Blowing back the smoke

According to estimates by the World Health Organisation (WHO), 8 lakh persons die from tobacco related diseases every year in India alone, with every cigarette reducing the life of smokers by 5.5 minutes. The economic and health costs of this consumption are staggering, considering that 60 per cent of the Indian population accesses health care by taking on loans or by selling property & assets. The Voluntary Organization in Interest of Consumer Education (VOICE), a Delhi-based non-profit, non-political consumer group, has resolved to tackle this, through research and advocacy on behalf of consumers.

The organisation, established in 1983 with the help of Delhi University students and faculty, advances consumer rights by forging links amongst consumers, market and government interests and by promoting sustainable and ethical consumption and production, both now and in the future. VOICE promotes consumer education through awareness programs; scientific interventions to make the market place better and consumer oriented; mobilizing public opinion to change the laws for the benefit of the consumers; providing legal advocacy and guidance; networking with other consumer groups on public interest issues; and spreading the consumer movement to new areas to benefit the poor and disadvantaged patients.

Tobacco is an important front on which VOICE is engaged in its mission to change consumer behaviour through information and advocacy. The organisation points out that tobacco is the only consumer product that kills its users when used exactly as intended by the manufacturers. Critics have also repeatedly cried foul that advertising for the product is often targeted at children, including through sponsorship of popular events. The tobacco industry, however, maintains that it does not want children to smoke. There have been several instances of the tobacco industry opposing basic consumer rights - the right to information, right to safe products, to compensation and redress for losses from the use of its products.

Like elsewhere in the world, consumer activists are actively looking at legal options to combat the power of such advertising. VOICE is mobilising consumer organizations in India to identify patients in their constituencies who are suffering from tobacco related diseases, and to claim compensation on their behalf for the loss and damage incurred by them. The legal suits will also expose, says VOICE, deliberate acts of negligence by the manufacturers to hide the facts about tobacco addiction at a young age.

Law enforcement agencies and other government departments are an important potential ally, and VOICE has been working with them actively. In a recent study conducted in collaboration with the Ministry of Health & Family Welfare, Government of India & World Health Organisation (WHO) India Office on the "Perceptions of the Tobacco Control Law Enforcers in India", VOICE acknowledges the work done by law enforcers to effectively implement the existing laws to control the sale and consumption of tobacco products in India. However, the study also points to many loopholes in implementation.

According to the study, “this project was conceived to sensitize law-implementing agencies in India on tobacco consumption and control with the objectives to mobilize law enforcers towards effective implementation and monitoring of existing legislations. Two Indian states – Delhi and Goa, were fairly pro-active in implementing the existing legislations curbing tobacco consumption and encouraging citizens to get rid of the dreadful addiction. VOICE conducted a survey and collated the outcomes from the survey to be presented as a resource kit over a training program. This kit would work as a tool for building awareness among the law enforcers and give the desired evidence for preparing an action plan by the law enforcers to make the existing legislations on tobacco control more effective and help to create a model for the other states in India to replicate from curbing the tobacco epidemic and health cost incurred by the poor and disadvantaged consumers”.

The study is based on the premise that the Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of) Trade and Commerce, Production, Supply and Distribution Act 2003 has raised the expectations of the citizens further on the role of the law enforcers. Among other features, the Act prohibits all forms of direct and indirect tobacco advertising; bans totally the sponsoring of any sport or cultural events by tobacco companies; prohibits smoking in public places; prohibits sale of tobacco products to persons under 18 years; prohibits sale of tobacco products within 100 yards of educational institutions; makes mandatory indication of nicotine and tar contents on the packets and presence of pictorial warnings on the packets in English as well as Indian languages.

A look at some enlightening findings from the study.

• 92% of the law enforcers in Delhi strongly disagree with the statement that there is nothing wrong in smoking/consuming tobacco.

• Only 70% of law enforcers in Delhi are aware of existing laws against smoking in India and of these only 58.8% are aware of the anti-smoking legislation of 2003. If the law enforcers themselves are not familiar with the laws then they are certainly not in a position to implement those laws adequately.

• 59% of the law enforcers in Delhi agreed with the statement that they do not want to take extra load by enforcing such 'minor laws' strictly. Instead, enforcing personnel believe they already have many other important laws to implement.

• 41% of the law enforcers in Delhi agreed with the statement that their involvement in tobacco related controls do not give them any benefit or recognition hinting that such enforcements have very little significance in terms of community and offence.

Studies like the one undertaken by VOICE bring to light the lacunae in implementation of anti-tobacco laws. Yet frightening statistics abound about the far-reaching health hazards posed by tobacco consumption. As though all this were not problematic enough, tobacco companies outshine each other in finding innovative marketing strategies. And this in a country in which it costs Rs. 27,760 crores to treat people with tobacco related diseases – which is more than 4 times the revenue earned from the tobacco industry (Indian Council of Medical Research, 1999).

According to current estimates, by the year 2030, tobacco will cause 10 million deaths globally of which 70% will be in developing countries. Despite such well-established scientific facts, the recommendations made by WHO and other scientific bodies for the control of tobacco in the interest of public health have not been readily accepted or applied in all countries. The recommended policies include a ban on advertising of tobacco products, increase in taxes, no smoking in public places, detailed consumer information, appropriate trade practices and others. Many issues among these like those related to advertising, smuggling etc. are transnational in character necessitating an international approach. For these and other reasons, the WHO proposed the Framework Convention on Tobacco Control (FCTC) with the objective of reducing the health hazards of tobacco use through collective international action and cooperation on tobacco control.

In India, new forms of tobacco advertising are an increasing concern. According to FCTC, cigarette companies have recently started sponsoring the sports page of newspapers given the proposed ban on tobacco sponsorship of sports events. Except for health-related magazines, few have any policy prohibiting advertisement of tobacco products. Moreover, reports on Gutkha advertising spotted on the cover pages of school notebooks have been coming in from Nagpur district in Maharashtra. The nineties saw tobacco companies outshining each other to win sponsorship rights of various sports and cultural events. Wills doled out Rs.33 lakh for every test match that India played while for every one-day match it paid Rs. 32 lakh. Gold Flake kept up by sponsoring tennis tournaments while Four Square cigarettes sponsored boat racing. Manickchand, who flooded the market with their Gutkha brands, started patronizing the Filmfare awards.

Its vigilance and advocacy have put the FCTC in the crosshairs of many. According to the Media Kit put together by the Indian NGO Initiatives on FCTC, part of the propaganda unleashed against FCTC is that it would affect the economy of tobacco growing countries. However,a World Bank report concluded that "the effects of tobacco control on employment have been greatly overstated. There would be no net loss of jobs, and there might even be job gains if global tobacco consumption fell. This is because money once spent on tobacco would be spent on other goods and services, thereby generating more jobs".

Such informed counters to the marketing efforts of vested interests is necessary, VOICE believes, to protect public health and consumer rights. By its integrated approach to tackle tobacco consumption, aiming diversely at consumers and producers and considering issues of advertisement, information and promotion, VOICE clearly intends to reign in a problem that has already been neglected too long.