A new report by the World Health Organisation on the global tobacco epidemic shows India, Bangladesh and Bhutan on top of the list of South East Asian countries that have achieved a high level of tobacco control. The prevalence of tobacco use in India has fallen from 34.1% to 28.6%, the report says, comparing data from two rounds of the Global Adult Tobacco Survey (GATS) in 2009-10 and 2016-17. The key findings of GATS-2, including the reduction in the number of tobacco users in India by 81 lakh in the seven years between GATS-1 and GATS-2, were released by the government on June 8.
The WHO Report on the Global Tobacco Epidemic, 2017: Monitoring Tobacco Use and Prevention Policies, was released in New York on Wednesday on the sidelines of the United Nations High-Level Political Forum on Sustainable Development. The report covers 194 countries, divided into The Americas, South East Asia, Europe, Eastern Mediterranean, Western Pacific, and Africa. There are 11 countries in the South East Asia group, of which India is a part.
Mumbai, Kolkata, Delhi, Hyderabad, Bengaluru, Pune, Surat, Kanpur, Jaipur, Lucknow and Nagpur are among the top 100 cities across the world listed for the strict implementation of policies to prevent tobacco use. The report lists the cities population-wise, using figures published in the UN Statistics Division’s Demographic Yearbook.
More than half of the top national performers on tobacco control are low- and middle-income countries, showing that progress is possible regardless of economic situation. A tracking of MPOWER measures — introduced by WHO in 2007 to assist in the country-level implementation of measures to reduce the demand for tobacco — has revealed that the number of people protected by at least one best-practice measure has quadrupled to 4.7 billion — or almost two-thirds of the world’s population. 121 out of 194 countries have introduced at least one MPOWER measure at the highest level of achievement (not including monitoring or mass media campaigns, which are assessed separately).
Thirty-four countries with a total population of 2 billion people have adopted large graphic pack warnings. Six countries (Afghanistan, Cambodia, El Salvador, Lao People’s Democratic Republic, Romania and Uganda) have adopted new laws making all indoor public places and workplaces smoke-free. Six countries (El Salvador, Estonia, India, Jamaica, Luxembourg and Senegal) have advanced to best-practice level with their tobacco use cessation services, the report says. India and Nepal are regional and global leaders in implementing large, pictorial warning labels on tobacco packaging. With the increase in the size of pack warnings to 85% of both front and back panels on all tobacco products, India now has the third largest pack warning label among all countries. The findings of GATS-2 showed that graphic warning labels depicting throat cancer and oral cancer are a strong tool to discourage the youth from initiating tobacco, and have motivated 275 million current users to quit.
Dr Vinayak Prasad, Geneva-based head of the WHO Tobacco Free Initiative, told The Indian Express that among the many measures to control tobacco in India was the joint WHO-International Telecommunication Union initiative mCessation, launched in 2015 with the Ministries of Health and Family Welfare and Communication and Information Technology. “The programme to encourage people to quit tobacco use registered more than two million users last year and the initial evaluation showed that more than 7% quit successfully after six months,” Dr Prasad said.
WHO has been helping countries set up and scale up national tobacco cessation programmes that provide quit support using mobile phones. The programme commenced in India in 2015, providing personalised tobacco cessation advice. More than 2 million tobacco users have so far enrolled for the national bilingual mCessation programme that was launched last year. Programme data monitored through a real-time dashboard indicate improvements in both outreach and impact.
The National Health Policy, 2017 has set a target of “relative reduction in prevalence of current tobacco use by 15% in 2020 and 30% by 2025”. Dr Pankaj Chaturvedi, cancer surgeon at Tata Memorial Hospital, Mumbai, and one of the country’s foremost tobacco control advocates, said: “Raising taxes to increase tobacco product prices is the most effective and cost-effective means to reduce tobacco use and encourage users to quit. But it is one of the least used tobacco control measures.” The new report, funded by Bloomberg Philanthropies, is the sixth WHO report on the global tobacco epidemic. It is focussed on monitoring tobacco use and prevention policies. The WHO produces two key, complementary reports on global tobacco control: the Global Progress Report on the Implementation of the WHO FCTC, which uses self-reported data from member states; and the biennial Report on the Global Tobacco Epidemic.
The WHO Framework Convention on Tobacco Control (WHO FCTC), the first international treaty negotiated under the auspices of WHO, was adopted by the World Health Assembly in 2003, and entered into force in 2005. It has since become one of the most widely embraced treaties in UN history.