Cancer Society of India

ing is responsible for 4 per cent
deaths.

8.

tCo/ud. from Page 165)

—M.L. MEHTA

In some States mechanics are

posted to maintain the cold chain
In states like Himachal Pra­

at district level but they are not

desh workers show interest but they

effective partly due to their indif­

are not given adequate guidance in

ference partly due to the bureauc­

lhe maintenance of cold chain and

ratic delays.

7.

maintenance

ters.

of

Supervision

proper

regis­

at

levels

should be strengthened.

all

In some

overcome by getting the equipment

repaired by private companies on

arc known only in small percen­

contractual basis.

tage. People are more keen about
the polio immunizations than
other immunizations. I.E.C. acti­

Sterilization

of

and

satisfied with the programme with­

9.

out having made any field visits.

syringes at the sub-centre level and

The Medical Officers and Health

in the field are not satisfactory.

Visitors rarely visit the field

is recommended that the steriliza­

JULY 1993

in

level by autoclaving and the
syringes and needles should be
taken to the field in sterilised
kits.

10.
The awareness in the com­
munity about the need for immuni­
zation is fairly adequate. But the
details of immunization schedule

Such delays can be

States. State officials seem to be

some States.

Awareness
Dr V.P. Mehta, Delhi branch,
Indian Cancer Society emphasized
the need to create awareness among
people to stop smoking. Diseases
like lung and oral cancer were
caused due to the ‘mad’ use of
tobacco.
Dr Mehta emphasised on eating
fibrous foods for good health.
Dr
V.S. Wadhwa,
Director,
CHEB, proposed a vote of thanks.

needle

It

tion should be done at the PHC

vities have to be strengthened to
give complete information about

all immunizable diseases, immuni­
zation dosages and the timings of
immunization.

179

4

DEAR FRIEND

NEWS CLIPPINGS

Why Hyde Park ?
Increasingly pleased to read the last bulletin.

Smoke of 100,000 million dollars
Smokers through out the world puff away yearly

The Editor has made appreciable efforts to reconstruct

a trillion cigarettes worth 100,000 million dollars, an
international ‘Stop Smoking Conference’ has been told

the bulletin. I am inspired to write for the bulletin by

here. Dr. Jerome Schwartz, Chairman of the confere­

It is a great pleasure to read new columns added
from the last issue. But I don’t understand why the

nce called on the world’s nations to develop a system
of state-aid to smokers wishing to kick the habits,
with all forms of therapy.
New York, June 22-UNI.
*
*
*

repeated humble requests from him.

name ‘Hyde Park’ is given to the column for it’s use
as a ‘People’s Parliament’. We all think in

terms of

our Country, our own health policy and our culture.
Then why to borrow the name? Can’t we select other

Smoking burns up memory

name which is more meaningful and understandable.

How relaxing is a cigarette? Enough to make you
forget.... According to researchers of the University of

appreciable. We want to be real medico friends

California, nicotine has adverse effects on both short­

true sense.

The practice of calling no one as ‘Sir’ is really

HI year student,
Ahemadabad

ers, J.P.Houston, M.E.Jarvik and N.G.Schneider test'ed the ability of habitual smokers to recall items read
out to them from a list of 72 items containing names,

in

Vallabh Kathiria

term and long-term memory. The California research­

“I would like to visit Nagapur.”

professions, animals, vegetables and minerals. The

I have been following, with considerable interest

exprimenter read out the list. They were then given

the activities of ‘Medico Friend Circle,’ since the last
six months, when I myself enrolled a member of the

three minutes to recall as many items as they could.

The test subjects were divided into two groups.
Both groups were first tested without smoking anything

same. I have read the reports in your bulletins and
am very glad that there exists a group of people who

and the two groups were found to be more or less equ­
al in their recall ability. They were then given three
recall tests after they were given a cigarette to smoke.

are trying to overcome them.

do realise the discrepancies not only in medical educ­
ation, but in the complete health system in India, and

One group was given a cigarette containing 1.5 mg of

It is also essential, of course, to have various

nicotine and in the second group volunteers smoked a
nicotine-free cigarette; the two groups did not know
which type they had smoked. The researchers found

meetings to decide the course of future actions, but I
solving the various health problems. I came to know

that the nicotine cigarette group did not fare as well

through the bulletin about the MFC group ofdevagram

as the other group. Which indicates that short-term
memory was affected.

Two days later, the subjects were asked to recall

feel it is time we do something more concrete towards

Medical College working at Nagapur. I would be very
glad to visit them not only to see what has so far been
achieved, but also to talk to other members of MFC.

.as many items as they could (from the list presented
’to them two days before). Here again, the nicotine-free

group’s performance was much better.

This

goes against earlier findings which had

shown

that

nicotine improved long-term memory.

*

*

Uma Ladiwala
IV year Medical Student
Grant Medical College,
Bombay

clearly

‘Science Today’, May, 78
*

Medical studies in Malayalam?
TRIVANDRUM, July 27.
The Kerala Government has accepted in princi­
ple the Union Government’s proposal to make
Malayalam the medium of instruction for medical
education, Health Minister J. Chitharanjan informed
the Assembly today.
However, Malayalam will be introduced only in
a phased manner and it will be ensured that the stud­
ents are put to minimum difficulty.
Mr. Chitharanjan said that the proposal is part
of the Union Government’s move to make the regional
languages the media of instruction. But to his underst­
anding no final decision has been taken.
Indian Express.

Role of non-medicos
You have rightly mentioned in your editorial
that MFC is not an organisation of Medicos alone, but

of all ‘those who are involved in health and health re­
lated activities’. You proceed saying that it also aims

at improving the non-medical aspects of society for
a better life.
Frankly speaking, I could not understand it
quite well. During our talks in Rewa Camp,

even

Meera once said that non-medicos can play a big role.
in MFC and it is a sad thing that our health system is ■
totally in the hands of doctors. I would like to. know ■

what role can the non-medicos play in MFC and also
in general, in the health system of our country. .
Our

Rewa

Camp has been summarised very well by Luis.

It is

, Anyway, the bulletin is excellent.

eg® Lin JB1—euupasmffi

/

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• 3 AUu 34,73

r Anti-smoking
lobby makes
^presence felt
Our Bureau
CALCUTTA

en, like restricting or banning cigarette advertising and sponsor­
ship or making cigarette manufac­
he anti-smoking lobby made
turers liable for the damage to the
its presence felt significantly
health of active and passive smok­
at the annual general meeting of ers, shareholders will hold the
tobacco major 1TC Ltd, by throw­ directors of the company respon­
ing up questions related to adher­ sible for having ignored the writ­
ence to advertising norms and
ing on the wall.
Deveshwar said that unlike
sponsorships of sporting events;
by cigarette companies.
the tobacco giants in the West,
ITC chairman
who have been
Yogesh
Chander
made to pay for
Deveshwar justi­
damages
for
fied the company's
coming up with
activities by saying
findings,
a
that 85 per cent of
result
of
value-addition
in
research and
the cigarette indus­ CALCUTTA: ITC will consid­ development,
try accrues to the er appealing to higher judicial which encour­
exchequer at vari­ authorities if its Rs 800-crore age persons to
ous levels and this excise case pending at the smoke, ITC is
way ITC is indirect­ Customs Excise & Gold only catering to
ly
contributing (Control) Appellate Tribunal is a demand that
towards the social defeated. The verdict on the is there for cig­
case is expected next Monday. arettes. It is not
sector.
At the compa­ ITC is also considering opting involved in any
ny's. AGM
on for Kar Vivad Samadhan intro­ activity related
Wednesday, Pune­ duced in this budget
to
research
based Visheshwar
This was disclosed by ITC and
develop­
Raste, a voluntary chairman Y C Deveshwar to ment 'We-will
anti-smoking
reporters after the company's always abide
activist, who inter­ annual general meeting in by the law," he
estingly was also an Calcutta
yesterday. (Our said.
.ITC shareholder, Bureau)
One of the
shareholders
questioned
why
the cigarette com­
■ also suggested
pany was into sponsoring sports
that ITC must make a special pro­
events, when both the fields had
vision of Rs 1,000 crore for per­
nothing in common. He chose the
sons, who may be dying'out of
occasion to point out the fact that smoking cigarettes.
the world's tobacco giants spent
'Tobacco is a sunset industry
. large amounts of money cultivat­ and according to WHO, if current
ing a clientele that found the
trends continue, the annual death
hyped-np mystique and allure of toll from smoking would rise from
the cigarette as a fashion state­ 3:5 to 10 million by 2025, exceed­
ment He warned that when seri­ ing AIDS, TB, automobile acci­
dentsand homicides," said Raste.
ous measures are eventually tak-

T

ITC considering
Samadhan

r.noto oop»

Ming auri-lV"

1 A blow to anti-smoking campaign
HE agreement between the Indian to­
bacco giant ITC and the B/\T for mar­
keting the British leader’s world famous
brands in this country will be viewed with
concern by public health activists who have
been campaigning for a drastic reduction in
smoking. Ironically, the ITC move has come
within weeks of the observance of the “World
No Tobacco Day" on May 31. on which occa­
sion the Union Health Minister pledged to re­
double official efforts to reduce tobacco­
consumption. The ITC proposal is awaiting
the Centre’s clearance.
For quite some time the anti-smoking lobby
in the developed countries has been effective
in driving home the health implications of
tobacco use in any form, in the U.S., the legal
liability of the tobacco Industry to pay for the
damage it has been causing to the health of
the people has recently been established. Fol­
lowing this, a settlement* of sorts has been
worked out between the industry7 and the attomeys-general of States, where the cases are
still pending, under which it should reduce
teenage smoking in phases over 10 years by
60 per cent or pay a heavy penalty. The in­
dustry is also committed to funding cam­
paigns to dissuade people from smoking and
persuade those already addicted to quit.
Similar pressures in other countries in the
West have forced the cigarette industry to
turn to the gullible developing markets of
Eastern Europe. Asia and West Asia. A study
conducted by the London-based Panos a cou­
ple of years ago revealed that smoking in the
developed countries had dropped by 50 per
cent between 1954 and 1994 and the num­
ber of smokers, from six to three out of every
10 adults. At the same time smoking in the
developing countries is on the rise. Forty
years ago no woman there smoked and
among men only 20 per cent were smokers.
Now 50 per cent of men and eight per cent of
women smoke in the South.
According to figures released on the occa­
sion of the ‘World No Tobacco Day’, every
year 6.000 billion cigarettes are smoked. In
the developed countries the annual consump­
tion dropped from 2.800 cigarettes per adult
in the early 1980s to 2,400 in the early
1990s. In the developing countries, which
account for 75 per cent of the world pop­
ulation. the annual consumption during this
period, rose from 1150 to 1400. It is increas­
ing at 1.7 per cent per year. Already there are
an estimated 1.1 billion smokers in the world.
What is more shocking is that somfe of the
products exported to the developing countries
by the world’s largest firms have been found
to have a higher content of tar and nicotine

By B. S. Padmanabhan
than the brands sold in the developed nations.
One of the main targets of the industry is the
non-smoking woman. There has been a pro­
liferation. of “women’s brands."

The health implications of tobacco use in
any form have been brought out periodically.
Recent epidemiological studies have shown
that half of all smokers will eventually die as a
result of smoking, a fact not fully appreciated.
About half of all smokers killed by tobacco die

needed is a change in the social attitude to
tobacco use. A positive atmosphere should be
created in which non-use of tobacco will be
regarded as a normal social behaviour, in­
stead of smoking getting social respectability.
The mass media has a pivotal role to play in
motivating the vulnerable group. For the mo­
tivation and education to yield the desired
results, there should be a supportive environ­
ment. What impact can one expect of motiva­
tion if, an adolescent; after being told about

A positive atmosphere should be created in which non-use of
tobacco will be regarded as a normal social behaviour, instead of
smoking getting respectability. The mass media has a pivotal role
to play in motivating the vulnerable group.
in their middle age. On an average, these
smokers lose 20-25 years of their productive
adult life, with devastating implications for
the well-being of their families.
Currently three million deaths are caused
worldwide by tobacco and the developing
countries account for one-third. Estimates
from the Indian Council of Medical Research
show that about eight lakh people die every
year from tobacco-related causes, which im­
plies that one death occurs every 40 seconds
in the country. If the tobacco use continues
unchecked, the annual toll will touch 15
lakhs by 2020. In India, there arc an estimat­
ed 214 million tobacco users above 15 years
of age, one-third of them female. Smoking is
prevalent
among
cent—
of adult males
r
------------------o -53- rper
-..........
and three per cent of adult females.
« •
Scientific
evidence shows that tobacco is a
risk factor for 25 diseases. No other single
factor is known to have such an adverse im­
pact on human health. In India there are
about four lakh cases of cancer. 13 lakh per­
sons with heart ailment and at least 70 lakh
persons suffer from chronic obstructive lung
diseases. Half of all cancers in men and onefourth of all cancers in women are attributed
directly to tobacco use. /\ strong association
has been established between tobacco use and
increasingly lower birth weight, male foetal
loss, high loads of stillbirths, and increased
prenatal mortality among female tobacco
chewers.
The health services in India are subsidised
and hence such a high incidence of tobaccorelated diseases is bound to result in a huge
expenditure to the Government. What is

the dangers of smoking, is exposed to huge
cigarette advertisements on the street, commericals on TV and films in which his favou­
rite stars enjoy a smoke?
Hence, a holistic approach and combined
effort by all sectors involved in the tobacco use
will be required for effective control. The
Health Ministry has. after consultations with
other ministries, drafted a comprehensive leg­
islation which aims at a complete ban on to­
bacco advertisements, ban on smoking in
public places and at a more telling health
warning against all tobacco products. The
Parliamentary Committee on Subordinate
Legislation has made certain recommenda­
tions for being incorporated into the legisla­
tion. The inordinate delay in its enactment
has justifiably caused concern to the public
health and environmental activists.
In spite of the powerful industry lobby, the
Healthy Ministry has convinced other sectors
with the result the Indian Airlines has
banned smoking on its flights, a number of
Government offices and private establish­
ments have been declared "no smoking"
zones, smoking in public places has been
banned in Delhi and cigarette advertisements
are not allowed by Doordarshan. But the in­
dustry has resorted to sponsorship of sports
and cultural events, thereby getting visual
publicity indirectly.
One of the points raised by the tobacco lob­
by is that any curb on tobacco use will ad­
versely affect the fanning conununity, besides
reducing government revenues. Admittedly.
the revenues will fall but this loss will be more
than compensated by the reduction in the

expenditure on treatment of tobacco-related
diseases. According to official sources, pa­
tients with tobacco-related diseases spent Rs.
2,830 crores on their treatment in 1990-91.
whereas the revenue generated was only Rs.
2,353 crores. As regards the impact on tobac­
co farmers, scientists of the Indian Council of
Agricultural Research have already identified
a number of equally remunerative alternative
cash crops which they can take up.
The environmental impact of tobacco use
has not caught rhe attention it desenes. To
cure one kg of tobacco, an average of 7.8 kg of
wood will be required. Increased tobacco pro­
duction and curing will result in increased
denudation of forests and consequent soil ero­
sion. land degradation and threat to food pro­
duction. Tobacco depletes soil nutrients much
faster than many other crops and conse­
quently more chemical fertilizers .need to be
applied.
The occupational health risks in the tobac­
co industry too have not received much atten­
tion. According to Dr. S. K. Ghosh of the
Ahmedabad-based National Institute of Occu­
pational Health, the hands of workers en­
gaged in harvesting and processing get
affected by the chemicals in tobacco and sick­
ness is caused when nicotine gets absorbed
into the body through the skin. The symp­
toms arc characterised by head-ache, nausea.
vomiting, etc. The prevelance of "green symp­
toms." as these are called, is as high as 86 per
cent among the workers harvesting non-virginia tobacco and 5 3 per cent among those
handling Virginia tobacco.
The agreement to market the BAT brands
in India should be viewed in the light of these
facts. The Health Ministry. according to one
of its senior officials, has sought details of the
U.S. court ruling fixing liability' on the indus­
try for the diseases caused by the tobacco use
and ordering hefty compensation payable by
it to meet the treatment cost. Based on this.
the Ministry would explore the possibility of
fixing a similar liability on the industry in
India, where there are about 20 firms manu­
facturing more than 100 brands.
The Industry Ministry cannot turn a blind
eye to the health implications and permit the
ITC to expose the Indian market to foreign
brands merely on the basis of liberalisation
and globalisation policies. One hopes that the
Health Ministry' will take up this issue with
the Industry Ministry’ and see that the ITC
move does not go through. The Health Minis­
try will be failing in its duty if it does not do so.
This will be a test case for the new Minister of
State. Ms. Renuka Chaudhary.

2 2 ^1997

Another Kerala village Karasseri
pledges to free itself from tobacco
By P.K.Surendran
The Times of India News Service
KARASSERI (Kerala): On Independence Day a group of
villagers assembled at the Karasseri public school of
Kozhikode district. They had no pretence, nor a grand­
iose scheme to announce. They had formed an anti­
smoking committee to free their village from this all­
pervading vice.
After a few speeches, they took a collective pledge to
rpake Karasseri of 2500 people free of tobacco. P.T. Mo­
hammed, a retired school master and a chain smoker led
the way. Revealing his tobacco-stained lips and teeth,
the teacher said though he was 65 he looked 85 only be­
cause of the heavy smoking of the past few decades. He
volunteered to announce that he is quitting smoking
from this day, August 15.
“My head swims sometimes,” he told the correspon­
dent on the fifth day sans smoking. “But it is a pledge of
honour to the young and, Insha Allah, I shall stick to it.”
Now, many now are preparing for a smoke-free life.
The first phase of creating awareness has begun with
doctors explaining to the evening village sabha how
"Lady Nicotine” steals the health. The next step is target­
ting the houses of smokers and pleading with them to
kick the habbit, says the young convenor of the Karasseri
committee for tobacco-free village, N. Aboobaker.
The committee plans to declare the village smokingfree on August 15 next year. “For full one year we will
prepare the ground,” says the committee chairman and
teacher K. Balakrishna Pillai. Himself a compulsive smo­
ker, Mr. Pillai abandoned it a few years ago, and he
swears that he feels refreshed now.
Karasseri has a role model nearby. The Koolimadu vil­
lage, four kilometres away, had set an example by be-

/□u lot you;
study

coming the first “tobacco-free village" of Kerala, perhaps of India, two years ago.
With exemplary zeal, Koolimadu village, housing 125
families, preserves the newly-found status. The village
shops do not sell tobacco items, nor are people seen vio­
lating the self-imposed ban. "For some time, Mr. Abu, a
state transport driver had difficulty. He used to go out of
the village on off duty to smoke, but today he too has
quit,” says members of the Akshara arts and sports club
of Koolimadu.
Banners and posters at the outskirts of the village in­
form the visitors that they are entering the ‘tobacco-free
village.’ "It was no easy task" recalls Anil Kumar of the
Nehru Yuva Kendra who has provided active support to
the village. “In this part even aged women used to
smoke beedi or chew tobacco,” he observed. "But the
zeal of the young overrode all obstacles."
Today the Akshara club has some 300 members who
include school-going children to the septuagenarians.
Each calculates the money one should have incurred
had one developed the smoking or chewing habit. The
equivalant money is given to the club to purchase news­
papers or sports items. The reading room of the club has.
all papers available in Kozhikode.
“Many come here wondering we are really a village
free of smoke,” says K.M. Sulalman exuberantly. They
ask how was it possible to be sure that people do not
smoke on the sly. "But we know our people. They hon­
our the word, and slowly the habit fades away,” he says.
It is also remarkable that bo(h Koolimadu and Karasseri
have no liquor shops.
"Health is our reward. We do not need any other," re­
marked a youth at Karasseri. Both villages have underta­
ken the task without any promptings or external help.

For a smokeffree society
The revenue earned from the tobacco industry is far less than the Government expenditure on tobacco-related patients, says Y P Gupta
he Delhi Medical Association re­ by the year 2000 from tobacco-related wives of the non-smokers. It is reported hardly r niuch concern among the people
cently reported that tobacco will diseases.
that an average life is shortened by eight over itss iill-effects. A widespread antiemerge as a major killer by 2020,
Tobacco contains harmful substances Vears for a two-pack-a-day smoker. smoking; <campaign is mounting throughIt is estimated that nearly 3.5 million peo­ such as nicotine, carbon monoxide and "Pregnant women exposed to involuntary out the■’'orld
to create mass awareness
___________________________
ple annually die in the world from smok­ tar. On inhalation, these substances en­ smoking have a great risk of delivering of the hialth hazards from tobacco use.
ing-related diseases, of which two-thirds ter the bloodstream affecting the brain still born or deformed babies.
Theg’iyernments of Bahrain, Kuwait,
die in the developing countries. The and causing heart and other ailments.
The horrors of tobacco use are high­ Oman, jatar, Saudi Arabia and the
World Health Organisation has report1 Nicotine increases secretion of chemicals lighted every year, and mandatory warn­ United Arab Emirates have already
ed that over 150 million children in the like adrenaline which increases the ing is given in small print on each ciga­ brough
____ o.. out legislation to ban tobacco
world die of tobacco-induced diseases, heart rate and blood pressure. Nicotine rette and tobacco packages, but there is chewinf. The Hamilton City Corporation
one-third of which, under five years, are also interferes with the functioning
in Canada has restricted, by law,
§
due to acute respiratory infections and of blood vessels increasing the
snaking in public places including
The horrors of tobacco are
pu lie
,. transport to achieve
V,
L goal
tobacco smoke. If the trend continues, to- tendency of blood clots. Other ad­
§
the
bacco use would kill nearly 10 million verse effects are respiratory infec­
smoke-free society by the year
of----------------------highlighted every year with greater
2 people every year.
tions, gastric ulcers, pregnancy
2000.
»0. Many airlines
airlinesincluding
:
Indian
gv
In India, over 10 lakh people annual- complications etc.
. .. lines, Thai Airways and Chinese
intensify, yet its use in the world has
X
ly or 3,000 every day, die from smoking.
Tobacco intake is a major con­
Ai lines have declared no-smoking
w Several lakh more are disabled by to­ tributing factor for causing cancer.
fli hts for domestic routes.
increased by 75 per cent in the last
bacco-related diseases. The victims in­ It is reported that about 300 mil­
I espite these efforts, tobacco use
clude those non-smokers who often re1 lion would be afflicted by cancer in
in he world has increased by 75 per
two decades. It may further rise by
main in the company of smokers. It is un­ the next 25 years and about 200
celt in the last two decades. It may
fortunate that 20 million children are ad­ million would die due to the disease.
further rise by another 10 per cent
another 10 per cent towards the end towards end of this century as an in­
dicted to smoking every year (nearly A WHO report says that tobacco use
55,000 children are becoming smokers is responsible for 90 per cent of lung
creasing trend is evident in most de­
of this century as an increasing trend veloping countries. Some 46 million
every day in comparison to 3,000 in the cancer deaths, 30 per cent of ail
I US).
cancers and over 80 per cent of
Americans aged 18 or above are
'
There are 110 crores smokers world- chronic bronchitis cases. Also, 20
is evident in most developing
slnokers. However, there is a de­
33 wide, 41 per cent being from developing to 25 per cent of coronary heart dis­
caning trend in western countries.
CT* countries. In India, over 200 million peo- eases and stroke are attributed to
countries. However, there is a
[(dipped from 52 to 26 per cent in
6** pie consume tobacco in one form or the smoking.
tile US in the period 1965 to 1991.
i other. China has the largest number of
Smoking has been causing 30 per declining trend in western countries. It
The Delhi Government too banned
_ J smokers (some 700 million) in the world cent of cancer deaths in the US and
smoking in public places although its
dipped from 52 to 26 per cent in the effective implementation is still un­
—y constituting 34.9 per cent of its popula- UK. A study from Japan, US, UK,
—.t tion. Their number has been rising by Hongkong and Greece shows that
der cloud. It has also banned ad,
US in the period 1965 to 1991
seven per cent a year. It is estimated that smokers' wives are more prone to
vertisements on tobacco products.
Q^two million Chinese would die every year lung cancer and heart attack than
However a recent proposal to impose

T

>

a ban on distribution and selling of chew­
ing-tobacco has led to a controversy. It
is understandable for India is the world’s
third largest tobacco producing country.
Nearly 50 per cent of the tobacco pro­
duced is consumed in the domestic
market annually (424 million kg is con­
sumed in the country and 94 million kg
is exported).
The apex body of pan masala and
gutkha manufacturers in the country has
claimed that chewing of tobacco is 98 per
cent safer than smoking. The annual con­
sumption of raw tobacco by the chew­
ing-tobacco industry is over 35 million
kg. Gujarat is the major tobacco grow­
ing state, with over 50 lakh tobacco grow­
ers in the State. If such a ban is imposed.
it would jeopardise the livelihood of mil­
lions of farmers and workers engaged in
growing tobacco.
A community drive against tobacco use
is thus badly needed to fight this men­
ace. The public, particularly in the rur­
al areas, must be made aware of the
harmful effects of smoking so that they
are discouraged from tobacco use.
Though the country earns a revenue of
about Rs 1,100 crore per year it must not
forget that it spends nearly Rs 2,400
crore on patients suffering from tobac­
co-related cancers. Therefore the
Government must also take punitive steps
to ensure compliance with the anti-smok­
ing regulations to achieve a smoke-free
society.
"
______ I

Whither tobacco control?

LO
A

co

cost of healthcare of those affected by tobac­
UR policy-makers and administrators
By B. S. Padmanabhan
co-related ailments, which is met from the
seem to be adept at talking to an oc­
casion but not rising to it Howelse stimulate, support and coordinate all these sustained campaign to counter the tobacco> Government exchequer, is much more than
.
industry's promotional campaign and high-- what the industry contributes by way of tax- .
can one explain the Health Ministry remain­ activities.
es. Thus, there is a net drain on the govern- !
A
decade
has
passed
since
India'.sub?
light
the
toll
tobacco
use
takes.
ing a mute witness tto'jie entry of foreign
n
----- -----—■ —is.~> ment resources. Illness or the premature ■
brands of cigarette irii ‘)pr country after its scribed to these resolutions but no slgnif; -,
Every
year. iw
6.35 1-1,1,
lakh .-i,tobacco-related
political and administrative bosses waxed icant follow-up has been taken, except deaths take place in India. An estimated 65 death of the tobacco-users would cast a
eloquent on the “.World No Tobacco Day" banning smoking in public places and public per cent of men use tobacco and in some heavy economic burden on their families,
every year on the hazards of tobacco use and transport and printing a statutory warning parts a large proportion of women chew to­ perpetuating the cycle of poverty.
on cigarette packets. Even here, the action bacco and bidis. About 33 per cent of all
promised vigorous measures to contain it?
It was in this context that action has been
Last year, within weeks of the "World No has been half-hearted with the ban on cancers are caused by tobacco. About 50 per initiated in the U.S. to recover the cost of .
Tobacco Day." the Indian tobacco giant — smoking in public places confined to Delhi cent of all cancers among men and 25 per treating tobacco-related ailments from the '
ITC — announced its plans to tie up with and a few other cities and the statutory cent among women are tobacco-related. industry. On the occasion of the World No
BAT of the U.K. to make and market the warning being followed more as a ritual and The number of cases of avoidable tobacco- Tobacco Day in 1997. a senior Health Minis­
latter's brands in India. The Health Minis­ printed in such small letters that the con­ related cancers of the upper alimentary and try official indicated that the U.S. court judg­
try’s attention was drawn toithe implica­ sumer hardly notices it. Advertisement in respiratory tracts, coronary heart disease ment would be studied to explore the
tions in the hope that it wouldjpersuade the the government-controlled mass media has and chronic obstructive lung disease has possibilities of taking similar action in India.
Industry Ministry not to givcLlearance for
But nothing has been done so far.
the tieup. But nothing happened.
As regards the possible impact of any curb
Within a year, ITC introduced two of these Except on the occasion of the World No Tobacco Day, once a
on tobacco use on tobacco farmers, studies
brands. Benson & Hedges antf State Express year, there has been no sustained campaign to.counter the
by the Rajahmundry-based Tobacco Re­
555: the former four month! ago, and the
search Institute of the ICAR have brought
latter in the first week of July. In fact. ITC tobacco industry’s promotional projects and highlight the toll
out equally remunerative alternatives to to­
has planned to invest Rs. 1,000 crores over tobacco use takes.
I
bacco cultivation, besides use of tobacco for
the next five years to moderate and upgrade
purposes other than smoking and chewing.
its four cigarette factories which Will double
the production capacity from the current been prohibited, but it continues unabated been estimated as 2.00.000 every year.
Time is of the essence as the industry is J
in the print media and private television Many still-births, low birth infants, and pre­ targeting the youngsters to make good the
level of 78 billion sticks. S
natal mortality have been reported among loss of market with the increasing death of
All these are taking placsright under the channels.
A silver lining on this otherwise gloomy female chewers.
nose of the Government of India, which is a
adult smokers. According to WHO. only 5
Tobacco kills 50 per cent of its regular per cent of the smokers start at the age of 24
party to the 16 or so resolutions adopted by horizon is the code framed by the advertising
the World Health Organisation since the industry's regulatory body. Advertising users within 40 years", observed Dr. Jayant and more than 90 per cent earlier. Sports
1970s, particularly the one adopted in 1986 Standards Council of India (ASCI). The code, Sharad Vaidya of the Royal Marsden Hospi­ sponsorship by tobacco companies has been
which urged member-countries to formu­ requires that the advertisements of tobacco­ tal. London, in a letter to the National Med­ found to be an important factor influencing
„„. minds. This
*.,,0 has been confirmed
products should
not encourage
mi- ical Journal of India, a couple of years ago. cluvItav
late a comprehensive national tobacco con- based
------- ,-------------------- -----------------o- ....
adolescent
Apart from these direct health implica- by a study of the impact on adolescents who ,
trol strategy. It was envisaged that the nors or induce non-smokers to use tobacco
use. the
by watched the Wills World Cup Cricket match­
,1,. hazards faced
r»^a k„
strategy would contain measures (1) to en- products. They should not suggest that the tions of tobacco ™
sure effective protection to non-smokers use of tobacco products would lead to ex- the those engaged in the plucking and cur­ es telecast for a month in 1996.
from involuntary exposure to tobacco traordinary success In various areas of hu- ing of tobacco leaves have been highlighted
The study carried out by Dr. S. G. Vaidya 1
srnoke; (ii) to promote abstention from the man endeavour. They should not imply any by researchers of the Ahmedabad-based Na­
use of tobacco to protect children and young link
,:-1‘ between tobacco -----<= ----use and’ manliness
or tional Institute of Occupational Health. The of the Goa Cancer Society. Dr. U. D. Naik of 1
the National Organisation for Tobacco Erapeople from becoming addicted: (iii) to en­ female emancipation. They should not con­ hands of the workers get affected by the
.
dication.
Panaji. and Dr. Jayant S. Vaidya of
sure that a good example is set on all health- tain any endorsement of tobacco use by ce­ chemicals in tobacco and sickness is caused
Institute
of Surgical ■Studies.
- -------•;—
— -■••—University
-------- ■
More....
important
the advertisement when nicotine gets absorbed into the bodv the
related premises by all health personnel: (iv) lebrities.
------------------r----------------------------------to progressively eliminate all incentives should not depict any model below the age through the skin. The symptoms are head- College. London, shows that the sponsorship ,
by
ITC
promoted
not just
its brands but
ache,
nausea
and
vominng.
bv
1X0
Dromoted
lust lts
and
not*
show
any model
smok
which maintain and promote the use of to- of 25~ —
J "should
u—,J —
---------------J_'----'■ ­
smoking
in
general.
Even
those children
All these well-documented findings are
bacco (v) to prescribe statutory health warn­ ing or chewing tobacco. The code will come
available with the Health Ministry but if it having full knowledge were prompted to ,
ings on cigarette packets and the containers into force on October 1.
smoke after the Wills World Cup because of I
The code by itself will not be sufficient has not taken any effective action it can only
of all types of tobacco products; (vi) to estab­
the false personalised perceptions like I
lish programmes of education and public in­ unless it is supplemented by a comprehen­ be attributed to the clout which the tobacco
formation on tobacco and health issues with sive multi-sectoral national r
.JJ
industry’ enjoys in the corridors of power. “smoking improves one's performance in
programme.
the active involvement of health profession- The lack of such a programme was noted by One of the pet contentions of the industry is cricket."
India can learn from the innovative initia­
als and media; (vii) to monitor trends in WHO in its review of the situation in South­ that it makes a significant contribution to
smoking and other forms of tobacco use. East Asia on the last "World No Tobacco the exchequer by way of taxes and hence tives taken by some of the countries in '
tobacco-related diseases and effectiveness of Day". The Government's lip-service is re­ should not be disturbed. Also a large num­ South-East Asia to educate the public and
ber
of
tobacco
farmers
will
be
hit
if
con_____ awareness of the health imcreate
a greater
national smoking control action: (viii) to fleeted in the absence of any mention about
promote viable economic alternatives to to- this in the Health Ministry's Annual Report. sumption is curbed. Both these have been plications of tobacco use and help tobacco
farmers switch to equally remunerative al- i
bacco production, trade and taxation; and Except on the occasion of the World No To- countered by WHO forcefully.
Several studies have brought out that the ternative cash crops.
>I
(Ix) to establish a n^^nal focal point to bacco Day, once a year, there has bee^no

A

^TOBACCO INDUSTRY • Anuradha Himatsinghka/Shehla Raza Hassan /Calcutta

25

g

Companies at the receiving end yet again
T Tnion finance minister Yashwant
Yas’------- —Sinha
<---------------------------*—taxation
<-•—=- in
—;excise
------------—«-=<
-----------------\ of single point
net,
while
a more
kJ yesterday announced
per cent
nounced a
a6
6 to
to 11
liner
cent 'Its pre-budget memoran- 'The burden Will be felt rational tax regime would
. increase in excise duty on cigarettes across Mum to the union govern­
have provided a fillip to the
by
cigarette
firms
i specific grades, confirming speculations ment However, it is now
international
tobacco
: that the industry would be at the receiving plain that this suggestion
• majors setting up shop in
especially in the
1 end of an excise duty hike in budget 1998.
has not been strictly
India.
As expected, the government went adhered to.
micro segment,
This would definitely
jahead with the hike, considering the fact
The finance minister ,
which do not have : I eliminate to a large extent
tfhat there was a yawning Rs 4500 crore gap
tried to cushion this effect
the havoc being caused by
‘in excise duty collection in the previous
premium brands to
on smokers, by simultanethe grey market, thus
jyear. The cigarette industry posed the least ously announcing lower-.
relieving domestic ciga­
absorb
the
shock
of
[restraints compared to other sectors.
ing of excise duty on j
rette manufacturers from
The burden will be felt by cigarette man­ matches from Re 0.50 to Re
shouldering the burden of
an excise hike
ufacturers especially in the micros seg­ 0.25forevery lOOmatches. *
excise hikes year after
ment, which do not have premium brands
But that will mean little to
year. While details relating
to absorb the shock of an excise hike.
the tobacco industry.
to hikes on specific grades are not yet
• The Tobacco Institute of India (TH) had
The latest hike is likely to upset manu­ known, cigarette manufacturers have been
sought the retention of existing duty rates
facturers as the grey market of internation­ paying excise according to the following
and specific duty along with the restoration
ally famous premium brands escapes the
rates during 1997-98:

------ —ci
Excise levied on cigarettes
otherthan fil­
ter cigarettes, of length nofexceeding 60
millimetres is Rs 90 per 1,000 sticks. Excise
levied on non-filter cigarettes of length
exceeding 60 millimetres but not exceed-'
ing 70 millimetres is Rs 350 per 1,000 ciga­
rettes. Filter cigarettes of length (including
length of the filter, the length of the filter
being 11 millimetres or its actual length,
whichever is more): Excise on lengths not
exceeding 70 millimetres is Rs 500 per
1,000 cigarettes. Exciseon lengths exceed­
ing 70 millimetres but not exceeding 75 mil­
limetres is Rs 820 per 1,000 cigarettes.
Excise on length exceeding 75 millime­
tres but not exceeding 85 millimetres is Rs
1,100 per 1,000 cigarettes.
Cigarettes were earlier taxed on the
basis of packets.

go

8

~ 4 MAY 1998

/atp - w fxpr^3

Ban on smoking
goes up
in a
puff
<|?h,
-w>7^
SAURABH SHUKLA

1

NEW DELHI, MAY 3
HE ban on smoking at the
city’s railway stations has
turned out to be a total
washout. Five days after the Delhi
Government issued the ban,
smokers could be seen in full form
at the platforms of the city’s sta­
tions. The order clearly stipulates
that the ban includes railway em­
ployees, but the smoking commu­
nity is clearly having its way with no
restrictive authority in sight. “It is
illogical to ban smoking in a big
place like a railway station. Ciga­
rettes are sold openly here. How
can you expect people not to
smoke?” asfc an incredulous rail­
way employee at the Old Delhi
Railway Station.
Vendors selling cigarettes seem
unaware of the ban. And in the ab­
sence of any clear. directive, the of­
ficials seem confused as to how to
deal with them. “We just can’t ask
the vendors to leave overnight.”
Senior railway officials say that
they are confused About the ban as
no clear directive has been issued.

T

Officials contend that they have
not received any written instruc­
tions. “We have only read about
the ban in the newspapers. We had
received a notice earlier that the
ban has to be implemented from
May 1. But there has been no fresh
notice since,’’says an official.
At the New Delhi Railway Sta­
tion, a stone’s throw away from the i
offices of senior railway officials,
the official notice seems equally
elusive and the awareness of a ban
equally dim. For platform vendors
selling cigarettes, it is business as
usual. And according to the inter­
pretation of some railway officials,
the ban is only for smoking in the
premises of the railway station and
does not extend to evicting ciga­
rette vendors. A senior railway offi­
cial also confesses that they do not
have enough manpower to en­
force the ban.
Spokesperson, Northern Rail­
ways, Chandralekha Mukherjee,
however, says the ban is well on its
way to being enforced. “We have
put up notices banning smoking at
railway stations but no one has
been booked for smoking till now.”

- 1 MAY 19 98

Police asked to enforce smoking ban
V Radhika

New Delhi
TUI- DI-I.H1 Government has sought
the help of Delhi police to enforce
its anti-smoking law.
The request came in the wake of
complaints voiced by Government
personnel about belligerent smok­
ers who cocked a snook at their at­
tempts to cut out challans.
Last week in a meeting with
Police Commissioner TR Kakkar.
Health Minister Dr Harsh Vardhan
requested the deployment of police
personnel in the Government’s mo­
bile enforcement squads. A request
which, according to Dr Harsh
Vardhan. has been heeded by Mr
Kakkar.

With the Government plagued hy
recurrent nightmares of seeing its
own law, (which has been in force
for over a year) go up in smoke, the
police help might just come in
handy, particularly in the light of
Assembly elections six months
down the line. The presence of the
khaki-clad men. it is hoped will help
in keeping the law in place as the
guiding assumption is that the av­
erage Delhiite is still wary of a ba­
ton-wielding cop. It is important to
point out here, that the emergency
call came in the wake of a we-don'tgive-a-damn-attitude towards the
Delhi Government officials/a ethe­
rised officials who tried to enforce
the law. The meek threats of issu­
ing challans fell on deaf ears. "A few
officials were also roughed up by

die-hard smokers, when the officials
attempted to issue a challan," said
a senior official.
At another time, when a Blue-line
bus driver and conductor were
found smoking inside the bus, the
officials sought the help of the
lYansport Department to tick off the
errant duo. "Nothing much came of
it," says an official. Ironically, bus
drivers and conductors art*, expect­
ed to check smoking in their re­
spective buses. I lence the novel idea
of having cops escort officials when
they are doing their rounds.
The initially reluctant Delhi Police
finally agreed to put the law in place
- courtesy a meeting that took plan*
between the Health Minister Dr
Harsh Vardhan and Police
Commissioner T R Kakkar.

Inadequate man power was cited as
one of the reasons for the initial re­
luctance of the Delhi police.
With the police chiefs willingness
to extend a helping hand to the Delhi
Government, the Health Minister's
confidence in finally seeing the law
through has received a shot in the
arm. brom the local thanas, cops
will be deployed for the help of of­
ficials of the enforcement squad,
said Dr Harsh Vardhan and added
that "the law which has been
found wanting till now due to lack
of police support will be really ef­
fectives now. " If the Government pull
this one off. it could well be its
crowning glory, For. eventually, it is
the greater plan of the B.IP to con­
vert smokers into healthy nonsmokers.

STATESMAN

' 1 6 MAh’ 1993

Man
THE STATESMAN

V
S the body that wiped out smallpox and has done
so much to promote mass vaccination losing its
way? hi recent weeks the reputation of the World
Health Organisation has suffered a number of
blows, as critics have accused it of bowing to political
pressures rather than publishing unpalatable research
findings.
One instance emeiged this week. A controversial
new study which looked for links between lung can­
cer and passive smoking found that non-smokers
married to, working with or growing up with smokers
were not at significantly more risk from lung cancer
than anyone else. The research, commissioned by the
WHO and coordinated by Rodolfo Saracci of the
WHO's International Agency for Research on Cancer.
involved a seven-year-long study of 650 lung-cancer
patients. Since it was one of the biggest single pieces
of research conducted into the
issue, its results were eagerly
__________________
awaited by the medical world
and lobby groups. But instead
of being released with a fan­
fare. they were summarised in
three short paragraphs and
buried in a bulky WHO inter­
nal document.
Those paragraphs emerged
in the British press —
undoubtedly tipped off by the
. country's tobacco lobby —
and were accompanied by

I

Smokes
failed to tackle the issue of cancer risk. Indeed, it left
out a vital piece of research by' the NCI's own scionlists. This had found a high incidence of thyroid cancor associated with radioactive iodine. An indopendent committee was set up by the USA's National
Academy of Sciences to look into the NCI's conclu­
sions about the
health risks from
nuclear testing.
Dr Baverstock is
the only WHO

a
p
p

tackle the issue of cancer risk. Indeed, it left
al piece ol research by the NCI's own scionis had found a high incidence of thyroid cancialed with radioactive iodine. An indepen-

The World Health
Organisation is
showing signs of
allowing politics to
get in the way of
the truth, says The
Economist

gleeful accusations that the
WHO was trying to suppress
the findings. Certainly, the
conclusions would have been
an embarrassment to the organisation. Though the
■WHO has long admitted that the links between lung
■ cancer and passive smoking are weak, it has nonethe­
less used the perceived dangers to rally public sup­
port against the tobacco industry, particularly in
pressing for a worldwide ban on smoking in public
' places. Surely, say its critics, if this study had sup­
ported the WHO's anti-smoking position, it would

have trumpeted the fact.
But the study not only clashes with the tenor of the
WHO’s own anti-tobacco campaign, it also appears to
. undermine the U S government's war on public
smoking. Unsurprisingly, many fear that the WHO's
. agenda is no longer governed solely by scientific prin' ciplcs. Rather, they suspect it is influenced by its
biggest paymaster — the USA. This view is rein­
forced by the stance the WHO has seemed to take on
another awkward issue: the links between radiation
•and thyroid cancer.
Sources close to the otjanisalion allege that Keith
Baver-stock, a leading scientist at the WHO, has been
put under unrelenting internal pressure to leave the
organisation following his work on the incidence of
■ thyroid cancer after the Chernobyl nuclear accident
in 1986. This research, which found cancer rates that
were more than 100 times normal in some areas of
the Ukraine and Belarus, conflicts with work done by
Die U S government in its own study of dangers Io
public health from nuclear testing in Nevada in the
1950s.
That study, published by the government's National
Cancer Institute last year, was inconclusive, and

employee
on
that committee.
Why should Dr
Baverstock be
under such pres­
sure? One expla­
nation is that, if
the health risks
associated with
nuclear tests and
accidents have
been underesti­
mated or under­
stated, the U S
government
could face new
lawsuits
on
everything from
the Nevada tests
to the Three
Mile
Island
nuclear accident in 1979.
And there is a third instance where the WHO has
apparently been embarrassed by its own findings,
and embarrassed America into the bargain. On 21
February’ New Scientist claimed that the WHO had
caved in to political pressure by failing to include
data suggesting that cannabis is less harmful than
alcohol or tobacco when it published a report on the
effects of the drug. New Scientist alleged that the
WHO was persuaded not Io publish by warnings
from America's National Institute on Drug Abuse, and

PERSPECTIVE

also from the United Nations, that its findings would
play into the hands of groups campaigning to legalise
pot.
The WHO has countered some of these accusations,
though it would not comment on the case of Dr
Baverstock, saying the issue is between him and his

rslock is
t WHO

I

There are lessons, though, in the
ease with which the WHO's motives
have been impugned by sceptics. It
is dangerous to become involved in
campaigns that are not solidly
based on scientific evidence. For

ilth
is
of
s to
of
fhe

imittee.'*’
hould Dr
:ock be
ich pres­
to expla-

1th risks

tests and

kderestiir under-

reg
str
III
tio
gel
Jm
gre
get
aln
pal
1

lace new
is
on
ing from
ada tests

accident in 1979.
lore is a third instance where the WHO hasi
tly been embarrassed by its own findings,,
aarrassed America into the bargain. On 21
' New Scientist claimed that the WHO had
to political pressure by failing to include
gesting that cannabis is less harmful than
ir tobacco when it published a report on the
f the drug. New Scientist alleged that the
is persuaded not to publish by warnings
erica's National Institute on Drug Abuse, and

in a smoke-free environment), but that it was tiny
compared with the 2,000 per cent increased risk for
active smokers. The BMJ therefore decided that the
WHO's results were riot noteworthy enough to print.
The WHO says it is still trying to have the study pub­
lished. It submitted the research to the Journal of the
National Cancer Institute in February and is waiting
for it to be peer-reviewed.
As for the study of the impact of cannabis, the
organisation denies accusations of suppressing data.
Alan Lopez, who manages its substance-abuse pro­
gramme, says the decision to withhold the findings
on cannabis was because epidemio­
logical data on tire drug are less reli­
able than those for alcohol or tobac-

regional director. In the case of the passive smoking
study, Richard Peto, an epidemiologist at Oxford
University who advises the WHO, says that accusa­
tions of a cover-up are nonsense. The WHO tried to
get its findings published by the British Medical
Journal late last year, but they were rejected on the
grounds that the BMJ had just published a much big­
ger meta-analysis study on passive smoking, collating
almost 40 research papers on more than 4,000 cancer
patients.
This linger study came to the conclusion that there
was indeed an increased risk of lung cancer from pas1 sive smoking (25 per cent higher than for those living

instance, even the small ill-effects of
passive smoking found by the metaanalysis were the result of chronic
exposure at home or at work, not
casual whiffs in a pub. Although
passive smoking is unpleasant and
irritating for non-smokers, that
alone cannot justify banning it in
public places.
The danger, if the WHO appears to
be campaigning against passive
smoking primarily for political rea­
sons, is that it will weaken the mes­
sage about the real risks of smoking
(which causes six per cent of all
deaths and is the world's fastestgrowing killer after Aids). The
oiganisation ought rather to concen­
trate on where its research, rather
than politics, leads it
Unfortunately the structure of the
WHO makes this difficult. It exists
at the pleasure of its 191 member
states, which finance it but demon­
strate no real understanding of how
to run it. Its regional directors are
. appointed not by the organisations
director-general, but independently
by health ministries in each coun­
try. Because the member countries
pay the fees and appoint the direc­
tors. the WHO could find it difficult
to resist pressure to support their
political agenda. Critics claim that
the result is an organisation which is dispirited, con­
fused and lacking in vision.
The WHO needs once again to become a neutral
arbiter of health information, .ready to put its advice
into practice, as it did in its fight to eradicate small­
pox. There are hints of change. The new director-gen­
eral, Gro Harlem Brundtland, who will replace
Hiroshi Nakajima this summer, is considering alter­
ing the way regional directors are appointed to make
them more directly answerable to the organisation.
With the WHO turning 50 Jiu; year, it needs to over­
come its mid-life crisis. /
,
Z
— @ The Economist Newspaper. London. 199fl
:'

AMRITSAR. MARCH 18

Shiromani Gurdwara Parband: Committee (SGPC), at its onebudget session here today, pro­
hibited Sikhs from running any
tobacco-related business besides sowing its
crop and using it in any form.
SGPC president Gurcharan Singh
Tohra read out the resolution which was
approved unanimously. The SGPC has
made an appeal to all Gurdwara commit­
tees and Sikh organisations to get this deci­
sion implemented strictly.
The issue of imposing restrictions on

in response to queries put to die SGPC by
certain Sikh organisations abroad. In
many parts of India and in foreign coun­
tries a large number of Sikhs are believed to
be carrying on tobacco-related business.
The SGPC also endorsed the hukamiiaina issued by Sikh high priests, imposing
a ban on holding anand karaj (Sikh mar­
riages) in hotels and marriage palaces. The
committee also made an appeal to Sikhs to
obey theluikaninama in letter and spirit.
The SGPC unanimously passed bud­
get proposals for the year 1998-99. to­
talling Rs 8.49 crore—about Rs 1.23 crore
higher than that of previous vear.

Rs 8.17 crores for Dharam Parchar Com­
mittee. For the first time the SGPC has
earmarked a sum of Rs one crore for
maintenance and reconstruction of Gurdwara buildings in Pakistan. While speaking
on budget provisions, Tohra requested the
Pakistan Government to allow the SGPC
to undertake construction of Gurdwaras
there. He said that it would be in the inter­
est of economy of that country and added
that the SGPC was ready to make all pay­
ments in dollar currency.
The SGPC also made an appeal to all
Sikh organisations and Sikhs settled
abroad to donate liberally for setting up an

estimated cost of this project would be
about Rs 7 crore.
The SGPC also demanded a perma­
nent election commission to conduct the
SGPC elections every five years.
Through a resolution, the SGPC paid
tributes to late Sadhu Singhbhaura former
jathedar of Akai lakht, Aijan Singh Josh.
MIA, Ran Singh SGPC member. Aijan
Singh Bhatia and Bishan Singh Samundari
former Vice Chancellor of Guru Nanak
DevUniversity.
In all. 12 resolutions were adopted by
the House. More than 50 members were
absent todav. Bhai Raniit Singh, iathedar

of Akai lakht arrived late for the budget
session but two of his colleagues Bhai
Manjit Singh, jathedar of Takh t Kesgarh
Anandpur Sahib and Bhai Kewal Singh,
jathedar of Damdama Sahib, Talwandi
Sabo were absent.
The Sikh high priests had yesterday re­
turned their official vehicles to the SGPC
protesting against its action ofquestioning
their integrity in financial matters. Tohra
today morning met jathedar at the latter’s
residence to iron out the matter. Though
the outcome of the talks is not yet known.
Bhai Ranjit Singh today drove to the
venue of budget session in his private
vehicle.

’■•■■.re of mou

A)

Producers will launch campaign
to c urb tobacco use among kids
By A Staff Reporter
MUMBAI: Cigarette and chewing
tobacco manufacturers on Mon­
day agreed >to initiate a campaign
to prevent tobacco consumption
among children and the youth.
After being pressurised by the
Food and Drug Administration
(FDA) and renowned doctors to
take responsibility for the haz­
ardous health consequences of
their products, the tobacco indus­
try agreed tot formulate a plan for
such a campaign by January 1998. ■
; Tobacco industry representa­
tives agreed, to the proposal at a
meeting on Monday organised by
the FDA to plan more effective reg­
ulatory measures for the tobacco
industry.
■ The Tobacco Institute of India
(TH), which represents the ciga­
rette industry, said it was willing to
launch a drive with ‘paanwallahs’
asking them not to sell cigarettes
or ‘beedis’ to children below 18
years. “There may be several prac­
tical difficulties in implementing
this drive. But this is one area
where we can use our resources to
curb tobacco use amongst chil­
dren," said Til president Amit

Sarkar.
FDA commissioner Anil Lakhina
asked the industry to frame a plan
to compensate children who suf­
fer from severe health problems
due to tobacco consumption. He
also asked them to formulate a
campaign to prevent other chil­
dren from using tobacco.
However, most doctors and
health researchers present were
not satisfied with the agreement.
They demanded that the govern­
ment take certain firm measures
to control the industry and make it
more accountable.
They insisted on a ban on adver­
tising of tobacco products.
Prakash Gupta from the Tata Insti­
tute of Fundamental Research
(TIFR) pointed out, “Studies con­
firm that in countries which have
banned tobacco advertising, con­
sumption of tobacco products has
fallen.”
Seven
countries
including
Malaysia, Singapore, Norway and
Canada have banned any tobacco
advertising, while 12 EEC coun­
tries have banned chewing tobac­
co. Mr Lakhina said that it was
time India also framed stringent

laws to regulate the tobacco industry.
Mr Lakhina further called for
more stringent control on adver­
tisements and sterner statutory
warnings on packets. He added
that tobacco companies often
flout advertisement regulations.
“Tobacco and tobacco products
should be declared as drugs or
medical devices. The government
of India should enact laws for the
qualitative production and-ethical
distribution of such drugs. It
should otherwise amend the
Drugs and Cosmetics Act so that
the nicotine levels are regulated at
production levels,” he added.
Countering arguments by indus­
try representatives that the tobac­
co cannot be banned since it is an
important sector of the economy,
Dr Dastoor, director of the Tata
Memorial hospital, asserted, “The
cost of human life and suffering,
burden of health costs and the
loss of productivity suffered by to­
bacco addicts is a burden that the
industry will have to face up to."
Mr Lakhina estimated that 20
million Indian children under 18
years are addicted to tobacco.
_

$ 75

Psyched by terrorism, Kashmiris puff away
PRADEEPDUTTA p
SRINAGAR, NOV 5

i J"/

'

; 'TTT'ASHMIRIS, say doctors,

caused to cigarette smoking like

Ahmed. “Some of the chronic

tion, while I am still in the final year

examination days and become ad-

bronchitis. ulceis/emphysema,
heart-attacks and cancers.
A majority of the patients who

smokers come to us with an advanced stage of cancer,” says Dr
BashirAhmed.

ofgraduation.”Hewasreferringto
the recently introduced the tenplus-two-plus-three system of

diets.”
A more frightening manifestation of the disease in Kashmir is

Most patients who come for

smokers. A three-year-oid smbking is nowacommon sight in the
streets of Kashmir towns. Dr
Mehraj-ud-Din, who along with
his wife runs a de-addiction clinic
at Dalgate, says, “These cases are
an eye-opener for the society”.

jy~|^~iglhffi&aitiuuuus'psycho- 1 flocjkLu capital arefrouiPulwania,

JL jhdogical struggle with the
long prevailing conflict have made
smoking their way of life in a sub­
stantialway.
I
Data collected from various
hospitals_point_to_a_sLx-;fQldin­
crease in deaths due trithe diseases

Bandipore, Budgam and Kulgam.
“Patients with serious chest ail­
ments are shifted to Chest and Dis­
ease Hospital and some serious
cases are referred to Sher-e- Kash­
mir Institute of medical sciences,
Soura,” informed Dr Tanveer

''

' '

tup the fastest among the students
community. Suhail Ahmed, a second-year undergraduate student,
says he picked up the habit out of
frustration: “AH my friends who are
studying outside the State have
even completed their post-gradua-

---------------------help to
psychiatrists
are-------------in the age
group of 25~to'35~years. Says Dr
Avatar S'ingh, a psychiatrist in
Rainawari Hospital, ‘It is seen that
most of the students smoke to im­
prove their concentration during

*

................

2 J SEF 199?

■rain

Cancer patients to start anti-tobacco campaign in villages
mwf

*

“

°

...
___________________
______________
He was
also advised to„go
to Mumbai,, __
to the
Tata Memorial Hospital. That was six months
ago. On Friday, he had his last course of radiation
therapy, and tells his story through his nephew
and companion Anil Mintu Kumar.
Now Varma goes back to his village, six daugh­
ters, one son and wife and Iris profession as a karigar in silver jewellery, trying to restart life, and try­
ing to relearn how to talk, with a clectro-lamyx.
And then, trying come to terms with cancer, the
effects of his former addictions and trying to cre­
ate awareness in those around. He hadn’t known,
earlier, about the possible connection between
tobacco and cancer. Now he does.
For Satyaprasad Dwivedi, 43, just arrived in
Mumbai, the journey into cancer treatment is just
beginning. His right cheek is swollen, the pain has
spread to the side of his neck. He can hardly open
his mouth to speak,.he cannot eat solid food and
ready tears fall from his cheeks as he looks back at
his days as a panwallah in Siddhi, Madhya
Pradesh. On Monday, Dwivedi will start treat­
ment at the Tata Memorial Hospital — though
he’s still looking for the funds.
Like Varma, Dwivedi ran from doctor to doc­
tor, looking for a cure for the 25 paise coin-sized
sore in his mouth, which surfaced almost two
years ago.
There’s nothing wrong said most, have some
vitamin 13 injections said others, and visit a dentist
said yet another. The dentist sent him for a biop­
sy. And oral cancer was the diagnosis.
“But 1 always knew, had a fear within myself,
that this was cancer, no matter what people said,”
Say no to tobacco: Mutidrika Prasad Verma
Dwivedi weeps. “But how could 1 tell the doctors
with his electro-larynx
— they are much bigger than me.” How did he
know about cancer and tobacco? "Nowadays with
By RANJONA BANERJ1
TV, we’re told all kinds of things.”
Dwivedi cannot read or write one word of any lan­
MUNDR1KA Prasad Varma, 52, goes back to his vil­ guage, but he remembers every date on which every’
lage on Monday with his hands folded, begging his doctor gave him the wrong diagnosis, he remembers
friends and relatives to kick the tobacco habit. Of the date of his last meal —■ two rotis and dal — and the
course, Varma can’t actually do the talking himself, date when he started his pan shop. That was 1076,
because he has no larynx.
and he was an addict of his own goods.
Twenty years of smoking five bidis a day and eating
“Then I was told by a friend that I was selling poi­
tobacco non-stop led to throat cancer. Starting from son, that I have to stop. That like sowing seeds in a
doctors in his village in Sasaram, Bihar, Varma trav­ field, eating tobacco was sowing the seeds for cancer.
elled to Mhow, Patna, Varanasi and through allopa­ I shut the shop in 1991 and became a fruit vendor.”
thy, homoeopathy and ayurveda, looking for a cure,
But cancer struck anyway. “Now what will happen
when the first symptoms surfaced a year ago — he to my six daughters and one son?” he asks plaintively.
started losing his voice.
September 22 is Rose Day, and the Cancer Patients
From Varanasi, Varma found his way to Belur Aid Association, together with other voluntary agen­
where bi, problem was diagnosed as critner and he cies, will be working to increase cancer awareness and
was advised tu ;,t«.p
king and chewing ubacco alleviate the miseries of cancer patients, through work­
shops, entertainment programme; and o.h,-r schemes
immediately.
:

~~

~

Goa to ban cigarette sale to those under 21
India Abroad News Service
PANAJI

ne can vote at 18, but one cannot buy a
cigarette till 21. That is going to be the
position when a newly passed legislative
measure becomes law in Goa soon.
The country’s smallest state has taken
the lead in controlling the sale ofthe tobacco
leaf, brought into Asia via Portugal and
Spain after Columbus’ voyages to America.
But the move has left the tobacco industry,
which has strongly protested the law, finn­
ing.
Tobacco lobbyists warn that the law
would bring “devastating losses to busi­
ness” and would also adversely affect the
I tourist traffic to Goa, whose golden beaches
are a big draw.
•
Smoking will be banned in all public
| places, including restaurants and hotel
[ lounges. Vendors selling tobacco products

O

to those below 21 will have to pay a mini­
mum fine of Rs 1,000 and face a three-month
jail term for a second offence. Advertising of
tobacco products has also been banned.
Anti-tobacco lobbyists, who have long
been active here, have praised the govern­
ment “More grand children will be able to
enjoy the company of
their grand parents
----(with
anti-tobacco
measures). It will
add up to 15 to 18
years of life lost otherwise to tobacco '
/• JiqL,
users,”
Shared

said
Dr
G Vaidya,

v-

chairperson of die
Goa-based National

Organisation
for
Tobacco Eradication
(NOTE). “If we had
known the effects of

ft \
fgC

U A

tobacco long before it became universally
acceptable, no government would have ever
allowed it to be marketed or even cultivat­
ed,” said the septuagenarian campaigner
Vaidya. Surveys conducted by the Goa,
Cancer Society show that there were some
11,500 boys and 7,200 girls below the age of
15 Qn 1992) who were
regular smokers.
The
Tobacco
Institute of India
(TTID showed signs
of panic over what
;
could spark off a
trend among larger
Jj)..
states in India and
\C^3
even internationally.

V- to
-£>
I

>

Globally
research
indicates that the
tobacco-growing
regions are shifting to
the
developing

nations ever since the West and other devel­
oped areas have become more health con­
scious. Tni said the ban on tobacco adver­
tising would result in “harassment to
thousands of poor retailers and hawkers,
whose families depend solely on these
‘paan’ (betel leaf) and cigarette shops.”____
Pointing to possible loopholes, t ill
asked how the state government would
implement the ban on advertising when
newspapers and magazines from other
states come in to Goa regularly.
“This law is based on two misconcep­
tions that passive smoking is harmfid to
non-smokers, anp that there is a correlation
between the existence of advertising and
levels of consumption of tobacco products,"
TTn said here. Industry sources said that it
would be impossible to implement the law
which proscribes the sale, storage or distri­
bution of any tobacco products within a
radius of 100m from any place ofworship.

’ Ml

;iES OF WOM
JotABAS)

Tobacco Under Fire
'
picqq :t ■

The distribution of an anti-smoking pamphlet at ITC’s antiuhl general
meeting in Calcutta last week marks the debut of the ‘guerrilla share­
holder’ in India, a breed that makes strategic investments in various scrips .
not in order to make a killing but, arguably, to prevent it..The memoran- dum urged 1TC to get out of harmful and addictive products like cigarettes
— so far the company’s core competence — and concentrate instead on
its other lines of business like'edible oil and hospitality. And though Mr Y
C Deveshwar, the tobacco giant’s chief executive, tried to stub out the op-position by claiming that cigarettes are “a legal business”, he was missing
Jhe key ethical point that the shareholder sought to make. Whichever way
one looks at it, the evidence linking cigarette smoking to mortality is
[damning and incontrovertible. Last week, in fact, the CEO of Philip Mor­

ris admitted before a Florida court that at least 100,000 people a year die
[because of smoking. For years, the world’s tobacco giants disputed the

Jink and spent large amounts of money cultivating a clientele that found
the hyped-up mystique and allure of the cigarette as a lifestyle and fashion
(statement so irresistible. Niche marketing ensured the appeal of cigarettes
(for different sections of the market such as women and the young. Today,
the markets with the highest ‘growth’ potential are all in the developing
[world.
In Beijing last week, the WHO’s director-general, Mr Hiroshi Nakaitna, called on Western governments to prevent their cigarette companies
font entering or expanding their operations in developing countries. He
said that if current trends continue, the annual death toll from smoking
would rise from 3.5 million to 10 million by 2025, exceeding AIDS, TB,
car accidents, homicides and suicides put together. This push overseas
has, to a certain extent, been fuelled by Western governments themselves,
which have imposed strict restrictions on cigarette companies operating in
their domestic markets while giving them a free hand to do as they please
abroad. The landmark US settlement in which the tobacco giants agreed to
[pay $368.5 billion over a 20-year period as full and final settlement of all

'

f

legal claims made against them now or in the future was widely wel­
comed by the tobacco industry precisely because the deal imposes no ob­
ligations on overseas sales. Besides, many tobacco companies had already
restructured themselves to lessen their dependence on cigarettes in antici­
pation of legal problems. Perhaps it is time for ITC to do the same. To­

bacco is a sunset industry and Indian companies should not imagine that
[the relative laxity of regulations here will continue indefinitely. Some
jcosmetic anti-smoking attempts have been made by the Delhi government
and others but when serious measures are eventually taken — like restrict­
ing or banning advertising and sponsorship or making cigarette manufac­
turers liable for the damage to the health of active and passive smokers —
Shareholders will hold the directors of their companies responsible for
jhaving ignored the writing on the wall.
—

zvu

you? poroonu

Don’t light Mgs if
SANDESH PRABHUDESA1 In PANJIM
OA is set to enact the
most comprehensive
anti-smoking
legislation in India.
The Goa Prohibition of
Smoking and Spitting Bill, which
was unanimously passed in the
recent monsoon session of the
state assembly, not only
prohibits smoking and spitting
in public places but also bans
the sale of cigarettes to minors
and the sale, distribution, and
storage of cigarettes in the
vicinity of a school or place of
worship.
As a result, the state’s famous
festivities like the Carnival,
Christmas, and night dances
are likely to become tobaccofree, while sponsors will suffer

as any form of tobacco
advertising has also been
banned.
Predictably, the move has been
strongly opposed by the Tobacco
Institute of India.
While not displaying “No
smoking zone" boards in. public
places will be a cognizable
offence, stringent fines will also
be levied for advertising or
attempting to promote smoking
or chewing tobacco, including
gul, tobacco paste, pan masala.
zarda, or gutka.
Going a step ahead of the
anti-smoking law in Delhi, Goa
has also banned tobacco
promotion in the form of writing
instruments, stickers, symbols,
logos, trademarks, T-shirts,
shoes, sportswear, caps, carry
bags, and the like.

Places of public use as defined
in the bill comprise auditoria,
cinema halls, conference or
seminar halls, hospitals, health
institutions, amusement centres.
restaurants, eating houses, hotel
lounges, other waiting lounges.
public offices, court buildings,
educational institutions,
libraries, bus stands, ferry boats
or other public transport, places
of worship, sports stadia and
even beaches.
“This is bound to affect the
tourist traffic, while hotels and
restaurants will lose business,
resulting in lay-offs and making
hundreds of people jobless,"
complained A C Sarkar, TH
director, in a protest letter to
the state government. Markets
in almost all Goan villages are
located near places of worship

are
and educational institutions.
The law empowers even
recognized non-governmental
organizations to file complaints
before the courts for violation
of its provisions. Dr Sharad
Vaidya. who pioneered the bill,
suspects the tobacco lobby of
getting the clause pertaining to
the ban on advertising removed
from the original bill. It was
included later.
Dr Vaidya, who dismisses the
Til's claim that advertising does
not increase the incidence of
smoking or chewing tobacco as
baloney, is happy that the new
law will impose a complete ban
on all the sponsorships the
tobacco companies were
involved in, including the
Carnival floats,
"It will affect the retailers

@®a

far more than the dealers, as
tobacco companies may find
other innovative forms of
promotion," feels Datta D Naik,
a local dealer of the Golden
Tobacco Company Ltd. But he
admits that sponsorships for
cultural or sports events and
distribution of sportswear will
now stop.
Dr Vaidya admits that bars,
taverns, and paan-cigarette
shops in the tourist belts may
be forced to pay more hafta by
the "authorized officers" in
return for lax implementation
of the law, “but that doesn't
mean the act is useless”.
What propelled the bill was
the fact that smoking and
chewing of gutka has spread
even among schoolchildren in
the tiny state on the west

coast. A recent survey revealed
that half the’ income of any
small shopkeeper accrues from
the sale of cigarettes and gutka.
But the Til's Sarkar argues,
“Rather than make an
impractical legislation which
violates principles of freedom
of commercial expression and
denies the right to smoke, we
will develop a programme to
discourage smoking and
chewing tobacco”.
The government, however, is
yet to react to the Til's
suggestions for self-regulation.
And there seems to be little
chance of that happening now,
with the bill already before the
governor for final assent, and
the law having been widely
welcomed by legislators and
the people as well.

TIMES CF INDIA

(roMUAYj

THE TIMES OF INDIA, MUMBAI

Passive smoker
in Kerala wins
case against bus
owner, conductor \
IDUKKI (Kerala): Holding tlint
cigarette smoking is injurious not
only to the health of a smoker,
but also could cause greater
harm to a passive smoker, a con­
sumer court here recently or­
dered a bus owner and conductor
to pay a compensation of Rs
2,000 to a passenger for failing to
prevent his co-passcngcrs from
smoking inside a bus. Giving his
ruling on a complaint filed by Silbi Mathew of Vellthooval panchayat in Idukki district, con­
sumer forum president K A Ab­
dul Salam said under the Provi­
sions of Motor Vehicles Act, the
conductor had the responsibility
to ensure safe and comfortable
journey to all passengers.
This was part of the service re­
quired to be rendered by the bus
owner to the passenger who pays
for the journey. The passenger,
who has paid for the journey, was
a consumer. In this instance, de­
spite complaints from a section
of passengers, the conductor had
failed to prevent a few co-passengers from smoking inside the I
moving bus. The services were
deficient so as to attract the pro- I
visions of Consumer Protection ,
Act, he said.'j)
f(5i
■
The amount had to be paid by
them within a month failing
which, the forum said, a 12 per
cent interest would have to be
paid to the complainant.
According to the complainant,
he had boarded a private bus on
July 14 last from Ncllimattom to
Adimali. Following a blockade in
the normal route, the bus was di­
verted through a different route.
When the vehicle reached Ncriyamangalmn, several passengers
started smoking inside the bus.
Since it was raining and window
screens had been pulled down,
the smoke that gathered inside
started suffocating the passen­
gers. T he complainant said de­
spite his repeated requests, the
conductor did not prevent the
smokers. The complainant said
he had to cut short his journey by
bus
near
Ncriyninangaiam
forests and was forced to pro­
ceed home by another vehicle af­
ter waiting for over two hours in
the rainy night, e, | 31 9 9
Shaken by the experience, the
complainant moved the court
seeking compensation for his
mental agony mid also prayed
that the authorities be alerted
| against such practices.

T)'75
TIMES OF If-.EM

i

(comba'o

2 MAR 1995

Info about smoking on death certificate
will help anti-tobacco campaign^

WAS WI.X
DECEASED
A SMOKER?
Smlta Deshmukh
Convinced that only cold facts
will help it win the battle against
smoking, the Cancer Patients Aid
Association (CPAA), Is now
campaigning for death certificates
to state whether the deceased was
a smoker or chewed tobacco.
•' In fact, at a recently-concluded
International workshop in the city,
experts had suggested the
Inclusion of this fact in the death
certificate as It would provide
ammunition to NGOs such as the
CPAA to bring a ban on smoking,
widely considered as responsible
for several forms of cancer. It would
also be a valuable form of
documentation.
Dr Prakash .Gupta, senior
research scientist at the Tata
Institute of Fundamental Research
(TIFR), told the Bombay Times that
the exercise would be costeffective. Till now, we have been
depending on studios conducted in
the West for data. This is a robust
technique and will help us get
correct estimates of the disease."
As a first step towards
implementation, a pilot project is
being worked out and several
experts in the field have offered to
help. Suggestions have also been
put forth on how this information
can be gathered through the death
certilicato. A copy of ttio proposal

will be sent to the RegistrarGeneral of India and the Census
Commissioner for their approval.
“The method is being successfully
implemented in China and the
same can be done here,' points out
Dr Gupta.
At present, the CPAA screens
at least 1,000 people in a year and
comes up with the tobacco
consumption trend. "Inclusion of
smoking habits in the death
certificate will be a stepping stone
to developing a huge data bank on
cancer in India. Dealing with such
a massive disease, we must realise
the importance of documentation to
understand
Its
magnitude."
explains Viji Venkatesh. director,
diagnostic services. CPAA.
Both Gupta and Venkatesh do
not lorosee any objections from the.
families of the deceased on the
issue. "It is a routine matter. But by
this, we will have access to the
lilostytns and smoking hnblls ol
people."
Y K Sapru, founder president of
the CPAA, said that once this
information is made available on
death certificates, they will be able
to identify larget groups and direct
their awareness campaigns at
them. "Such programmes require
funds and this way they can be used
in the most effective manner," he
. added.

II 4 F’-n J979

Ad council’s tobacco
code up in smoke
PRASHANT DHAVAN
ITH the Advertising
Standards Council of
India (ASCI) with­
drawing its almostfinalised code with relation to
the advertising of cigarettes and
tobacco-related products, manu­
facturers of such products are
virtually free to advertise any
way they want, fear consumer
activists.
The ASCI says it withdrew
its proposal because it did not
want to force it upon the tobacco
industry against the manufac­
turers' wishes.
Consumer activist N G Wagle
says, "It is strange that what­
ever regulations were in place
on tobacco advertising have also
been removed (with the with­
drawal of the ASCI proposal).
And no one is protesting. The
tobacco companies are virtually
free to advertise the way they

W

Arter refusing to follow the
ASCI code, cigarette and other
tobacco-product manufacturers
are readying to appoint a watch­
dog committee to ensure the
observance of “their own
code”.
Ram Poddar, chairman of the
Tobacco Institute of India (TH)
and managing director of God­
frey Phillips, says, “Our new
code covers every aspect of
tobacco advertising, including
direct marketing and sampling.

It will be applicable to all
tobacco companies operating in
India, whether they are mem­
bers or non-members of TH. A
committee comprising people
from legal, social and commer­
cial fields will soon be appoint­
ed.”
He adds: “Since ^ve have
now revised and enlarged our
own code, the ASCI witlidrew
its code. It was always intended
to be done like this.”
However, quite interesting is
the fact that several clauses in
the TH code seem as if they

were directly lifted from the
Advertising Standards Council
of India's (ASCI) document.
Activists find the tobacco in­
dustry's refusal to follow the
ASCI standards inexplicable.
They are worried by too few
advertising restblctlons on an
industry that multinationals are
swarming to enter.
An ASCI official says: "The
ASCI code, though at the dis­
cussion level, was never follow­
ed. Contrary to its provisions,
a film-star modelled in a cam­
paign with slogans like 'Red

and White smokers are one of
a kind’. Companies indulge in
surrogate advertising (that is,
advertising non-tobacco prod­
ucts that bear the same name
as tobacco products). Indian
cricketers continue to wear the
Wills logo, and Four Square
cricket gear is advertised during
cricket broadcasts. This shows
that they are not bothered about
the code.”
Wagle says, "The ASCI
works in tandem with the media.
to maintain pressure on the
tobacco industry. If the Industry
was really sincere in its inten­
tions, it would have suggested
modifying the ASCI code and
would have followed it. Forming
its own code is fine, but can it
ensure implementation? Will an
offender punish himself?"
Poddar asserts that the Til
ombudsman would ensure the
strict Implementation of the TH
code. The Til is a representative
body of tobacco farmers,
exporters and cigarette manu­
facturers.
With regard to the withdrawal
of the ASCI document, Wagle
says, “The ASCI has set a bad
precedent. Though following it
was voluntary, the code should
have remained. The AgCI can't
forsake its role as a watchdog
just because the industry wishes
so. No code will be effective
with such a submissive atti-t
tude."

IP
THE! CODE

Any human model shown holding a
cigarette, or smoking, or using a tobacco
product shall be over the age of 25 years.
No more than one third of persons shown
in a group shall be shown smoking.
Advertisemenls will not make hea til claims
about tobacco products or smoking or will not
stale that smoking is safe, healthy or, natural.

Advertisements shall not claim that smoking is
essential to success In sports or is necessary
for attainment of social or business success.
Promotional letters, leaflets, and catalogues
shall be sent only to persons of 18 years of age
and above, and will carry the words" only foi
tobacco users aged 18 years and above
prominently

THE ASCI CODE
Anyone shown holding a cigarette or smoking,
or using a tobacco product, shall be and
clearly seen to be, over the age of 25 years.

Cigarettes, cigars or bidis shall not be
shown In the mouth and other tobacco .
products should not be shown chewed or sniffed.

No more than one third of persons
shown in a group shall be shown with
clgarettes/bidis in hand.
Advertisements shall not claim directly
or indirectly (hat smoking is a sign or a proof
of manliness, courage or daring or a sign
of female emancipation.
Advertisements shall not feature heroes of
the young or imply any personal testimonial
for, or recommendation of a tobacco product by
any well-known person of distinction in
any walk of life.

Tobacco tastes ‘bitter’, so do the ads
The withdrawal of advertising code for tobacco products by the Advertising Standards Council of India
has sparked off an unsavoury controversy between the regulator and the tobacco industry. The industry
insists that it will benchmark the ads against a code developed by itself However, current ads do not
raiS
seem to substantiate industry’s claims. Rakshande Italia reports
20]

V

he Advertising Standards Council of India
(ASCI) has formally cancelled the advertising
code for the tobacco industry, following its inability
to get prominent tobacco companies to toe its iine.
Drafted after two years of hectic debate and dis­
cussions, the withdrawal of the code is now proving
to be an embarrassment to the advertising regula­
tor. The tobacco industry seems to have had its way
—the ASCI code is no more, even while the tobac­
co industry itself is speaking in different voices
about having its own self-regulatory code.
Godfrey Phillips managing director Ram Poddar
(makers of Four square and Red and White
cigarettes) says: "One of the reasons why ASCI'
repealed the code was that they did not feel the
need to keep two codes for the same industry. The
Tobacco Institute of India has formed its own code."
ASCI sources say this is not entirely true. They
argue that ASCI was willing to look into and modi­
fy some of the rules in its code, but was not willing
to compromise on the basic tenets of the code.
ASCI chairman Bharat Patel says: "‘We did not
want to enforce a code that the industry is unwilling
to accept as ASCI is all about voluntary self-regula­
tion. Nor are we willing to modify our code to make
it acceptable to the tobacco industry ."
For instance, one of the key features of the code
was that ads shall not include or imply any personal
testimonial or recommendation of a tobacco prod­

T

uct by any well-known personality. Nor could an ad
claim directly or indirectly, the recommendation of
any particular brand by any group or class of peo­
ple, which attracts public admiration or emulation.
Godfrey Phillips' ad used a celebrity endorsement
— film actor Akshay Kumar, and wanted ASCI to
delay giving effect to the code because of it. say
ASCI sources. The code was to be effective since
October, but Godfrey's Red and White premium
cigarettes are still being advertised in heavy doses.
The endorsement is loud, particularly at point of
purchase outlets (like Pan and Bidi shops). The
posters, for instance, show a snapshot of Akshay
Kumar, and just above it a line reads: "Red and
White smokers are one of a kind.” Mr Poddar refus­
es to be drawn into a conversation on this.
When asked if he thinks thar-this ad is appropri­
ate he says: "That's not the issue-lets not get into
that...that is a separate subject." Repeated messages
to his office and Godfrey Phillips' public relations
agency Clea PR drew a blank, making attempts to
discuss the violation futile.
Although Mr Poddar, who is also the president of
the Tobacco Institute, claims that a self-regulatory
code exists for the tobacco industry, neither his
office nor ITC are able to produce a copy of the
code. Even the Tobacco Institute could not furnish
the code to this paper. Incidentally. ITC's Amit
Sarkar is a key spokesperson for the Tobacco

Institute.
However, sources insist that the Tobacco
Institute's own code bans testimonial advertising.
One of the provisions on testimonial advertising
says: “Advertisements shall not include any direct
personal tests by written or spoken word especially
urging or recommending the use of a tobacco prod­
uct by any well-known person of distinction in any
walk of life in a manner which is particularly attrac­
tive to minors." The institute is silent about whether
it is taking any action in this case.
Another key difference between the ASCI and
the tobacco industry was in respect of surrogate
advertising. For example, the ad for Four Square
Cricket Gear, say industry sources, could be termed
as a surrogate ad as Four Square Cricket gear is not
made available in large quantities. The advertise­
ment. if one recalls, shows prominent cricketers laz­
ing in the backwaters of Kerala while looking at
Kerala's famous boat race. The cricketers on
impulse plan to take part in the race and finally end
up winning the race.
The practices of the tobacco industry also violates
a combination of regulations in ASCI's now-abort­
ed code. The code says: "Any advertisement for any
products or service or activity bearing the brand
name of the tobacco product shall be governed by
the code." So, for example, if a bat with the brand
name Wills (marketed by ITC) is advertised, ITC

cannot use a cricketer like Tendulkar to promote it.
since by doing so it would violate the ASCI code.
which does not allow testimonial advertising by
famous personalities to endorse a cigarette brand.
Tobacco industry sources argue that there were
several lacunae in ASCI's code and it should have
been modified. One of the clauses says: "Anyone
holding a cigarette or smoking or using a tobacco
product shall be and clearly seen to be over the age
of 25 years." Another clause contradicts this by say­
ing. "cigarettes, cigars of bidis shall not be shown in
the mouth and other tobacco products should not
be shown chewed or sniffed." These two clauses
were pointed out to ASCI, say sources.
Vice chairman of the ASCI code on tobacco adver­
tising Bharat Kapadia when asked on these says:
"There was difference of opinion in some of the issues
but in some provisions no consensus was reached.
However, we have tried to modify many of these but
we concluded that there is no point in forcing anyone
who does not want to follow the code."
ASCI insists that it is all about voluntary self-reg­
ulation. And while the tobacco industry has evolved
its own self-regulating code, what remains to be
seen is how far the industry will succeed in adhering
to its ow n code. Will it bend the code' to suit its
needs or. will it 'bend' its needs to suit the code?
Will ’practice what you preach' hold gcod for the
tobacco industry ?

rI^sofND“
the

.1 8 DEC W

Govt s inaction may
resu
ay
result
in nation
’s I
J
KWT . .
ryl C
health going’up mr smoke*
activists
The Times of India News Service
especially amongst the disadvan- of smoking policies employers need
MUMBA1: The Centre’s proposal taged, and pregnant women who to have.
The World Health Organisation
to permit direct foreign
eigr.investment
_________ __. smoke will be a prime focus of this
'by multinational
•
■ tobacco
■*-*
■
campaign.To protect children from (WHO), welcoming the British gov­
majors
hascomtrnrasTitrek ioTuTThtobacco the effects of tobacco advertising, a ernment’s pledge to work with
secondary legislation
will
be other governments towards a global
campaigners in India.
Prakash Gupta, senior research brought forward in the 1998-99 par­ bap on tobacco advertising, said it
scientist at the Tata Institute of liamentary session to end tobacco will initiate urgent discussions
Fundamental Research, Mumbai, advertising on billboards. There is towards joint implementation in
said the ministry of health and fam­ also a proposal to simultaneously areas where they have a role. Warn­
ily welfare must be urged to emu­ prevent such advertisements shift­ ing of the adverse impact aggressive
late the UK government, which ing to the print media. A legislation tobacco marketing is having on chil­
recently brought out a white paper, treating repeated sale of tobacco to dren and adolescents in developing
unveiling its plan for a 100 million underage children as a criminal countries, WHO has launched a ini-'
offence will also be considered.
dative to promote effective policies
pound war on tobacco.
The health department, in coor­ and interventions to reduce tobacco
'lite white paper, titled ‘Smoking
Kills’, published by the UK govern­ dination with local governments, consumption and thereby the bur­
ment’s department of health, is held associations of traders and others, den of disease.
Meanwhile, a group of 17 US
to be one of the most comprehen­ has initiated a new ‘enforcement
sive policy documents issued in protocol’ to crack down on tobacco Congressmen recently wrote to the
recent times, which calls for world­ sale to minors. In collaboration with International Monetary Fund warn­
wide action for a total ban on tobac­ the licensed hospitality trade, it has ing that the process of economic
co advertising and introduction of also set up a charter that supports restructuring in OevelodiHglcoiiri- .
global tobacco marketing stan­ consumers’ choice of eating, drink­ tries should not encourage policies i
dards. According to it, a major por­ ing and socialising in areas free of a ■that underminehealth considera- t
tions. .
tion of the will should go towards smoky atmosphere.
A national industry-led scheme
Specifically referring to the role
setting up of smoking cessation pro­
grammes, assisting seven out of ten will be introduced to badge restau­ of the tobacco industry in Asian
adult smokers who want to give up rants, pubs and bars with an agreed markets, the senators say that smok­
the habit. Counsellors attached to symbol denoting the type of smok­ ing rates in countries like Japan,Taiwan,South Korea and Ihatland wiladvice clinics will offer a week’s ing policy in operation inside.
The existing measures will be fur­ nessed a hike of ten per cent.higher
supply of nicotine replacement
therapy, free of charge, to smokers ther toughened on smoking in "than 2hey_woyld..ha.x.eJiecause of
workplace. The Health and Safety the aggressive marketing of private
least able to afford it.
Besides this, 50 million pounds Commission will be consulted on a tobacco corporations following
will fund the most sustained and new code to improve protection to “misguided US pressure” in forcing».
coordinated media publicity and all employees by defining the kind open the markets of those countrieZ |
marketing campaign ever undertak­
en — to stop children from taking
up smoking and reduce smoking
amongst adults. Youngsters and
adults who want to kick the habit,

.4T0ST-' BO This photo copy . c boinfc ourpJ?«u
co you for your porsonal reforenco and Ptudy

1 3 NOV W8

Pay heed to results of Chinese’study^Tibbacco

By Rupa China!
By Rupa China!
The Times of India News Service

MUMBAI: Indian research scien­
tists and anti-tobacco activists say
that India needs to pay heed to the
results of a major study conducted
in China, which finds that tobacco
is causing 12 per cent of deaths
amongst adult males in that coun-

The Chinese study, which was
released recently by the British
Medical Journal (BMJ), reveals
(that China now consumes one-

Based on a nationwide prospec­
tive study, the journal reports that
"The recent substantial increase in
cigarette consumption by Chinese
men will eventually cause a sub­
stantial increase in mortality. To
monitor the long-term evolution of
this epidemic, a large nationally
representative prospective study
will continue for some decades.
This report describes its early
(1992-’95) results, indicating that
tobacco already causes 12 per cent
of Chinese adult male deaths”.
j Outlining the medical implica­

tions, the study says that of the Chitions, the study says that of the Chi­
nese deaths now being caused by
tobacco, 45 per cent are from
chronic lung diseases, 15 per cent
from lung cancer and 5-8 per cent
from each of oesophagus cancer,
stomach cancer, liver cancer,
stroke, ischaemic heart disease and
tuberculosis.
Tobacco now causes 12 per cent
(and will probably eventually cause
about 33 per cent) of adult male
deaths, but only 3 per cent (and
perhaps eventually only about one
per cent) of adult female deaths in
China.'rhe hazards are similar for
both sexes, but the proportion of
young women who smoke has

It further says that two in three
males now become smokers before
age 25. Few give up, and about half
of those who persist will be killed
by tobacco in middle or old age. So,
on present smoking patterns about
100 million of the 300 million Chi­
nese males now aged 0-29 will
eventually be killed by tobacco.
Annual Chinese cigarette con­
sumption was 100 billion in the
early 1950s, 500 billion in 1980, and

has been about 1,800 billion in
has been about 1,800 billion in
recent years. Tobacco caused 0.6
million deaths in 1990.
The BMJ says, “In Britain and
America about half of all persistent
cigarette smokers are eventually
killed by tobacco, and about the
same overall risks will be seen in
China. Hence, on current smoking
patterns about 100 million of the
300 million Chinese males now
aged 0-29 will be killed by tobacco
in middle or old age, as will a few
million of the females. But
although the hazards are about as
great for female smokers as for
male smokers, the prevalence of
smoking in young women has
decreased substantially in recent
decades, which should limit the
female epidemic”.
According to Prakash Gupta,
senior research scientist at the Tata
Institute of Fundamental Research
in Mumbai, the Chinese evidence
has similar implications for India.
This careful, cohort study from
China now proves what had been
earlier been known through pro­
jected estimations. In India, it is
estimated that 630,000 deaths are

tobacaJrelatld* each year. W
tuuoww .vioivu vovi. year. While
more precise data is being worked .
upon, it will not be lower than what
has already been estimated, he
says.

India’s prevention efforts are
sporadic, and reaching only a small
section of the population, says Dr .
Gupta.The use of tobacco is mean- ■
while growing, through cigarette '■
and beedi smoking, and chewing
tobacco such as ghutka.Tlie official
response has not moved beyond a
1975 order that called for a weak
statutory warning on cigarette.
packets and advertising; and an
executive order banning smoking
in government offices, which in any
case is not implemented.

In China, the government has
instituted a ban on all tobacco
advertising in public places. Thai­
land has moved even more deci­
sively by preventing the promotion
of any product that has the same
name as a tobacco product.
Recently, it has forced a new statu­
tory warning on cigarette packets
which warns of impotency caused
by smoking.
____ '

ctt<-

ASCI CODE FOR ADVERTISING OF TOBACCO
PRODUCTS (effective October, 1998)
Some consumer bodies are totally opposed to promotion of tobacco products.
Isn’t it antisocial to market a poison? CGSI agrees, because tobacco products
are insidious killers, code or no code
he Advertising Standards
Council of India (ASCI) has

T

formulated a Code for the

Advertising of Tobacco

Products in India. The Code, which lays

down standards for self-regulation in the

advertising of tobacco products, is
supplementary to the ASCI Code for
Self-Regulation in Advertising and will
be implemented from October 1, 1998.

This is being done to give industry time
to adapt its communication to meet the
various provisions of the Code.

$

X

to the public, which in the normal course

The Code prohibits the use of

would be recognised as an advertisement
by the general public, is included in this
definition, even if it is carried free of

personal testimonial by any well-known
person of distinction in any walk of life

charge for any reason.

heroes of the young will also be allowed

for the use of tobacco products. No

Any written, graphic or visual

to feature in advertisements. Nor will

matter on packaging is subject to the

tobacco advertisements be allowed in

Code in the same manner as any

any publication, TV channel, TV

advertisement in any other medium. The

programme or any other medium that
is directly wholly or mainly to minors

Code covers the new electronic media,
including the Internet, E-mail, pagers
and CD-ROMs. The Code specifies that
no advertisement shall be targeted at

below 18. Surrogate advertising, using
the name of tobacco products for non­
tobacco products, is also banned under
the Code.

On the basis of comments and

underage consumers and that anyone

discussions with various interests, ASCI

shown holding a cigarette or smoking,

The ACS I was formed 12 years ago

has developed the Code to safeguard

or using a tobacco product should be

with the objective of promoting self­

public interest to ensure that
advertisements will not overtly

"clearly seen to be” over the age of 25.
No more than a third of lhe persons seen

regulation in advertising. Over the years,
it has played an increasingly important

encourage minors (those below 18) or
induce non-users to take up the use of

in a group shall be shown smoking,

role and its Code has, in the main, been

according to the Code.

accepted and adhered to by advertisers

tobacco products, suggest that their use

The

Code

specifies

that

leads to extraordinary success in various

advertisements shall not suggest that

areas of human endeavour, or resort to

smoking or consuming tobacco products
is safe, healthy or popular, or that it is

surrogate advertising for tobacco
products by circumventing the
provisions of law, rule, or the Code.
The Committee developed a draft

Code after studying similar Codes

abroad, which was later adopted by the
Council’s Board of Governors

necessary for concentration or
relaxation. Advertisements shall not also

claim, directly or indirectly, that use of

tobacco products is a sign or proof of
manliness,

female emancipation,

courage or daring. Nor will they be
titillating or imply a link between

for all products containing tobacco,

smoking and success in relations with
the opposite sex. The Code also prohibits

including cigarettes, cigars, bidis, hand-

advertising which claims that use of

The Code applies to advertisements

rolled and chewing tobacco, gutkha/

tobacco contributes significantly to the

zarda/kiwam/gudaku and snuff. The

attainment of social or business success

Code specifies that any communication

or in sports.

and advertising agencies.

-ASCI News Release

Although an ad may be
withdrawn due to peer
pressure, the retractation is not
equally publicised, nor any
apology expressed for breach of
the Code. More often than not,
the damage is done without a
word of regret.
The success of a self-regulation
Code, voluntary in nature,
depends on the commitment of
its constituent members to the
letter and spirit of the Code.
-Ed.

NBFC DEPOSITORS’ AND NEW REGULATORY FRAMEWORK
(Contd. from pg 18)
iii) An NBFC may grant a loan up
to 75% of the amount of public deposit

RBI's concern towards the
protection of depositors is felt by one and

former RBI. Deputy Governor, has
rightly observed, “An NBFC cannot

consider raising deposits as its divine

to the depositor, after 3 months from the

all but lhe strict enforcement of the

right. The sanctity of the depositors

date of deposit, at a rate of interest 2

Directions and penalising to the NBFCs

should be unquestioned and in essence

percent above lhe interest rate payable

contravening the Directions should be

this is what the RBI regulations are all

on the deposit.

on the top of its agenda. S. S. Tarapore,

about”.

May 1998

KEEMAT

19

DECCAN HERALD, MONDAY, MAY 17, 1999

Promotion of tobacco by cricketers

HC issues notice on
plea to ban ads
NEW DELHI. May 16 (PTI)
The Delhi High Court has issued
notices to the Centre, Information
and Broadcasting Ministry and
the
Director
General
of
Doordarshan (DD) asking them to
file replies to a petition seeking to
ban advertising of cigarette and
tobacco by Indian cricket players.
A division bench comprising
Justice Arun Kumar and Justice
Manmohan Sarin asked the re­
spondents to file replies while fix­
ing the next hearing on July
seven. The petition filed by
Voluntary Health Association of
India (VHAI) sought a direction to
the Board of Control for Cricket
in India (BCCI) to cancel its con­
tract with Indian Tobacco Com­
pany (ITC) and prohibit the
players from wearing the com­
pany’s logo.

However, the court, at this
stage, did not issue the notice to
BCCI, which is also named as a re-'
spondent in the petition. The peti­
tion said cricket, which today had
attained great popularity, had

turned into a ‘scourge’ of millions
of children and any advertisement
about cigarette and tobacco would
definitely have an ‘adverse’ effect
on them. The petitioner said
unfortunately the sports related
advertisements of cigarette were
rapidily growing and there was
every likelihood of children being
‘lured’ by the manufacturers’
onslought.

"The cigarette companies are
using sports sponsorship to
unleash a wave of surrogate
advertisements in the garb of sur­
rogate products which these com­
panies hardly sell. The companies
are actually promoting the sale of
cigarette,” the petitioner claimed.

Besides ITC. Godfrey Phillips
(makers of Four Square brand)
had also entered into individual
contracts with Indian cricket
players. Cigarette and tobacco
products have proved to be the
major cause of cancer and a num­
ber of developed countries have
taken various safeguards to pro­
tect children from its effect.

‘Quit tobacco’,
march on//=
May 30
By Our Staff Reporter
27. The Cancer
Patient’s Aid Association (CPAA)
will conduct "Quit Tobacco"
mqrch to mark the World No To­
bacco Day" on May 30.
bangalore, may

The objective of the Inarch is to
create an awareness among the
public of the hazards involved in
the use of tobacco and to spread
the message that tobacco leads to
cancer and other health prob­
lems.

The children of Bharath Scouts
and Guides will carry posters and
display them at the EKG Prestige
Centre.The scouts and guides will
also perform street plays on the
subject on M.G.Road and in Malleswaram.

Theater personality, MsArundhati Nag, Lyn Fernandes of Nritya
Grama and other personalities
will participate in the march,
which will commence at 10 a.m. —
The CPAA has stressed the need
to create awareness of the ill-effects of tobacco consumption,
and has pointed out that 10,000
people die of tobacco-related dis­
eases every day. Tobacco is the
cause for at least 25 life-threaten­
ing diseases and yet 1.1 billion
people throughout the world
smoke.

The CPAA has pointed out that
even if a small percentage of
smokers were to quit their habits,
the benefit to the economy would
be immense.

Lo

THE TIMES OF INDIA, BANGALORE

Why choke in rings of smoke
60% of cancers are lifestyle-linked: studies
Sriranjan Chaudhuri and
Anantha Krishnan M.

BANGALORE: It is called the
Onco Gene. If switched on, cancer
could be the end result. There are
many things that could do that.
Nicotine, an inherent component of
every tobacco-laden product, is
being touted as one of the prime
reasons, though. In that context
World Anti-Tobacco Day (May 31)
is a day to think about one’s choices.
And tobacco is not just about
cancer, ask a cardiologist and he'll
tell you that smoking is causing
havoc with hearts; a vascular sur­
geon says his patients are bearing
the brunt of heavy smoking, diabetologists aren’t sure what else
they need to do to convince diabet­
ics not to smoke and neurologists
say that a major cause for strokes is
continued smoking.
While society blacklists drug ad­
dicts and alcoholics and there are
any number of organisations provid­
ing support to those who intend to
quit, smokers find no such support.
Says Dr G Kilara, director of
medical services, Curie Institute of
Oncology, “Smoking is a matter of
choice and it is not a question of be­
longing to one lobby or the other.
The body soon reaches a state of
dependency and the craving is as
bad as tjiat for ganja or heroin.”
But the debate still rages the
world over ones rights. Western data
showed that after a 10- year period
in the 70s when the number of can­
cer cases among men were coming

Pie 'poison stick',as it is called by many,
dates back to the 16th century. The
Introduction of tobacco is traditionally
attributed to Sir Walter Raleigh but in fact it
was already being cultivated in England as
eariy as 1573 following experiments in
Portugal by French Ambassador to Lisbon
Jean Nicol It was Nicot who apparently sent
the first tobacco seeds to Queen of France
Catherine de Medici in the mid 16th century.
Nicot was said to have believed that tobacco
smoke had medicinal properties and he might
have derived this view from North American
Indians, who probably introduced it to
Portuguese traders. Many believe it was from
Jean Nicot the word Nicotine took birth.
According to historians, many North American
Indian tribes had used tobacco for centuries,
believing in its ‘healing properties'. The Turks,
during the Crimean War in the 1850s, taught
the British how to handle cigarettes.

TOl Graphic: FraxashBatv

down, those among women were on
the rise. Increased smoking by
women was a leading cause - The
situation that prevail here today.
Says
psycho-oncologist
Dr
Brindha Sitaram, “Parents tell their
children that smoking is bad but do
not go beyond that, the way they
would with drugs or alcohol. It is a
dependence that society accepts.”
“Also, the reasons attributed for
one to smoke are almost every­
thing under the sun. And since
stress management is one of its pur­
ported roles, there are increasing
numbers, including women, who
take to smoking for all the wrong

reasons,” she adds.
Dr Kilara suggests that, “Over 60
per cent of cancers in India are
lifestyle related, including smoking.
So with a little bit of care, many
lives can be saved. An attitudinal
change is needed for that.”
So the smoke rings continue to
hypnotise many more. An estimat­
ed 1 billion people smoked the
world over in the beginning of the
1990s. If current trends continue,
WHO estimates that the toll be­
cause of smoking will top the 10
million mark by 2030, meaning one
death every three seconds. But if
that is what one chooses.......

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.v.

One more campaign day has passed by with concerned researchers and doctors drumming up the
evils of smoking. Though the warning drum beats associated with anti-smoking day (May 31) may
wane, the danger still remains. New research shows.that apart from smoking leaving behind dead­
ly footprints of cancer, the habit also tinkers and tampers other organs, especially the stomach

Smoke On The Lips

FIRE IN H IE BELLY
By Dr. Rohini Kelkar
ven with new health risks
turning up every day, smok­
ing probably ranks as Public
Enemy No. 1. Even diehard
smokers admit its connection to many
grim afflictions from lung cancer and
heart disease to bad breath. Still, many
people are unaware that cigarettes can
also contribute to digestive problems.
New research reveals that smokers are
more likely to suffer heartbum, acidi­
ty, ulcers and even cancers of the food
pipe, stomach and pancreas. Can
cigarette-smoke damage organs, which
it does not even touch?
It can and it does. Cigarette smoke is
not just hot air. It’s a fairly vicious
fume, containing 4,000 chemicals,
including 200 known poisons. Once
these enter the system they cause
changes in body chemistry, with farreaching consequences.
First of all, smoking hits the head­
quarters of the digestive system - the
liver. The effects of-smoking on the
liver are rarely mentioned, ‘but
researchers find that smoking alters
the way the liver handles drugs
(including medicines) and alcohol. The
effect of these substances on a smoker
is worse because his liver is less effi­
cient at removing toxins. In medica­
tion, a smoker may need an altered
dosage. If a heavy drinker also smokes,
he is inviting greater damage from the
same amount of alcohol.
Smoking seems to change the way in
which normal food is processed by the
body. The body of a smoker absorbs
less nutrition and uses food less effi­
ciently. So while the average smoker
may weigh less than his non-smoking
equal, his fitness is worse and nutri­
tional deficiencies are more. Just to

E

stay on a par, smokers need to con­
sumer greater amounts of vitamins.
The biggest digestive discomfort for
smokers is acidity and heartbum, that
burning feeling in the chest after a
meal. This is often wrongly linked to
spicy food.
The burning sensation actually
comes from strong stomach acids
which have flowed backward from the
stomach into the food pipe. Normally
the valve at the end of the food pipe
prevents this back flow. But smoking

(among other factors) loosens
valve. So when the smoker lies down,
bends over, wears a tight belt or has a
big meal, stomach acids wash upward
into the food pipe. Moreover, smoking
increases acid production in the stom­
ach. As if that is not enough, it invites
backward movement of bile salts and
enzymes fi-om the intestine.
The result? The smoker’s upper
digestive tract is awash in strong
acidic material. Cigarette smoke
seems to directly injure the lining of
the food pipe as well, so it is more sen­
sitive to the acid.
Researchers also know that ulcers
(whose exact cause is unknown) are
more likely to occur and are slower to
heal, in a smoker. Experts have been
investigating the connection. It has
been found that not only does smoking
raise acid secretion, the production of
acid-neutralisers like sodium bicar­
bonate is temporarily reduced after
smoking.
There are also indications that smok­
ing speeds up the emptying of acidic
material from the stomach into the
intestine. The aggravated acidity could
explain the ulcer-proneness of smok­
ers. Any existing weakness of the stom­
ach or intestine simply becomes worse
or chronic with smoking, say experts.
If cancers of the digestive organs are
also more common in smokers, there
are plenty of explanations.
It could be due to the 30 cancer-caus­
ing chemicals in tobacco smoke or due
to the effect- of enzymes and metabo­
lites that the nicotine produces in the
body. Then again, it could be the hand­
iwork of free radicals released by the
smoke. Take your pick!
Fortunately, a smoker is not perma­
nently condemned to indigestion.
There are indications that tobacco-.
damage to the digestive system can be
reversed if the smoker kicks the habit
He may not be able to actually see his
cancer risk going down, but he will
enjoy some relief from acidity and
heartbum.
(The author is a member of
Healthy Home Advisory Services
(HHAS) and is also Head,
Department of Microbiology,
Tata Memorial Hospital).

INSIDE

Gls

2

Stealth fighters

are designed to strike &
destory targets with _
a far greater impact z

Fly Ash can be made
commercially viable
it recycled properly
O

The detence satellite
Chandra's closest point
from the Earth will
«
be 10,000 km

One more campaign day has passed by with concerned researchers and doctors drumming up the
evils of smoking. Though the warning drum beats associated with anti-smoking day (May 31) may
wane, the danger still remains. New research shows.that apart from smoking leaving behind dead­
ly footprints of cancer, the habit also tinkers and tampers other organs, especially the stomach

Smoke On The Lips

FIRE IN THE BELLY
By Dr. Rohini Kelkar
ven with new health risks
turning up every day, smok­
ing probably ranks as Public
Enemy No. 1. Even diehard
smokers admit its connection to many
grim afflictions from lung cancer and
heart disease to bad breath. Stiff, many
people are unaware that cigarettes can
also contribute to digestive problems.
New research reveals that smokers are
more likely to suffer heartbum, acidi­
ty, ulcers and even cancers of the food
pipe, stomach and pancreas. Can
cigarette-smoke damage organs, which
it does not even touch?
It can and it does. Cigarette smoke is
not just hot air. It’s a fairly vicious
fume, containing 4,000 chemicals,
including 200 known poisons. Once
these enter the system they cause
changes in body chemistry, with farreaching consequences.
First of all, smoking hits the head­
quarters of the digestive system - the
liver. The effects of-smoking on the
liver are rarely mentioned, but
researchers find that smoking alters
the way the liver handles drugs
(including medicines) and alcohol. The
effect of these substances on a smoker
is worse because his liver is less effi­
cient at removing toxins. In medica­
tion, a smoker may need an altered
dosage. If a heavy drinker also smokes,
he is inviting greater damage from the
same amount of alcohol.
Smoking seems to change the way in
which normal food is processed by the
body. The body of a smoker absorbs
less nutrition and uses food less effi­
ciently. So while the average smoker
may weigh less than his non-smoking
equal, his fitness is worse and nutri­
tional deficiencies are more. Just to

E

stay on a par, smokers need to con­
sumer greater amounts of vitamins.
The biggest digestive discomfort for
smokers is acidity and heartburn, that
burning feeling in the chest after a
meal. This is often wrongly linked to
spicy food.
The burning sensation actually
comes from strong stomach acids I
which have flowed backward from the j
stomach into the food pipe. Normally f,
the valve at the end of the food pipe 11
prevents this back flow. But smoking 11

(among other factors) loosens this

(fl

valve. So when the smoker lies down,
bends over, wears a tight belt or has a
big meal, stomach acids wash upward
into the food pipe. Moreover, smoking
increases acid production in the stomach. As if that is not enough, it invites
backward movement of bile salts and

11
II
II
II
II

I
I

enzymes from the intestine.
The result? The smoker’s upper
digestive tract is awash in strong
acidic material. Cigarette smoke
seems to directly injure the lining of
the food pipe as well, so it is more sensitive to the acid.

I
II
II
II
II
II

Researchers also know that ulcers
(whose exact cause is unknown) are
more likely to occur and are slower to
heal, in a smoker. Experts have been
investigating the connection. It has
been found that not only does smoking
raise acid secretion, the production of
acid-neutralisers like soditun bicarbonate is temporarily reduced after
smoking.
There are also indications that smoking speeds up the emptying of acidic
material from the stomach into the
intestine. The aggravated acidity could
explain the ulcer-proneness of smokers. Any existing weakness of the stomach or intestine simply becomes worse
or chronic with smoking, say experts.
If cancers of the digestive organs are
also more common in smokers, there
are plenty of explanations.
It could be due to the 30 cancer-causing chemicals in tobacco smoke or due
to the effect of enzymes and metabolites that the nicotine produces in the
body. Then again, it could be the handiwork of free radicals released by the
smoke. Take your pick!
Fortunately, a smoker is not penna-

II
II
II
II
II
II
II
II
II

nently condemned to indigestion.
There are indications that tobaccodamage to the digestive system can be
reversed if the smoker kicks the habit
He may not be able to actually see his
cancer risk going down, but he will
enjoy some relief from acidity and
heartbum.

Il
H
I

(The author is a member of
Healthy Home Advisory Services
(HHAS) and is also Head,
Department of Microbiology,

I

I

I
I
I
II
I
I
I
I
I
I
I
I
II
II
U
H
j
|

I
I
I
I
I

'

Tata Memorial Hospital).^

„ I.V

£.

IT F

THE SUNDAYTIMES

The leader hears
the reader

R

T F

7 F

at again for
]ary battle

This week’s ques|

H.S, BALRAM

Should smokii

nnhlif ho
the contest will be multi-cornered litis time is
puuuv ui uuiu„AX Bul who lhe main contenders are> no one
Cail lIlP hail \ov/s‘ Finding 'he right candidate has become a
ugh job. The Congress in particular is facing a peIiar problem.
•'
None of the sitting ministers or legislators want to
Smoking in public placesit and contest. And some, who are interested, are
banned. It can be enforcet in the good books of lhe party. In fact, the Conaction is taken to stop thiss is without a leader of stature in Bellary except
cigarettes inside cinema 1 M.Y.Ghorpade, Rural Development and Panfices, etc. I also feel that sdyat Raj Minister in Krishna’s cabinet. K.C.Konvate premises can be man, who had held the seat before the 1999 elec­
smoking zones. Anybodyts, made way for Sonia and was promptly reward­
smoking in a public place vith an entry ticket to the Rajya Sabha.TTie party
severely fined.
(now left the choice of a candidate to the party
Prema Menon, Mico Layout command.
Bangalore
fie BJP is going it alone this tune. But it is yet to
Yes, indeed. Smoking is a hade on a candidate. The JD(U) is zeroing in on
non-smokers too as hafandidature of M.P. Prakash. Its request to non­
proved. It can be enfor<gress parties to support its candidate has fallen
bringing in strict legislation. j£af ears. The Bahujan Samaj Party is fielding
Sanju Prasannan, KoramJ^ohd Khan.
Bangalore
it paper, the chances of the Congress retaining
Ban smoking and spitting inPat !ooks bright-whal with lhe opposition votes
too. The ban on smoking ir<ed among half-a-dozcn candidates. In the last
and trains has worked. So!°ns’ ““P1 *°£,the JD(S) which had fielded a
general public too take offeldate- ali anti-Congress votes went to Sushma
smoking in public, we can riPJ ^Jbe BJP.
selves of this hazard
6 JD(U) is keen that the BJP support its candiNagamani P, Ulsoor, Bangui^ Be'JaO' seat in fact, had earlier been eared for JD(U) before Soma decided to contest
A ban is most welcome.. R. and everyone lhought thal Sushma would be
medical studies confirm thateaj candidate

enforced?

(v that neither Sonia nor Sushma is in the fray,
gg
. JP should hand over the seat back to the
argue its leaders. But the BJP, which cannot
should be to lhe defeal jt suffered because of its alliance
banned. At lle jd(U), is not relenting.
so.mpubIic.'eleCiiOn is thus as crucial to the Congress as to
^position. Though s|,orn oj t|le colour and
such vice wni wimessed during the September elections,
,S "I0re, aangitest is certain to generate heat and dust.
erousthan w*allLSingh@timesgroup.com or Balramhs@init appears to
Smoking in p
ic places is a crime, because it n;
only ruins the smokers’ health, I
•
•
g 'g
gg
also that of the inhalers. Chand Qf Pf* 1T1
I I
VAT
jOfpassive smoking are more in
111 UVyllCll y
public place. I am very emphatic
*

is BJP candidate
You can’t enforce it by leaving iirff Mo­
the conscience of the smokers. It
can be enforced through
sources,
legislation, my idea of penalty is
: Hegde
imposing a spot fine of not less
than Rs 1.000. JJ
“
T.N. Seetharam, Director of the tel asking
serial ‘Mayamriga’
> to file
• till the

junath on Saturday, decided to field
Thippeswamy who is from Chitradurga district.
He was a minister in the previous
government.
The board meeting was attended
by former prime minister H.D.
Deve Gowda besides other party
leaders C. Naravanaswamv, K.H.

FOR GREENER KARNATAKA: Principal Chic
islcr T.B. Jayachandra, Forest Minister K.H. Ranga
C. Lingaraj Urs at a seminar bn the theme 'Prosp
Karnataka' in Bangalore on Saturday

Melee depriv
The Times of India News Service

participants v
narrow route
MYSORE: She won the first prize
participants [
in a non-descript competition, only
each other be
to lose the chance to compete at
the race and
the national level.
each tried ti
That is what happened to
other. Severa,
Yashika, a ninth standard student
in the melee.
of CKC Convent here. The event
The studer
was a mini-marathon run conduct­
ed by lhe students’ forum of SDM funds for sor
Institute of Management here on Parents of th
SDMIM
stu<
January 26. And she is not about to
forget what winning there has lected Rs 10
meant — a week after the race, the About 700 of
“The orga
wounds she suffered at the thor­
oughly unorganised run are yet to to conduct tt
heal. And on Sunday, as many ciplined- ms
other athletes compete at the state­ ■ more inter
level cross-country race at Bel- money,’’ Ra;
gaum and try to get into Karnata­ one of the
ka's team for the national level When the po
events, Yashika will have to brood the entire ra
over her had luck.
ganisers sim .

explosive-36) was a high-grade ex-

up to 164 hours.

Teenagers, the butt of tobacco cos now
Kaipana Jain

\\

NEW DELHI: Cigarette manufacturers are tar­
geting children as young as 12 years of age to en­
sure an ever-increasing pool of nicotine-addictive
adults, says the World Health Organisation, as it
launches a global campaign to beat this strategy.
And as the campaign against tobacco gets un­
derway, more and more disturbing practices re­
sorted to by tobacco companies are being re­
vealed. For instance, a recent meeting in New
Delhi discussed how teenagers were being
picked up as the most attractive customers with
well-defined strategies to appeal to them.
“The teenage years are the most important
because that is the time when one begins smok­
ing, the years in which initial brand selections
are made and the period in the life cycle in
which conformity to peer group norms is great­
est,"’ said officials of a tobacco industry during a
meeting to discuss promotion of their sales.
At the same time, companies were using spe­
cial techniques to enhance the effect of nicotine,
the addictive substance in cigarettes. This,
among other details, was shared by WHO con­

sultant Ross Hammond with experts who at­
tended the meeting in Delhi.
It was revealed that one tobacco industry had
launched a special project to “learn everything
there was to learn about how smoking begins,
how high school students feel about being
smokers and how they foresee their use of to­
bacco in the future”.
And one industry, on the basis of its surveys
said. “The adolescent seeks to display his new
urge for independence with a symbol and ciga­
rettes are such a symbol since they are associat­
ed with adulthood, and at the same time, adults
seek to deny them to the young.”
Such aggressive campaigns to target the youth
become necessary for the industry’s survival as it
has to fill the gap being created by the death of
11,000 people every day globally due to smok­
ing-related causes, says WHO.
WHO has also voiced concern over the in­
creasing hold the industry is getting in develop­
ing countries. India, it says, may be heading for a
tobacco epidemic. One-fifth of the 28 lakh peo­
ple who die every year the world over due to to­

<•

i TO/

bacco-related diseases are Indians. Nearly 50
per cent of the male population in India over the
age of 15 are smokers, it says.
According to WHO, in the next two to three
decades, seven million people will die of tobac­
co-related illnesses in the developing countries.
The tobacco pandemic is described as “one of
the major public health disasters of the 20th cen­
tury”. There are about 4,000 chemical sub­
stances in tobacco smoke, of which 438 can pro­
duce cancer, the most dangerous being nicotine,
tobacco tar and carbon monoxide.
Nicotine is an alkaloid that affects the central
nervous system and is probably the cause of the
smoker’s dependence on the habit. When a ciga­
rette is lit, the nicotine is transferred from the
burning tobacco to the smoke, where it mixes
with minute droplets of tar. As the smoke is in­
haled, the nicotine is absorbed easily into the
bloodstream.
Regular use of nicotine increases the pulse
rate, constricts blood vessels, increases blood
pressure and affects the normal functioning of
the heart.

No-smoking march in city today
Staff Reporter^

,

T-T-. i. 2ooo.

BANGALORE: The Manipal Heart Foundation will
organise an anti-smoking campaign on Saturday dur­
ing which vice-chairman .and the moving force behind
this mission, Dr Devi Shetty will submit a petition to
Health Minister Malaka Reddy.
The petition seeks passage of a legislation to make
Karnataka a no-smoking state and also that there should
be no outlets selling cigarettes within a certain kilometre
radius of educational institutions and children below the
age of 18 should not be allowed to buy cigarettes.
In this connection, Dr Devi Shetty will lead a walk
from Queen Victoria Statue to the Vidhana Soudha
at 8.30 am. It will be flagged off by Justice Michael

Saldanha. Union Minister for Sports, Youth and Cul­
ture Ananth Kumar is scheduled to participate in the
walk.
Participating educational institutions include Bishop
Cotton Boys’ High School, Bishop Cotton Girls’ High
School, Cathedra! High School, Sophia High School,
Goodwill Girls High School, St Johns’ School, Francis
Xavier Girls High School, National Public School, St
Joseph’s Boys High School, Jyothi Nivas College, St
Joseph’s College,-Bishop Cotton Women’s Christian
College and Mount Carmel College.
Event supporters include Lion’s Club, Rotary Club,
Texas Instruments. Britannia, Indo Nissin (Top
Ramen), BPL.TVS Suzuki and Getit Yellow Pages.

January 6, 2000

THE TIMES OF INDIA

Tobacco consumption worries WIIO planners
Tha Times of India News Service
NEW DELHI: The health costs of
tobacco-related diseases are far
greater than the income generated
from tobacco as a cash crop, says a
new study by the Indian Council of
Medical Research (ICMR).
The average cost of one case of to­
bacco-related cancer is Rs 3.5 lakh.
Last year alone, 1.63 lakh people de­
veloped cancer due to tobacco use,
says the study conducted by
ICMR’s deputy director general,
Kishorc Choudhary. The study was
conducted at two centres, Delhi and
Chandigarh.
As it is, says the World Health Or­

ganisation (WHO), India may be
heading for a tobacco epidemic.
One-fifth of the 2.8 million people
who die each year the world over
from tobacco-related diseases are
Indians. Nearly 50 per cent of Indian
males over the age of 15 are smok­
ers, it says.

Therefore, to check the increasing
cigarette consumption in develop­
ing countries, WHO is using interna­
tional law for the first time to reduce
damage to health caused by tobacco
products An international treaty is
being drawn up for tobacco control.

To discuss these issues, a threeday international conference is be­

ing organised in Delhi from Friday.
Tile conference is being sponsored
by the Indian government and
WHO.

WHO says in the next two to
three decades seven million people
will die of tobacco-related illnesses
in the developing countries The to­
bacco pandemic is dcscrilx'd as "one
of the major public health disasters
of the 20th century".

However, policy-makers realise
that reducing tobacco consumption
will not be easy. Union health secre­
tary J A Chowdhury says curbing
the consumption of tobacco-based
products is a complex issue as tobac­

co cultivation is very remunerative.
Therefore, strategies will need to be
worked out for providing alterna­
tives to farmers The conference
here will examine issues from the
perspective of a developing country.
What is little known to people is
that there arc about 4,1X10 chemical
substances in tobacco smoke, of
which 438 can produce cancer, the
most dangerous being nicotine, to­
bacco tar and carbon monoxide.
Nicotine is an alkaloid that affects
the central nervops system and is
probably the cause of smokers' de­
pendence oil the habit.

Details at www.tlmesoflndla.cotn

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DECCAN CHRONICLE, HYDERABAD

AVGUST 9. 1999

Smoking ban hits Kerala economy
Kochi, Aug. 8: The economic
impact of the recent ban on
smoking in public places as per a
Kerala High Court order is stat­
ed to be severe even as protests
have started mounting from
those surviving on the industry
despite a general welcome from
the public at large for the ban.
According
to
economic
experts, since smoking had been
virtually banned everywhere
except in one’s private confines,
the sale of cigarettes and beedies
has already come down by 30 to
50 per cent with a cascading
impact on the State’s revenue
and livelihood of thousands.
Its adverse impact on the
State’s revenue by way of excise

duties paid by beedi coopera­
tives and cigarette companies
besides its impact on the corpo­
rate tax collected, octroi, luxury
tax and other levies would be to
the tune of several crores,
experts point out quoting statis­
tics.
Tobacco industry in Kerala
alone had an annual turnover of
almost Rs 1.200 crore and the
industry ’employs about one million people. Over 2.5 lakh retail­
ers "in the State sell tobacco
products and their collective
jncome was estimated to be in
the range of Rs 60. erpre^
Tobacco was first brought to
India by Portuguese merchants
in the early- 16th century who

introduced the same in the
Mughal court.
India is stated to be the third
largest producer of tobacco in
the world with an output of
approximately 520 million kgs
annually of which flue-cured
Virginia tobacco accounts for
120 million kgs. About 85 mil­
lion kg of tobacco is being
exported annually of which FCV
is about 65 million kg.
In India 430 million kg of
tobacco is consumed in various
forms of which_54 percent is in
the form of beed.is. 27 per cent in
the form of pan masala, snuff.
chewing tobacco ancTihc like
cigarettes, accounts for 19 per
cent whereas it is 90 per cent

internationally, experts say.
Quoting statistics, the experts
pointed out that per capita con­
sumption of cigarettes in India is
just one-tenth of warld levels.at
101 cigarettes per annum as
against the global, average of
1,030 cigarettes.
This is attributed mainly
towards the general non-accep­
tance of cigarettes by the wom­
enfolk in'India unlike in the
West and the popularity of beed­
ies among the rural folk.
The experts also pointed out
that smoking of cigarettes is
gradually coming down among
the young generation in India
where it was a craze of teenagers
a few decades ago. (PTI)

New Delhi

Thursday

b January 2000

metro

'the HINDUSTAN TIMES

Legislation awaits Cabinet approval
HT Correspondent
New Delhi, January 5

HE GOVERNMENT is preparing to
introduce a comprehensive legislation for
reducing the use of tobacco and its prod­
ucts in the country. The draft legislation, which
is intended Io cover cigarettes and other harm­
ful tobacco products like "gutka", is nearly
ready and awaiting Cabinet clearance before a
Bill can be formally moved in Parliament to
enact a law for the purpose.
Disclosing this here today, Union Health
Secretary J A Chowdhury said —_.1^,1
that for enacting a legislation to
check the use of most edible MraTCmWi
tobacco products, the concur­
rence of States would be needed.
While the Bill on tobacco products was not
likely to be moved in the coming Budget ses­
sion, it would possibly be ready later in the year,
he said.
The Indian Government and the World
Health Organisation (WHO) are jointly organ­
ising an international conference in the Capital
from January 7 to deliberate on suitable global
legislation to curb the use of tobacco which kills
one in every 10 adults worldwide.

T

The world currently had 1.25 billion smokers
and this figure would go up to 1.6 billion by the
year 2020 if urgent steps were not taken to con­
trol tobacco consumption. This was stated at a
Press conference organised by the Health
Ministry and WHO.
In India alone, there were 208 million tobacco
users of which over 150 million were smokers,
Mr Chowdhury informed at the news confer­
ence, which was also attended by WHO
Regional Director Dr Uton Muchtar Rafei and
other senior officials of the Health Ministry.
The three-day conference on "Global tobacco

VurbOnUseofTobapcQ
control law: Towards a WHO framework con­
vention on tobacco control" would be inaugu­
rated by Prime Minister Atal Behari Vajpayee.
Tire Health Secretary cited disturbing evi­
dence, indicating that the social cost of tobaccorelated diseases was rapidly overtaking the
value of tobacco-based products and empha­
sised that any programme to reduce tobacco
use would depend less on legislation and more
on awareness campaigns and behavioural
changes.

Curbing the consumption of tobacco-based
products was a multi-faceted issue for many
developing countries where tobacco was an
extremely paying cash crop and which provided
valuable employment to many, Mr Chowdhury
observed.
In view of this, India’s perception was that the
proposed convention on tobacco control should
be so designed as to facilitate the gradual intro­
duction of legislation in affected developing
countries, he added.
Speaking on the occasion, the Director
General of the Indian Council of Medical
„ Research (ICMR), Dr N K.
Ganguly, slated that over 23 per
ua&Kiiaul cent of males and 4 per cent'
females used tobacco in the
urban areas of the country. In the rural areas, it
was used by 33 per cent males and 8 per cent
females, he added.
Referring to the data obtained from a nation­
wide survey by the National Sample Survey
Organisation, Dr Ganguly pointed out that an’
estimated 1,63,500 cases of cancers developed
due to tobacco use in 1999. Nearly 4.45 million
cases of coronary artery disease and 3.92 mil­
lion cases of chronic obstructive lung disease
were also caused due to tobacco.

Petitionfiled againsi tobabco^mmw^turers
Calls for more Central control on cigarette sales; Rs 500-cr compensation sought
By Olr Correspondent
New Delhi, July 17: A public interest liti­
gation case has been filed in the Supreme
Court demanding greater governmental
control on the manufacture and sale of
cigarettes, and the payment of Rs SOO
crores by tobacco giants as compensation
for the hazardous effects of tobacco prod­
ucts sold and promoted by them.
The petition, filed earlier this month by
former MP Murli Deora, demanded the
payment of Rs 500 crores by ITC, VST
Industries. Godfrey Phillips India, GTC
and the Tobacco Institute of India as com­
pensation for the hazardous effects of
tobacco products sold by them. This.
amount would form the corpus for a
“health care and awareness fund” to be

operated by the Union government, the
petition said.
The tobacco giants and several Union
ministries have been named as respon­
dents in the case.
The petition urged the government to
take urgent steps to combat health prob­
lems, particular­
ly lung cancer,
caused by smok­
ing
to
both
smokers and non-smokers. Although the
Parliament had acknowledged long ago
that smoking was a harmful habit that
could lead to “grave health hazards,” it
had done very little to control dr regulate
tobacco trade, Mr Deora said.
Mr Deora pointed out that several ciga­
rette giants had shifted their operations to

third world countries like India after they
were directed to pay billions of dollars as
damages by courts in the US.
A part of the “health care and aware­
ness fund” should be allotted to cash
strapped cancer hospitals and research
centres. In addition to more prominent
and
clearer
the hazards of
smoking
on
packaged tobacco products, the petition
called for restrictions on all kinds of pub-.
licity and glamorisation of tobacco prod­
ucts, surrogate advertising and sponsor­
ship of sports events by tobacco firms.
It also demanded very strict quality con­
trol measures which should be incorpo­
rated in very the process for making ciga­

rettes.
The petition said tobacco consumption
in India in t he form of cigarettes had
increased frm .n 21 million kg in 1951-52 to
80 million kg in 1994-95.
The sales o ,f pan masala and gutka had
risen from J ,<s 200 crores in 1992 to over
Rs 1000 cro res at present.
Indian cig .arettes were more toxic than
those whicl i were sold in developed coun­
tries, with one mgm of nicotine and 21
mgm of tai
The fiite' r efficiency of Indian cigarettes
was less 1 han 20 per cent, compared to
over 30 p er cent efficiency for cigarettes
sold in de veloped countries.
. Moreov er, the hydrogen cyanide, phenol
and benzopyrenes content was higher in
Indian r J garettes.

Tobacco crop in Mysore district
is poised for another setback
By

K Shivakumar

W "'i

Mysore. July 28: If tobacco growers were badly
affected by shortage of fertilizer in the previous
year, poor rains during the last one month will
hit the yield by 40 per cent this year.
Fanners who had grown tobacco in 54,000 hec­
tares with a production of 55 million kgs have re­
duced the plantation to 51 million hectares, tha­
nks to the fall of tobacco prices last year.
Tobbacco growers had sold low-grade tobacco
at Rs 4 per kg. With the increase in global produ­
ction last year, farmers of H D Kote, Periyapatna, Hunsur. Ramanthpura and Shimoga have
grown tobacco in 52,000 hectares and they have
banned growing tobacco in paddy fields, which
produce low-quality tobacco.
However, sources in the Department said that
the Tobacco Board had permitted to grow toba­

cco in 37,480 hectares registered area. The poor
rain in June and the first two week in this mon­
th has worried fanners who had taken up prem­
ature plantation.
Poor rains and premature plantation may not
affect tobacco grown in 1,300 hectares in Shim­
oga district. It is also said that increase in prod­
uction of tobacco from 45 million kgs (1997-98) to
55 million kgs (98-99) has brought the average
rate of 1 kg tobacco from Rs 45 to Rs 34.
Nagesh of H D Kote said that the increase in
production had made farmers to dispose lowquality tobacco at Rs 4. However, the average
prices of tobacco was increased from Rs 4 to 15
(low grade), Rs 42 (medium) and high grade to
Rs 55 per kg after the intervention of Union Com­
merce Minister Ramakrishna Hegde. The Gove­
rnment has permitted upauthorised tobacco
growers to dispose of tobacco in auctions.

■Two jailed for smoking in public M

3“KtoetaXtnced

C0Utt bar­

imprisonment for smoking in puW^oHcJ1
15 days simpIe
ted on Wednesday for srnokSe rn
I Rve perSons arres'
before the court. While toTpereom• ST
Pr°duced
by paying a fine of Rs 500 each thp^r
d d lmpnsonment
jail as they did not have money to^XTme?^*0 016

BRIEFS —Bare

^sc notice to cigarette majors
toe?;aretteTma?sremiTCOrori v«tTiSSUednOtlces t0

What the people say...
No smoking in public places
Smokers beware. The fines and
summary arrests that have
become the lot of smokers in
Kerala
have
won
wide
admiration. Almost 79 per cent
of our browsers want other
states
to
follow
Kerala's
example and punish those who
smoke in public places.
Only 19.5 per cent assert that
no state has the right to
imprison
or
fine
people
smoking in public places. Two •
per cent of the browsers were
undecided.

Q: Should other Indian states
also follow Kerala's example and
ban smoking in public places?

Total responses

THE HINDU (BOMBAY)

: 0 JUL 1999

‘iterate barn on sate of
_
bi^-wh
cigarettes ow trams’ -rr

,; '

By Our Special Correspondent
new DELHI, JULY 7. The eco-friendly

tribe may have welcomed the
Centre’s move but it has positive­
ly made one group unhappy. The
decision to ban the sale of bidis
and cigarettes on railway plat­
forms and in passenger trains has
left the central trade unions bit­
ter.
Describing the decision as 'uni­
lateral', the unions have deplored
the Government’s disregard for
tripartism. Clarifying that they
were not against any public
health programme of the Govern­
ment, the union representatives
— from the C1TU, A1TUC, I IMS,
BMS and TUCC — today submit­
ted separate memoranda to the
Prime Minister, Mr. Atal Behari
Vajpayee, and the Union Railways
Minister, Mr. Nitish Kumar, to
underline that such gimmicks
would only prove to be counter­
productive.
"How far will the ban serve its
avowed purpose? What is the

■

_

B

■

n

'

guarantee that the ban.will not
aggravate consumption through
unauthorised and unfair sales?"
are the questions raised by them.
But tlte unions are more hurt
about the fact that the ban was
effected without any consulta­
tions with them, "in doing so. the
Government has grossly violated
the concept of tripartite consulta­
tion despite being a founder­
member of the Indian Labour Or­
ganisation (ll.O) and a signatory
to its recommendations on tripar­
tism,” the memoranda said.
By constantly and increasingly
sidelining trade unions in deci­
sions of economic and social rele­
vance,
the
Government
is
contradicting its own endorse­
ment of the ILO recommenda­
tions on tripartite consultations,
according to the union leaders.
They feel the ban on sale of bidis
and cigarettes on railway plat­
forms and in passenger trains
from June 5 was more of a public­
ity stunt of the Railway Ministry.
Haying the Ministry for its lack

n

n

of concern for the lakhs of ciga­
rette and bidi vendors by depriv­
ing them of their only means of
livelihood and not caring to pro­
vide any alternative source of in­
come, the unions have urged the
Government to revoke the ban
immediately and keep the pro­
posal in abeyance till a tripartite
dialogue is carried out between
the employer (Railways), employ­
ees (hawkers) and experts.

I he leaders are surprised that
the Government has not learnt a
lesson from its earlier experi­
ments like banning the sale of
"paan" in the Railways’ premises.
"Addiction is a habit which can­
not be shaken off with legislation.
The need is for mass awareness
campaigns on hazards of tobacco
consumption and leaving tire de­
cision to people,” said the state­
ment, further suggesting the
Railway Ministry to concentrate
on more pressing problems such
as increasing thefts on trains, rail
accidents and ticketless travell­
ing-

Tobacco is
scheduled drug,
claims petition
New Delhi, July 4: Do tobacco
products fall within the defini­
tion of ‘drugs’ under existing
laws and should their sale b'e
regulated as ‘scheduled drugs’?
The issue has been raised bef- :
ore the Delhi High Court in a
petition.
A division bench comprising I
Chief Justice S N Variava and 1
Justice S K Mahajan during
hearing of preliminary submis­
sions asked the petitioner to
bring more material by July 26
to prove his point before noti­
ces could be issued to authorit­
ies concerned.
The bench observed that if,
according to the petition, toba­
cco products are considered
drugs, sale of these has to be re­
gulated as ‘scheduled drugs'
under the laws • PTI

:b w
INDIAN EXPRESS
(BOMBAY)

" 5 JUl 1999

.■Tobacco is_drug, claims plea in HC|
'press TRUST or INDIA^LIJ

‘scheduleddrugiTiodcrdwIawA

NEW DELHI, JULY 4

Petitioner Parmanand Katara
argued that tobacco products like
cigarettes, bidis, cigars, pan­
masala, gutka and zarda would fall
under .the scope of Narcotics
Drugs and Psychotropic Sub­
stances Act, Drugs and Cosmetics
Act and Drugs and Magic Reme­
dies (objectionable advertisement)
Act. ‘Tire data collected through
reports indicates that tobacco
products practically kill more peo­
ple than in war,’ the petition said,
adding that thegovemment should
not make these a source of revenue
at the cost of human lives.
The petition said according to
clause (iii) of Drugs and Magic

E-

v ' DO tobacco products fall
,*within the definition of‘drugs’ un’•der existing laws and should their
■Jsale be regulated as ‘scheduled
'^drugs’ - the issue has been raised
before the Delhi HCin a petition.
A division bench during hcar1’1’ng of preliminary submissions
j asked the petitioner to bring more
^material by July 26 to prove his
I point before notices could be is| sued to authorities concerned.
I,
The bench observed that if, ac­
ts cording to the petition, tobacco
I’-products are considered drugs, sale
i. .of these has to be regulated as

Remedies (objectionable adver­
tisement) Act, any article, other,
than food, intended to affect or in­
fluence in any way the structure or
any organic function of human
body is a ‘drug’. ‘Since tobacco
causes functional disorder of the
heart, it amounts to affecting the
organic functions of human body
in the sense ofa drug, it said.
Various reports had indicated
that hazards of tobacco products
were “widespread’ and main cause
of oral cancer, the petitioner said.
Seeking to declare tobacco as
‘scheduled drug’, the petitioner
said sale of its products should not
be allowed in wholesale and open
markets without prescription.

Kerala High dSiFbans
smoking in public places
Express News Service
other places where people con­
gregate. The Bench, consist- '■
Kochi, July 12: In a landmark ing of the acting Chief Justice
judgment today, a Division AR Lakshmanan and Justice K
Bench of the Kerala High Narayana Kurup, also directed
Court declared that smoking of . all district collectors, in the
tobacco in public places, whet­ State to promulgate an order
her in the form of cigarettes, ci­ . under section 133(a) of the Cri­
gars, beedis or otherwise, is ill­ minal Procedure Code prohibit­
egal, unconstitutional and viol­ ing public smoking within one
ative of the right to life ensh­ month from today.
rined in Article 21 of the Con­
After the promulgation of an .
stitution. •
order under section 133(a), if;
Public places will include any person is found smoking
educational institutions, hosp­ in a public place, the police
itals, shops, restaurants, com­ can arrest him without warr­
mercial establishments, bars, ant, the court said. The distr­
factories, cinema theatres, ict collectors are further direc­
parks, walkways, stadiums, ted- to to issue appropriate dir­
places of amusement, bus ections to the Regional Transp- '
stops, bus stations, railway sta­ ort Officers to strictly enforce
tions, railway compartments, the provisions contained in
buses and other public trans­ Rule 227(l)(d) and 227(5) of the>
port vehicles, highways or Motor Vehicles Rules.

BUSINESS STANDARD
r I Jdl bbi

Court stays |
railway
. ban onW'
cigarettes
Anjan Mitra &
Surajeet Das Gupta
NEW DELHI
A Bareilly court has put a stay on a
railways order banning sale of
bidis and cigarettes at railway sta­
tions and in trains. The order was
pased on a petition filed by a
hawker.
On an appeal filed by V K
Sharma, a vendor of bidis and ciga­
rettes at Bareilly junction railway
station, the district judge ordered,
"Issue notices to other parties fix­
ing 30.7.99. Meanwhile, the appli­
cant or licencee shall not be inter­
fered by other parties (railways
and the government) in his busi­
ness under contract till the date
fixed."
Those made party to the case
are the government through the
GM of Northern Railways, divi­
sional railway manager, NR, Moradabad, senior divivsional commer­
cial manager, NR, Moradabad and
station master, Bareillyjunction.
The Indian Railways Caterers’
Association too has filed a case in
the Mumbai High Court seeking
redressal against the government
policy banning sale of bidis and cig­
arettes on railway platforms from
June 5. The case is yet to be listed
forbearing.
In his petition, Sharma said the
order requiring the applicant to
stop sale of bidis and cigarettes
was "wrong, illegal and unsustain­
able" on the following grounds:
• The period of vending contract
(10.8.1998) is valid up to 31.8.2001, ■
and prior to that, the opposite par­
ties have no right to refrain the hini
from selling bidis and cigarettes at
Bareillyjunction railway station.
• The licence fee up to 30.9.1999
has been deposited.
• No prior lawful or contractual i
notice for termination of the paid
contract has been given to the
applicant
The petitoner has said, "The
decision to stop bidi and cigarette
vending on tlie railways' premises
is arbitrary and unreasonable."
The petition states that since the
railways’ contract with the licencee
runs till 2001, the ban has given
rise to a dispute under the said con­
tract which is "liable to be referred
forarbitration."
Meanwhile, the association has
said that about a fourth of the
■ income from the stalls on railway
platforms and trains comes from
the sale of cigarettes and bidis.

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Customer be damned

less dangerous, that’s 12,000 lives saved
each year in the OK alone.”

Taking lhe cue, a small company

Star Scientific of Petersburg, Virginia, is
.A new report claims that cigarette manufacturers had the know-how
to make cigarette smoking safer, but did not introduce them

ACCORDING to a report by the Action
on Smoking and Health (ash) and
the Imperial Cancer Research Fund,
UK, tobacco giants possessed the
technology that could have reduced
the death toll caused by their products,
but did not use them fearing that
marketing a ‘safer’ cigarette would
amount to an admission that smoking is
dangerous.
An article in the New Scientist
(Vol 161, No 2176) says that though
58 methods were patented by cigarette
manufacturers for cutting levels of
toxic chemicals in cigarette smoke,
none were introduced. In 1980,
British American Tobacco (hat) filed
a patent (us 4)82348) by which carbon
monoxide and nitric oxide was removed
from smoke. A similar patent was
registered by Philip Morris in 1981,
which claimed to cut levels of hydrogen
cyanide.

There are many reasons
why these technologies were
not adopted. A few experts
feel that the cost of imple­
menting these processes
could have been a constraint.
But the real reason, many
feel, is the legal difficulties
the companies would have to
face in admitting the dangers
posed by their products.
Says Clive Bates, director
of
ash:
“Marketing
a cigarette on the basis that
had less of a tasteless
gas like carbon monoxide
would
effectively
mean
admitting the product was
bad for you. Then you would
move into the area of pro­
duct liability with the smoker
who has had heart disease
made worse by inhaling
carbon monoxide."
Interestingly, cigarette
companies have introduced
lower-tar brands for many
years. But they have not said
that they are comparatively
safer. Instead, they marketed
them as tasting milder, says Bales.
A (Confidential memo written by
Patrick Sheehy, the chief executive of
hat in 1986, states: “In attempting to
develop a 'safe cigarette you are, by
implication, in danger of being inter­
preted as accepting that the current
product is unsafe and this is not a posi­
tion I think we should take.”
However, Bates’ claims have
been refuted by Chris Proctor, head
of science and regulatory affairs at
hat’s London headquarters. These
technologies were not developed
because they might, in theory, increase
levels of other toxic chemicals, says
Proctor. But he could not confirm
whether bat had conducted tests to
exclude this possibility.
To what extent these technologies
could have cut the number of deaths,
still remains unclear. Claims Bates: “If
you could make cigarettes 10 per cent

planning to introduce nilrosamine-frcc
cigarettes next year. Nitrosamincs
arc the most dangerous of substances
found in cigarette smoke. Their method
is to microwave tobacco to kill the
bacteria that creates the right chemical
environment for the production of
Nitrosamincs. The company patented
this method (us 5803081) in 1998.
“If their process is effective,
it should be applied to cigarette
manufacturing
everywhere,”
says
John Slade, a specialist in nicotine
addiction at the University of Medicine
and Dentistry of New Jersey in Newark.
“But it might require legislation,"
he adds. ■

The web widens
Cancer cases in Hong Kong will

reach an all-time high, says a
study
Cancer cases will rise by 10 per cent
in seven years and more than
13,000 cancer patients will die each
year in Hong Kong. A document to
be discussed at the government's
medical services development com­
mittee says the number of new
cancer cases will reach 22,286 by
2006, compared with 20,231 this
year. Cancer has been the number
one killer since 1991, accounting
for one-third of all deaths in the
Southeast Asia.
The Hong Kong Cancer Registry
projects that by the year 2006, the
total number of cancer deaths will
reach 13,724. The seven leading
cancers in Hong Kong are lung,
liver, colon, breast, nasopharynx,
stomach and rectum. Liver cancer is
the most dangerous — only five per
cent of liver cancer patients survive
the first five years — followed by
lung cancer (10 to 15 per cent) and
stomach cancer (20 per cent).
The five-year survival chance
for cancers of the colon, naso­
pharynx and rectum is 50 per cent.
Breast cancer patients have about
a 70 per cent chance of surviving
five years.

Down To Earth June 30,

SUL’DAY

D75

(BUirfDAE)

• G J Uli i9”S

Fta^®oa§ urged to
stop promoting

cigarette brands
Vinay Krishna Rastogi
LUCKNOW. June 5
THE Indian Society Against
Smoking will urge the members of
the Indian cricket team to stop pro­
moting cigarette brands.
Professor Rama Kant, president
of the society, said promotion by
the cricketers inspired youngsters
to smoke.
He said a World Health
Organisation (WHO) report has
established that children between
12 and 17 were prone to start smok­
ing after watching sports events
sponsored by cigarette companies.
He condemned the gimmicks
which companies resorted to in
promoting the smoking habit
through mass media.
According Io a survey conduct­
ed in Lucknow on 818 students of
classes 8 to 12, about 13 per cent
expressed the desire to smoke, 5.4
per cent were smoking a particular
brand and 16 per cent had smoked
some other brand after watching
the cricket World Cup matches in
1996.
The body against smoking high­
lighted the fact that the European
Union has banned sponsoring of
sports events by cigarette compa­
nies.
Recently, hundreds of children
pledged to check their parents’
consumption of tobacco during the
anti-tobacco march organised by
the Maseeha Cancer Foundation of
India in Lucknow.
The foundation urged chief min­
ister Kalyan Singh to declare spit­
ting and smoking in government
offices a criminal offence. It also

demanded a ban on sale of paan
masala and cigarettes near govern­
ment offices and hospitals and in
railway stations.
A Rizvi, the foundation’s secre­
tary. said tobacco alone would be
responsible for the death of 20 mil­
lion people by the year 2000.
Cigarette smoking and tobacco i
chewing is responsible for 45 per
cent of mouth cancer cases.
Smoking also causes problems dur­
ing pregnancy.
According to a survey by the
department of surgery. King
George’s Medical College. 60 per
cent of smokers and those who

chewed

tobacco

had

heroine

addicts before the age of 21. It is
difficult to give up the habit
formed al a younger age, even if
tobacco users intend to quit at a
later stage of life.

i

5 JUN 1999

| OMBUDSMEN WILLENFORCE NORMSiNLETTERAND SPIRIT |

Tobacco cos set up panel to
track ad code compliance
^□’75/£T

5/61 <i‘|

Javed Sayed
NEW DELHI 4 JUNE

'

HE tobacco industry has
set up a panel of ombuds­
men to monitor and ensure
compliance with a voluntary mar­
keting and advertising code for
cigarette and tobacco companies.
All major cigarette manufac­
turers such as ITC, Godfrey
Philips India (GPI), VST and GTC
have agreed to subscribe to the
code prepared by the Tobacco In­
stitute of India. The ombudsmen
will deal with complaints from all
quarters against violation and in­
fringement of the code and the
panel's decision will be binding
on the subscribers of the code.
The panel includes Deepak
Shourie, executive president of
Hindustan Times; marketing
guru Shunu Sen and former in­
dustry secretary Suresh Mathur.
Retired Justice H R Khanna has
been approached to head the com­
mittee, sources said.
Besides looking into complaints
against infringement of the code,
the committee will resolve issues
relating to its interpretation and
suggest modifications. The pan­
el’s recommendations may in-

T

SMOKERS’ CHAMBER
► Advertisements
shall not make t
any health
., claim about
C
tobacco products
or smoking

:

, /A
.• U
\>
iiJ

► Commercials shall not claim
overtly or covertly that smoking or
consumption of tobacco products
is essential for manliness or
female emancipation
► Promotion campaigns shall not
encourage Increased smoking or
excessive use of tobacco products
► Copy or Illustrations that are
sexually titillating not to be used
elude revision or withdrawal of
advertisements that infringe the
code, the sources said.
The ‘Voluntary and Self Regu­
latory Code For Marketing Of To­
bacco Products In India', which
was updated by the Tobacco In­
stitute in November, 1998, lays
down standards for self regula­
tion of marketing of tobacco
products including advertising
and promotion. The main objec­
tive of the code is to ensure that
tobacco marketing is directed
only at adults. The first meeting

of the panel is expected to take
place by the end of this month
where the modalities will be fi­
nalised, the sources said adding
the Tobacco Institute will act as a
secretarial body for the panel. All
complaints will be sent to the in­
stitute, which in turn will for­
ward them to the panel.
The sources said, the institute is
holding discussions with AU-India
Paan Masala and Chewing Tobac­
co Manufacturers Association _
and the Bidi Manufacturers’ Asso­
ciation about subscription to the
voluntary code. Besides ITC, GPI,
VST and GTC the other companies
that have agreed to subscribe to
the code include Reliable Cigarette .
& Tobacco Industries Ltd, Hyder1
abad Deccan Cigarette Factory
Ltd, Venus Tobacco Co Ltd, Asia
Tobacco Company Ltd, Hilton To­
baccos, National Tobacco Co.
The code has imposed several
restrictions on tobacco compa--nies preventing them from tar­
geting their promotional cam­
paigns at minors. With several
provisions of the code being open
to interpretation, an independent
panel of ombudsmen is expected
to play an important role in effec­
tive monitoring of the code.

"

(BOMBkn

5 JUN 1395

SWA to petfttoo for inclusion of
tobacco m 'drags’ category
PRESS TRUST OF INDIA
NEW DELHI, JUNE 4

c///qr,

>I b I I (

-DI'j

IE

Political lobbying and money power of tobacco
companies were the major bottlenecks in initiating
such a measure, he said, addingsponsoring of events by
tobacco companies should be stopped first
THE Indian Medical Association (IMA) here will
He said the railway ban on the sale of cigarettes
soon file a public interest litigation (PIL) seeking inand bidis on platforms and trains should also include
' elusion of tobacco under the “drugs” categoiy to regu­
other tobacco products like “gutka”. Tobacco should be
late its sale and distribution in the countiy.
labelled as an addictive drug, Alan Landers, who for­
IMA has consulted lawyers and modalities for filing
merly modelled as the “Winston man” to promote RJ
the PIL are being finalised, Dr Chandcr Prakash, sec­
Reynolds tobacco products, said.
retary of IMA Academy of Medical Specialities, told
Landers, who quit smoking and modelling for to­
newsmen hereon Friday.
bacco after surviving lung cancer and a bypass heart
A drug, as defined by the Drugs and Cosmetics Act
surgery, said nicotine content in cigarettes could be
of India, is any substance other than food that causes
lowered resulting in lesser health hazards if tobacco
| change in the functioning of the body.
■ As a total ban on tobacco products was impossible,’ ' 1 carite uriderth'e “addictive drugs” category;
-IMA wanted the government to rcgulate'the*
1sale'of j ur^i-Thc warriing'on'cigarette packetsshould tell that
tobacco products, he said. Tobacco product packs d cigarettes cause lung'cancer and heart problems, he
said. Tobacco companies spend six billion US dollars
should carry messages in different languages men­
annually to promote their products, but regarding ad­
tioning ill effects of tobacco.
verse health effects, they put the blame on the users, a
Once tobacco came under the drugs category,
now wiser Landers told newsmen.
IMA would campaign for including it in the “danger­
Tobacco should not be made freely available in
ous drugs” category. Even cultivation of drugs like co­
shops and aspiring smokers should be dissuaded,
caine is strictly regulated, Prakash said, adding to­
Prakash said. Strict penalty should be imposed on sell­
bacco companies should be sued by lung cancer
ers selling tobacco products to children, Landers
patients with the help of non-govemmental organisa­
added.
tions (NGOs).

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£Wi32d.
,?;

Fact 2. Cigarette smoking causes as many deaths as the
annual total of accidents, infections, diabetes, murders and
suicides combined.
VERYONE'S always harping about why you
Fact 3. This one is for all those young, would be
shouldn’t smoke; how terrible it is for your system 'Beauty Queens’ & ‘Macho Hunks’ who think smoking
and how smoking causes cancer. But. you’ve been is the "cool” thing to do: Tobacco is responsible for
smoking for years, and you’re hooked. It's easy for the early wrinkled skin; falling hair; red eyes; discoloured
people who don’t smoke to talk. Do they have any idea lips/teeth; retarded growth and bad breath. That's the
how tough it is to give up? What do they know about physical part; mind-wise it kills your concentration
'withdrawal symptoms?’ Besides which, it's "my life, isn't and can leave you mentally ill through constant use.
it?” Sure, these selfish thoughts might be relevant to you.
Fact 4. Every 1 Kg of Tobacco processing needs 100 to
What about the rest of society?
130 Kg of Wood -smokers are contributing to deforestation.
While everyone talks about nicotine, tobacco tar and car­
Fact 5. Weedicides, insecticides and chemical
bon monoxide, are you aware that cigarette smoke con­ fertilisers required to cultivate tobacco are polluting
tains 4000 chemicals?
both ground water and soils, in their areas.
Read this (these are just some of the chemicals in cigarette
Fact 6. Children who come into contact with tobacco
smoke):
smoke suffer some of these symptoms: frequent cough;
Act^jme = Nail polish remover;
pneumonia; colds; asthma; tonsils; poor weight gain; stunt­
Amwlnia = Floor/Toilet cleaner;
ing; ear aches; stomach aches; bronchitis and the risk of
Arsenic/Hydrogen Cyanide = Poisons; Butane = Cigarette getting lung or oral cancers through passive smoking.
lighter fluid;
Let us anticipate your final question! “I’ve already been
Cad-mium = Car battery fluid;
a smoker for sooooo long; how’s it going to help me if 1
Carbon Monoxide = Vehicle exhaust fumes; DDT = Insec­ stop Now?!?” Here’s how, friend:
ticide;
A. Within 20 minutes the blood pressure and pulse rate
Methane = Petroleum gas:
drop to the levels before smoking.
Toluene = Industrial solvent. The list goes on.
B. Within 8 hours, blood levels of Carbon Monoxide and
Normally, you wouldn’t consider keeping these frighten­ Oxygen return to normal.
ing chemicals near you. What madness then makes you
C. After 72 hours the lung capacity begins to increase
actually inhale these? Also, you're not a "mass murderer"
D. After 3/5 years, the risk of heart disease drops to the
are you? Then why are you puffing these chemicals out at level of a non-smoker.
people around you?
E. Within 10 years, the risk of death due to lung cancer
Here're somefacts:
drops to levels of a non-smoker.
Fact 1. 4.5 to 5% of total hospital beds are occupied
(Dr. Pankaj Mehta is Director, Medical Education. Manipal Hos­
due to tobacco smoking.
pital. Hangalore.)
Dr. PANKAJ MEHTA &
CHIPPY GANGJEE

E

1

IO

j Sb

~

THE HINDU (bombzy)

- 1 JUN 1999

WHO to help bring down Mscost of ‘nicotin patch’
H
By Our Special Correspondent

NEW DELHI, may 31. WHO is working with the pharma­
ceutical industry to try and bring down the cost of
nicotin patch and other pharmacological formula­
tions that have proved to be of help in assisting
smokers quit their habit in the developed countries.
The exercise has been undertaken particularly in
the context of the steady shift of the tobacco market
from the developed to the developing world because
of the mounting pressures against the tobacco in­
dustry in the former.
Nicotin patch and several other pharmacological
formulations have been shown to make a real differ­
ence to the smokers’ chance of succeeding in their
quit attempts, though personal motivation and
commitment on the part of the smokers continues
to be a sine qua non for them to kick their habits.
Currently, these formulations are too expensive and
are within the reach of only a few in the developing
countries.
Announcing the new initiative at a press confer­
ence here today, the South East Asia Regional Direc­
tor of WHO, Dr. Uton Muchtar Rafei, said the WHO
was also seriously pursuing an international frame­
work convention on tobacco control — a legal in­
strument that would address issues as diverse as
tobacco advertising and promotion, agricultural di­
versification, smuggling, taxes and subsidies.

The issue of having such a global tobacco control
treaty had come up for discussion at the recently
concluded session of the World 1 Icalth Assembly at
Geneva. The Assembly, which was attended by Min­
isters and other representatives of the 191 member­
nations of WHO, decided to start the negotiation
process on the framework convention. It is expected
to be ready for ratification by 2003.
A highlight of the press conference organised in
connection with the World No-Tobacco Day was the
participation of Mr. Alan Landers, who had played a
major role in the promotion of tobacco as a model
for a cigarette brand in the U.S., but has since turned
into a bitter critic of the tobacco industry after un­
dergoing surgery for lung cancer contracted because
of years of smoking.
Making a passionate plea for regulating tobacco
products as addictive drugs like heroin and marijua­
na, he said the tobacco industry, which spent over
$6 billions on their advertisement campaigns to se­
duce the youth into the habit of smoking, must be
taken to court for marketing a product, which they
themselves knew was lethal. "Only law suits would
make them see reason", he said. On the occasion,
Dr. Rafei also presented the WHO award for anti­
tobacco work to Dr. P. C. Gupta, senior research
scientist at the Mumbai-based Tata Institute of Fun­
damental Research.

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5'U 36

pH- io

HOW TO STOP SMOKING
PREPARATION OF SURROUNDINGS
w

Two weeks prior to quit date, limit your smoking to one room in your home.

w-

Clean and remove the smell of cigarette smoke from your home.

PREPARATION OF YOUR PHYSICAL SELF

w

Get your teeth cleaned. With tar and nicotine removed from your teeth.

w

Reduce your caffeine consumption prior to quitting

w

Get plenty of rest.

Monitor your alcohol consumption.

Your body needs time to readjust without the drug,

nicotine

w

Drink plenty of fluids.

w

Use healthy oral substitutes.

PREPARATION OF YOUR EMOTIONAL SELF
Repeat to yourself your reasons for needing to quit smoking

Plan activities for your first smoke-free week.
Occupy your hands with other objects when you feel something is missing

without a cigarette.

mt

Beware of cigarette advertisements.

mt

Never allow yourself to think that one cigarette won’t hurt.

ENLISTING SOCIAL SUPPORT FOR YOUR QUIT DATE.
w

Remind your friends and family that you are going through the quitting
process and that it is important to you that they support you.

w
w

Be assertive and direct when asking for support.
Working with a smoker. It is important to make a request for support or at

the very least for respect of your efforts to quit smoking by not smoking in
your presence. You may also ask for a transfer to a work area that is somke

free.

COMMUNITY HEALTH CELL

You’r quit date and the weeks that follow.

1.

Visualize and reinterpret your physical systems as “Symptoms of recovery.

Initial phase of quitting; you may experience a list of nicotine withdrawal

symptoms

“Craving”.

process.

Restlessness,

(i.e.

disturbances,

dry

These

mouth

or

irritability,

sore

difficulty

in

fatigue,

coughing

throat,

symptoms are short-term and

concentration,
and

necessary to the

Try to think about them as symptoms of recovery”.

sleep

Nicotine
healing

When you are

feeling irritable and restless or having a "Craving" remind yourself that your

body is healing.

Imaginary exercise of healing process....... !!
Close your eyes and imagine your lungs.

See the black tar sitting on the tiny

little air sacs that makes it hard for you to breathe at times.

Each time you feel

“uncomfortable” imagine this tar gradually being lifted off your lungs.
breath that you take feels easier.
lung

tissue.

You

see

the 4,000-plus

bloodstream being washed away.

Each

You feel the clean air healing the wounded

particles

that

are

floating

in your

You feel your arteries relaxing and allowing

blood to pass more readily through, cutting your risk for strokes and heart
attacks. With each passing day you see more and more healing occurring inside

your body.

2.

/-

Pay attention to your "high risk” situations.

_

These are times, such as when

you are stressed at work or finishing a meal, when you are most likely to desire

a cigarette.

Try either to avoid these situations or at the very least to have

alternative strategies available.
3.

Use distraction techniques.

When you find yourself tempted to smoke a

cigarette get some distance from the thought or situation.

Distraction is a

wonderful technique for preventing impulsive smoking.
4.

Reinforce your reasons for needing to quit smoking.

reasons need to be specific and personal to you.

Remember, these

These reasons will help get

you through the periods of temptation.
5.

Repeat to yourself the benefits of quitting smoking.

list of benefits to yourself several times a day.

COMMUNITY HEALTH CELL

Repeat the following

3

BENEFITS OF QUITTING SMOKING
1.

Circulation improves.

2.

Significantly decreases your risk for lung cancer and emphysema.

3.

Increases lung and breathing capacity

4.

Decreases allergies

5.

Eliminates chronic

bronchitis (which decreases

energy level,

resistance to

infection, and predisposes one to emphysema) in a few months after cessation.

6.

Reduces number of cavities and increases chance of keeping your own teeth
(smokers have three times more cavities and gum disease than non-smokers)

7.

Decreases risk of esophageal cancer by 500 percent.

8.

Decreases risk of kidney cancer by 50 percent

9.

Decreases frequency and intensity of headaches.

10.

Decreases risk of osteoporosis

QUICK FIX COPING STRATEGIES.
Things You Can Do

I

Do relaxation exercises.

2

Go to a place where smoking is not allowed.

3.

Take a walk.

4.

Exercise.

5.

Listen to your favorite music.

6.

Drink fruit juice, water, or soda with lemon.

7.

Take a hot bath.

8.

Call a friend for support

9.

Do some gardening.

THINGS TO THINK ABOUT OR SAY TO YOURSELF
l

Think about how many ways quitting will improve your health.

2

Think about how not smoking will help your loved ones.

3.

Go over your reasons for quitting.

4.

Imagine yourself as a non-smoker.

5.

Think about how much better food tastes when you are not smoking.

6.

“I can manage this without a cigarette.”

7.

“I have made it this far."

8.

“My lungs are getting healthier.”

9.

“I can breathe better.”

10.

“NO!!!!”

COMMUNITY HEALTH CELL

MANAGING SYMPTOMS OF ANXIETY RELATED TO NICOTINE
WITHDRAWAL
1. The symptoms of anxiety that you are experiencing are caused by the physical

withdrawal process from nicotine.
This is your body’s way of healing itself.

2.

The discomfort you are feeling will

lead to overall healing and improved health. It is "good” pain.

3.

These symptoms of anxiety will last for only a couple of weeks.

The worst

feeling will be around the third or fourth day after your last cigarette.
Practise visualizing how nicotine increases your heart rate and blood pressure.

4.

Next visualize how without nicotine your heart rate and blood pressure will

return to normal.
You may want to picture your anxiety as a wave.

5.

You can feel it rise - but as

you ride it out you can feel it subside. It passes without any action on your part.

Steps to Beating Depression - Related to Nicotine Withdrawal
»*•

Recognize your triggers to depression

w-

Avoid isolating yourself.

iw

Push yourself to engage

in small tasks.

Depressed

complain of no energy or interest in activities.
goals for yourself.

individuals

often

Set small but reasonable

For example, force yourself to go to the grocery store or

to a social function.

or

Get support from those you trust.

w

Seek

professional

help.

You

don’t

necessarily

depression gets really bad to get professional help.
treat depression the worse it can get,

have

to wait

Compiled By

D. Rcdendran.

Community Health Cell, #367, “Srinivasa Nilaya”, 1st Main, 1st Bloc,
Koramangala, Bangalore - 560 034. Ph : 5525385. Email: sochara@vsnl.com
Source : “HOW TO STOP SMOKING” - Lori Stevic-Rust & Anita Maximin.

COMMUNITY HEALTH CELL

the

and subsequently the harder it is to

beat.

S.

until

The longer you wait to

Effects and consequences of tobacco consumption on
the health of an individual and on the community
Around 650,000 deaths occur annually in India due to tobacco usage.

About 36,000 (29,354 and 6,587 women) die of cancers due to tobacco consumption out
of the recorded few who can avail treatment for the cancers.

There are about 65,000 children below the age of 15 who are regular tobacco addicts.
Types of tobacco products - They can be classified under six principal headings:

i) cigarettes;
ii) bidis.
iii) Chewed tobacco as such, or through consumption of paan, paan masala, Gutkha, etc.
iv) Cigars
v) Pipe tobacco
vi) Snuff.
Data from the sub-continent show 20% consume tobacco in the form of cigarettes. 53%
consume tobacco in the form of bidis. 37.5% chew tobacco or use it in the form of snuff.
Effects of smoking on health:

It is the major cause of lung cancer.
It accounts for 90% of lung cancer deaths in men over 65 years of age.
Other cancers caused by tobacco consumption in some form or the other are the
following:
Cancer of the: i) Pharynx; ii) Oesophagus; iii) Stomach; iv) Larynx; v) Lip; vi) Oral
cavity; vii) Pancreas; viii) Urinary bladder; ix) Renal pelvis; x) Cervix.
Other diseases caused by smoking:
i) Chronic bronchitis; ii) Ischemic heart disease; iii) Coronary artery disease; iv)
Emphysema; v) Peptic ulcer; vi) Buerger’s disease; vii) Sudden infant death syndrome;
viii) Impotence.
Risks of smoking:

The danger of early death is greatest for smokers between the age group 45 and 54.
Other contributory or secondary factors are the amount smoked, the habit of inhaling and
the age at which smoking begins. Smokers of plain cigarettes rather than filtered ones are
at a higher risk.

Cigarettes of high tar and nicotine content have been proved to be more dangerous than
low tar and nicotine ones.
Smokers of low tar and nicotine cigarettes (commonly known as lights) inhale more on
such cigarettes, and smoke more number of cigarettes eventually, to get the required
amount of nicotine in the blood.
Consequences of smoking in Pregnancy:

Low birth weight of new bom babies

Low mental development of the foetus
High amount of DDT passed on to the foetus through breastfeeding.

Additional risk factors in India:

i)

ii)

Hyperglycemia or high blood sugar levels. An association exists between increased
iron levels in the blood, smoking and cancer.
Poor nutritional status of the people.

Effects of Passive smoking:

Passive smoking increases the risk of heart disease and lung cancer by 25% although only
1% of the side stream smoke is inhaled. Sidestream smoke contains 3i/2 times more
benzopyrenes which is highly carcinogenic or cancer producing substance.

Additional effects on family: Poorer sections of people in rural and urban areas live in
smaller houses with their family. Overcrowding with poor ventilation puts the whole
family, including children, at a high risk of the effects of passive smoking. An additional
problem with the women in such houses is that they are also exposed to the fumes which
are emitted from the fireplace through either using firewood or kerosene as the main fuel
for cooking.
Constituents of tobacco smoke:

About 4,000 compounds have been identified out of which the main three culprits are
nicotine, tar and carbon monoxide. Tobacco tar is the condensate of tobacco smoke.

Nicotine-, is a very harmful constituent. It is that which mainly produces dependance.
Eg: Nicotine content of just one small cigar if injected intravenously could be enough to
kill an adult man.

D:\OFFICE\~WRL3042 imp

2

Carbon monoxide: This is a harmful gas which when absorbed into the blood, blocks the
transport of oxygen to the different parts of the body, including the brain.

Irritants: The smokers hacking cough is due to irritant substances in tobacco smoke
which affect the self cleansing mechanism of the lungs. This effect is mainly caused by
the irritant substance called acrolein.
Cancer producing substances - The main cancer producing substance in tobacco smoke is
a chemical substance known as N-nitrosonomicotine. The concentration in unbumt
tobacco is between 2,000 and 9,000 parts per billion. One part per billion in food is
regarded as a potentionl health hazard, thus explaining the link between tobacco
chewing and cancer of the mouth.
Chewed tobacco:

Tobacco is either chewed as such or in combination with other additive flavouring agents
eg: Gutkha, Zarda, paan masala, etc. Gutkha comprises roughly 50 percent areca nut, 50
percent tobacco, sandal wood powder, lime, betel nut powder, flavouring agents and
additives. Betel quid or paan contains betel leaf, areca nut, a pinch of catechu, slaked
lime and tobacco. Studies conducted independently by Tata Institute of Fundamental
Research and the Tata Memorial Hospital established the link between prolonged
consumption of gutkha and sub mucous fibrosis (SMF), a pre-cancerous condition. An
afflicted person with SMF is 400 times more likely to get oral cancer than one not
afflicted.
Studies have also established the link between betel quid chewing, SMF and oral cancer.
These studies were undertaken by Sumati V. Bhide, Cancer Research Institute, Tata
Memorial Center, Mumbai, India.
The power of the cigarette:

Nicotine reaches the brain more rapidly than heroin which can cause a “buzz” when shot
intravenously. It takes 7 seconds for nicotine from the lungs to reach the brain.
It takes 14 seconds for blood to flow from the arm to the brain.
At 10 puffs per cigarette, the pack-a-day smoker gets more than 70,000 nicotine shots to
the brain every year.
Effects on the environment:

i) Trees have to be felled in order to create tobacco farms.
ii) Fuel wood is needed to cure or dry out the harvested crop from its natural green to
brownish colour seen in cigarettes. Approximately, 10 kg of wood on an average is
required to cure 1 kg of tobacco.

D:\OFFlCEV-WRL3042.tmp

3

Socio-economic conditions of tobacco workers:

i)
ii)
iii)

iv)

v)
vi)

vii)

Contract wages are low, about Rs.80/- per day for 12 hours work;
No medical / health care or coverage;
Housing is poor as only huts are provided for a family, or for groups of families.
Thatching material for the roof is very bad;
The workplace is far away from the houses. Mothers have no time to feed their
babies;
No schooling facilities for children.
Occupational hazard as they are constantly exposed to tobacco dust and in case of
bidi rollers, exposure to tobacco leaf causing allergies and absorption of nicotine
through the skin into the blood.
a) If in case the workers fall sick, they have to think about that day’s wages
before taking off from work; b) about travelling a long distance to a hospital in
addition to the medical bills. In case the sick labourer manages to reach the
hospital, having covered the travel expenses, if he/she has to get admitted, he/she
has to forego his/her wages for the number of days off work. All this if the sick
labourers manage to reach the hospitals. In some cases, they are too sick to travel
and remain at home for two - three days before they feel a little better, again
having foregone their wages for the number of days off work. On feeling a little
better, they opt to work and get paid rather than travelling to reach a hospital for
medical care.

Tobacco economics or bad economics: Our country earns Rs.800 crores from exports
and Rs.7,000 crores from tax revenues. On the flip side, though, we spend about
Rs.22,000 crores, nearly three times the total earnings to treat the various diseases due to
tobacco consumption.

Benefits at hand for quitters:

i)

ii)
iii)

iv)

CAD (coronary artery disease) decreases by 50%, 1 year after quitting. Within 15
years, relative risk of death for coronary artery disease for an ex-smoker reaches
that of a long time non-smoker.
Risk of developing lung cancer, chronic obstructive pulmonary disease and stroke
decrease.
10-14 years after quitting, the risk of mortality from cancer reduces to nearly that
of those who have never smoked.
In fact, health benefits are observed within 12 hours of quitting.

D:\OFFICE\~WRL3042tmp

4

TOWARDS MAKING THE NATION TOBACCO FREE
by S.J.Chander

Community Health Cell, Bangalore

Introduction
Right now the global and the national environment for tobacco control give us the hope that
tobacco control is possible. Indian parliament has set the precedent to the nations by passing a
comprehensive bill to curb the epidemic in the country when the global treaty “Framework
Convention on Tobacco Control” (FCTC), was formally adopted at the 56,h World Health
Assembly (WHA), the annual meeting for health ministers on 21bI May 203.

The adoption of the FCTC and the bill passed by the parliament is the first step. The task of
implementation is of great concern to the public, public health professionals and activist.
Implementing the bill will depend on political commitment in brining the tobacco control
measures as a priority in the national agenda with necessary resources. People’s participation
is crucial in taking necessary action at state level in pressuring the center to expedite the
process of framing the rules and creating awareness among the masses.

Recent news report said that tobacco consumption in the country has gone up. Tobacco
industries continue to capitalize on the lack of awareness on the ill effects of tobacco to
increase consumption. The vast awareness need on ill effects of tobacco is left to a few small
groups /organizations working in different parts of the county. The understanding of a few in
the country on ill effects of tobacco is restricted to a few health effects like caner and heart
diseases. It is hoped this article would enlighten the reader understand the role of tobacco
industry' and the process of globalization and other socioeconomic, environment and health
implications.

Tobacco industry and globalization
As the tide of globalization is sweeping the nations, India is experiencing its effects like the
new communication technologies that have fuelled an explosion of business opportunities for
tobacco industries to capitalize on the fastest growing middle class in the world and half of its
population who are ignorant of the ill effects of their products and lives on less than a dollar a
day.

Tobacco industries faces a time of dwindling sales and expensive lawsuits in the west
contributed by increased public awareness. The tobacco companies are looking to developing
country markets to increase sales and profit. They follow various strategies for achieving
their goals; particularly through advertisements they target children. Their advertisements are
region and target specific. If advertisements do not promote sales, as they say; why are they
pumping in millions of dollars into advertisement? Sponsoring music concerts and sports and
giving free samples are the other ways they target children.
"Half of all the Indians are under 25 years of age. It is estimated that 4 million below the age
of 15 years are regular smokers. All the industries are trying to capitalize on this youthful
market- none-more so than the tobacco industry " (Saskia Sassen)

The following quotes by the chief executives of the tobacco companies should convince of
what they believe about advertisement.
"He believe in our right to provide adult smokers with brand choice and information.
alongside our responsibility to ensure that our marketing does not undermine efforts to
prevent children from smoking. "[Martin Broughton, Chairman of BAT. 2000][ 11
"... IVe refined the objective of a juvenile initiative program as follows: "Maintain and
proactively protect our ability to advertise, promote and market our products via a juvenile
initiative".
[Cathy Leiber, Philip Moms International, 1995][4]

The industry's very survival depends on new teenage customers. The tobacco industry needs
to recruit new smokers every year to replace those who die from tobacco-related diseases and
a few who mange to quit. It is estimated that they need about 10000 new customers every
day. Very few people start smoking as adults. Thus, children are the industry's most
significant targets. Who will protect these children from the trap of tobacco industry?

Health implications
Tobacco kills over 5 million people worldwide annually (WHO, 2003). By 2020, it is
predicted that tobacco will cause more deaths worldwide than HIV. tuberculosis, maternal
mortality, motor vehicle accidents, suicides and homicides combined.

Cigarette smoke contains over 4000 poisonous chemicals and over 40 of them have found to
be carcinogenic (cancer causing) The poisonous gases, hydrogen cyanide, sulphur dioxide.
carbon monoxide, arsenic, nitrosamines and the residual pesticides in tobacco affect the
health, including reproductive health of men and women. In laymen’s terms these poisonous
chemicals are known as a. (toilet cleaner) ammonia acetone (nail polish remover),
formaldehyde (dead body preservative) and carbon monoxide (smoke from car exhaust).
Tobacco causes serious adverse effects such as cancer, diseases of heart and blood vessels,
diseases of lungs and other organs, leading to suffering, disability and death. Tobacco use
among men causes impotency and infertility among women. Considerable amount of funds,
public and private, are spent in treating the persons affected. Passive smoking is equally
responsible in the causation of adverse effects, affecting millions of non-smokers and
particularly pregnant women, reducing the growth of the foetus and causing abortion.

Economic implications
Economic losses to the nation are immeasurable. The health of the workforce is adversely
affected. Household money that is spent on tobacco reduces the amount available for food,
education and medical care. Children may also suffer the emotional pain and financial
insecurity that comes from the loss of a parent or caretaker who dies an untimely death due to
tobacco. Al the rate of 20 cigarettes per day a smoker will pay around Rs. 10, 950.00 per year
to support the habit. For 30 years the smoker has to spend Rs.3, 28,500.00, enough money to
educate two children through medical and engineering colleges. A retired senior government
official from a district said that he spent Rs. 15 lakhs for cigarettes in about 20 years. When
he came to know this he quit. He was one of the lucky ones who could get rid of the deadly
addiction. 90% of the tobacco users though want to quit, find it extremely difficult to do so
due to severe addiction that nicotine causes. Long term studies by the Indian Council of
Medical Research and the World Bank report that economic losses to the state and national
government far outweigh the economic gain from taxes, exports to the state / country. A
World Bank study report came to the same conclusion based on international data.

Social and environment implications
Somehow, over the years tobacco use has been accepted socially because they are ignorant of
the various serious implications that tobacco use. Every child has the right to grow up without
tobacco. If this has to be achieved, there is a need to change the environment, (t is estimated
that the smoker inhales only 15% of the product that he/she smokes, the remaining 85% being
inhaled by the people around, which means one doesn’t have to smoke if he/she is around a
smoker. Passive smoking, also known as Environmental Tobacco Smoke (ETS), contains
basically all of the same carcinogens and toxic agents that are inhaled directly by smokers.
Evidences regarding the serious health consequences of ETS, both for adults and for children
are many. These findings make a strong case for a tough policy to limit smoking in public
places. A few stale governments have made some efforts towards this: further actions have to
be taken by them to pass the government orders and ensure that their staff and citizens
enforce the law.
7000 billion tonnes of paper are used every year for wrapping cigarettes globally. It is
estimated that to cure one kg of tobacco, it requires 8kgs of wood. It means cutting of trees
and destroying forests causing immense damage to the environment. It has been estimated
that every for 300 cigarettes smoked, some one somewhere has killed a tree.

Is there a way out?
Where there is a will there is a way. The only argument that the industry puts forth against
banning use of tobacco is that millions of tobacco growers and others involved in beedi
rolling for their survival will lose their jobs. The more tobacco is grown the more it will find
its way to the market. It is the duty of the State to help find people alternate jobs. I f argued, it
is millions of deaths and suffering over survival. What is needed is, to reduce tobacco
growing in a phased manner. Experiments in a few areas have shown that there are other food
grains, which are equally economically viable, could be grown if the attention the
government gives to tobacco in terms of subsidy and other support is given to the alternate
crops. The industry lobby is too strong for the weak political will. The elected political
representatives and bureaucracy may be weak and influenced by other interest, but if the
masses unite and put up a strong fight against this evil, it is possible to overcome.

Let us unite
■

To create awareness among all the people and particularly among the children and the
youth of the evil effects of tobacco to reduce the demand.

■

To increase advocacy for banning of all forms of direct and indirect advertisements
and sponsorship of sports and recreation and cultural events, promoting demand; and

To ensure implementation of the law banning smoking in public places to prevent
passive smoking and enable people, particularly children to breathe clean air for healthy

living.

pH- io

Towards Tobacco Control in a Globalised Economy
The 21st century witnessed the world markets being thrown open to free trade rules, raising alarming
consequences especially to the developing world. Nevertheless, it worked to the benefit of certain interest
groups in the market, the prominent among them being the tobacco industry.
The form, nature and the magnitude of the tobacco industry varies from country to country. But
globalisation, has primarily given them all access to the global market, thereby expanding their business
territories and areas of operation.

The Multinational Tobacco Industry
Tobacco industry today spans across seas, with companies like Philip Morris (PM), British American Tobacco
(BAT) and Japan Tobacco expanding its horizons way beyond their countries of origin. These cigarette
majors have managed to reach their brands to remote corners of the world either through large buyouts of
domestic tobacco companies or by opening up subsidiaries and branches. For example, in India, Philip Morris
holds 41% shares in Godfrey Philips (popular for their Four Square brand) and BAT holds 31.4% shares in
Indian Tobacco Company. Thailand stands out for its resistance in 1995 to the US Trade Representative
trying to force open its market to the US tobacco companies.

The political reach of tobacco companies is no secret. Philip Morris has been the largest contributor of
unregulated political donations in the last two federal elections in the US1. Considering the leading role­
played by the US in the global economy, it is but strategic for tobacco corporations to maintain political
influence in the US. In 1995, the company capitalising its close association with high political offices drafted
a law on growing, manufacturing and advertising of tobacco which was later approved by the Lithuanian
government1
2. Thus, tobacco trade has moved on from being a token of goodwill between kings to that
which dictates the world order. What is wrong about building a billion-dollar business that boosts the world
economy?

The true color of the industry
a)
b)

c)
d)
e)

Tobacco is the only consumer product, which if consumed as per the manufacturer's instructions
kills half of its life-long users;
Tobacco industry has known about the harmful effects of tobacco for more than 30 years but
intentionally opted to keep its consumers in the dark about it
Besides inflicting 44-odd illnesses in human beings, tobacco poses serious threat to the
environment;
Tobacco depletes national reserves through high medical costs for tobacco-related diseases
Tobacco is more addictive than cocaine or marijuana thereby robbing its user of the freedom to
decide on continued use or discontinue its use.

Magnitude of the Tobacco Menace
According to World Health Organisation (WHO), 4million people die globally from tobacco-related illnesses
every year. This is more than the combined global death toll from HIV, Tuberculosis, maternal mortality,
homicide, alcohol, suicide and automobile accidents put together3*. WHO projects that by 2030, the global
tobacco death toll would rise to 10 million and 70 % of these deaths would occur in poor developing

1 From research conducted by the Center for Responsive Politics, Washington, D.C. www.opensecrets.org
2 INFACT survey by Tomas Stanikas, Kaunas Medical Academy, Lithuania, presented at the 10lh World Conference on

Tobacco or Health, Beijing, August 1997.
’ Hoard, Barnum. “The Economic Burden of the Global Trade in Tobacco," Paper presented at tire 9'11 World

Conference on Tobacco or Health, October 1994.

countries. In India, tobacco kills more than 8 lakh persons every year. If current trends continue, 250 million
children alive today will be killed by tobacco4.

Youth are the hot favorites of the tobacco industry. Tobacco companies use aggressive advertising geared
towards getting the children addicted at an early age so that they remain tobacco users for a lifetime. This is
in clear violation of the commitments the countries from the region have made under the UN Convention on
the Rights of the Child, which guarantees right to life, survival and development of a child.
Scientific studies have shown that Tobacco has been proven to cause cancer of the lungs, mouth and throat,
breast, urinary bladder and cervix. Smoking is a leading cause for Peripheral Vascular Disease, which
eventually leads to amputation of limbs and even early death. A cigarette smoker has two to three times the
risk of having a heart attack or a stroke compared to a non-smoker. Smokeless tobacco users are more likely
to develop cancers of the lip, tongue, and floor of the mouth, cheek and gum than non-users.
Non-smokers who are exposed to tobacco smoke at home, have a 25 per cent increased risk of heart
diseases and lung cancer. WHO estimates that 700 million, or almost half of the world's children, breath air
polluted by tobacco smoke, particularly at home. Children of smoking parents are more prone to respiratory
tract infections such as bronchitis, pneumonia, cot death, middle ear diseases and asthma attacks5.

Tobacco production costs the environment dearly. In 66 tobacco-growing countries in the world, 4.6% of
national deforestation is due to cutting of trees for curing tobacco and for building curing barns. Trees are
also cut to produce paper for wrapping cigarettes and for packaging of tobacco products. In Thane district in
Maharashtra (India), vast acres of forest land is cleared to procure "katha", an ingredient of the indigenous
tobacco products Gutkha and pan masala from the bark of Khaire trees6. Smoking causes an estimated 10 %

of the global deaths from fire. Disposal of the butts, packs, and cartons of tobacco products produces much
trash that workers in the US complain that sweeping up cigarette butts causes them hours of extra work
each month 7.
o

Challenges Paused by Tobacco
Factors Influencing Demand For Tobacco And Feasible Solutions
Entrapping Advertising: Tobacco industry is the largest advertiser in the world. Obviously, they have to
try hard to sell their product against all its proven dangers to public health. In 1996, Philip Morris the world's
largest multinational cigarette company spent $3.1 billon advertising its tobacco and food products 8. In
India, approximately Rupees 400 crore is spent on tobacco ads every year. In Bangladesh, British American
Tobacco which owns controlling share of Bangladesh's former tobacco monopoly, spent $ 3.4 million on
brand promotions and development in 1998.

With the growing restrictions on direct advertising of tobacco products world wide, the industry is evolving
dubious and unscrupulous marketing strategies to circumvent law. A quick look at these promos exposes
their tactic to hook young and fresh consumers to their products through indirect means like brand
stretching and sponsoring youth programmes. The industry has always opposed Ad bans and ingeniously
suggests voluntary restrictions, which have proven to be ineffective in other countries. In a recent study

4 C.J. Murray and A.D. Lopez, Eds. The Global Burden of Disease: A Comprehensive Assessment of Mortality and
Disability from Disease. Injuries and Risk Factors in 1990 and Projected to 2020 (Cambridge MA: Harvard School of

Public Health, 1996).
' Report of the Scientific Committee on Tobacco and Health. Department of Health, UK. 1998.
“ "Dawood is diversifying into Gutkha”, Bombay Times, 04/12/2000.
Novotny & Zhao 1999.
" R. Hammond. Tobacco Advertising and Promotion: The Needfor a Co-ordinated Global Response. Geneva: World

Health Organisation. 2000

involving 22 high-income countries it was revealed that where most comprehensive advertising restrictions
were in place, tobacco consumption would fall by 6 %9.

Package Advertising: Tobacco companies for decades have been effectively using the tobacco package
space as an excellent advertising media. Countries like Canada, Brazil and European Union have realised the
power of package advertising and have made it mandatory to display pictorial health messages on tobacco
packs. The Canadian experience as revealed in a recent survey has been that 44 % of smokers said that the
new warning increased their motivation to quit and among those attempted to quit in 2001, 38% cited the
warnings as a motivating factor. 35 percent of smokers and 34 percent of nonsmokers said they know more
about the health effects of smoking than they did before the new warnings I011
.
Tobacco & Poverty: Researchers from Bangladesh and India report that tobacco use further impoverishes
poor-income households. In a recent survey conducted among 400 pavement dwelling families in Mumbai,
India, the poor spend more on purchasing tobacco than on nutritious food like meat, milk, fruits or egg11.

Similarly, among the poor income households in Bangladesh a typical male smoker spends 5 times as much
on cigarettes as the per capita expenditure on housing, 18 times as much as for health and 20 times as
much as for education12. Obviously, tobacco reduces the purchasing capacity of the poor.

Affordability: Increasing tax is a feasible strategy to reduce accessibility and affordability especially among
income-sensitive groups. This should be a hot favorite among the Governments as it brings additional
revenue to the Government exchequer.
Increasing taxes, increases smuggling" is the typical industry line of argument. However, it has been found
that increase in contraband and smuggling arises out of poor low enforcement and customs regulations
rather than from tax increases.

Rights and Awareness: Addictive as tobacco is, it robs its user of the power to choose its use or
discontinue it. In doing so, it deprives the consumer of the basic right to choose. Tobacco companies hide
information about the harmfulness of their products thereby denying them the right to information based on
which they could otherwise make an "informed choice". Children's rights to life, survival and development
are jeopardized in terms of reduced access to health and education from increasing tobacco expenses
incurred by adults in the family. They are choked from passive smoking, which the adults in their
environment are unmindful of.

Issues related to the Supply of Tobacco
The tobacco industry perpetually whips up farmers' associations and unions creating fear that tobacco
control would lead to massive unemployment in the tobacco production sectors. However, economists Jha &
Chaloupka (1999) who have done extensive macro analysis of tobacco producing economies allay these
fears13.

They opine that the negative effects of tobacco control on employments have been grossly overstated. While
there would be no net loss of jobs, there might even be job gains if global tobacco consumption fell. This is
because money spent on tobacco would be spend on other goods and services thereby generating more
jobs. Even in economies heavily dependent on tobacco, aid adjustment, crop diversification, rural training
and other safety net systems would take care of the problem.

9 P. Jha & F.J. Chaloupka. Curbing the Epidemic,Governments and the Economics of Tobacco Control. Washington.

1999.
10 Research by Canadian Cancer Society on the Effectiveness of Pictorial Health Warnings. 2001.
11 S. John, S. Vaite & D. Efroymson. Tobacco and Poverty: Observations from India and Bangladesh. PATH Canada.
October 2002.
12 D. Eforymson & S. Ahmed. Hungryfor Tobacco. Work for a Better Bangladesh. 2001.
13 P. Jha & F.J. Chaloupka. Curbing the Epidemic, Governments and the Economics of Tobacco Control. Washington.

1999.

Even in countries with comprehensive tobacco control policies, tobacco consumption reduces at best by 1 %.
With increasing population in most of the developing countries it would be a while before there would be any
considerable impact on tobacco production, giving farmers sufficient time to diversify into alternate avenues.

A recent study conducted among tobacco farmers in Karnataka, one of the leading tobacco producing States
in India, reveals that diversification to alternate livelihood is a feasible option for those engaged in various
tobacco production avenues. Tobacco farmers have been found to suffer from several occupational health
hazards and complain of perpetual state of poverty and debts14.
Envisaging future decline in bidi smoking, Kerala Dinesh Bidi, the largest co-operative society in Asia
launched its diversification efforts into food processing and other consumer products. In the first three years
of diversification, 15 out of the 30 products have been reported to be breaking even15.
Another major argument leveled against diversification is that with these efforts countries would cease to
receive the tax they are currently getting from tobacco taxes. This is a fallacy. In India, for instance, the
Government revenue from tobacco is way below what it spends on treating tobacco-related illnesses.

Also, with tobacco users reducing its consumption in response to tobacco control measures, it is likely that
they would invest in other consumer products. This would lead to development of other sectors of the
economy and thus contribute to overall national growth.

Framework Convention on Tobacco Control (FCTC)
In 1998, the World Health Organisation invoked its prerogative to propose an international tobacco control
treaty named Framework Convention on Tobacco Control to contain the global tobacco epidemic. The treaty
addresses transnational issues pertaining to tobacco advertising, smuggling, packaging, testing and reporting
of toxic constituents, environmental tobacco smoke and resource sharing.

The treaty is currently moving towards the final stages of its negotiation by 190 odd Member Nations of
WHO in the last and sixth round of negotiation scheduled for Mid February 2003. It is slate to be adopted by
World Health Assembly in May 2003.
The treaty is significant for the Asian countries, primarily in resisting the tobacco industry which considers us
the prime target in this decade. It serves as a booster to build national tobacco control policies and
programmes. The negotiations for the first time in the history of tobacco control movement, has brought
together people, Governments, NGOs, energy and resources from all over the world to address the tobacco
pandemic.

Tobacco Control in Asia
In the last decade, several organisations in the region have initiated awareness programmes among
children, youth, women and workers as a prevention strategy. Some of them advocate strong tobacco
control policies home and abroad. In India, Research and surveillance have been carried out on different
population groups on their tobacco control patterns.
Thailand has advanced tobacco control programmes and policies. India has of late proposed the Tobacco
Products Bill, banning tobacco advertising, promotions and smoking in public places among others.
Bangladesh and Nepal are also drafting national policies to contain the tobacco epidemic.
In the recent years, tobacco control activists have realised the power of collective strength and have formed
networks and coalitions at local and national levels. The Consortium for Tobacco Free Karnataka, Indian
Coalition for Tobacco Control, Bangladesh Anti Tobacco Alliance, South Asia Tobacco Control Forum and

'"S. John. S. Vaite & D. Efroymson. Tobacco and Poverty: Observations front India and Bangladesh. PATH Canada.
October 2002.
15 Ibid. Interview with Kerala Dinesh Bidi Office Bearers.

South East Asia Tobacco Control Alliance, Framework Convention Alliance are a few of the active alliances in
the region.

In 1998, World Health Assembly launched the drafting of an international treaty to address trans-national
tobacco control issues. The treaty, Framework Convention on Tobacco Control is currently is in the last
stages of its development, with over 150 world countries concluding its negotiations coming summer in
Geneva. Countries and organisations from the region play a vital role in demanding stringent tobacco control
measures in this treaty.

Emerging Needs of Tobacco Control in Asia
Industry documents and operations reveal that they are now training their guns on Asia and Africa. Lack of
adequate tobacco control policies and failure in implementing the existing policies make us all the more
vulnerable to the attacks of these companies as also to tobacco epidemic. Illiterate masses and cultural
practices also seem to be hurdles in tobacco control in Asia. The emerging needs therefore for the region
are:

a)
b)
c)
d)
e)
f)

Building awareness among the Asian masses about the health and socio-economic consequences of
tobacco use and trade
Exposing myths and cultural practices that promotes the habit
Training development workers and organization on tobacco control issues
Building networks and coalitions that would serve as pressure groups in policy advocacy
Engaging in active advocacy for tobacco control policies at national and regional level
Advocacy for effective implementation of FCTC commitments in the region

Possibilities for Collaboration
The issues involved in tobacco control demands a matching o-ordinated response from different sectors of
the civil society. World Health Organisation responded to this global epidemic by setting up the Tobacco Free
Initiative in 1998, which in turn supports various global campaigns and programmes in tobacco control. It
calls upon the civil society each year to observe 31s' of May as the World No Tobacco Day.
Besides, there are various networks, coalitions and organizations already engaged in active tobacco control.
If you are further interested in learning or engaging in tobacco control issues, feel free to contact any of the
organisors of the event listed below:
Shoba John, PATH Canada
Thelma Narayan
South East Asia Focal Point,
Community Health Cell
Framework Convention on Tobacco Control.
International Secretariat,
Member, Indian Coalition for Tobacco Control.
People's Health Assembly
Email: sjohn_pathcan@vsnl.net
Email: sochara@vsnl.com

Dr. Srinath Reddy
Professor of Cardiology, AIIMS.
Secretary,
SHAN & HRIDAY, New Delhi.
Email :info@hriday-shan.org

Dr. Anant ** & Chander **
Consortium for Tobacco Free Karnataka
Email:sochara@vsnl.net

Naveen Thomas
Fellow, Oxfam India Trust
Email:navthom@vsnl.net
Paper prepared by:
Shoba John
PATH Canada, India.

for Asia Social Forum
Workshop on "Working Towards Tobacco Control in Asia"

January 2003

Subject: Motes from today's meeting - comments welcome!

Date: Thu, 12 Sep 2002 20:06:35 +0100
From: "Roger Drew" <rogerdrew@rogerdrew.free-online.co.uk>
To: "Tom Novotny” <Tom.Novotny@lshtm.ac.uk >, "Anna Gilmore" <Anna.Gilmore@lshtm.ac.uk>,
"Bernard Trude" <irude.b@heal!hlink.org.uk>, <c.netllelon@heallhunlimiled.org>,
"Emmanuel Guindone" <Guindone@.who.int>, '"Karl Blanchet"' <karl.blanchet@hi-uk.org>,
"Mathew Shaw" <mathcw.shaw@lshtm.ac.uk>, "Prccti Patel" <Prccti.Patcl@lshtm.ac.uk>.
"Ross Mackenzie" <Ross.Mackenzie@lshtm.ac.uk>, "Tim Shaw" <tim.shaw@sas.ac.uk>,
"'Tim Cullin'" <Tim.Cullinan@merlin.org.uk>, "'Adam Oliver'" <A.J.01iver@lse.ac.uk>.
'"Alan Beattie'" <a.beattie@ucsm.ac.uk>, "'Alastair Burtt'" <aburtt@rydercheshire.co.uk>,
"'Alex Rosdol’" <a.k.rosdol@lse.ac.uk>, "'Andrew Chetley'" <chetley.a@healthlink.org.uk>,
"’Andrew Pendleton'" <apendleton@christian-aid.org>,
’"Andy Haines'" <Andy.Haines@,lshtm.ac.uk>, '"Anna Malos'" <amalos@bond.org.uk>,
"'Anna Thomas'" <anthomas@christian-aid.org>,
"'Anthony Costello'" <a.costelio@ich.ucl.ac.uk>, '"Balwant Singh'" <bsingh@ifh.org.uk >,
'"Barbara Judge"’ <Barbara.Judge@lshim.ac.uk>, ’"Befrienders"' <admin@befrienders.org>,
'"Bridge! Sleap"’ <bridgels@panoslondon.org.uk >, "'C Mears'" <cmears@redcross.org. uk>,
"'Carlos Grijalva"’ <C.Grijalva@.ich.ucl.ac.uk>,
"'Chiara Carcianiga'" <Chiara_Carcianiga@lcpra.org.uk>,
"’Christiane Fischer'" <bukopharma@compuserve.com>,
"'Clare Haskins'" <haskins.c@healthlink.org.uk>,
"Costanza de Toma'" <cdetoma@bond.org.uk >, "’craig burgess'" <craig@merlin.org.uk>,
"David Woodward"' <woodwardd@who.ch >, "Di Ross'" <dross@ifh.org.uk>,
"Dorothy Flatman'" <d.flatman@wcf-uk.org>, "Doug Soutar'" <doug_soutar@lepra.org.uk >,
'"Elena Medi"' <e.medi@tiscalinet.it>, '"Emma Back'" <e-back@dfid.gov.uk>,
"'Gern' McMahon’" <GMcMahon@.actionaid.org.uk>, '"Iona Heath'" <pe3 l@dial.pipex.com>,
"'Jane Banez Ockelford'" <janebanez@aol.com>, '"Jane Betts'" <jane.betts@worldvision.org.uk>,
"’Janee Rambocus"' <janee.rambocus@stopes.org.uk>,
"'Janine Fearon'" <janine@fearon28.freeserve.co.uk>, '"Jean Jones'" <jeanj@llmew.org.uk>,
'"Jeff Collin'" <Jeff.Collin@lshtm.ac.uk>, "'Jenny Brown'" <JBrown@.christian-aid.org>,
'"Jerry Clcwctt'" <j.clcwctt@hcalthunlimitcd.org>, "'Jo Best'" <JBcst@.rcdcross.org.uk>,
'"Judith Cook"' <nick.alex@virgin.net>, "'Jukka Sailas'" <sailasj@who.int>,
'"Kelley Lee'" <k.lee@care4free.net>, '"Laura Ferguson'" <L.Feiguson@AF.4REF.org>,
<LBANNIST@heipage.org>, "Lidia Simbitseva'" <simb@comset.net>,
i
"Lucien Bigeaull'" <lucien.bigeaull@freesbee.fr>, '"Malayah Harper'" <m-harper@dfid.gov.uk >,
"Manjit'" <manjitk@.echohealth.org.uk >, "'Margaret Reeves'" <margreeves@yahoo.co.uk >,
"Maura Odonohue'" <modonohue@cafod.org.uk>,
"Melaina Barnes'" <bames.m@healthlink.org.uk>, "Melany Zipperer'" <zippererm@who.ch>,
'"Mick Matthews'" <ukaidscon@gn.apc.org>, '"Mike Rowsori" <mikerowson@medact.org >,
<Mona@Map-uk.org>, "Mwajuma Masaiganah'" <masaigana@africaonline.co.tz>,
'"Nick Pahl'" <n.pahl@helplhehospices.org.uE>,
'"Nick Priggis'" <nick.priggis@.worldvision.org.uk >, "'Onkar Mittal"' <o-mittal@.dfid.gov.uk>,
"Tam Zinkin'" <pamzinkin@gn.apc.org >, "Paul Sommerfeld'" <paul@.somhcaly.dcmon.co.uk >,
"'Penelope Key'" <Penekey@btintemet.com>, "'Peter Poore"' <PDPoore@aol.com>,
"Teter Raven'" <praven@intemational-alert.org>,
'"Ravi and Thelma Narayan'" <sochara@vsnl.com>, "Regina Keith'" <r.keith@.scfuk.org.uk>,
"Richard Lansdowri" <r.lajjsdbwn@ich.ucl.ac.uk >,
"Rosemary Gilbert'" <rosenrary.gilbert@befrienders.org >
"Rosemary Rodgers'" <rrodgers@rcgp.org.uk>, "Ruairi Brugha'" <Ruairi.Brugha@lshtm.ac.uk>,
"'Sandhya Sastry'" <sandhya.sastry@.stopes.org.uk>, "'Sandra Kabir'" <skabir@rhae.org>,
"'Scott Hardie'" <s-hardie@dfid.gov.uk>, "'Sheila Davie'" <resultsuk@gn.apc.org>,
"'Sue Lawrence"' <Sue.Lawrence@lshtm.ac.uk>, ’"Susan Crane'" <scrane@ifn.org.uk>,
’"Susan Fallori" <sfallon@projec!hopeuk.org>

Notes fiuffl today's meeting - comments welcome!

Tobacco Control: A Key Development Issue?

The Health and Development Forum held a meeting on the 12th September 2002 at the London School of
Hygiene and Tropical Medicine to discuss issues relating to Tobacco, Health and Development. This
meeting was convened following a request to BOND from DFID for information as to what UK
development NGOs were doing in the area of Tobacco Control.

Jeff Collin of the London School of Hygiene and Tropical Medicine opened the meeting with an overview
of the subject. He acknowledged that whilst there were valid reasons why the subject could be approached
in the conventional way of focusing on the effects of tobacco on the health of smokers, there were many
other ways in which the issue could be approached which might be developmentally more relevant. These
included looking al it from either an economic or globalisation approach. He explained that measures to
control tobacco use, such as increasing taxation brought in additional income to governments. In addition,
he argued that the economic benefits of tobacco production had been overplayed. Only 18 countries gain
over 1% of their income from tobacco, only 4 gain more than 5% and only 2 (Malawi and Zimbabwe) have
economies which are highly dependent on tobacco. He also explained that 4 tobacco countries control 75%
" f the market and that they have successfully portrayed tobacco control as a first world issue.

He then introduced the Framework Convention on Tobacco Control which was first formulated at the World
Health Assembly [WHA] in 1999. It is planned to ratify the convention at the next WHA in 2003. Issues
being debated on the current text include trade, smuggling, advertising, packaging and numbers of countries
needed to agree the convention for ratification purposes.

Scott Hardie then briefly responded on behalf of DFID. He explained that DFID is interested in tobacco
because, not only is tobacco a major health issue but it goes well beyond that. DFID is particularly
interested in the effect of tobacco on women and children. DFID is supporting the critical work of WHO on
this issue and hying to develop a coherent approach.

Andrew Pendleton of Christian Aid then presented work they had been doing with small-scale tobacco
fanners in Brazil. Their conclusion was that farming tobacco could be as bad for your health as smoking
itself because of the unregulated use of pesticides and the absorption of nicotine through the skin. In
addition, the fanners were often kept in debt by Souza Cruz (a BAT subsidiary) and forced to sell their
tobacco to the company at low prices. The main conclusion of the Christian Aid research was that they
wanted to advocate for better conditions for Brazilian tobacco fanners and they had had a meeting with
BAT to pursue this matter.

In the discussion that followed, the view was expressed that although there might appear to be differences in
conclusions when the issue is approached from different perspectives they were in fact broadly similar
irrespective of whether the starting point was the welfare of the smoker or the small-scale fanner. It was
also noted that there were many other perspectives from which the issue could be approached, such as
economic and environmental. The hope was expressed that major development NGOs might take on this
issue more. However, the majority of these seek to respond to the needs of poor people. If tobacco control

9/13^211:39 AM

,'ows from today’s meeting - comments welcome!

is not seen as a major need by poor people, it could be considered paternalistic and patronising to force
* these issues on them. It was acknowledged that for many poor people fear of contracting a smoking-related
disease when they were older was not as pressing a concern as the immediate survival issues they face on a
daily basis. Another reason why development NGOs had not been so active on tobacco issues was
suggested, namely that there is little space for them because the field was already filled with health NGOs.
The situation was reported to be different in Africa where the range of NGOs active on tobacco issues is
broader.

Concerning the proposed Framework Convention on Tobacco Control, concern was expressed about the
value of any convention which the US refused to sign. The tension was recognised between a strong
convention which very few countries signed and a weaker convention which more countries could sign up
to. Whatever the outcome, it was recognised that the framework convention was already playing a valuable
role in stimulating discussion on tobacco issues.

A concrete proposal which was made by the meeting was that DFID consider organising a meeting aimed at
major development NGOs, perhaps in co-operation with BOND. This meeting would be seen as seeking to
promote dialogue on issues of common concern between those working actively on tobacco issues and those
jvorking in deveiopment more generally.

For more details of this meeting, contact Roger Drew on roger@mendlesham.fsnet.co.uk

Roger Drew

Health and Development Consultant
9a The Green
Mendlesham Green

IP14 5RQ

Tel: 01449 76S947
Fax: 01449 7678S8
Mobile: 0781 275 3152

E mail: roger@mendlesham.fsnet.co.uk

9/13/02 11:39 AM

A
.» 8 ?
J0

Write up for TFI conference in 2006
CFTFK

The Consortium For Tobacco Free Karnatak (CFTFK) was formed in the year 2000 AD. Prior to
formation of CFTFK a few of the health care organizations and hospitals working in Bangalore
would come together and organize a public rally on World No Tobacco Day (WNTD). The idea of
forming a consortium was felt during the reflection after the WNTD rally of 2000. The partners of
the network felt the need for addressing both the demand and supply issues in tobacco control in a
sustained manner.
Goal:
Work towards initiating tobacco control measures in Karnataka state

Objectives:
1.

To create and increase awareness on various implications of tobacco use among various groups

2.

To launch educational Programs for the educational institutions

3.

To advocate for tobacco control policies that would address the socio, economic, health and environment
implications of tobacco use.

1.

Public awareness

To create public awareness the CFTFK has organized public rallies, poster exhibition talk on radio
and television written to print medium and talks to professional groups. (L&T senior engineers)
Rotarians
2.

Schools and colleges

Awareness session
3.

Students’ action for tobacco control

4.

Workshop for college and school teacher

5.

Street children

Audiovisual presentation and role-plays
6.

Poster Exhibitions

Exhibitions at public places and institutions
7.

Puppet shows

For street children and during seminar
8.

Street play

On WNTD by professional team
9.

Public Rally

Each year the public rally was conducted in a different manner to capture a larger audience

10.

District workshops

Orientation programme were conducted to voluntary organizations working in various districts
11.

Radio and television

Members of the consortium have gone to the studios of DD, Udaya TV, Chandana TV Star Plus ,
Radio programme All India Radio, Gyan Vanin of IGNOU
12.

Print media

The reporter of poplar dailies regularly interviews members of the consortium
13.

Seminar and workshop

Conducted workshop at ASF, IHF, Participated at the workshop on tobacco at World Social Forum
14.

Memorandum submission

pu-io

Quit Smoking Tips

AMERICAN
Massachusetts Division, Inc.

Preparing to Quit

Ask yourself 3 key questions: How much do I smoke? Why do I smoke? What will be my most difficult hurdle in quitting?
If you’re feeling ambivalent about quitting, ask yourself which you want most: to smoke or
to stop. (Remember, you don’t have to get rid of the desire to smoke before stopping.)
Throw away all cigarettes and matches. Put away your ashtrays or fill them with
sugar-free gum, low calorie candy or potpourri.

Choose a method of quitting. Cold turkey is the most successful, but a gradual approach is
fine.

Decide to cut down by a certain number of cigarettes per day, and increase your reduction
by that number each succeeding day.
Postpone the first cigarette of the day by an hour, and extend that time daily.

Make it hard to get and smoke a cigarette. Put them in a different place. Wrap up the
package and put elastic bands around it. Smoke with your left hand if you usually smoke
with your right.
Change to a brand you don’t like. Buy only one pack at a time.
Change your everyday behavior so that everything you do becomes a conscious choice.
If you always have a smoke with your coffee, switch to tea, juice or soda.
If you smoke in bed, don’t — stand up instead.
If you shower first, don’t— have your breakfast first.

Call up your friends and tell them you’re going to quit. (Choose to tell the friends who will offer
only positive reinforcement.)

Make a list of why you smoke and why you want to quit. Choose the most important
reason why you want to quit and write it on a 3" X 5" card; carry it with you at all
times and read it when you get the cravings.
Set a final quit date.

Tips - For and After the Day you Quit
Visit the dentist and have your teeth cleaned to get rid of the tobacco stains. Notice how nice they look, and resolve to
keep them that way.
Make a list of things you’d like to buy yourself or someone else. Estimate the cost in terms of packs of cigarettes, and put
the money aside to buy these presents.

Spend as much free time as possible in places where smoking is prohibited — libraries, museums, theaters, churches.
Drink large quantities of water and fruit juice. Nicotine is flushed out of the body in four to five days.

(over)

Quit Smoking Tips - cont'd
Avoid alcohol, coffee and other beverages that you associate with smoking. The connections between alcohol and ciga­
rettes is an intense one. BEWARE! Alcohol lowers your resistance to temptation.
If you miss the sensation of having a cigarette in your hand, play with something else — a pencil, a paper-clip, a marble.
Keep oral substitutes handy: toothpicks, cinnamon sticks, carrots, pickles, apples, raisins, etc.
If you quit for one day, you can quit for another. Try it.

If you break down and have a cigarette, don’t give up. Some people take several tries before they
nake it. Just don’t have a second cigarette.

FIND NEW HABITS - Seek new activities or perform old activities in new ways. Do
things differently and develop a non-smoking environment around you.
AVOID TEMPTATION - Stay away from situations you associate with pleasurable smoking.
Brush your teeth.
Think positive thoughts and avoid negative ones.
Take deep rhythmic breaths similar to smoking to help you relax.

Remember that a craving to smoke will pass, whether you light up or not.
If cigarettes give you an energy boost, indulge in moderate exercise, such as short walks after meals, pushups, deep knee
bends, a walk up a flight of stairs, or touching your toes.
Stock low-calorie snack food at home and at work. Keep celery or carrot sticks ready to eat in the refrigerator. Avoid
eating new foods that are high in calories.

If you gain a few pound while quitting, don’t get discouraged. To reach the same health risk as smoking one pack of
cigarettes per day, the average smoker would have to be roughly 125 pounds overweight.

Eat several small meals. This maintains constant blood sugar levels and helps prevt.H the urge to smoke. Avoid sugary or
spicy foods that trigger a desire for cigarettes.
Take 10 deep breaths, hold the last one while lighting a match. Exhale slowly and blow out the match. Pretend it is a
cigarette and put it out in an ashtray.
Take a shower; you can’t smoke in the shower.
Learn to relax quickly and deeply. Visualize a soothing, pleasing situation, and get
away from it all for a moment. Concentrate on that peaceful image and nothing
else.

Call a supportive friend.
Never allow yourself to think that “one won’t hurt,” because it will.

Remember that the best way to deal with change is to create change. If you want a
cigarette, don’t sit there letting the craving whittle away at you — MOVE.

Walk around the block, get a drink of water, do something else!
REWARD YOURSELF. Plan to do something fun for doing your best.
Good Luck!
For more information call 1-800-ACS-2345

Ohorn Utt

Voluntary Organisation in Interest of Consumer Education

Tobacco Ofe.
Oid you know...

Faces of Terror . . . Oral
Cancer Patients

♦ 2200 Indians die everyday due to
tobacco use.
♦ 40% of all cancers in India are
due to tobacco use.

♦ India has the highest number of
oral cancer cases and 90% of all
oral cancers are tobacco related.
♦ One Cigarette smoked costs 14
minutes of your life.

Tobacco Consumption
in India

♦ Tobacco smoke contains more
than 4000 harmful chemicals.
♦ Some of these harmfid
chemicals are: Ammonia (used in
floor cleaners), Arsenic (white
ant poison), Carbon Monoxide
(dangerous gas in car exhaust),
Naphthalene (used in mothballs),
Nicotine (used to kill insects).

Every child has the right to grow up without being temp­
ted to use tobacco and live in a tobacco free environment
A conscious effort needs to be made towards providing
such an environment

Where

L _'_'ioking is considered
normal behaviour

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Passive Smoking
Cigarette smoke is a major indoor air pollutantclassified as human cancer causing agent
♦ Are you living or working
with smokers?

♦ You are prone to 20% - 30%
increased risk of fatal
cardiac problems.

♦ There’s no safe level of
exposure for passive smoking.

♦ Children and Women are
most vulnerable.

♦ Some alarming results of
Passive Smoking are:
Bronchitis, Pneumonia,
Asthma, Reduced rate of
Lung Growth, Miscarriage,
Low Birth Weight Babies,
Sudden Infant Death
Syndrome (SIDS).

When a passive smoker
inhales cigarette smoke,
it acts on the brain within
6 seconds

Passive Smoking:
Deadlier than you think

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Economic Cong@^uen©e©
Tobacco industry insists that sale of tobacco
benefits the economy.

Don’t get mislead!
We incur more losses than gains.

The real picture:
♦ 661 trees are cut for one tonne of
tobacco.
♦ Environmental costs such as
deforestation and collection of
tobacco users’ litter.

♦ Loss of land that could grow food
instead of tobacco.
4- Absenteeism from work due to

poor health resulting in low
productivity.

It costs
Rs. 27,760
crores to treat
people with
tobacco related
diseases
(more than 4
times the
revenue earned
from the
tobacco
industry)
(Source: ICMR, 1999)

Contribution of tobacco
to the GDP is mere 0.14%
of the total GDP.
That comes at a high
price - tobacco
causes 1 in every
5 deaths in India.
(Source: Tobacco Quit India)

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Tobacco Advertising & Promotion
♦ Tobacco advertisement contributes
Rs. 300-400 crore to the advertising
industry.
♦ Newspapers, Magazines, Billboards,
surrogate forms of advertising
encourage tobacco use e.g.
Manikchand Flimfare Awards, Wills
“Made for Each Other” contest etc.

♦ Of 395 films made in India between
1991-2002, 76.5% showed tobacco use.
(Source: WHOINMHITFII03.01)

Alcohol,
cigarettes,
® '
drugs...
'l
these are all
; temporary
highs. What
“ one should
pursue are things of more
permanent nature such as
\ love, passion and good
\ deeds. I may smoke on
screen, but I will never
■ endorse cigarette smoking.

k

Vivek Oberoi,
actor

Cigarette Brand 1 Advertising Expenditure
Gold Flake

Rs. 50 crore

555

Rs. 10 crore

B&H

Rs. 10 crore

ITC Brands

Rs. 40 crore
(Source: Times of India, 9th~February, 2001)

Figures collected in 2000 indicate that
spending on tobacco brands grew by
28%, specifically targeting the youth
segment.
(Source: The Role and Responsibility of Media in
Global Tobacco Control. Geneva: WHO, 2002)

How does tobacco advertising &
promotion work?

Seductive images, endorsements, usage
in movies tempt people to try it. Once the
trial happens, a person gets addicted.

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Tobi©e© CorrtroS L®w in India
Indian Parliament enacts stringent
Tobacco Control Act, May 11, 2003
Called the Cigarette and Other Tobacco
Products (Prohibition of Advertisement,
Regulation of Trade and Commerce,
Production, Supply and Distribution) Act 2003,
it enacts the following:-

♦ Prohibit all forms of direct and
indirect tobacco advertising.
Smoke-free restaurant

♦ Total ban on sponsoring of any
sport or cultural events by tobacco
companies.

♦ Prohibit smoking in public places.
♦ Prohibit sale of tobacco products to
persons below the age of 18.
♦ Prohibit sale of tobacco products
within 100 yards of educational
institutions.

Smoke-free public transport

♦ Indication of nicotine and tar
contents on the packets.
♦ Indication of pictorial warnings on
the package in English as well as
Indian languages.

Smoke-free educational institution

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Tobacco Control Laws
at State Level
♦ Public smoking is banned in
Himachal Pradesh, Tamil Nadu,
Meghalaya, Jammu and Kashmir,
Assam, Rajasthan and Sikkim by
legislation.

♦ The Goa “Prohibition of Smoking &
Spitting Act” 1997, prohibits smok­
ing or spitting in places of public
work in Goa. It also makes it manda­
tory for a “No Smoking/Spitting”
board to be displayed prominently
at all places of public work.
♦ A similar legislation was brought
about in the National Capital
Region of Delhi, in 1996 and in the
state of West Bengal in 2003.
♦ The governments of Tamil Nadu,
Andhra Pradesh, Goa, Bihar and
Maharashtra have recently banned
sale of Gutkha in their states.

♦ Ln Kerala a High Court order
prohibits smoking in public areas.
The other existing regulations are:

♦ The Supreme Court has declared
smoking in Public Places a punishable
offence in November 2001.
♦ The Railway Ministry has banned the
sale of tobacco products on the railway
platform and inside the train.

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Action Points
A11 states in India should effectively
implement the Tobacco Control Act.
Advocacy with State Govts.Haw
enforcersIlocal leaders for developing
systems for implementation

1
2
3

Tools - Brochures, local prevalence data,
appeals by children, mobilising support
from local sports persons and NGOs.

Consumer organisations and NGOs
should work as watchdogs to ensure
enforcement of tobacco laws.

Model of No Smoking City Ban

Toolsenforcers,
- Knowledge
of laws,
follow-ups
with
law
surveys,
mobilising
local
citizen groups, providing up-to-date data on
infringements of the law.

Sensitise elected representatives,
corporates, trade & student unions
Tools - Enlist support of corporates
through the programme
“Tobacco Free Workplaces”
Tools - Develop model interventions for
replication at state level.

A

/I
A

Monitor & publish role of surrogate
advertisements to educate consumers
& report to concerned Ministries in
Govt, of India (I&B/Health)
Tools - Conduct regular studies on
surrogate advertisements, action taken
& change in attitude of stakeholders.

On the move against tobacco - World
No Tobacco Day, 31st May, 2002
Trivandrum. Among the first
runners are B T. Usha, Minister
M.M. Hassan, MLA Vijayakumar

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Highlights of the VOICE study on tobacco
law enforcers in Delhi and Goa, 2003
( + ) Positive

n* e^W-330CV2003

REGISTERED NO. DL-3300V2003

ML

♦ 91% of law enforcers strongly
tion of tobacco products is harmful

^he (gazette

♦ 80% are aware of existing laws
on smoking/tobacco control.
37j
No. J7J

♦ 73% strongly commit that th<
laws on tobacco control strictly.

(-) Negative
♦ 60% agreed that smoking or consumption of
tobacco in public places is a MINOR law
infringement.

♦ 65% accepted that the tobacco control laws &
regulations are not monitored regularly.

♦ 62% said that they do not get support from the
citizens who are onlookers at the time of raid /
prosecutions.
♦ 80% felt that lack of infrastructural support
reduces the ability to enforce social laws like
anti-dowry, child marriage or sale of Gutkha (to
name a few).

♦ 53% were of the view that intense work
pressure lead to smoking and other addictive
habits.
For many more revealing facts and information of this
study contact:

Bejon Misra
Advisor, Consumer Voice
bejonmisra@consumer-voice.org

it ftwt. cro, Rf 19, 2002/tera 29,1923
NEW DELHI,MONDAY, MAY W. WTU VAISAKHA M. 1925

MINISTRY OF LAW AND JUSTICE
(Legislative Department)
New Delhi. the l9thMay.2003IVabakhay). 1923 (SbU)

THE CIGARETTES AND OTHER TOBACCO PRODUCTS
(PROI IIBITION OF ADVERTISEMENT AND REGl JLATION
OF TRADE AND COMMERCE, PRODUCTION, SUPPLY
AND DISTRIBUTION) ACT, 2003

THE DELHI PROHIBITION OF SMOKING
AND
NON-SMOKER'S HEALTH PROTECTION ACT, 1996

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consumeralert@eth.net

World Health Organization

-IO ­

RESEARCH PROPOSAL

Submitted by:

Sr. Mariet,
M.Sc., (N)-II Year.
________________

gxsoU, - 5~ -

pLftMNe'D TeftCJAWt “NICOTINE ABUSE”
STATEMENT OF THE PROBLEM :
A study to evaluate the effectiveness of planned teaching programme on

knowledge of “Nicotine Abuse” among adolescentgin a selected Higher Secondary
school in Kerala.

OBJECTIVES:

'

To assess the knowledge of adolescence regarding Nicotine Abuse before

1.

planned teaching programme in the experimental group, cx/wd C<mX.■

To assess the knowledge of adolescence regarding Nicotine Abuse after

2.

planned teaching programme in the experimental group and control group.

To evaluate the effectiveness of the planned teaching programme by

3.

comparing the pre - test and post - test knowledge of the experimental group
and control group.

To find the association between selected back ground factors and knowledge

4.

of higher-secondary-students on “Nicotine Abuse” among the experimental

group.

HYPOTHESIS :
H1 -

There will be significant difference in the knowledge of the experimental
group between pre - test and post - test.

hB »

There will not be significant difference in the knowledge of the
experimental group between pre - test and post - test.

H2 -

There will be significant difference in the knowledge of the control group
between pre - test and post - test.

HO -

There will not be significant difference in the knowledge of the control
group between pre - test and post - test.

H3 -

There will be significant difference in the knowledge obtained by the
control group and experimental group.

HO V

There will not be significant difference in the knowledge obtained by the
control group and experimental group.

H4 -

There will be a significant association between the age and knowledge of
Nicotine Abuse among the experimental group.
There will not be a significant association between the age and
knowledge of Nicotine Abuse among the experimental group.

H5 -

There will be a significant association between the
knowledge of Nicotine Abuse and sex of the experimental group.

HO -

There will not be a significant association between the
knowledge of Nicotine Abuse and sex of the experimental group.

ASSUMPTIONS :
It is assumed that
1.

Students would co - operate with the researcher and would be willing to

express their knowledge regarding “Nicotine Abuse”.

2.

The tool employed for the study would be adequate and sufficient for
gaining information about the knowledge of adolescence regarding
“Nicotine Abuse”.

3.

The Planned teaching programme would be effective in improving the
knowledge of adolescence regarding “Nicotine Abuse”.

DELIMITATIONS

The
I.

study is de limitedto The students studying in ST.ANNES Higher secondary

school.

2.

Only adolscence between 13 and 17 years

3.

Students who arestudying 9th-12thstandard

4.

Students who are available at data collection

5.

The measurment of knowledge only before and after the planned teaching

programme

PLAN AND ORGANIZATION OF REWIEW OF LITERATURE

It will be done on following headings

1. Study regarding nicotine in general

2. Study related to nicotine abuse
y 3. Study related to nicotine abuse among adolescence
y'4. Study related to planned teaching programme

A 5y&U=,

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INPUT

PROCESS

OUTPUT

Feed back

Conceptual frame work based on system model

key------------- > not under study

METHODOLOGY:

Population:

All the adolescence are the target population’ adolescence who are are studying in
the St;Annes higher secondary school is the accessible population

Sample:

S'istetnoViC.'TicMYKAow

A total of 60 adolescence are included in the present study “By convonienee sampling;
There are 30 subjects in the experimental group and 30 subjects in the control group.

Sample size: 60
Control group: 30
Experimental group: 30

SAMPLE SELECTION CRITERIA

Inclusion Criteria:

- Adolescence
-Adolescence who are studying in the St.Anne’s higher secondary school.
- Adolescence who are between the age group of 13-17.

- Adoles who are studying in the 9th -12 th standard.

Exclusion Criteria:

-Adolescence below 13 and above 17.
- Adolescence who are absent in the day of data collection
- Adolescence who are not studying in the higher secondary school.

RESEARCH APPROACH :
In view of the nature of the problem selected for the study and the
objectives

to

be

accomplished

an

evaluative

research

is

considered

an

appropriate research approach for the present study.

Setting :
The study will be conducted at St. Anne’s Higher Secondary School, Kurianadu,
Kottayam District, Kerala State.

Research Design
True experimental design : Pre - test, Post - test experimental design.
Randomized

Group
Experimental

Group

Pre - Test

Planned Teaching

Knowledge Test
Ch

Control Group

T reatment

Knowledge Test

Post-Test

Knowledge Test

Programme

o2

Xi
...

Knowledge Test

o3

04

VARIABLES UNDER STUDY
1)

Independent variable

2)

Dependent variable

Planned teaching programme.

a) Performance on pre - test (knowledge on Nicotine Abuse)
b) Performance on post - test.
3)

Attributed variables
Age, Sex, Educational qualifications and source of information.

Selection of the tool
A self administered structured knowledge questionnaire is selected for the

study.

It is considered to be the most appropriate instrument to elicit the

responses from literate subjects.

EXPRIMENTAL RESEARCH DESIGN

BLUE PRINT OF THE TOOL:

Weightage

No.

Items

SI.No.
01.

General aspects of nicotine

10

1-10

20%

02.

Methods of using nicotindj

12

11-20

22%

03.

Side effects of nicotine addiction

8

21-30

18%

04.

Manifestations of nicotine addiction

10

31-40

20%

05.

Management of nicotine

addiction

10

41-50

20%

Total

50

100%

Reliability and validity of tool:
Establishment of content validity:

Content validity ofthe tool, i.e. the structureal questionnaire, lesson plan of teaching
programme and the content of the studies will be sent to both nursing and medical experts.

Reliability of the tool:

3 samples are selected for reliability ofthe tool (by test-re-test method). The teaching
is performed two times at the interval fo 6 days. ,

DATA COLLECTION PROCEDURE:

Get the permission from the Principal of St.Ann’s high school and select the sample
SYSTEMATIC- R.<vndom

by

sampling select the control group and experimental group. Do the planned

teaching programme only for experimental group. Administer post test to the both control

group and experimental group.

PLAN FOR DATA ANALYSIS:

Find the frequency and percentage of samples for analysis of demographic variables.
- Find mean and standard deviation of knowledge of nicotine abuse of both

experimental and control group.

8

-

paired and unpaired “t” test will be used to determine the effectiveness

of the teaching programme on Nicotine abuse.

-

Chi - square test will be used to find the association of demographic

variables and level of knowledge among the experimental group,

PLAN FOR PILOT STUDY :

The pilot study will be conducted on 03.03.2003 to 08.03.2003.
Sample number will be 10, from the same school.

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