The second round Global Adult Tobacco Survey 2016-2017 (GATS-II) by the World Health Organisation and the Union Ministry of Health, after seven years of its first round, revealed that though smoking has been dropped during the period but the percentage of non-smoking tobacco such as Khaini, Gutkha and Panmasala consumers has not changed in Odisha. The percentage of non-smoking tobacco consumers is just double the national average in Odisha.
The Annual Health Survey of 2012 by Register General and Census Commissioner shows Odisha tops the list among tobacco chewers State of Assam, Chhattisgarh, Jharkhand, Bihar, UP, MP, Uttaranchal and Rajasthan. The smokeless tobacco users is highest in districts of Malkangiri followed by Mayurbhanj,Balangiri, Baragarh, Baleswar, Bhadrak, Dhenkanal, Keonjhar,Korapurt, Nabaragapur and Sambalpur. The district of Gajapati has less than 20 per cent of people consuming tobacco.
The studies on socio –economic background of tobacco consumers have found that tobacco consumption is higher among socially disadvantaged and low income groups in the country as India is having high prevalence of both smoking and smokeless tobacco users and it is also the second largest consumer of unmanufactured tobacco in the world.
The poor socioeconomic condition has a link with addiction of tobacco. Especially hard working poor people are more prone to tobacco consumption which is not only bad for their personal health but also reduce their productivity in long run that affects the family income and further pushes them to extreme poverty.
In everyday life, it is not very unusual to see most of the rural poor wage earners, even children, are engaged in consumption of Bidi, Gutkha, Khaini and Pan and there are tobacco shops everywhere in public places. The workplaces and public spaces have been openly used by the working population for tobacco consumption without restriction and there has been no awareness among the marginalized poor about such unhealthy habits.
There is also very less publicity about bad impact of non-smoking tobacco consumption. There are many poor children being engaged in Bidi rolling in Angul and Cuttack districts and also in other different parts of the State without any restriction over manufacturing of Bidi in the State which is equally harmful like cigarette when so much of restriction has been imposed over cigarettes the same extent of restriction must be imposed on manufacturing and sale of Bidi.
Studies found that tobacco consumption is one of the major reasons of increase in the number of non-communicable diseases affected patient in the State among the poor people. The poor people buy it regularly and a major part of their income goes to waste. The consumption of tobacco has been impacting the family economy as well as overall economic growth along with pushing the people to numerous health problems including the most serious cancer disease as tobacco use also is a major cause of non-communicable diseases in poor countries. It is told that every third oral cancer patient has history of tobacco consumption in the State.
The WHO reported about 7 million deaths every year due to tobacco use and it is apprehended that it may increase up to 8 million death by 2030.The poor economic condition and productivity of a household is very much linked to the tobacco consumption of the family members.
India is the second largest tobacco producer country after China followed by Brazil and the USA. Along with Odisha, about 13 other States are producers of tobacco that generates employment for farmers, farm labourers, tobacco factory workers, kendu leaf collectors and traders and retailers engaged in the production and distribution process.
The Government also has a good source of revenue generated out of the tobacco business. However, good health requires a tobacco free society to enjoy right to health and it is the duty of the Government to make all efforts for the wellbeing of its people by preventing tobacco consumption. The poor must be protected from the exploitation of tobacco traders by laws and health awareness among people. In line with the WHO framework convention on tobacco control, the Government of India as a signatory, along with 168 other countries, to the international treaty in 2003, has notified the Cigarette and Other Tobacco Products (prohibition of advertisement, regulation of trade, and commerce, production, supply and distribution Act, 2003. The anti-tobacco drive has been seen as a people’s right to highest standard of health by preventing such menace.
It is good that tobacco use in India has been dropped by six per cent and the Government of India has been projecting to reduce the current tobacco use further by 15 per cent by 2020 and 30 per cent by 2025.
The Ministry of Health has set up a toll free helpline for counselling to quit tobacco consumption. The Government has planned to engage 25,000 students of 309 dental colleges in the country in this anti-tobacco drive. Along with enactments to restrict the consumption of tobacco, such as the cigarettes and other tobacco products and campaign by Government and CSOs on health ground, the Government has also increased the price of tobacco to pressurise the consumers, but this has created very less impact over the consumers.
There have been relentless efforts by the Government and CSOs to control the consumption. The legal intervention of civil society organisations and anti-tobacco activists of the State of Odisha in the Orissa High Court has banned sale of tobacco products completely in 2013. States such as Karla, MP and Bihar also have banned gutka and prohibited manufacture and sale of chewing tobacco. Karla is the first State in the country which has banned smoking in public places in 1999 and later Chandigarh also did it and now many cities have been implementing the decision in the interest of public health.
The Government Odisha has been made efforts for the enforcement the Central laws and its compliances. As part of anti-tobacco drive by the Home Department, many illegal sale shops have been fined and the salesmen were arrested from twin cities. The State Government also has banned the sale of tobacco near educational institutions and other public places and its sale to children. The concerned departments such as Health, Home and Food and Civil Supply are involved in the process of enforcement. A State-level monitoring committee has been formed under the chairmanship of Secretary Health and Family Welfare for implementation of tobacco control programme.
The anti-tobacco campaigns by the Government should be a mass public education process at home, village, schools and all other public places. It is being observed that people are entering to hospital premises with pan, gutka and khaini and bidi or cigarette. They must refrain from such activity. It is also found that the attendants of the patient are using tobacco even inside the patient wards in almost all the hospitals. The railway station, bus stand, airport, Government offices and all kinds of public places such as eateries, cinema hall and public institutions, educational complexes must be free from any kind of tobacco consumption. There must be big hoardings in local language to be displayed as Government orders for public awareness.
The village level health awareness clubs such as Gaon/RogiKalyana Samiti and health workers of local PHC and CHC must be engaged in promoting awareness among the people and all schools and colleges must have awareness camps to educate the students about the impact of tobacco on health and its other bad impacts in the economy, society, personal and family life.
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