Making Health and Development a Reality for the people of India
Tobacco Control

Tobacco control has always been a priority public health concern for the Voluntary Health Association of India (VHAI). Being one of the first few organizations to take up tobacco control initiatives in the 1980s, our early initiatives included sensitizing varied stakeholders such as health professionals, researchers and representatives of civil society and using mass media for advocating anti-tobacco messages and legal advocacy for tobacco free sports. In recent times, VHAI’s tobacco control programme, supported by the Bloomberg Initiative since 2007 has travelled a long and multi-dimensional journey advocating on several focus areas as tobacco control is a vast and complex subject.

Over the last seven years, we have covered implementation of strong graphic health warnings, advocacy on bidi issues, tax increase across all tobacco products, seeking high level commitment from policymakers, comprehensive implementation of COTPA at the state-level, creating smoke-free settings, supporting the gutka ban, and media advocacy on tobacco control – VHAI has pro-actively worked on all these areas with significant results.
Current Update

1. The Seventh Session Of The Conference Of The Parties To The WHO Framework Convention On Tobacco Control Concluded In New Delhi

India hosted the seventh session of the Conference of the Parties (COP7) from 7th – 12th November 2016 at India Expo Mart Ltd. Greater Noida, Uttar Pradesh. The meetings jointly organised by the Government of India and the Convention Secretariat.

The formal title of the meeting wasthe seventh session of the Conference of the Parties (COP7).Tentatively around 1500 delegates participated in the conference from around 180 countries along with other observers in official relations with the WHO FCTC Secretariat.

It is the first occasion that a COP meeting was held in India that signals a strong and generous commitment of the Government of India to increase international co-operation and awareness of the WHO FCTC globally and especially in the WHO South-East Asia Region.

The seventh Conference of the Parties to the WHO Framework Convention on Tobacco Control (WHO FCTC) was concluded on November 12, 2016 with significant new developments for global tobacco control. Delegates leaving the venue heralded it a success and looked forward to extending the influence of the treaty.Several significant decisions were adopted in the course of the six-day session.

During an intense week of discussions delegates addressed the longest agenda of any COP indicating the enthusiasm of Parties and the growing role of tobacco control within areas of development and human rights, as well as public health.

The decisions reached shaping the future of the Convention, is set against the stark reality that without strong tobacco control measures tobacco will kill about 1 billion people in the 21st Century. By 2030 over 80 percent of the world’s tobacco-related mortality will be in low- and- middle income countries.

2. VHAI Participation at Conference of Parties (COP 7) Meeting

VHAI team members headed by Chief Executive attended the six day meeting of COP 7 as part of India Delegation from November 7th – 12th, 2016 at India Expomart, Greater Noida.

It is the first occasion that a COP meeting was held in India that signals a strong and generous commitment of the Government of India to increase international co-operation and awareness of the WHO FCTC globally and especially in the WHO South-East Asia Region. Around 1500 delegates participated in the conference from around 180 countries along with other observers in official relations with the WHO FCTC Secretariat.

The Conference was inaugurated by Shri J P Nadda, Union Minister of Health & Family Welfare. President of Sri Lanka, His Excellency ShriMaithripalaSirisenawas invited as a special speaker at the conference. The closing ceremony of COP 7 was attended by Minister of State for Health Anupriya Patel.

VHAI and its state partners got a great new experience and an opportunity to interact with a large audience of tobacco control advocates, educators and public health experts from around the world. The sessions at the COP 7 were well attended by VHAI and its state partners. VHAI and its state partners actively participated in every session and involved in the live discussions also during the meeting.

3. India Ranks No 3 in Pictorial Health Warnings on Tobacco Packages, International Report Released at COP 7

India has moved to 3rd position out of 205 countries that has pictorial health warnings on tobacco packages. India’s earlier ranking was 136 in 2014 and 123 in 2012. This was revealed by Cigarette Package Health Warnings International Status Report which was released by Canadian Cancer Society in Delhi, India, at the 7th session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control (FCTC), being held from November 7–12 at India Expo Mart, Greater Noida.

The report ranks 205 countries and territories on the size of their health warnings on cigarette packages and lists countries and territories that require graphic picture warnings. The report shows a significant global momentum toward plain packaging with 4 countries requiring plain packs and 14 working on it. The report also shows that 105 countries and territories have required picture health warnings on cigarette packages. This significant milestone in global public health will reduce smoking and save lives.

This is the 5th Canadian Cancer Society international report on cigarette package health warnings. Previous reports were published in 2008, 2010, 2012 and 2014.

The top countries ranked by warning size, as an average of the front and back of the package, are:

1. 90% Nepal
2. 90% Vanuatu
3. 85% Thailand
3. 85% India
5. 82.5% Australia (75% front, 90% back)
6. 80% Sri Lanka
6. 80% Uruguay
8. 75% Brunei
8. 75% Canada
8. 75% Laos
8. 75% Myanmar

(In this list, the warning size is the same on the front and back, except in Australia).

According to Rob Cunningham, Senior Policy Analyst, Canadian Cancer Society, "India has demonstrated global leadership by implementing 85% pictorial warnings on all tobacco packages. This accomplishment is praiseworthy as it has been achieved despite fierce opposition from the tobacco industry. India will serve as a very positive model for other countries, thus benefitting public health worldwide”

The report highlights include:
  • 105 countries and territories have finalized picture warning requirements, an increase from the 77 that had implemented these requirements by the end of 2014. In 2001, Canada was the first country to require picture warnings and to require a 50% size.
  • 58% of the world’s population is covered by the 105 countries and territories that have finalized picture warning requirements.
  • Nepal has the largest warnings in the world with picture warnings covering 90% of the package front and back. Vanuatu will also require 90% picture warnings in 2017. India and Thailand have the next largest warnings at 85% of the front and back.
  • 94 countries and territories require warnings to cover at least 50% of the package front and back (on average), up from 60 countries in 2014 and 24 in 2008.
  • The implementation by most European Union (EU) countries of the new EU requirement for 65% picture warnings was an important development contributing to the increase since 2014 in the number of countries requiring picture warnings.
Cigarette package warnings are a highly cost-effective way to increase awareness of the negative health effects of smoking and to reduce tobacco use. Picture-based warnings convey a more powerful message than a text-only warning, and larger ones increase impact. Picture warnings are especially valuable for low- and middle-income countries where there are higher rates of illiteracy and where governments may have few resources.

Guidelines under the WHO-FCTC treaty also recommend that countries consider implementing plain packaging. Plain packaging includes health warnings on packages, but prohibits Tobacco Company branding, such as colours, logos and design elements, and requires the brand portion of each package to be the same colour, such as an unattractive brown. The brand name would still appear, in a standard font size, style and location. The package format is standardized. Plain packaging puts an end to packaging being used for product promotion, increases the effectiveness of package warnings, curbs package deception and decreases tobacco use.

Plain packaging has been required in Australia (effective in 2012), the United Kingdom and France (effective May 20, 2016, at the manufacturer level) and Hungary (effective in 2018). The 14 countries working on plain packaging are: New Zealand, Ireland, Norway, Canada, Slovenia, Uruguay, Thailand, Singapore, Belgium, Romania, Turkey, Finland, Chile and South Africa.

Tobacco related diseases kills about 2500 Indians daily and over 10 lakh Indians every year. And it is estimated that about 5500 youth and children (as young as 8 years old), initiate tobacco use daily. India has 12 crore tobacco users, according to the Global Adult Tobacco Survey. Tobacco-use also imposes enormous health and economic costs on the country. The total direct and indirect cost of diseases attributable to tobacco use was a staggering Rupees 1.04 lakh crore ($17 billion) in 2011 or 1.16% of India’s GDP.

Click here to download the report

4. First comprehensive report on smokeless tobacco use in India highlights urgent need for stronger policy, programme and research efforts

The Ministry of Health and Family Welfare, Government of India (MoHFW), in collaboration with the World Health Organization (WHO), Public Health Foundation of India, Healis-Sekhsaria Institute of Public Health, Centers for Disease Control and Prevention, and National Cancer Institute, U.S.A released India’s first comprehensive report on the impact of smokeless tobacco consumption in the country at the COP 7 on November 11, 2016.

The report highlights the strong association between smokeless tobacco use and cancer, cardiovascular diseases and oral diseases. It calls for comprehensive measures to tackle the high burden of use among vulnerable populations. The report calls for multi-stakeholder engagement for an effective and comprehensive approach to preventing and controlling smokeless tobacco use in India. The report makes important policy, programme and research recommendations for future government action on smokeless tobacco use in India. This is the first such effort to compile all scientific information on smokeless tobacco into a single report and will become a one point reference for any aspect of smokeless tobacco use in India. Click on the link to the download the executive summary of the report.

5. Ahead of Budget of 2017-18, Finance Minister holds Pre-Budget Consultation Meeting with social sector groups

Union Finance Minister Arun Jaitley chaired the Pre-Budget consultation meeting with Social Sector Groups in New Delhi on November 26, 2016. Bhavna Mukhopadhyay, Chief Executive Voluntary Health Association of India made the presentation and requested the Finance Minister on increasing allocation on healthcare sectors in the upcoming budget of 2017-18. It was also suggested that all the tobacco products should be highly taxed under the new GST regime primarily because of health concerns.

Jammu & Kashmir

High Court Issues Notice to J&K Government on the Ban on Sale of Loose Cigarettes

The Jammu and Kashmir High Court on April 12, 2016 issued notice to the government on a Public Interest Litigation seeking ban on sale of loose cigarettes and tobacco products.

A division bench comprising Justice MuzaffarHussain Attar and Justice Janak Raj Kotwal asked the government through its Chief Secretary, Principal Secretary Home, DGP, Commissioner Secretary Health and Medical Education and Divisional Commissioners of Kashmir and Jammu to file objections to the petition within two weeks. Senior Additional Advocate General N ABeigh accepted notice in the open court. Media covered this news widely.

Removing Tobacco Advertisements at Point of Sale

VHAI conducted a sensitization workshop with all the SHOs of Budgam district to ensure complete removal of tobacco advertisement from the Point of sale. SSP Budgam assured his full cooperation to make BudgamPoS free and ensured no new boards will be put on display again. As a result of this workshop, the Jammu and Kashmir Police personnel removed numerous tobacco advertisements promoting cigarette and other tobacco products put at display at the point of sale (PoS) in District Budgam.

A police team comprising several police officials removed the advertisements put at display at Sheikhpora, Humhama, Airport, Budgam town and various other places in the district. Media covered this news widely.

Please click on the link to access the story:
State Level Initiative
At the state level, VHAI has been actively involved in a number of advocacy initiatives through policy, media and legal advocacy. In Jammu & Kashmir, much has been achieved in tobacco control with the support of the state police, the transport sector, the education sector, the tourism and hospitality sectors, railways, in their respective turfs/areas of work with the objective of making the state of Jammu & Kashmir COTPA compliant. The Director General of Police issued orders to restrict “Tobacco Advertisement and Promotion” at Points of Sale. Reporting on COTPA violations have been made a part of the Monthly Crime Review (MCR) in both Jammu and Srinagar divisions. Till date MCR has been streamlined in 25 districts of Jammu & Kashmir. Sensitization and training sessions for more than 200 Station House Officers and other senior officials have been initiated.

We are also working towards the ban on loose cigarettes both in Jammu & Kashmir and in the state of Delhi.
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