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Health

Will tough, new laws cut smoking rates in India?

Flickr: Rishi Bandopadhay

Globally, more than 6 million people die from smoking annually. India accounts for 900,000 of these deaths.

India’s public officials have been trying to reverse the rise in smoking and have recently stepped up their efforts.

The latest law that was passed focuses on minors. A 7-year prison sentence now awaits anyone who is caught selling cigarettes to people under 18 and cigarettes can no longer be sold within 100 meters of a school.

This clearly tries to prevent a future generation of smokers.

But what is the country doing to get current smokers to stop? Or to end smoking on a society-wide level?

After all, India is home to more than 110 million smokers, which is a 10% drop in the past 2 years, but an increase of 35 million smokers since the 1980s. 

Well, the country bans public smoking (at least in some spaces), all cigarette packages must feature pictorial warnings, TV ads for tobacco are banned, and some cities have tried to go entirely smoke-free.

However, smoking is still permitted in places, such as restaurants, if establishments provide a smoking area, which kind of undermines the smoking ban.

And the laws aren’t always enforced. The 7-year prison sentence for selling to minors will likely never be fully carried out.

Plus, the long-term rise in smoking suggests that laws have not been that effective in actually changing behavior.

And to makes matters worse, cigarettes in Mumbai are 6 times cheaper than they are in Melbourne. The cheaper cigarettes are, the more likely people will stay addicted. It's a lot easier to part with 1% of your paycheck than it is to part with 10%. 

There’s really no overstating the risk of smoking. The potential health problems are nearly endless. They are both short-term and long-term and they extend to those unlucky enough to be around smokers.

The national narrative of smoking is basically the same everywhere

Phase 1: Cigarette smoking becomes common as industrialization accelerates, cigarette companies grow and disposable income rises (cigarettes tend to be cheap at this phase).

Phase 2: From here, smoking steadily climbs as marketing and social expectations encourage new smokers. Teenagers are conditioned to think it’s cool and adopt life-long habits. And if you’ve ever seen Mad Men, you know how overwhelming it must have been to work in a smog-filled office during the 1950s and 60s in the US.

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Phase 3: Next, the health consequences of smoking (which are indisputable) start being discussed, but awareness lags as misinformation is spread.

Phase 4: Finally, health advocates break through and anti-smoking laws, higher taxes, better education, social stigma and health fears lead to a gradual decline of smoking.

All these measures reduce smoking. Laws that prohibit smoking in certain environments, for instance, drastically cut prevalence. 

As a report by the US Surgeon General noted, “There are several pathways for this effect including lower visibility of role models who smoke, fewer opportunities to smoke alone or with others, and diminished social acceptability and social advantage for smoking."

Together, however, these measures become unstoppable.

The US, for its part, has seen the number of smokers decline by tens of millions over the past several decades because of such efforts.

Some countries are in the final phase of smoking, others are still in phase 2 or 3--many of them in the developing world.  

80% of the world’s 1 billion smokers live in low- and middle-income countries. In many of these countries, smoking has not yet transformed into something expensive, unattractive and hard to do.

And many big tobacco companies have adapted to these trends by moving their operations to unregulated markets where they can lobby against new restrictions.

India used to be such a market

As the world tries to achieve the Global Goals by 2030, ending smoking has to be a main priority. Global Goal 6: Health and Wellness can not be achieved if a billion people still smoke.

Smoking also directly contributes to poverty (Global Goal #1). An addiction is hard to suppress, so oftentimes people spend money that they don’t really have on cigarettes. And the health risks of smoking can lead to bills that are impossible to pay. Further, the toll smoking takes on a person’s mind and body degenerates quality of life.

Smoking is a problem that is already concentrated among the poor.

The good news is that ending smoking is possible. In fact, it can even be easy. Governments just have to summon the courage to aggressively help their people and treat smoking like the slow-motion health crisis that it is.

India is taking an aggressive stance, the question, is will they follow through? 900,000 deaths a year hang in the balance.