Sunita Tomar is no more.” I awoke to this numbing text message, a cruel slap in the face and the final straw in days that have felt surreal. It’s 2015. Yet, here we are, responding to questions on whether or not tobacco indeed causes cancer, let alone other diseases. Sunita Tomar’s death felt like a sharp rebuke.
Most people would recognise her from a graphic, hard-hitting tobacco control public service announcement (PSA) that ran on national television and radio stations in 2014. Many would recognise her as the face of a campaign to encourage the government of India to carry through its decision to have graphic warnings covering 85 per cent of the pack for all tobacco products, smoking and smokeless, from April 1, 2015.
Sunita Tomar was, in many ways, an everywoman. From a small town called Bhind in Madhya Pradesh, she was married at 14 to a truck driver. She had two young sons and lived with her parents-in-law in their ancestral home. They made a relatively modest living and aspired for more for their children. And, like many women, Sunita began to chew tobacco. She chewed tobacco for pleasure, but she also consumed it in the form of an oral dentifrice, ignorant of the lethal effects of a supposed dental hygiene product. Not surprisingly, a few years later, she developed oral cancer. Hers is not an uncommon story.
But Sunita was extraordinary. Dealt this devastating blow, the family, at great personal cost, travelled to the Tata Memorial Hospital in Mumbai so that Sunita could undergo potentially life-saving surgery. That’s when the true courage of her character began to reveal itself. And that’s when we came to know her.
I work with an organisation that is part of an international initiative, known as the Bloomberg Initiative to Reduce Tobacco Use, which works hard with governments in low- and middle-income countries to support the implementation of policies and programmes that protect citizens from the harms of tobacco. The organisation I represent, the World Lung Foundation, has developed tried-and-tested mass media campaigns aimed at reducing the prevalence of tobacco. I know I speak for my colleagues when I say that we learn our most important lessons from people like Sunita.
I first met her during a press conference with former Union Health Minister Harsh Vardhan. Sunita had been fortunate in her choice of physician. Pankaj Chaturvedi of the Tata Memorial Hospital was not only an experienced surgeon but also a force for tobacco control in India. After the initial shock upon learning of her illness had passed, Sunita and her husband decided to join Chaturvedi in his efforts to spread the message about the ill effects of tobacco. My colleagues travelled to Mumbai to create a 30-second PSA that would tell her story.
Through the filming of the PSA, I heard about Sunita’s strength and humility, and the compassion of her husband. She was ashamed of the scars on her face. She tried to conceal the post-operative drooling from her mouth. She was frequently tired. My colleagues often asked if they should suspend filming. Both Sunita and her husband were determined. He’d say, “She’s a fighter. Give her a few minutes. She’ll be ready.”
Impressed with her story and courage, the Union ministry of health ran one of its strongest national mass media campaigns yet, featuring the Sunita PSA. Sunita, with her husband and children, travelled to Delhi — her first time in the capital — to be present at the launch of the campaign. She was felicitated by Harsh Vardhan, so were her husband and children. She spoke with dignity and clarity to the media, never flinching in the face of all that scrutiny. She pleaded for a tobacco-free world that would save her children and others from the suffering she experienced. As if in response to her plea, on that very day, Harsh Vardhan notified a ban on all forms of chewing tobacco. Two months later, even while Indian government officials were in negotiations on the Framework Convention for Tobacco Control in Moscow, Harsh Vardhan announced India’s intention to implement the new graphic health warnings on all tobacco packs. I was in Moscow at the time and recall the jubilance of tobacco control advocates from India and the region.
India is on the cusp of something great, continuing with its own legacy. It was among the first few to enact a comprehensive national tobacco control law (the Cigarettes and Other Tobacco Products Acts of 2003 and 2009). It became one of the first signatories of the World Health Organisation’s Framework Convention for Tobacco Control in 2004 and subsequently launched its National Tobacco Control Programme in 2008. India’s movie rules, which require health warnings every time tobacco is portrayed on a scene, are novel and other countries, like Russia, are considering following suit. The current reversal on the notified 85 per cent graphic warnings is a deep betrayal.
Sunita’s death was avoidable. The solutions to tobacco are evident and within reach. Graphic health warnings on all tobacco packs, increased taxes on tobacco products, hard-hitting mass media campaigns, enforcing smoking bans and bans on the promotion and sponsorship of tobacco products are proven ways of reducing the prevalence of tobacco.
Sunita is no more. But there are millions of young people like her falling prey to a seemingly innocuous but deadly habit. Her bravery stands in sharp contrast to the duplicity of the tobacco industry, which spreads misinformation about the health hazards of tobacco and the economic benefits of its products. We need large graphic warnings so people are aware of the real harm caused by tobacco in all its forms.
We need large graphic warnings to dissuade our children from starting this deadly habit. We need large graphic warnings to help reduce the annual 1.4 trillion rupee cost of tobacco to our economy. We need large graphic warnings to carry through the promise made to Sunita, that her pain and her experience — and her family’s loss — would not be in vain. Our government needs to go ahead and implement large graphic warnings without delay.
Doing anything less would be making a mockery of Sunita Tomar and her legacy.
The writer is country director, India, and global director for research, World Lung Foundation, US