This year, the focus on World No Tobacco Day has shifted to the implementation or non-implementation of the WHO Framework Convention on Tobacco Control (FCTC), an international agreement that 172 nations, including India, have ratified.
The FCTC was adopted at the World Health Assembly in May 2003. India ratified it in February 2004. The idea is to protect public health measures from the commercial interest of the tobacco industry, warn people about the dangers of using tobacco, ban tobacco advertising and sponsorship and support financially viable alternatives to tobacco farming.
The FCTC primarily calls for political will to implement all these provisions and that is what has been lacking so far in the country, says V. Shanta, chairperson, Adyar Cancer Institute (WIA). The tobacco lobby is very strong and continues to hold sway over national and regional governments.
“Every year, we have been saying the same thing. Nothing much has changed. It is necessary to have definite goals and work together. The community, family members of patients and cancer survivors themselves have to push governments to act,” says Dr. Shanta.
The thrust should be on prevention of non-communicable diseases and preventing youngsters from acquiring the tobacco habit. About 40 per cent of all cancers are tobacco-related and all preventive measures for common cancers are so simple that all it takes is moderate lifestyle modifications.
The situation is alarming enough to warrant strict action, T.G. Sagar, director, Cancer Institute, says. About 10 million new cancer patients emerge every year, 50 per cent of them from developing countries.
Significantly, 85 per cent of the cases are caused not by genetics but environmental factors, which can be changed. Government spending on tobacco-related conditions is much more than the revenue from selling tobacco products.
According to the Global Adult Tobacco Study, over 35 per cent of adults in India use some form of tobacco or the other, Arvind Krishnamurthy, consultant surgical oncologist, Cancer Institute, says.
The harsh fact is that the incidence of tobacco habit has been increasing by four per cent every year. Going by this, the number of deaths will double by 2020 if the nation carries on at the current rate without intervention.
E. Vidhubala, head, department of psycho-oncology, and Resource Centre for Tobacco Control, Cancer Institute, says in Tamil Nadu, despite a strong demand to increase taxation on tobacco products, the tax was lowered on gutka products and cigarettes and beedis were exempted completely in 2006. Weak enforcement of the FCTC combined with pro-tobacco measures such as this is responsible for the increasing consumption of tobacco products in the country.
Over the years, she says, the number of movies showing smoking scenes has increased to 89 per cent, showing the lead character smoking is up to 76 per cent and the visibility for top tobacco brands has gone up to 41 per cent according to a 2005 study. Tobacco kills about 10 lakh people every year.
She indicates that something must be done to curb huge investment (such as LIC) of public funds in the tobacco industry.
The counter measures are, at best, insufficient, thereby unable to have a significant impact, Dr. Vidhubala says. The Tobacco Cessation Centre at Cancer Institute will provide support to persons who willingly come forward to give up smoking or chewing tobacco.