Tamil superstar Rajnikanth may have immortalised a unique style in his movies where he flips a cigarette with his finger and then lights a match from the denim of the villain's jeans! The smoking scene has been carried forward by director Vishal Bharadwaj in his 2006 movie ‘Omkara,' with Bipasha Basu sizzling in the number Beedi jalaile jigar se piya, jigar maabadi aag hai…

These scenes in films make an impact despite a campaign spearheaded by former Health Minister Anbumani Ramadoss, which resulted in India becoming the first country to ban images of smoking in all television shows and new films, effective from August 1, 2006. The directive of the campaign is part of the Cigarettes and other Tobacco products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act 2003. Dr. Ramadoss believes that smoking scenes in movies are responsible for encouraging youth to pick up the habit. He cited statistics to show that 52 per cent of youth consume their first cigarette when they see their favourite movie actor smoke.

Another stipulation of the act is that a horizontal scroll warning the audience about the dangers of smoking must accompany scenes depicting smoking in existing films, and the image must be blurred each time an actor smokes on a TV show. Exemptions were permitted for live telecasts, certain old films and those based on historical characters who smoked as well as films that depict the health effects of smoking.

However, in January 2009, the Delhi High Court quashed the central government's decision to prohibit on-screen smoking, after Bollywood producer and director Mahesh Bhatt challenged the ban, saying that it violates the fundamental right to free speech and expression under Article 19 of the Constitution. Justice Sanjay Kishan Kaul of the Delhi High Court ruled that “directors should not have multifarious authorities breathing down their necks when indulging in the creative act. A cinematographic film must reflect the realities of life. Smoking is a reality of life. It may be undesirable, but it exists.”

Appeal

In an attempt to mitigate the effects of movie scenes on potential smokers, Dr. Ramadoss had appealed to Hindi movie actors Shah Rukh Khan and Amitabh Bachchan in the television programme “Devil's Advocate” aired on CNN-IBN a couple of years ago, to stop smoking in their movies, claiming that it could influence the youth.

Dr. Veda Sharan, professor of American studies at the English and Foreign Languages University in Hyderabad, believes that “Smoking scenes in films could encourage impressionable young people to start the habit. Banning smoking scenes in movies is good because it is a default discouragement of smoking. We need to prevent it.” His colleague Prof. Anand also endorsed the view, saying that young people are easily influenced by their heroes.

Smoking was once portrayed as something the villain or the anti-hero indulged in. Slowly, with the portrayal of suave heroes who smoked, the possibility of its attractions began to rise. Anti-smoking activists and health groups were quick to lobby for a ban on smoking scenes in movies, saying that it could influence the youth by portraying smoking as fashionable and ‘cool'.

MBK Nair, a retired engineer with the Kerala State Electricity Board, said although smoking scenes in movies are likely to encourage teens to pick up the habit, banning such scenes is unlikely to prevent them from smoking. Irrespective of whether movies encourage teenagers to start smoking or whether they pick up the habit due to peer pressure and the need to appear ‘cool,' smoking has been and will remain an integral part of Indian movies even if it is the baddie with a pipe hanging from his mouth.

Dr. Ramadoss also introduced the ambitious smoking ban in public places, starting October 2, 2008. However, enforcement has been lax with little or no fines imposed on violators. The smoking ban covers all public places, including restaurants, bars, bus bays and railway stations. The measure also bans the sale of cigarettes and other tobacco products within 100 yards of educational institutions. The measure is primarily aimed at protecting the public from the health risks of second hand smoke or environmental tobacco smoke (ETS). Although a majority of smokers are aware of the consequences of smoking on their health, little is known about the health risks of ETS on non-smokers. The prevalence of smoking among women is increasing in developing countries such as India, while a growing majority of women and children have a husband or father who smokes at home.

In addition, all tobacco products manufactured in India are required to display pictorial health warnings of a scorpion and diseased lungs, covering at least forty per cent of the principal display area of the pack with text warnings in English and other regional languages, under a measure that took effect on May 31, 2009.The directive requires cigarette and packs to carry the warning “Smoking Kills,” while manufacturers of smokeless tobacco products such as gutka and pan masala have to print “Tobacco Kills” on the packs in white font on a red background. The Group of Ministers, which was established by the government to consider the feasibility of implementing graphic health warnings, have decided to use “mild pictures” of “TB-affected lungs” and a “scorpion” – depicting death – to discourage tobacco use. The ministers also agreed to make the “skull and cross bones” optional following criticism from tobacco manufacturers and a religious minority group.

In a latest development, the Ministry of Health and Family Welfare approved a revised labelling regulation requiring images of oral cancer along with textual warnings in English and regional languages, but decided to postpone by six months until December 1 the implementation of the same.

However, leading advocate Shireen Sethna Baria does not believe that graphic health warnings will help deter hardcore smokers or chewing tobacco users, although she was positive about the smoking ban in public places. No single measure is likely to discourage smokers and it has been proven that comprehensive measures that include higher tobacco taxes, smoking bans in public places, and graphic health warnings may go a long way in discouraging at least some tobacco users.

Gender emphasis

World No Tobacco Day, an initiative of the World Health Organization, is observed across the globe on May 31 each year. The theme for World No Tobacco Day 2010 is “Gender and tobacco with an emphasis on marketing to women.”

A 2009 WHO report titled “Women and health: today's evidence, tomorrow's agenda,” noted that women constitute about 20 per cent of the world's more than one billion smokers, with the figure expected to grow further as cigarette advertising increasingly targets females. WHO Director-General Margaret Chan noted in the report, “protecting and promoting the health of women is crucial to health and development – not only for the citizens of today but also for those of future generations.”

The WHO's anti-tobacco treaty Framework Convention on Tobacco Control, which has been ratified by 168 countries so far, expresses concern at the alarming increase in smoking and other forms of tobacco consumption by women and young girls worldwide.

Women who smoke during pregnancy are at risk of giving birth to pre-term, underweight babies. The risk of abortion and infertility is also higher among women who smoke or are exposed to ETS during pregnancy.

The risk of sudden infant death syndrome, asthma and ear infections is higher among children exposed to ETS compared to those who live in smoke-free homes. Smoking also increases the risk of osteoporosis, hip fractures, multiple sclerosis and neurological disorders.