Huge tobacco use in India seen killing 1.5 million a year

Tobacco inflicts huge damage on the health of India's people and could be clocking up a death toll of 1.5 million a year by 2020 if more users are not persuaded to kick the habit, an international report said on Thursday.

Despite having signed up to a global treaty on tobacco control and having numerous anti-tobacco and smoke-free laws, India is failing to implement them effectively, leaving its people vulnerable to addiction and ill health, according to the report by the International Tobacco Control Project (ITCP).

"Compared with many countries around the world, India has been proactive in introducing tobacco control legislation since 2003," said Geoffrey Fong, a professor of psychology at Canada's University of Waterloo and a co-author of the report.

"However ... the legislation currently in place is not delivering the desired results - in terms of dissuading tobacco use and encouraging quitting."

As a result, India, with a population of 1.2 billion, currently has around 275 million tobacco users, the report said.

Harm from tobacco accounts for nearly half of all cancers among males and a quarter of all cancers among females there, as well as being a major cause of heart and lung diseases.

"The tobacco epidemic in India requires urgent attention," the report said, adding that by 2020, tobacco consumption will account for more than 1.5 million Indian deaths a year.

Worldwide, the number of deaths caused by tobacco is expected to rise from around 6 million a year now to more than 8 million by 2030, according to the World Health Organisation.

The ITCP India Survey conducted face to face interviews with 8,000 tobacco users and 2,400 non-users across four Indian states - Bihar, Madhya Pradesh, Maharashtra and West Bengal.

In India, as in most low income countries, death in middle age is increasing in relative importance due to an increase in smoking related deaths. The disease burden, health care costs as well as other fiscal losses resulting from premature deaths attributable to tobacco consumption will rapidly increase. Earlier WHO estimates suggest that deaths and disability adjusted life years (DALYs) attributable to tobacco use in India will increase from 129 000 deaths and 1719 DALYs in 1990 to over 1.5 million deaths and 24 024 DALYs by 2002. The high levels of tobacco consumption among disadvantaged population groups may lead to a doubling of the disease burden in these social groups from chronic illnesses related to tobacco consumption as well as from communicable and nutrition related diseases, which still account for a large share of total disease burden in the disadvantaged social groups in India. In addition to the differences in prevalence of tobacco consumption between disadvantaged and better off groups, the type and amount of tobacco consumption, which are shown to be directly associated with incidence of tobacco related diseases and mortality, may also vary between the two, further aggravating the differences in disease burden attributable to tobacco between the two groups. Though no data were collected in the NFHS-2 on the type and amount of tobacco consumed, which remains one of the weaknesses of survey, other studies suggest that the poor are 8–10 times more likely to smoke bidis that may lead to greater risk of oropharyngeal and lung cancer in this group than among the better off.