Re: Gutkha wars: India toughens up on oral tobacco use
Any legislation is as good as it is actually implementable and is implemented. India had enacted a very comprehensive legislation COTPA way back in year 2003 before most western countries globally including WHO’s FCTC but it was not implemented. The current Gutka ban in some states in India is best described as a good starting point to drive home the unacceptability and harmfulness of the habit, with its near non-existent enforcement mechanisms. Further, in isolation banning oral tobacco without concomitant ban on smoking forms of tobacco like “Bidi” defies all forms of logic and is not recommended in any tobacco control strategy. This is a definite evidence of the bigger money and political prowess which the cigarette and “bidi” industry wields in India like rest of the world.
The ban on oral tobacco use alone may be a culmination of commendable, relentless hard work and advocacy efforts of tobacco control activists and organizations but unfortunately has not changed prevalence of tobacco usage on the ground at all. Since, the ban on “Gutkha” by state government of Delhi recently, I have personally visited at least 10 urban slum areas in Delhi and it was available in all of them albeit at a higher price. They were available with all the small vendors and they were there in the pockets of all tobacco users as I was meeting lots of them for my research work. Since the largely untaxed “ Bidi” is still the cheapest form of tobacco, we are only encouraging smokeless tobacco users in India to switch to smoking Bidi, vendors to smuggle smokeless forms and sell them at a higher price, with no decrease in either morbidity or mortality due to diseases related to tobacco use in the long run. In summary this Gutka ban is a “well intended but a futile exercise without ban on Bidi”. India needs a multi-pronged attack on both smoking and smokeless forms of tobacco and also needs to provide infrastructure to provide requisite support to tobacco users for quitting.
Bidyut K Sarkar MBBS, M.D
University College London
Competing interests: No competing interests