Global health watch: In India, public-smoking ban can only go so far

NEW DELHI -- India may have banned smoking in public, but it’s not exactly making smokers an endangered species.

According to India’s first survey on adult tobacco use, nearly 35% of adults consume tobacco in some form, as do 10% of 15- to 17-year-olds. In addition to cigarettes, cigars, pipes and hookahs, Indians, particularly in poor communities, frequently smoke bidis, a sort of rolled up leaf tobacco that sells for a few cents for a pack of 30.

While 35% isn’t particularly high for a developing country, its use is rising with disposable income. But there’s at least a little good news in the government’s Global Adult Tobacco Survey of India 2010 released Tuesday.

A majority of users have noticed the mandatory health warnings added to tobacco packets in May 2009, while nearly a third have considered quitting because of the warnings, which feature a lung and a scorpion symbol with a health message.

Starting in December, the warning will become more graphic when the image changes to a cancer-ridden mouth. Still, the Indian cessation rate is among the lowest in the world with only 2% of smokers quitting annually compared with 40% in the United States and the United Kingdom, 15% in Thailand and 9% in China.

More than 5 million people die every year worldwide from tobacco-related illnesses, of which close to a million are in India. With a population of 1.2 billion, India is the second-largest consumer of tobacco worldwide and the third-largest producer.

Another recent study shows that tobacco taxes — seen as a key deterrent to consumption — in India are much lower than what the World Health Organization recommends. Bidis have a 9% tax compared with 38% for cigarettes, even though WHO recommends a rate of 65% to 80%.

A Bloomberg Philanthropies study estimated that an international taxation standard could mean a rise of $832 million in revenue for the Indian government. Anti-smoking groups have long criticized the government for low taxes.

--Anshul Rana / Los Angeles Times