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In a recent submission, Lakshmi Ramamurthy, Hon. Trustees, Center for Public Policy Research noted that India, in imposing a ban on e-cigarettes in 2019, failed to distinguish between different categories of products. In the 2021 Finance Bill, the government recognized the distinction between traditional cigarettes, e-cigarettes and HTP for tax purposes, with the distinction not being applied in the context of the ban on e-cigarettes.
Panama hosted the tenth session of the Conference of the Parties (COP10) in February. COP10, under the WHO Framework Convention for Tobacco Control (FCTC), carries great significance for the future of public health. FCTC addresses three important aspects of tobacco control – demand reduction, supply reduction and harm reduction. This year’s conference focused on steps forward, exploring cutting-edge technologies beyond the FCTC and laying the groundwork for COP11.
As an alternative to the combustible tobacco used in cigarettes with proven public health effects, countries around the world have adopted electronic cigarettes (e-cigarettes), such as vapes and other electronic nicotine delivery systems (ENDS).
A study conducted by Public Health England indicates that the risk of passive smoking associated with e-cigarettes is very low, as there is no combustible tobacco. Despite existing research and data on e-cigarettes, India’s Ministry of Finance announced a ban on e-cigarettes in 2019, followed by a ban on the manufacture, import, export, transportation, sale, distribution, storage and advertising of e-cigarettes. ..
The ban imposed a comprehensive ban on e-cigarettes, including all types of ENDS, heated tobacco products (HTP), e-hookahs and similar devices. Although often grouped as a single product class, these items constitute a diverse array with potentially significant differences in toxicant production and nicotine delivery processes.
However, the Government of India has failed to differentiate between these distinct categories of products in its legislation. In the Finance Bill 2021, the government recognized the distinction between traditional cigarettes, e-cigarettes and HTP for tax purposes, with the distinction not being applied in the context of the ban on e-cigarettes.
India, a major member of the FCTC, is grappling with the challenge of having the second largest number of smokers in the world, nearly 100 million (GATS 2017). ICMR in its cancer registry program found that tobacco-related cancers accounted for nearly half (48.7%) of the country’s cancer burden in 2021.
India, which has mainly focused on supply and demand reduction, has made significant progress in implementing measures such as taxation, content regulation and awareness campaigns. However, tobacco control results have been only moderately successful.
About 5.3% of India’s healthcare expenditure is allocated to the treatment of tobacco-related diseases, resulting in an annual expenditure of ₹13,500 crore, and by 2023, tobacco-related healthcare expenditure will be 1.04% of GDP.
Widespread use, particularly in the form of smoking bidis and chewing tobacco, has created significant public health concerns in India. More than one million adults in India lose their lives annually due to tobacco use, representing 9.5% of total mortality, making tobacco a leading preventable cause of death in the country. Despite the health risks, abandonment rates in India, especially among men, remain low at just 20%.
Addressing these challenges requires adopting strategies that address tobacco industry influence to achieve a meaningful reduction in tobacco use, such as improving access to cessation support, addressing psychological barriers, and countering tobacco industry influence.
India’s current framework for tobacco control has yet to fully introduce harm reduction strategies, including exploring safer alternatives to traditional cigarettes. Countries such as the United States, United Kingdom, New Zealand, Sweden, Japan, and Canada have adopted the concept of safer alternatives within their global tobacco control policies.
In 2022, the UK Annual Population Survey reported the lowest smoking rate since 2011 with only 12.9% of the adult population smoking cigarettes. The latest headline of tobacco duty figures shows that total tobacco receipts for the 2022-23 fiscal year were 3% lower than the previous year. Interestingly, 5.2% of survey respondents said they were current users of an e-cigarette, an increase from 4.9% in 2021.
For India, the main focus should be to explore scientific harm reduction strategies and state-of-the-art technologies with policy makers around the world.
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