The Government of India must be praised for drafting a bill aimed at curbing tobacco consumption in the country. The Ministry of Health has placed the draft of the Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Amendment Bill, 2020 in the public domain for stakeholders' consultation. The tobacco industry voicing opposition to the bill and dubbing it "draconian" is not surprising given the fact India is the third largest tobacco producer in the world. India's tobacco market is the second largest in the world with about 268 million tobacco users which explain the pressure mounted by the industry against harsher regulation. The government must not succumb to the pressure of the tobacco lobbies as increase in consumption has led to rise in incidence of non-communicable diseases and deaths resulting from such diseases. The National Cancer Registry Programme Report, 2020 released by the Indian Council of Medical Research says that tobacco-related cancer will account for 27.1 per cent of India's cancer burden in the year. The report sounded the alarm bell that higher proportion of females had cancers associated with use of tobacco in the north-eastern states, followed by cancer registries in the central and western regions in India. East Khasi Hills district of Meghalaya had the highest relative proportion of cancers associated with the use of tobacco with 70.4% and 46.5% of males and females respectively, it adds. The bill proposes to increase the permissible smoking age from 18 to 21 years, ban sale of loose cigarettes and do away with smoking rooms at airports and restaurants and harsher punishment and penalties against violation of smoking rules. The primary argument put forward by the industry against the bill is that harsher regulations and penalties will have far reaching consequences on 4.57 crore people in the country who depend on the tobacco industry for their livelihood. A cushion of alternative livelihoods to small retailers, farmers and others who may be affected by the provisions of the bill will be needed to ensure achievement of the desired goal of the bill. The government has inserted a new section which says that any person who produces or manufactures or supplies or imports illicit cigarettes or any other tobacco products shall in the case of first conviction be punishable with imprisonment for a term which may extend to two years, or with fine which may extend to one lakh rupees, or with both, and for the second or subsequent conviction, with imprisonment for a term which may extend to five years and with fine which may extend to five lakh rupees. The bill also seeks to prohibit production, supply and selling of cigarette of any other tobacco products person shall directly or indirectly, produce, supply without license, registration or permission required by any law for the time being in force, of the Central Government or a State Government. The Bill also seeks to remove the loopholes related advertising of tobacco use in existing smoking by inserting a harsher provision that states that "No person shall directly or indirectly advertise cigarettes or any other tobacco products through any medium and no person shall take part in any advertisement that directly or indirectly promote the use or consumption of cigarettes or any other tobacco products." Anti-tobacco campaign activists have been voicing concern over surrogate advertising by the industry to initiate smoking in adolescents to catch them young before the eligible smoking age. The provision to increasing the penalty for smoking at restricted areas from Rs 200 to Rs 2,000 is praise worthy but enforcement against smoking at public places or at restricted places has been a big challenge for the states. Awareness on health risk of passive smokers due to involuntary inhaling of smoke from other people's cigarettes will also empower them to seek strict enforcement of this provision. The enforcement of the provision that point of tobacco selling must be at least 100 metres away from educational institution in an area in Assam has not seen much success and selling of cigarettes and other tobacco products within this stipulated radius is witnessed across the state. There are indications that the tobacco industry is going to mount pressure on the government to withdraw the new bill during the stakeholders' consultation on the grounds of loss of livelihood and business. Such losses will have to be weighed against health risks to take a balanced view.
However, tobacco-related diseases creating serious health burden on the country, the states must support the Central government to enactment of the proposed bill. The North-eastern states should give wide publicity to the draft to facilitate participation of the people in the region in the consultation which closes on January 31. A stricter tobacco law in the country is long overdue.