30 Mar 2015

Tobacco or Health! U Turn On Pictorial Warning On Tobacco Products

Subhash Gatade

..Government is set to defer indefinitely the implementation of notification for increasing the size of pictorial warning on tobacco products beyond April one, when it was to come into force. ..The notification regarding amendment to the Cigarettes and Other Tobacco Products (Packaging and Labelling) Rules, 2008 sought increase in the size of specified health warning from the current 40 per cent to 85 per cent of the principal display area of the package of tobacco products.
The week gone by has brought back smiles on the face of Tobacco Corporates.
Thanks to the latest U turn by the Modi government, Acche Din would continue unabated for them. The non-transparent manner in which the decision was taken and the media was kept in the dark has raised further eyebrows. It was only on the evening of 24 th March that while talking to the media, the health minister J P Nadda had assured them that there is no rethink in the government on introducing pictorial warnings covering 85 per cent of packaging for tobacco products from April 1 and within few hours of this interaction he left for Beijing.
Definitely Nadda must have found time within that limited period to sign the order deferring the notification or as some journalists believe he had already signed it and was just pretending to avoid some inconvenient moments. It need be added that the said notification was brought in last October, when Nadda's predecessor Harsh Vardhan - another RSS Swayamsevak - was handling the department. It was declared at that time that it would be effective by 1 st April. Not very many people could have the premonition that the government is not keen about it and would reverse the decision at an opportune moment.
It is worth emphasising that India was not the only country from South Asia, which had taken a decision about it. Pakistan as well as Nepal both had similarly taken some concrete steps in that direction. Welcoming their decision the 'World Conference on Tobacco or Health' had even urged all the three to 'stand firm against the tobacco industry pressure'. It had also suggested to them that to effectively reduce tobacco consumption and improve public health it can raise tobacco excise taxes which would make tobacco less affordable and can also generate additional revenue for government which can be utilised for healthcare.
If India would have gone ahead with its decision, then it would have been the first country in the world which had so much space allocated for the pictorial warnings. Now that is passe because of some 'unexplained reasons'. Coming to pictorial health warnings on tobacco products there are enough studies available which vindicate that it makes the product less attractive and target smokers or users of tobacco products by providing them with information on tobacco-related health risks. Discussing reasons to introduce pictorial warnings on tobacco products ECL which is an Association of European Cancer Leagues makes few things clear. They are
1) Eye-catching: this is in line with the saying that "a picture paints a thousand words" and the general belief that an image can often be more powerful than words on a page.
2) Informative: research in four countries showed that in Canada, where pictorial warnings include information about the risks of impotence, smokers were almost three times more likely to agree that smoking causes impotence compared to smokers from the US, UK and Australia.
3) Additional motivation for smokers who want to stop smoking: 44% of smokers in Canada said the pictorial warnings increased their motivation to quit smoking.
4) Less attractive for youngsters: 48% of Belgian smokers aged 15 to 17 think the new warnings make the packaging look less attractive
(http://www.europeancancerleagues.org/tobacco-control/pictorial-warnings-on-tobacco-products/111-ten-reasons-to-introduce-pictorial-warnings-on-tobacco-products.html)
As things stand Nepal would be the only country from this part of South Asia which would go ahead with this decision. Like in many other such steps - which have been hailed by majority of countries, around which there is even a global consensus- India has decided to opt out this time again. Few months back (September 2014) India was one of the few countries which had abstained from a historic vote on violence and discrimination against sexual minorities. Not some time ago it had taken similar embarassing stance when it had supported Russian resolution which had opposed extending benefits available to spouses of UN employees to same sex couples under the specious plea of sovereignty. It had voted alongside Pakistan, Saudi Arabia and China
Interestingly in the hullaballoo around internal bickering of AAP and the media saturation accompanying it, this this reversal of its own decision by the Modi government has largely gone unnoticed.
Now to save face it is being said that the health ministry was receiving many representations asking for the decision to be reconsidered and it wanted time to brood over these observations. Perhaps the biggest stumbling block to the implementation of the notification was the Chairman of the Committee of Subordinate Legislations, which is effectively a panel of M P s only. The BJP M.P from Ahmadnagar Dilip Gandhi, who happens to be the Chairman had raised the validity of studies done in 'foreign' countries to study the ill effects of tobacco and who is of the firm opinion that 'Indian exceptionalism extends to our biology'.
Perhaps it would be opportune here to share his 'pearls of wisdom' which he had shared with the media ( Indian Express, 24 th March, Examine tobacco effects on Indians, says House Panel'):
"“There are no studies in our own country that have examined the health effects of tobacco. Whether at all it actually causes cancer or other diseases is subject to a study in the country. That has never happened and the basis of our stance towards tobacco products is basically studies that have happened in a foreign setting. We have recommended that a medical board or at least an expert committee comprising doctors, scientists et al should first do a study in India before we go ahead with such decisions.”
The irony of the situation is that neither he knew or nor perhaps wanted to enquire that there are enough national- international level studies which had firmly established the relationship between tobacco and cancer. It was mid-fifties or early sixties when the tobacco corporates had raised this debate that tobacco is not harmful to health and a path breaking report' by US Surgeon General Luther Terry had finally established a correlation between them.
Coming to studies done in India an editorial in Indian Express tells us the '[2]008 study published in the prestigious New England Journal of Medical Research used a nationally representative sample to find that smoking causes a large and growing number of premature deaths in India.' This study was supported by a government body called 'Office of the Registrar General'. It also provided details of another study whose results were published earlier this year done by Indian researchers based in India wherein it discovered 'statistically significant excess risks among tobacco chewers for respiratory tuberculosis, stroke and cancer, compared to never-tobacco chewers.'(http://indianexpress.com/article/opinion/editorials/anti-science-absurd/)
India happens to be a country where 27.5 crore people consume tobacco in one or the other form and according to one set of studies we witness 8 lakh deaths every year. Coming to the world by the year 2030, there would be 10 million deaths annually which would be tobacco related.
With its decision in October 2014, India had finally decided to join the growing consensus between many countries to have pictorial warnings which are not only an effective way of communicating the consequences of tobacco use but also act as catalyst to bring about behavioural change so that one quits usage of tobacco products or at least reduces its consumption.
Sooner or later it was going to have an impact on sale of tobacco products and would have definitely impacted on the profits of the corporates and big moneybags who are earning billions of Rs at the cost of health of people.
It was a step which was definitely not liked by the Corporates who had provided overwhelming support to the BJP and its PM candidate during election campaign last year.
With this U Turn they must be smiling.
Acche Din are here again.

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