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CURRENT ISSUE ANALYSIS
Year : 2004  |  Volume : 21  |  Issue : 4  |  Page : 63-64 Table of Contents   

Why did India need W.H.O. - Framework convention on tobacco control ?


Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012., India

Correspondence Address:
S K Jindal
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012.
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Jindal S K. Why did India need W.H.O. - Framework convention on tobacco control ?. Lung India 2004;21:63-4

How to cite this URL:
Jindal S K. Why did India need W.H.O. - Framework convention on tobacco control ?. Lung India [serial online] 2004 [cited 2019 Sep 16];21:63-4. Available from: http://www.lungindia.com/text.asp?2004/21/4/63/44470

India has now got the distinction of being the 7th country to implement WHO's Framework Convention on Tobacco Control (FCTC) [1] . This involves a ban on smoking in public places nationwide, prohibition of sale of tobacco to children, ban on advertisements and sponsorships promoting tobacco and demarcation of smoking areas in hotels and restaurants with more than 30 rooms from Ist May 2004. Obviously therefore, there is every reason to celebrate the 'No Smoking Day' which falls on May 31st every year. It is a major step of the Government of India which reaffirms the "right of people to the highest standards of health".

Tobacco was introduced in India in Bijapur in South India by the Portuguese traders who had brought it from the Americas where it was grown since 6000 BC [2] . It was taken to Emperor Akbar by his ambassador Asad Beg in 1604-5, was relished by every noble of the Court and soon achieved the status of a favoured item of trade. There is a long story of ups and downs of tobacco thereafter. But the concern about its use has assumed a wider perspective in the last decade or so. This has possibly paralleled the expansion of tobacco market especially after its decline in the Western countries. There has been a genuine fear that the multinational tobacco companies finding reduced market in the West, are likely to dump this country with the tobacco products . This fear is shared by many other countries of the Third World.

India is the third largest producer of tobacco leaf, and a very large consumer of tobacco products. In spite of low consumption of cigarettes on a per capita basis, the market potential in India is considered enormous in the trade circles. The Indian cigarette market was of of 83.9 billion pieces in 1990 and about 88.2 billions in 2002 [3] . The low per capita consumption of cigarettes compared to international standards is attributed to the large use of alternate forms of tobacco which are locally manufactured, cheap and available at ease. Interestingly, tobacco is consumed in India in very different forms [4] . The smoking types include the cigarettes, bidis, hukka, chillum, cigars and cherrot. "Chutta', prevalent in Orissa and coastal Andhra, is a most unusual type of tobacco, in shape of a 'large­bidi' whose burning end is kept inside the mouth. The nonsmoking forms which are chewed or snuffed are even more numerous. These are available as 'zarda', tobacco containing 'paan-masaalas', gutka, chewing­gums, tooth pastes, misri (etc.) in different parts of the country. The nonsmoking types of tobacco products are almost a part of culture of several communities and are used ad libitum.

Although the harmful effects of tobacco were described over 400 years ago when the Chinese Philosopher Fang Yizhi pointed that years of smoking 'scorches one's lung', the actual war on tobacco had started only about half a century ago when firm scientific evidence started pouring in on the role of tobacco in causation of diseases such as chronic obstructive lung diseases, lung cancer and coronary heart disease. Both the British Royal Society for Health and the US National Institute for Health published several reports on this association [5],[6] . The US Surgeon General Report on adverse effects of tobacco is an annual feature for about 40 years now. It was possibly the study from Japan that reported a significantly increased occurence of deaths from lung cancer of nonsmoker wives of men who smoked cigarattes, that attracted a much larger attention to the problems [7] . In the past, a smoker could find an excuse to continue smoking as his personal choice. But the risks to the life and health of nonsmokers caused by the smoking of a few were not acceptable to the community. Several other reports followed on the role of passive smoking causing lung cancer deaths, aggravating asthma, increasing morbidity and mortality from respiratory infections and other diseases, and heart attacks [8],[9],[10],[11],[12] . The cry for a need of tobacco control therefore, increased many fold and innumerable international organizations and agencies joined hands to enforce regulations [12] .

The Framework Convention of Tobacco Control was the first treaty negotiated under the auspices of the World Health Organization [1] . Based on firm evidence, the treaty includes provisions to implement reductions in tobacco specific demands as well as supplies. It is a noble document which gives priority to "the right to protect public health".

The Convention contains several measures which include the use of both price, tax and non-price measures; protection from exposure to tobacco smoke; regulation of the contents of tobacco products and their disclosures; packaging and labeling of tobacco products; public awareness measures; tobacco advertising and sponsorships and demand reduction measures. The tobacco supply reduction provisions relate to the illicit trade, sales to minors and provision of support for economically viable alternative activities.

The economic losses caused by tobacco control activities such as the FCTC constitute a major concern for the community as well as the government. But no financial loss is of greater significance than human health. Moreover, the losses are shown to be offset by the gains in human health and prevention of huge expenditures on management of and losses from effects of tobacco associated diseases.

It is now well established that tobacco causes ecological degardation by increasing soil salinity and reducing the water table. A large scale felling of trees is also required to provide fuel for curing of tobacco. Smoking is also an established and important cause of accidental fires in forestry as well as industry. Some of these ecological and economic losses can be prevented by tobacco control.

The FCTC lays the foundation for a healthy society. It is only the beginning. One hopes that more effective steps will follow for the implementation of different objectives. Tobacco cessation for smokers and advice for nonsmokers not to initiate the habit are other important issues. More importantly however, is the need of personal and social awareness of the hazards of smoking to human health. There are no good alternatives to education and self-awakening.

 
   References Top

1.World Health Organization, WHO Framework Convention on Tobaco Control. Tobacco Free Initiative, Geneva, 2003.  Back to cited text no. 1    
2.Raja Rao DCH. Early history of tobacco in India. Indian Tobacco 1956 ; April - June : 63-5.  Back to cited text no. 2    
3.ERC Reports - India ; World Cigarettes. Office on Smoking and Health, Centre for Disease Control and Prevention, Atlanta, USA 2001.  Back to cited text no. 3    
4.Bhonsle RB, Murti PR, Gupta PC, et al. Tobacco habits in India. Control of Tobacco related cancers and other diseases. International Symposium 1990, Ed. PC Gupta, JE Hamner III, Bombay, Oxford Univ Press 1992 ; 25-46.  Back to cited text no. 4    
5.Royal College of Physicians of London. Smoking and Health, 1962. Summary and a Report of the Royal College of Physicians of London on Smoking in relation to cancer of the Lung and other Diseases. Pitman, London.  Back to cited text no. 5    
6.6.United States Public Health Service. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. Public Health Service Publication No. 1103, 1964 ; Washington DC.  Back to cited text no. 6    
7.Hirayama T. Nonsmoking wives of heavy smokers have a higher risk of lung cancer : a study from Japan. Br Med J 1981 ; 282 : 183 - 5.  Back to cited text no. 7    
8.Hackshaw AK, Law MR, Wald NJ.The accumulated evidence on lung cancer and environmental tobacco smoke. Br Med J 1997 ; 315 : 980 - 8.  Back to cited text no. 8    
9.US Department of Health and Human Services. The health consequences of involuntary smoking. DHHS (PHS) 87 - 8398. Washington DC : USGPO, 1984.  Back to cited text no. 9    
10.Gupta D, Aggarwal AN, Jindal SK. Pulmonary effects of passive smoking : the Indian experience. Tobacco Induced Diseases 2002 ; 1 : 127 - 134.  Back to cited text no. 10    
11.Jindal SK, Gupta D, Singh Al. Indices of morbidity and control of asthma in adult patients to environmental tobacco smoke. Chest 1994 ; 106 : 746 - 49.  Back to cited text no. 11    
12.Schreoder SA. Tobacco control in the wake of the 1998 Master Settlement Agreement. New Engl J Med 2004 ; 350 : 293-301.  Back to cited text no. 12    




 

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