Decoding the 139th Report of Parliamentary Standing Committee on Health and Family Welfare— Striving to Counter a Non-Communicable Disease

Introduction

After China, India has the second largest¹ smoking population in the world. Tobacco which is one of the single most risk factors for all non-communicable diseases is alarmingly high in India. Increasing rates of smoking are a major factor in premature mortality and high health expenses. In India, tobacco smoking is seen in 22.4% of masses between the ages of 15 and 54.² To stave off this increasing threat in the country, the Parliamentary Standing Committee on Health and Family Welfare, in its 139th Report³ on “Cancer Care Plan & Management: Prevention, Diagnosis, Research & Affordability of Cancer Treatment” urged the Government to enact certain provisions in existing laws for abating not only the accessibility but also the consumption of the tobacco products. This article tries to look into the fundamental proposals of the report, by delving into its trinity approach – firstly, the proposal to abolish smoking areas, secondly, banning the sale of single stick cigarettes, and lastly, increasing the taxes on tobacco products.

Extirpation of designated smoking areas

Smoking in public spaces has detrimental effects that extend beyond smokers and infringes on the right of non-smokers to maintain a healthy lifestyle. Even if they do not smoke, they are prone, as a secondhand smoker, to contract heart disease owing to the smoke exhaled by the smoker.⁴ A serious effect of secondhand smoke can be seen in unborn children as well. Pregnant women who are exposed to secondhand smoke had a 23% higher risk of stillbirth and a 13% higher chance of congenital deformity.⁵

To safeguard the rights of non-smokers to breathe clean air and lead a life free from exposure to secondhand smoke, India’s primary anti-tobacco statute Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA Act)⁶ inhibits smoking in any public place providing exceptions for airports, hotels with more than thirty rooms, and restaurants with a minimum sitting capacity of thirty if a designated smoking area has been made in these establishments.

Interestingly, the Committee encourages the Government to extirpate designated smoking areas in these establishments per seand promotes smoke-free workplaces. Smokers will smoke less owing to being prohibited from smoking in public since they are likely to wait until they return to their private space to fire up a cigarette. This will ultimately help smokers who have been striving to quit or cut down on their smoking frequency and overcome their craving for cigarettes.

Proscribing the sale of loose cigarettes

By 2035, 17 lakh new instances⁷ of cancer are projected to occur annually in India. To eschew such a projection, it is incumbent upon the Government to act accordingly and contain the sale of tobacco products. And to make that possible, the Committee has highlighted the requirement to forbid the selling of cigarettes by the single stick, imposing severe penalties and fines on violators.

This provision is inclined to restrain adolescents from smoking. An adolescent may start smoking for a variety of reasons. They are considerably correlated with current cigarette use if adults smoke in their vicinity; influencing adolescents to smoke as well. It substantially raises adolescent’s chances of starting to smoke. The other reason could be that they happen to think that smoking makes a person “cool”. One in four adolescents said that teenagers who smoke are likely to have more friends.⁸ Owing to such instances, they are likely to purchase single sticks of cigarettes. As buying a single stick of cigarettes is more cost-effective than purchasing a whole pack. Adolescents who may have little money on hand may find this particularly appealing. A prohibition on the sale of single sticks would force them to purchase the full pack, which might not be very cost-effective, limiting the opportunity for exploration and regular consumption of cigarettes.

Raising the taxes on tobacco products

Due to the magnitude of the nation’s consumer base, it is easy for the tobacco business to thrive and take advantage of the market.⁹ In order to abate consumption, the importance of taxes cannot be subdued. The most economical method of reducing tobacco use would be through taxes. Hanging in consonance with the same reasoning, the Committee further determined that India has the lowest tobacco product pricing, thus it must consider raising taxes. In India, cigarettes are taxed according to their length. Hand-rolled bidis are subject to lower taxes than machine-rolled bidis, as such, around 38% of the sales price is made up of cigarette taxes. This rate is far lower than what the World Bank advises which is from 65% to 80% of the sales price¹⁰, which is frequently evident in nations with efficient tobacco control laws.

To make tobacco products unaffordable, the price increase should be inflation adjusted and greater than the growth in the per capita income. According to the Tobacco-Free Kids Organisation, the increase in the tax on cigarettes to 78% of the retail price will save 3.4 million premature deaths due to tobacco use while also generating an additional 3.1 billion USD in Government income annually.¹¹

Conclusion

In general, the Committee’s trinity approach is intended to reduce access to, and consumption of tobacco products. While parents may do a lot more, such as not smoking in the vicinity of the adolescents, to prevent them from being exposed to secondhand smoke, the Government should also pay special attention to policies that protect adolescents from tobacco industry promotion. The Government may convey that it is sincerely concerned for the welfare of its masses by eliminating the designated smoking locations in public places. The planned change is likely to decrease sales and consumption yet there still persists a great deal to be accomplished. Opinions and views can be sought from the public as well; as Cyril Alexander argues¹² that the Government should also take into account implementing vendor licensing. We may conclude that the cooperation and coordination between the Government and the governed play an important role in fighting the menace at hand.