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India overlooks $16 bn worth smoking related health crisis

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By Charu Bahri

Woman_smoking_a_cigarette

New Delhi:  In January, the government asked for public opinion on tougher new laws to curb smoking: To raise the minimum smoking age to 21 from 18, and to ban the sale of single cigarettes, which account for 70 percent of nationwide cigarette sales.

People responded enthusiastically; 45,000 emails and 100,000 letters poured in to the health ministry, as Reuters reported earlier this month. What they said, however, is not known because the government hasn’t yet read the messages, according to a health ministry representative quoted in the story.

Like those messages, the World Health Organisation’s Report on the Global Tobacco Epidemic 2015 is largely ignored in India. Its single-line message: Raising tobacco taxes can help curb smoking.

Curbing smoking is very important to India for two reasons:

* About one million Indians die from smoking-related causes every year, which are among the top three ways to die.

* Smoking also saps Indians of money; more money, it emerges, than it earns for the government.

Indians aged 35 to 69 spent Rs.104,500 crore ($15.9 billion) in 2011 on diseases associated with tobacco-including cancer, respiratory diseases, tuberculosis and cardiovascular diseases. This figure is almost six times as much as central excise tax collections from all tobacco products that year, according to the Indian government, WHO and the Public Health Foundation of India.

To put the health cost of tobacco in further perspective, it exceeded the combined annual state and central government expenditure on health care by 12 percent in 2011.

Taxes on cigarettes rise – not enough – but they do. Bidis are the problem

A 10 percent price increase on tobacco products could cut consumption between two-eight percent in developing nations, according to the WHO. Tax hikes increase prices, which in turn lower demand and protect people from the ill-effects of tobacco.

“Raising taxes is a win-win situation,” said Arun Thapa, acting WHO representative to India. “It’s good for human health and for the country’s fiscal health.”

Over the last 19 years, taxes on cigarettes in India have risen 1,606 percent. That isn’t quite enough and the six-tier tax structure is so complex – based on stick lengths and filters – that companies manipulate it with relative ease to keep demand intact.

The biggest problem in curbing tobacco use lies with the influence wielded by those who make the humbler – but more damaging – cousin of cigarettes, the bidi.

Taxes on a pack of bidis are seven percent of the retail price, less than a tenth of the WHO’s suggested level of 75 percent. A 20-stick pack of best-selling cigarettes is taxed around 60 percent of the retail price.

Bidi smokers make up 61 percent of the nation’s 120 million smokers, according to the Global Adult Tobacco Survey (GATS) 2010. This is a conservative estimate. Some studies peg the numbers of bidi smokers higher, at 73 percent and even 85 percent.

Bidi smokers face a higher risk of developing potentially-fatal chronic obstructive pulmonary disease (COPD), among other illnesses, because tobacco is packed more loosely in bidis, requiring smokers to inhale more strongly.

But the bidi industry has consistently squeezed concessions from the government.

Millions of jobs and livelihoods at stake, so taxes must stay low, argue bidi barons.

Here are some concessions the government gives the bidi industry:

  • Handmade bidi units (98 percent of bidis are handmade) producing less than two million sticks in a year are exempt from excise duty.
  • Bigger bidi makers pay a duty of 1.6 paise per handmade stick and 2.8 paise per machine-made bidi. The duty on cigarettes varies between Rs.1.28 and Rs.3.37 per stick.
  • Some eight million people work as bidi rollers nationwide, said a representative of the All India Bidi Industry Federation.

“Imposing taxes on bidis and introducing pictorial warnings on bidi packs would lower demand,” said Sudhir Sable, secretary, All India Bidi Industry Federation. “Any fall in production would jeopardise the jobs of bidi rollers. It would also adversely impact tobacco farmers, as well as the thousands of corner shops selling the product.”

Increasing taxes on bidis would invariably increase the illicit trade in bidis, leading to the proliferation of fake bidis, Sable argued. It would also deprive states and the central government of tax revenue.

These arguments do not wash, say experts.

No socio-economic case for low bidi taxes, contend experts

In 2013, the bidi industry contributed less than three percent to the government’s central excise collection from tobacco products, not surprising, given the low excise duty it pays.

A Public Health Foundation of India study says there is indeed scope for taxes on bidis to be increased.

“Doubling bidi excise would help cut consumption by 40% and increase tax revenue by 22%,” said Monika Arora, director, Health Promotion and Tobacco Control Initiatives, Public Health Foundation of India.

Essentially, the argument goes, higher tax rates would offset any loss of excise from fall in consumption. In the bargain, spending on “useful” goods and services will grow.

“Money not spent on bidis or cigarettes will not disappear from the economy,” said Prabhat Jha, founding director of the Centre for Global Health Research, University of Toronto. “It will be spent on other products which generate employment.”

Additional revenue could help the government meet the cost of transitioning bidi workers to other means of employment. The government has previously considered a cess on cigarettes to encourage farmers to switch from tobacco to other crops.

So, why not tax all segments of the tobacco-products industry, experts suggest, to fund a gradual transition? Bidi workers, among some of India’s most disadvantaged people, can only benefit.

(IANS/IndiaSpend)

 

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UK Study: E-Cigarettes help Smokers Quit as Much as Stop-Smoking Aids

This study involved almost 19,000 people in England who had tried to quit smoking in the preceding 12 months, collected over a 12-year period from 2006 to 2018

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FILE - A sales associate demonstrates the use of an electronic cigarette and the smoke-like vapor that comes from it, in Aurora, Colorado, March 2, 2011. VOA

People using e-cigarettes to quit smoking are about 95% more likely to report success than those trying to quit without help from any stop-smoking aids according to the results of a large study in England.

The research, funded by the charity Cancer Research UK and published in the journal Addiction on Thursday, analyzed success rates of several common stop-smoking methods – including e-cigarettes, nicotine replacement therapy (NRT) patches and gum, and Pfizer’s varenicline, sold as Champix in the UK.

It also adjusted for a wide range of factors that might influence success rates for quitting – such as age, social level, degree of cigarette addiction, previous attempts to quit, and whether quitting was gradual or abrupt.

Latest World Health Organization data show that smoking and other tobacco use kills more than 7 million people a year globally. Of the 1.1 billion people worldwide who smoke, around 80 percent live in poor or middle-income countries.

E-cigarettes
A woman smokes an electronic cigarette in London, Aug. 19, 2015. VOA

E-cigarettes have no tobacco, but contain nicotine-laced liquids that the user inhales in a vapor. Many big tobacco companies, including British American Tobacco, Imperial Brands and Japan Tobacco, sell e-cigarettes.

This study involved almost 19,000 people in England who had tried to quit smoking in the preceding 12 months, collected over a 12-year period from 2006 to 2018. Successful quitters were defined as those who said they were still not smoking.

As well as the 95% increased success rate for e-cigarettes, the study found that people prescribed Champix were around 82% more likely to have succeeded in stopping smoking than those who tried to quit without any aids.

“Our study adds to growing evidence that use of e-cigarettes can help smokers to quit,” said Sarah Jackson, a professor at University College London who co-led the study.

Using e-cigarettes, or ‘vaping,’ is considered by many experts to be an effective way for smokers to give up tobacco, but some in the scientific community are skeptical of their public health benefits, fearing they might normalize the idea of smoking and lead young people into the habit.

e-cigarettes
E-cigarettes have no tobacco, but contain nicotine-laced liquids that the user inhales in a vapor. Pixabay

Smokers who were prescribed NRT by a medical professional were 34% more likely to quit successfully, the study found. But those buying NRT from shops were no more likely to succeed that those trying to quit without any help at all.

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Experts said the results were robust and important. Peter Hajek, director of the tobacco dependence research unit at Britain’s Queen Mary University of London, said the study yielded two key findings about e-cigarettes:

“They help smokers quit at least as much as stop-smoking medications, and they are used by many more smokers. This means they generate many more quitters and do this at no cost to the NHS (National Health Service),” he said in an emailed comment. (VOA)