Tobacco is the only consumer product which is grown and available legally and is lethal for human beings. At the current rate, the number of smokers dying every year in the world is likely to reach (10 million) 1 crore by 2020.
In India tobacco kills 1 million (10 lakhs) people annually.
Tobacco definitely is a global health epidemic, whose rapid spread around the world presents daunting challenges to policy makers and people engaged in public health concerns. Yet one finds an unacceptable contradiction here. Tobacco control policies and tobacco promotion measures seem to be coexisting comfortably. On one hand we have governments all over the world, initiating well deserving measures to combat tobacco consumption, while on the other hand, they continue to promote cultivation, sale, trade and export of tobacco and its products.
While I was in Mumbai attending the 14th World Conference on Tobacco or Health (WCTOH), I met a noted writer who said she was unable to understand the logistics of tobacco control. She echoed the sentiments of several others that the best solution to the problem would be to stop growing tobacco and stop manufacturing its products. Why produce the poison and then go all out to prevent its usage?
India is one of the signatories to the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), thereby agreeing to implement its provisions. FCTC is the first global corporate accountability and public health treaty. As a Party to the treaty, India is obligated to take measures to bring down the consumption and production of tobacco in the country. It is the latter, which merits serious attention in order to achieve the former.
It makes sense that the strong legislative efforts of our government to curb tobacco use, sale and advertising need to be supported by proper and stricter enforcement. But far more important is to back these measures by comprehensive policies that have far reaching effects on tobacco cultivation and on manufacturing of all tobacco products like cigarettes, bidis, chewing tobacco, snuff and other localized versions. There is no safe way to use tobacco - whether inhaled, sucked, sniffed or chewed, and there are no safety levels.
The main reasons cited for this dual behaviour are the economic dependence of the tobacco growing farmers and the bidi rollers on this activity and of the government on the revenue collections. But if we delve a little deeper in the issue, then the reality will be different from these arbitrary assumptions. The task to overcome these 'obstacles' should not be as formidable as it appears to be.
Tobacco cultivation in India , especially the Flue Cured Virginia (FCV) tobacco used for cigarette making, has been enjoying government support for decades.
The area under tobacco cultivation is presently 368.5 thousand acres, which is less than 0.3% of the net sown area in the country. Around 3 to 5 lakh farmers are engaged in this activity. Tobacco farming is seasonal and restricted to a few states only, with Andhra Pradesh, Karnataka, Gujarat, Maharashtra and Orissa accounting for more than 90% of the total tobacco cultivation. It is easy for government to intervene as around 35% of tobacco crop area is governed by the rules of Tobacco Board, Government of India.
Case studies/experiments carried out by tobacco research centres suggest alternative crops like soybean, groundnut, different varieties of gram, maize, paddy, mustard, sunflower, cotton, sugarcane etc. which yield almost similar returns and are far more eco and health friendly. In fact, in some states tobacco has sadly replaced cultivation of food crops like jowar, maize and ragi - which were once called the poor man's food, and are now high even on the health conscious' diet chart. This shift from growing tobacco to something healthier can only affect the economic status of the farmers in a positive way. Of course, the government will have to provide them incentives by way of technical know how, seeds and marketing links for the alternate crops.
Supply of tobacco products from external sources, both legal and illegal will also have to be controlled. India is a lucrative market for foreign cigarettes and cigars. The government would therefore need to ban the import of tobacco products and foreign direct investments in the tobacco sector.
Another populist argument given in favour of tobacco production is the dependence of about 4 lakh people (two thirds of whom are women) on bidi rolling as a major economic activity. But the ground reality is that bidi manufacturing is the most exploitative work, wherein most of the workers (more than 50%) do not get even the minimum wages. This industry is largely in the unorganized sector. Manufacturers easily resort to all sorts of underhand dealings to evade excise duty as well as circumvent the minimum wages act. Many children are also engaged in this activity in direct contravention of the Child Labour (Prohibition) Act.
A recent study, initiated by Voluntary Health Association of India (VHAI), on the bidi workers from the districts of Murshidabad in West Bengal and Anand in Gujarat has brought out their dismal health and socio economic conditions. The study revealed that most of the respondents (more than 76%) earn a measly sum of Rs.33 per one thousand bidis that they rolled in more than 12 hours. This is much below the minimum wage of Rs.40 per day. Coupled with poor wages are the deplorable working conditions. The bidi workers are constantly exposed to the grave risk of contracting tuberculosis, asthma, lung disease and spinal problems. Women who carry their infants to work expose them to hazardous tobacco dust and fumes. Occurrence of asthma and respiratory / skin diseases is very common in children engaged in bidi manufacturing. Moreover, they have to juggle school with bidi rolling, and often discontinue after the primary level (especially the girls) to engage full time in bidi rolling to augment family income.
A whopping 95% of the respondents wanted to shift from their present occupation, to some other livelihood, with some external support.
Regarding the fiscal benefits accruing to the government from revenue collection, here again facts are very different from fiction. According to a study reported in the January 2009 issue of Tobacco Control (a publication of the British Medical Journal), India spends more on treating tobacco related diseases than it collects by way of taxes from the tobacco industry. The study used the data from the National Sample Survey conducted in 2004.
The total economic cost of tobacco use in India (direct and indirect) amounted to US $1.7 billion in 2004. This is 16% more than the total excise tax revenue of $1.46 billion collected from all tobacco products in India in the same period. It is also many times more than the expenditure on tobacco control measures.
Global tobacco production has almost doubled since the 1960s. In 2006, world tobacco production totaled nearly 7 million metric tones, with 85% of the leaf grown in low and middle resources countries. Even the Tobacco Atlas published by the American Cancer Society recognizes that tobacco agriculture creates extensive environmental and public health problems. The WHO agrees that tobacco cultivation creates extensive environmental and public health problems. Pesticide/fertilizer run offs contaminate water resources. Curing of tobacco leaf with wood fuel leads to massive deforestation. Agricultural workers, even if they do not consume tobacco, suffer from pesticide poisoning, green tobacco sickness and lung damage from particulate tobacco smoke and field dust.
The FCTC rightly calls for financial/technical assistance to tobacco growers, so that they may shift to nutritious, economically viable and environmentally sound livelihood alternatives. Unskilled bidi workers will have to be found alternate employment with the help of public - private partnership. The time is ripe to focus not only on reducing tobacco consumption but also to question state support to tobacco cultivation. Tobacco control cannot be effective unless its supply is restricted and gradually stopped altogether. India cannot afford to continue exhibiting the dual policy of control of tobacco consumption and promotion of tobacco cultivation / production of tobacco products, side by side. Tobacco kills 1 million people in India annually.
A planned and phased reduction in tobacco production is going to benefit all. People employed in retailing, processing and in industries manufacturing cigarettes / chewing products can get alternate employment. In fact, most of the tobacco multinationals have diversified into other businesses and should be encouraged to close down their 'poison manufacturing units' in the name of corporate social responsibility.
Let the Asian Tiger take the lead in this matter for the rest of the world to follow. Contributed by: Shobha Shukla