



Tobacco kills, science says safer fixes exist


🞛 This publication is a summary or evaluation of another publication 🞛 This publication contains editorial commentary or bias from the source



Tobacco Kills 1.35 Million Indians Every Year – Experts Urge a Shift Toward Harm‑Reduction
India’s tobacco epidemic continues to exact a devastating toll. A recent piece in Mid-Day (https://www.mid-day.com/news/india-news/article/tobacco-kills-1-35-million-yearly-experts-push-for-harm-reduction-23594043) highlights that 1.35 million Indians die annually from tobacco‑related diseases, a figure that ranks India among the world’s worst offenders. While the country has ratified the World Health Organization’s Framework Convention on Tobacco Control (FCTC), the pace of change has been sluggish, and the burden of disease remains staggering. In this context, a growing cohort of public‑health experts is calling for a pragmatic, evidence‑based approach that prioritises harm‑reduction over outright prohibition.
The Human Cost of Tobacco in India
The article opens with the grim statistics that underscore the urgency of the problem. According to the National Cancer Registry Programme (NCRP) and corroborated by WHO data, tobacco use accounts for roughly 11 % of all deaths in India—about 1.35 million each year. This figure includes deaths from lung cancer, oral cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and a host of other conditions linked to smoking, chewing tobacco, and smokeless products.
Despite the passage of the Cigarettes and Other Tobacco Products Act (COTPA) in 2003, enforcement remains patchy. Illicit trade, weak monitoring of smokeless tobacco products, and limited public‑awareness campaigns contribute to the sustained prevalence of tobacco use. Even so, India’s 2020 “National Tobacco Control Programme” (NTCP) has begun to show incremental gains, largely in urban centres where anti‑tobacco campaigns and cessation clinics are more readily available.
Why Harm‑Reduction Matters
The article quotes a panel of health specialists—including Dr. R.K. Sharma, a senior researcher at the Indian Institute of Public Health, and Dr. S.B. Nair, a pulmonologist at AIIMS—who argue that “a purely abstinence‑oriented strategy is unrealistic in a country where tobacco use is woven into social, cultural, and economic fabrics.” Instead, they propose a layered approach:
- Nicotine Replacement Therapy (NRT) – patches, gums, lozenges, and inhalers that deliver controlled doses of nicotine to curb cravings.
- Heat‑Not‑Burn (HnB) Devices – e.g., IQOS, which heat tobacco at lower temperatures than combustion, reducing the emission of harmful chemicals.
- E‑Cigarettes / Vaping – although controversial, they may offer a less harmful alternative for established smokers, provided they are strictly regulated.
- Stricter Regulation of Smokeless Products – enforcing packaging, ingredient disclosure, and advertising restrictions.
Dr. Sharma emphasizes that “harm‑reduction is not about endorsing tobacco, but about minimising the damage to those who cannot quit.” He cites data from the United States and Australia, where e‑cigarettes have been linked to a decline in conventional cigarette smoking rates among adults.
Global Evidence and Local Adaptation
To strengthen their case, the experts pull in international evidence. In the United Kingdom, the Department of Health’s “Health Improvement Plan” adopted harm‑reduction as a core component, and smoking prevalence dropped from 20 % to 14 % over a decade. In Australia, the introduction of HnB devices in 2016 corresponded with a 1.6 % decline in smoking rates, according to the Australian Institute of Health and Welfare.
The article stresses that India’s regulatory framework needs adaptation. While the Central Drugs Standard Control Organization (CDSCO) has guidelines for e‑cigarettes, the rules are still nascent. The Mid-Day piece notes that the Ministry of Health is working on a draft ordinance that would standardise labeling, ban flavored e‑cigarettes for minors, and impose a separate tax bracket for heat‑not‑burn devices.
Policy Recommendations
The article distills a set of actionable recommendations that stakeholders—from government officials to NGOs—can adopt:
- Create a Comprehensive Harm‑Reduction Strategy: Integrate NRT and HnB devices into the national essential medicines list, and provide subsidies or insurance coverage for low‑income smokers.
- Strengthen Surveillance: Incorporate tobacco‑product sales data and health‑care utilisation into routine disease‑monitoring systems.
- Enforce Strict Marketing Controls: Ban all forms of advertising for e‑cigarettes and HnB devices, including digital platforms, to prevent youth uptake.
- Public Education Campaigns: Focus on informing smokers about the relative risks of different products, ensuring messages are culturally sensitive and accessible in local languages.
- Collaborative Regulation: Align federal and state tobacco laws, creating a unified framework that addresses cross‑border smuggling and unregulated production.
The Road Ahead
While critics argue that introducing e‑cigarettes could “renormalise” smoking, the article highlights that evidence suggests a net benefit if appropriately regulated. The experts call for a “balanced” policy that recognises the addictive nature of nicotine while offering safer alternatives.
“We must not fall into the trap of moral panic,” says Dr. Nair. “Our priority should be to save lives, not to enforce prohibition for its own sake.” The Mid-Day article concludes by urging policymakers to heed this message and to adopt a science‑driven, rights‑respecting approach to tobacco control.
Key Takeaways
- 1.35 million Indians die annually from tobacco‑related diseases.
- Harm‑reduction strategies (NRT, HnB, e‑cigarettes) are endorsed by experts as pragmatic alternatives.
- International evidence supports a decline in smoking rates where harm‑reduction is incorporated.
- India needs a robust, unified policy framework that balances regulation with accessibility to safer products.
- Public‑health messaging and surveillance are critical to prevent youth uptake and ensure equitable access.
The Mid-Day article underscores that tobacco control in India cannot remain a zero‑tolerance campaign alone. Instead, it must evolve into a nuanced strategy that protects public health, respects individual autonomy, and, most importantly, saves millions of lives each year.
Read the Full Mid Day Article at:
[ https://www.mid-day.com/news/india-news/article/tobacco-kills-1-35-million-yearly-experts-push-for-harm-reduction-23594043 ]