India needs to adopt tech to cut down on smoking

NEW DELHI: Suggestions are filling the tables of the Finance Minister for the annual budget, economists and experts are offering their point of views. Among them, a handful have suggested increased taxes on tobacco products, ostensibly because—claim that pack of economists—it will ensure better health of citizens, and, more importantly, help the Indian government’s vision of a five trillion-dollar economy by 2025.
It is like missing the tree for the woods, increased taxes of tobacco products will burden the companies, put users at discomfort and continue to keep India away from technology that is being practiced across the world to curb smoking.
India is the world’s second largest consumer of tobacco behind China. The Indian tobacco market is worth $30 billion. More taxes would mean more revenue to the government but it is certainly not the best harm reduction alternative.
In short, the nation’s public health policy refuses to engage into any meaningful discussion. A set of experts continue to raise their points of view with the government without much success. E-cigarettes and harm-reduction products continue to remain banned for over three years, while legal and illegal sales of cigarettes, bidis and other tobacco-based products continue.
The big question is: For how long India will avoid technology the world has embraced to cut down on smoking? When will the Indian government regulate the category to potentially lower smoking rates and improve public health outcomes?
In India, everything gets masked behind some huge numbers. It helps those arguing for more taxes. Nearly 267 million adults (15 years and above) in India are users of tobacco. Tobacco use is higher in rural areas, among those with a lower socio-economic status, and among those with lower levels of education.
So, recommending more taxes seems to be the best way out for some. Despite harm reduction alternatives being available to smokers, no one knows why these are yet to be effectively incorporated into tobacco control policies by health experts, and economists.
Globally renowned public health organisations such as Public Health England, The Royal College of Physicians, American Cancer Society and National Academy of Sciences, Medicine and Engineering have acknowledged the lower harm potential of e-cigarettes. Further, these are supported by the Heart Care Foundation of India, which has prepared a consensus statement on tobacco harm that was signed by leading medical practitioners in India.
But experts in India refuse to believe that tobacco harm reduction must be scientifically debated on the basis of rigorous evidence. Indian experts refuse to believe that e-cigarettes and vaping devices pose only a small fraction of the risks of smoking because they crucially remove combustion from the process.
Studies in India have shown that toxic chemicals such as class 1 carcinogens, respiratory toxins and carcinogenic metal ions were found to be present in significantly higher quantities in conventional cigarettes compared to ENDS vapour. Yet, experts advising the FM refuse to relent.
Tobacco harm reduction is based on the absence of combustion, a process that creates almost all of the toxins that a smoker inhales, resulting in high risk for disease and death. E-cigarettes have no combustion and do not contain tobacco. Available scientific evidence provides that e-cigarettes are by far less harmful than smoking. In fact, they fit perfectly to the definition of tobacco harm reduction.
Except, it does not work in the current scenario in India. E-cigarettes remain banned and tobacco products continue to get higher taxes. Worse, researchers in India often wrongly interpret data and make a hash of everything. Good sense must prevail and the consumer in India must have a right to select, and the government must allow them to do it because the consumer will do it with proper senses. It is high time India understands the tobacco control landscape, especially when there is a wide range of evidence-based tools available. The challenge lies in getting the right tools into the hands of the people who are in a position to use them effectively and making sure they will be the right fit for the needs of each country in which they are applied. After all, tobacco is a product that kills more than 13 lakh Indians every year.