New anti-tobacco warnings inadequate: Health activists

New Delhi: They say a picture is worth a thousands words. But if the opinion of health activists - and many youngsters - is anything to go by, the new set of pictorial warnings for tobacco products are not enough to deter those addicted to the lethal habit.

"It is certainly better than the previous warnings that had hazy pictures of shrunken lungs. But this alone is not going to help as the notification has to be bolstered by many other actions in the anti-tobacco campaign," said Pankaj Chaturvedi, associate professor of head and neck cancer department at Mumbai`s Tata Memorial Hospital.

After two years of campaigning and nudging by the civil society groups, the health and family welfare ministry Saturday approved harsher pictorial warnings for cigarettes and chewing tobacco products to be implemented from December this year.

The warnings will carry gory pictures of mouth and lung cancer on smoke packets and non-smoke pouches. They will be rotated every two years.

According to a 2009 study by the Global Adult Tobacco Survey (GATS), India accounts for nearly 274.9 million tobacco users -- around 35 per cent of the population.

Chaturvedi, who initiated the nationwide `Voice-of-Victims` campaign against tobacco, said: "Firstly the pictures issued for smoking are very mild as compared to the pictures for gutka or chewing tobacco, then the rotation should be within a period of six months so that people are able to know multiple adverse effects of smoking."

Experts believe that steps need to be taken to improve low public awareness, deter strong industry lobbies, and for stringent implementation.

"Now that the first important measure has been taken, it should be accompanied by raising taxes on cigarettes and gutka and raising public awareness about the ill-effects of tobacco at different stages under various age groups," said Monika Arora, senior director at Health Related Information Dissemination Amongst Youth (HRIDAY), an NGO.

Noting that gutka in plastic sachets had been banned, she added: "There should also be a crackdown on those violating the rules to ensure that the laws are not just made on paper."

Youngsters, however, feel that the pictures shown are the effect of long and constant tobacco use.

"What has been shown is glorified. It is probably something that happens with long and constant smoking or even gutka use, not when you smoke just twice a day," said 24-year-old Rahul Kaul, who works with a multinational company in Gurgaon.

Shubham Tripathi, 22, an engineering student, said: "On seeing these warnings, the thought of harm will strike once, but obviously it will not overpower the strong urge that smokers have."

Chaturvedi feels the reaction from the youth is very justified as the change needs to happen differently on the basis of age groups.

"Over 50 per cent of oral cancer cases we see daily come in late stages, so the warnings cannot be termed generic. What is required is a quick market survey, and then warnings aimed at different target groups... like you can show stained teeth for early users," he said.

Tobacco, already responsible for 40 per cent cancer-related deaths in the country, is expected to be responsible for seven of every 10 tobacco-attributable deaths in developing countries by 2030.

"The only way to bring down mortality rate of oral and neck cancer is by preparing a combination of strategies for target groups such as women, children, men, and teenagers," Chaturvedi explained.

The four new pictorial warnings on smoking tobacco packs are comparatively milder, three of them showing X-ray depiction of human lung with cancer. The fourth shows mouth cancer in an advanced stage.

The pictures on chewing tobacco products are, however, harsher and depict extreme form of oral cancer with gory pictures disfigured lips, cheeks, jaws and teeth due to oral cancer.

The harsher warnings were earlier supposed to be implemented from June 2010, which was delayed to December 2010, and now to December 1.


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