Consumption of Tobacco Products
The consumption of various tobacco products in branded, unbranded and packed forms has not been separately assessed by the Government. However, the MoHFW undertook the Global Adult Tobacco Survey, India (GATS) during 2009-10 to assess the consumption of tobacco products in the country. The prevalence of consumption of various tobacco products has been assessed in this study.
The major findings of the study are annexed.
Government of India has launched the National Tobacco Control Programme (NTCP) in the year 2007-08, with the objectives to (i) create awareness about the harmful effects of tobacco consumption, (ii) reduce the production and supply of tobacco products, (iii) ensure effective implementation of the provisions made under “The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003” (COTPA) and (iv) help the people quit tobacco use through Tobacco Cessation Centres. The programme is presently under implementation in 21 states covering 42 districts.
Section-5 of COTPA prohibits all forms of advertisements (both direct and indirect) of tobacco products. The MoHFW has developed guidelines for effective implementation of the COTPA (including those for Section-5) and has disseminated the same to all states and enforcement agencies. In order to ensure mandatory compliance with the anti-tobacco laws, the Ministry sends regular advisories to the states. Ministry has written to the Director Generals of Police in all states/ UTs to make compliance with COTPA 2003 a part of the monthly crime review meetings at district level. Ministry has also written to Ministry of Home Affairs to get the compliance with COTPA 2003 included in the agenda of ‘Social Policing’.
Further, under the National Level Public Awareness Campaign, this Ministry has launched media campaigns both in national as well as regional electronic channels focusing on the harmful effects of smokeless tobacco use. The Ministry has also notified the new pictorial health warnings which have come into effect from 1st April 2013. Three sets of warnings each have been notified for smokeless as well as smoking forms of tobacco. The Ministry has also notified the rules to regulate depiction of tobacco products or their use in films and TV programmes. As per these rules, all films and TV programmes (both Indian & Foreign) depicting tobacco products or their use have to screen a health spot of 30 seconds duration and a disclaimer of 20 seconds duration on the harmful effects of tobacco use, at the beginning and the middle of the films and TV programmes.
Annexure
GATS India was conducted in 2009–2010 as a household survey of persons age 15 and above. A nationally representative probability sample was used to provide national and regional (North, West, East, South, Central and North-East) estimates by residence (urban and rural) and gender and state estimates by gender. The survey was designed to produce internationally comparable data on tobacco use and other tobacco control indicators using a standardized questionnaire, sample design, data collection and management procedures. GATS India was the first nationwide survey in which electronic hand-held devices were used for data collection and management. A total of 69,296 interviews were completed among which 33,767 and 35,529 were of males and females respectively. Out of all completed interviews, 41,825 interviews were conducted in rural areas and 27,471 interviews in urban areas. The overall response rate was 91.8 percent which ranged from the highest of 99.2 percent in Tamil Nadu to the lowest of 80.1 in Arunachal Pradesh.
GATS India revealed that more than one-third (35%) of adults in India use tobacco in some form or the other. Among them 21 percent adults use only smokeless tobacco, 9 percent only smoke and 5 percent smoke as well as use smokeless tobacco. Based on these, the estimated number of tobacco users in India is 274.9 million, with 163.7 million users of only smokeless tobacco, 68.9 million only smokers, and 42.3 million users of both smoking and smokeless tobacco. The prevalence of overall tobacco use among males is 48 percent and that among females is 20 percent. Nearly two in five (38%) adults in rural areas and one in four (25%) adults in urban areas use tobacco in some form. Prevalence of smoking among males is 24 percent whereas the prevalence among females is 3 percent. The extent of use of smokeless tobacco products among males (33%) is higher than among females (18%).
The prevalence of tobacco use among all the states and union territories ranges from the highest of 67 percent in Mizoram to the lowest of 9 percent in Goa. Prevalence of tobacco use in Arunachal Pradesh, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Manipur, Meghalaya, Mizoram, Nagaland, Odisha, Sikkim, Tripura, Assam and West Bengal is higher than the national average. In most of the states/UTs, the prevalence of both smoking and smokeless tobacco use among males is higher than among females with exceptions in Puducherry, Tamil Nadu, Meghalaya, Tripura and Mizoram, where prevalence of smokeless tobacco is higher among females than males. More than 75 percent of tobacco users, both smokers as well as users of smokeless tobacco are daily users of tobacco. In India, khaini or tobacco-lime mixture (12%) is the most commonly used smokeless tobacco product, followed by gutkha, a mixture oftobacco, lime and areca nut mixture (8%), betel quid with tobacco (6%) and applying tobacco as dentifrice (5%). The prevalence of each of the smokeless tobacco products, except dentifrice, is higher among males than females. Among smoking tobacco products,bidi (9%) is used most commonly followed by the cigarette (6%) and the hookah (1%).
Among both males and females, the prevalence of cigarette smoking is higher in urban areas but the prevalence of all other smoking products is higher in rural areas. The prevalence of each of the smokeless tobacco product is higher in rural than urban areas, however, gutkha is almost equally prevalent in both urban and rural areas.
On an average a daily cigarette smoker in India smokes 6.1 cigarette sticks per day, and a daily bidi smoker smokes 11.5 bidi sticks per day. One-fourth of daily cigarette smokers smoke more than 10 cigarettes per day, and more than half of the daily bidi smokers smoke more than 10 bidis per day.
The mean age at initiation of daily tobacco use for tobacco users age 20–34 years is 17.8 years. The mean age at initiation of smoking as well as use of smokeless tobacco among users of respective products age 20-34 years is 17.9 years. Two in every five daily tobacco users age 20–34 had started using tobacco daily before attaining the age of 18. The quit ratio for smoking (defined as former smokers among ever daily smokers) is 13 percent, while the quit ratio for use of smokeless tobacco use (defined as former users of smokeless tobacco among ever daily users of smokeless tobacco) is 5 percent. Three in five (60%) daily tobacco users use tobacco within 30 minutes of waking up in the morning.
This information was given by Union Minister of Health & Family Welfare ShriGhulamNabi Azadin written reply to a question in the LokSabha today.
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