::: Voluntary Health Association Of India :::

Tobacco production, manufacture and consumption in various smoking and smokeless forms, is a serious public health concern in India. It has assumed epidemic proportions with strong implications on public health, as well as having far - reaching social and economic implications.

VHAI is one of the pioneers in tobacco control at the national level, working simultaneously at the state level through its federation of 27 State Voluntary Health Associations (SVHAS) as well as at the grassroot level through the member networks of State Voluntary Health Associations.

The Key Focus Areas in VHAI’s Tobacco Control campaign are:

Policy-focussed research
Coalition building and networking
Policy and media advocacy
Establishing national and state-level resource centres
Creation of comprehensive smoke-free environments
Working with the government for the effective implementation of COTPA
Monitoring and reporting of violations
Alternative livelihoods and other advocacy issues for bidi and tobacco workers
Development of advocacy materials

A number of landmark activities and developments have taken place in the last year which have not only strengthened the campaign but also enabled VHAI to take it forward:

The Air Quality Monitoring Study and Release of Findings

Approximately one year after the smoke-free law went into effect, VHAI and 11 of its state partners across India conducted an Air Quality Monitoring (AQM) Study concluded in September 2009, across 12 states/Union Territories covering 16 cities. The study helped in evaluating the quality of air in public places like restaurants, bar, pubs etc. The Air Quality Monitoring (AQM) study and release was a major milestone. The AQM study was an effective tool to monitor second hand smoke exposure in public places and release the findings as substantive evidence. The findings of the AQM study brought to light that over 60% of the bars-cum-restaurants surveyed across the country are not complying with the smoke-free law. The study demanded urgent steps from the Government to protect the health of citizens from the dangers of secondhand smoke by effectively implementing the law in all public places and deploying resources to increase compliance. The findings of the National AQM Report were officially released in New Delhi, Rajasthan, Kerala, Orissa, Uttar Pradesh, Madhya Pradesh and Meghalaya, generating wide media coverage in both the print and electronic media.

Development of a Tobacco Control Advocacy Kit for Parliamentarians, Public Health Advocates, Mediapersons, NGOs and Government Personnel

An advocacy kit on tobacco control was developed by VHAI for parliamentarians public health advocates, NGOs, media persons, senior bureaucrats and enforcement officials. The kit comprises a handy advocacy brochure and fact sheets on various aspects of tobacco control with key messages on various aspects along with actions needed. It serves as a ready reference document for MPs, urging them to support the provisions of the COTPA and enforce the laws in larger public health interest. It also appeals to them to implement additional measures on tobacco control like higher taxes on tobacco products, alternate livelihoods for bidi workers, alternate cropping to replace tobacco farming and mainstreaming tobacco control into national programmes. The kit has been translated into a number of regional languages like Hindi, Tamil, Bangla, Malayalam, Telugu, Oriya, Gujarati, Khasi, Assamese and Urdu.

Political Advocacy with Members of Parliament (MPs), Members of Legislative Assembly (MLAs) and Members of Standing Committee on Health and Family Welfare

VHAI sent copies of the advocacy kit to all 542 Lok Sabha and 250 Rajya Sabha members, key ministers like the Minister of Health & Family Welfare, State Health Ministers, and to other concerned ministers like the Minister for Labour, Women and Child Development, Information and Broadcasting, Railways, Finance, Food and Agriculture, Commerce and Human Resource Development. The brochure was also officially released by Members of Parliament in several states like Orissa, Gujarat, Tripura, Andhra Pradesh, J&K, Meghalaya, Uttar Pradesh, West Bengal and Rajasthan along with significant policy-level developments:

Orissa

In Orissa, Shri D P Behera, Joint Secretary to the Government of Orissa issued a notification to make Bhubaneshwar smoke-free by May 2010. A written directive was issued to all officers in charge of Government offices, private, banking, corporate and non-government organizations, managers of public places and heads of educational institutes to take up various steps to create awareness of the law and identify gaps and challenges in its implementation.

Uttar Pradesh

VHAI and Uttar Pradesh Voluntary Health Association (UPVHA) organized an Advocacy Workshop to make Lucknow Smoke Free” on 4th Dec. 2009. The workshop was formally inaugurated by Mr. Sukhdev Rajbhar, Hon’ble Speaker, Vidhan Sabha (Legislative Assembly), Uttar Pradesh, who extended his full support to make Lucknow smoke free.

Jammu and Kashmir

Following an advocacy workshop conducted by VHAI and J ammu and Kashmir VHA, where the Speaker released the VHAI advocacy brochure, a notification from the Health and Medical Education Department has been issued to form State and District level Monitoring Committees to enforce Sec. 5 of the Tobacco Control Act, banning direct and indirect advertising of all tobacco products.

Gujarat

In Gujarat, a district level advocacy programme for Panchayati Raj (PRIs) members or Village Council/local self government representatives was organised by the VHAI, Gujarat State Tobacco Control Cell and Gujarat VHA. The objective was to sensitize and initiate more active and effective involvement of PRIs in tobacco control and implementation of the COTPA. The event helped the participants to get sensitized on key tobacco control issues as well as the provisions of the law.

Implementation of COTPA/Smoke free Public Places: Mapping of Achievements, Gaps and Challenges in select districts of India

India has a comprehensive tobacco control law but implementation and enforcement is still a matter of concern. In a vast country like India, multi-faceted efforts are needed to monitor and ensure that violations are minimum and defaulters are fined. VHAI is conducting a mapping exercise to understand the current status of implementation of tobacco control laws in different settings, identify the gaps & challenges associated with it and come out with specific recommendations for effective implementation of the law so as to ensure smoke free public places. This exercise is being carried out in 13 districts of 9 states – Assam, Delhi, Uttar Pradesh, Madhya Pradesh, Rajasthan, Kerala, Meghalaya, Orissa and Sikkim. The study will be carried out in two districts each in 4 states covered under National Tobacco Control Programme (NTCP) (Pilot Phase-I) and VHAI’s PAT & APPLE project; one district where the National Tobacco Control Programme (Pilot Phase-I) is being implemented and the other which is not covered under NTCP (Pilot Phase-I).

Partnership Building for Campaign against Tobacco Round Table on Child Rights and Child Labour in the Bidi Industry

A Round Table on Child Rights and Child Labour was organized with the objective of bringing together and to a common platform, groups and organizations working on child rights in order to strengthen the ground for and help in strategizing further VHAI’s ongoing work on child labour in the bidi industry. Participants at the roundtable included Child Rights and You (CRY), Prayas, Bachpan Bachao Andolan (BBA), Save The Children – India, Butterflies, Campaign Against Child Labour (CACL), National Coalition for Education (NCE), UNICEF and Lawyers Collective. All of them collectively expressed support to work on the children’s education issues as well as on a joint press release highlighting child rights concerns on November 13th, the eve of Children’s Day.

Legal advocacy Initiatives

Interim order on Pictorial health warnings: After a long battle of several months, finally an interim order on the implementation of pictorial health warnings was given by the Supreme Court in May 2010. This cleared the way for the implementation of pack warnings on all tobacco product packages from 31st May 2009. Given the odds against tobacco control advocates and the fear that pack warnings may get further diluted and delayed by the next government there was reason to believe that this was a preliminary victory for civil society battling against the tobacco industry.

Filing of PIL on Child Labour in the Supreme Court: A Public Interest Litigation (PIL) was filed by the Health for the Millions Trust on November 16th in the Supreme Court. The Chief Justice of India, K G Balakrishnan heard the plea and the bench issued notices to the the Ministry of Health and Family Welfare, Ministry of Women and Child Development and the All India Bidi Industry Federation. The plea has asked for a complete ban on child labour as the bidi industries among others, is violating the law by employing children in hazardous occupations.

Research Initiatives on Tobacco Control

VHAI’s research initiative aims to document local evidence on tobacco-related issues to strengthen our advocacy initiative and garner political and public support. The research initiative includes the following:

Mainstreaming Bidi Workers through Alternative Livelihood Options

The Action Research on Mainstreaming Bidi Workers into alternative livelihoods in Murshidabad district of West Bengal, began in 2008. The main objective of the research is to get a comprehensive understanding of the factors influencing the livelihood pattern of Bidi workers, assess other feasible livelihood options, learn from observations, interactions and practical implementation of alternative livelihood strategies for bidi workers.

Alternative Cropping to Tobacco Cultivation to phase out Tobacco Production

The main objective of this research is to understand tobacco cultivation pattern in India, examine the factors responsible for the increase in tobacco production and yield. The study also looks into national efforts towards alternative cropping and inter-cropping patterns, to understand the economics of alternate crops and document success stories therein.

Political Economics of Tobacco

The production, consumption and distribution patterns of the diverse forms of tobacco other than cigarettes have not received much attention in mainstream policy research. This study attempts to understand the political economy of tobacco in India with particular focus on cigarettes and the bidi industries. The study also makes policy recommendations of both fiscal and non-fiscal types focussing more on the bidi industry, to control smoking tobacco in India.

Integrating Tobacco Control in the Medical Curriculum of Health Workers and Medical Students

The objective of this research is to review the existing curriculum of medical schools and health care providers in the country to assess to what extent tobacco control can be incorporated into these curriculums. An evidence-based document will be submitted to the Medical Council of India (MCI), the Nursing Council and the Government of India with key recommendations towards the need for incorporating tobacco control in the Indian medical education syllabi.

Tobacco and Poverty

VHAI is conducting this study to highlight that tobacco and poverty are deeply connected at the individual, family and societal levels. Family incomes are spent on tobacco use and treatment of tobacco-related diseases at the cost of basic necessities. Tobacco cultivators and bidi rollers earn measly wages and suffer from diseases caused by exposure to tobacco dust and hazardous chemicals. The society suffers from huge healthcare costs and loss of productivity. This study will generate stronger evidences to demonstrate that tobacco is closely linked to poverty as well as underdevelopment and is not just a public health concern.

Media Advocacy through State Level Workshops

No advocacy campaign can get off the ground, make the desired impact and build public opinion without the support and publicity of the media. In order to sensitize and win media support in the campaign against tobacco, media sensitisation workshops were conducted at the state-level on key policy priorities in Gwalior, Lucknow, Bhubaneshwar, Jaipur, Shillong, Guwahati and Kolkata.

The workshops were able to enhance and generate media attention on tobacco control issues, and COTPA. They also helped in highlighting the violations of the law especially, pictorial warnings and advertising. All these workshops witnessed good participation by mediapersons and helped to improve relations with regional media.

Screening of VHAI Bidi film across various locations in India

VHAI’s path breaking film on bidi workers – “Turning Their Lives to Ashes” was screened at several locations across India like Hyderabad, Bengaluru, Bhopal, Guwahati, Kolkata, Lucknow, Agartala, Ranchi, Patna, Jaipur, Bhubaneshwar, Chennai as part of our advocacy campaign. The film screenings were also an opportunity to discuss and highlight crucial issues like, health effects of bidi smoking as well as bidi rolling, pack warnings, taxation policies of bidi industry, issues of child labour in bidi industry, violation of basic human rights and exploitations of the bidi workers, etc.

All these events were well attended by senior officials from ministers, officials from various government departments (health, women & child, labour, human rights, commerce, etc), representatives from UN organizations, public health organizations various civil society organizations, prominent citizens, celebrities, and media.

VHAI Documentary Film on Tendu leaf pluckers

The process of bidi making starts with the plucking of tendu leaves which are used to wrap the tobacco to form a bidi. Collecting tendu leaves from the forests is another form of tobacco-related employment which is highly labour intensive involving tribal women and children. VHAI’s film on tendu leaf pluckers and their livelihood is an attempt at a situation analysis to analyze the dynamics of tendu leaf plucking - the role of different players, the process and the economics of this trade. VHAI intends to present this through a documentary film and field research amongst the Gonds and Baiga communities of Tendu pluckers. At VHAI, we have traversed a long journey on tobacco control and although we still have miles to go, along with our member network we have been successful in taking strong, path-defining steps as well as setting milestones that will make the onward journey a much more substantial, significant and successful one.