*Tobacco and Health - Feature article
May 31 st is observed as World No Tobacco day by the World Health organisation.
While the west the consumption of tobacco products are coming down there is an alarming
increase in the consumption in developing countries and particularly in India. In this
feature we try to focus our attention on Tobacco, its impact, the World No Tobacco day
celebrations at Geneva, Mumbai Municipal corporations initiative, the problems envisaged
in enforcing the advertisement code on Tobacco in India and other matters.
The extremely negative impact of tobacco on health now and in the future is the
primary reason for giving explicit and strong support to tobacco control on a worldwide
basis. The increased impact of tobacco looms as one of the greatest public health threats
in the 21st century. WHO estimates that there are currently 4 million deaths a year There are currently over a billion smokers in the world. The largest single
number is in Asia. The proportion of women that smoke is comparatively higher in Europe
and North America than in other parts of the world. However, recent estimates suggest
growing numbers of smokers in developing countries, particularly amongst women. Recent trends indicate that the smoking prevalence rate in adolescent boys and
girls is rising in many countries where previously tobacco control had been considered
successful. Thus, while new markets are being opened by industry actions, old markets have
not been closed - tobacco is a global threat. The economic impact of tobacco has been analysed in many countries in recent
years. Studies in countries as diverse as Thailand, South Africa, Switzerland, China and
Brazil are now available to complement some of the previous studies done in the United
Kingdom, USA and Canada. Together, these studies show that the alleged economic benefits
of tobacco are illusory. There are, however, large direct, indirect and intangible costs
associated with tobacco that hamper economic development rather than promote it. Tobacco
harms the environment In many of the tobacco growing countries evidence indicates negative
environmental impacts of tobacco agriculture, particularly when associated with
deforestation required to increase farmland and cure tobacco plants. Effective policies and interventions
make a difference Effective policies and interventions make a real difference to tobacco
prevalence and consumption, and associated health outcomes. Most of the documented
successes have occurred in developed countries where effective approaches have been
implemented for several years. In more recent years, several developing countries have
introduced similar measures. Early indications are that they too will be effective. The Finish experience is particularly important since it stresses the need to
consider success in periods of decades rather than years. The combined impact of
legislation, increased tax and comprehensive community-based strategies on tobacco
consumption in adults in Finland has led to significant reduction in tobacco use. Further,
it should be noted that when Finland began addressing tobacco, it was then not the wealthy
country it is today. This has implications for other countries wishing to consider the
Finnish model as one way to move ahead. One major study has analysed the individual and combined effects of a range of
policies and interventions on futureprevalence (Townsend 1998). Price increases (through
excise taxes on tobacco products) constitute by far the most important policy tool
available. The other interventions have demonstrated effectiveness when properly enacted
and enforced (advertising bans, treatment of tobacco dependence, smoking restrictions, and
health education). The UK study highlights the need for policy makers to use the best mix
of policies that will be supported within a particular country at a particular time. Success stories indicate the importance of considering the best mix of specific
interventions required to achieve the same goal: increased cessation and lowered
initiation. The elements of the WHO comprehensive policy supported by Member States are
summarised in Table 1. The specific mix of interventions in a broad policy framework will
vary according to each country's political, social, cultural and economic reality. Public
support, mediated through the media and the legislative process, are crucial determinants
of success. Human, institutional and financial resources for all aspects of
tobacco control at country, regional and global levelsare severely inadequate. Faced with
a US$400 billion industry, global spending on tobacco control has not addressed most
countries' need for even a modicum of human and institutional capacity. Tobacco control is
often tagged onto other functions. Financial support for international research, policy
development and action to address the impact of tobacco has been restricted to a few
modest initiatives. World No-Tobacco Day Events in Geneva ON 31st May at the WHO headaquarters in Geneva the world's largest chocolate
ashtray will be displayed. The DG of WHO will then recieve the model of the same after
listening to public reactions. Mumbay Municipal corporation declares anti-gutkha week from May 31 Brihanmumbai Municipal Corporation (BMC) will observe `anti-ghutka' and
`anti-tobbaco' week from May 31 to June four. Deputy Mayor Ram Barot said that the World
Health Organisation (WHO) will be observing Anti-Tobbaco Day on May 31st where paan shops
and other stalls selling ghutka will be pursuaded not to sell ghutka which is injurious to
health. During the week, BMC will organise discussions seminars, medical tests, display
posters and banners in greater Mumbai. About 5000 volunteers would take part in the
campaign to pursuade the common man to stop using the tobacco, he added. The Indian advertising regulations MUMBAI: Even as the US has decided to ban outdoor
advertising of tobacco products and in the UK live models are barred in tobacco ads, there
is no enforceable code to regulate tobacco advertising in India. The only self-regulatory advertising code that could have ``morally bound'' the
tobacco lobby was the one formulated by the Advertising Standards
Council of India (ASCI), which was prematurely struck down after the tobacco
industry decided it could not adhere to many of its diktats. So now we have a code on advertising that has been formulated by the Tobacco
Institute of India (a body of The ASCI code, incidentally, broke down because of two key issues--celebrity
endorsements and surrogate advertising (like the Red and White Bravery Awards or the Four
Square and Wills Cricket Gear ads). Both these issues are linked to the same issue--that of targeting youngsters,
say ASCI officials. Explains Sam The glamour and aspirational element is also harmful,'' says Swarn Kohli,
chairperson, Consumer Education and However, TII spokesperson Amit Sarkar feels otherwise. ``A survey has shown
that advertising does not initiate tobacco consumption and it is other factors like peer
pressure, for instance, that induces the youth to take to smoking,'' he reasons. When
questioned on why companies like ITC then spend crores of rupees on advertising if ads
don't induce consumption, Mr Sarkar says: "That is for building a trademark. There is
nothing wrong if companies use their trademarks, which are perceived to be of high value
by consumers, and diversify into new product categories.'' Wills, for instance, has extended its brand name to
cricket gear. But that's fine'' says Mr Balsara. ``No one is stopping you from making bats,
but then don't show Sachin Tendulkar carrying a Wills bat. Tendulkar is a hero to millions
of little children and youngsters.'' The ASCI code, explains Balsara, required that if the
name of a tobacco brand was to be used for any other product category, it was only fair
that the same restrictions imposed on the tobacco brand be applicable to that category as
well. ``If not, then the whole exercise becomes redundant'' he adds. The second issue -- that of surrogate advertising
-- had also got ASCI and the tobacco lobby in a non-negotiable Leave alone the ASCI code, even the TII code does not seem to have been adhered
to by many of the members themselves . For example a provision states that ads shall not
include any direct personal testimonial (written or spoken) urging or recommending the use
of a tobacco product by a person of distinction in any walk of life in a manner which is
particularly attractive to minors. However, The Akshay Kumar ads for Godfrey Philips' Red
and White cigarettes all over the city are a mute testimony to the fact that the code is
being violated. Incidentally, the managing director of Godfrey Philips, Ram Poddar, is the
president of the Tobacco Institute of India. Repeated messages to his public relations
agency, Clea, to get Mr Poddar to respond did not elicit any response. Mr Sarkar, however, takes cover under a small
technicality in the code which says that if the personality was signed on before he
attained celebrity status, then that ad can continue. ``From what I know,'' he says ``Akshay Kumar was signed on much earlier and in any case he is not
as big a star as Shah Rukh,'' he counters.
Another provision prohibits tobacco ads through any media primarily meant for
schools, hospitals and places of If there is a violation, then even at the cost of commercial loss it should not
be used if the tobacco lobby is serious about implementing the code.'' On direct
marketing, the code says: ``No known non-smoker or non-user of tobacco products will be
sampled or contacted.'' The catch in this sentence is the word `known' Says Amol Bose of
Amol Bose Advertising and past president of the Advertising Association of India: ``It
iswell-nigh impossible to ask every individual whether he is above 18 or not, and there
have been instances where youngsters have been asked to distribute cigarette samples near
cinema halls.'' According to Ms Viji Venkatesh of the Cancer Patients' Aid Association,
``A leading brand of cigarettes from ITC was freely sampled to all and sundry near Shivaji
While the tobacco code stipulates that minors (those
below 18 years) should not be targeted, Mr Rakshit says this whole business of minors is
wrong. Its youngsters, period, who should not be targeted. A person could be 20 years old
and yet be a potential target. Students who just enter college are clearly below the age
of eighteen (assuming they haven't repeated any class.'' The code is vague on other issues too. It states that exhibition of any tobacco
product should not be undertaken in a children's film or a TV show meant for children. But
on the other hand, it says: ``It is clarified that the mere Is the government really serious about regulating advertisements for the
benefit of the consuming public? One It's high time these issues were discussed in open forums, and more
importantly, aptly represented by all sections of society, to arrive at a consensus.
Why Focus on Tobacco?
Economics of Tobacco
Effective policies and interventions make a
difference
World No-Tobacco Day Events in Geneva
The Indian advertising regulations
attributable to tobacco, a figure expected to rise to about 10 million by 2030. By that
date 70% of those deaths will
occur in developing countries. Mortality data do not reflect the enormous additional toll
caused by tobacco that is felt in terms of morbidity, disability and suffering among
children and adults.
tobacco majors). Although it took shape in 1995 and underwent a revamp last year, it is
yet to get the proposed
ombudsman ``comprising officials of TII, industry and eminent
people'' to oversee the implementation of the code.
The TII has still to rope in the industry and the rules of procedure are yet to be
finalised, since they have to be
done in consultation with the ombudsman.
Balsara, managing director of Madison DMB&B and one of the members who drafted the
ASCI tobacco code, What we were worried about was that ads which use movie stars and other
celebrities have a direct bearing on the minds of the youth, and ASCI strictly forbids
this''.
Research Centre and an ASCI member. ``The glamour element associated with cigarette
smoking is definitely pernicious. The swanky houses, lavish cars and rich lifestyles
portrayed even in brands which are not targeted at the upper class is disturbing. But the
main concern is that these ads portray (to youngsters) that smoking is the `in thing'. The
small illegible health warning on the packs too needs to be reviewed and made bigger.
Youngsters near colleges and schools also should not be targeted.''
mood. The Red and White Bravery Award instituted by Godfrey Philips is one such example.
Says Gautam Rakshit, managing director, Avenues Advertising:``Role models portray the
ideal behaviour patterns for the youth of today. The Red and White Bravery Award is
attempting to create role models for the young and the association of a role model with a
brand of cigarettes is by implication stating that role models endorse cigarette smoking.
This has a negative influence on young people.''
worship, or on the compound walls of these institutions. However, the most blatant
violation of this clause is seen
within the premises of the Mahalaxmi temple at Haji Ali in Mumbai.
Inside the compound wall of the main temple (at the coveted junction of Peddar Road and
Bhulabhai Desai Road is a huge hoarding of Indian Tobacco's Company's (ITC) Wills Sport ad
(cheering India for the World Cup). Just some weeks back a Gold Flake hoarding towered
over commuters. A few yards away, near a smaller temple, a Four Square Cigarette signage
illuminates another paan shop. The entrance near the Haji Ali Dargah too has similar shop
signs of Will's Filter Kings. Adds Mr Rakshit: ``
Park and at various discotheques.''
granting of a U certificate does not make the film a children's film.'' But then there is
no special certification for children's films. Unless there is a clear-cut way to define a
children's film, it won't be easy to interpret the clause. The code has to be more
explicit in its definition of what constitutes a children's film, say industry officials.
wonders, especially with many traffic booths being sponsored by tobacco companies.
Moreover, it is time to define what constitutes an advertisement. According to a high
court judgement, a logo in itself does not constitute an
advertisement, and so we see the Indian cricket team sporting the Wills logo. But the
anti-tobacco insists that a
logo is an advertisement. If that weren't the case, one fails to understand why ITC spends
crores of rupees to get
sportsmen to don its Wills logo.
