For all the government’s efforts to discourage smoking, it remains a common sight across India. What’s worse is that the deadly habit can begin incredibly early, affecting children as young as 10 years old.
There are over 625,000 Indian children (pdf) aged between 10 and 14 years who smoke cigarettes every day, according to the latest edition of The Tobacco Atlas (pdf), published earlier this month. A partnership between the American Cancer Society and the non-profit, Vital Strategies, the Atlas measures the tobacco epidemic across the globe. Its data on India’s young smokers includes over 429,500 boys and 195,500 girls as of 2015.
In percentage terms, India has fewer young smokers than the average recorded by countries in the medium human development index category. Based on life expectancy, education, and income per capita, this category includes “medium developed” nations such as Vietnam, South Africa, Bangladesh, and Nepal. But as a Reuters investigation revealed last year, tobacco companies such as Philip Morris have increasingly been targeting young Indians, using cunning strategies that previously worked in the US. With over 13,000 Indian men and 4,000 women dying every week due to chronic tobacco use, it’s becoming clear that smoking is a public health emergency, one requiring the government to recalibrate measures to protect young boys and girls.
The Tobacco Atlas also estimates that the economic cost of smoking in India is around Rs181,869 crore ($27.93 billion). This includes health care expenditure and indirect costs such as lost productivity.
So far, India has banned smoking in health care facilities and educational institutions, besides running anti-tobacco campaigns on television, radio, and at movie screenings. Cigarette packets are required to carry graphic warnings that cover 85% of their surface, and advertisements are banned.
As a result, the prevalence of tobacco-use has declined from 34.6% in 2009-10 to 28.6% in 2016-17. Yet, some 267 million Indians (pdf) continue to be affected, especially as cigarettes and other tobacco products remain cheap and relatively easy to access, with many small street stores selling single sticks. While the World Health Organisation recommends that excise tax account for 70% of the retail price of cigarettes, it remains at just over 26% in India, according to The Tobacco Atlas.
And beyond cigarettes sold by tobacco giants, smokeless tobacco products such as gutka and hand-rolled cigarettes (beedis) are widely popular in the country. These products also cause lung disease and other deadly infections.
But whether the thousands of children who remain outside of the formal economy and established educational institutions are aware of this is something the government desperately needs to address. For this, India could look to the US: In the 1990s, regular surveys were used to identify the profiles of smokers. Based on the results, the non-profit American Legacy Foundation, now called the Truth Initiative, was able to better target its anti-smoking campaign towards teenagers, and contributed to bringing down teen smoking rates in the country.