India: A Doctor Takes on Big Tobacco

India (and South East Asia) are a huge market for tobacco. Cigarette companies are also targetting youth between 15-25. Two countries where tobacco sales are expected to zoom up are India and Indonesia.

This former Portuguese colony, the gateway which brought tobacco into India, is now turning into a battleground against the weed which enchants millions in India. Led by a surgeon from Goa, the National Organisation for Tobacco Eradication (NOTE) has embarked on an ambitious campaign against tobacco, 'ghutka' (chewable tobacco) and snuff.

Dr Sharad G. Vaidya, a medical practitioner who heads NOTE, has put the powerful industry on the mat by focussing on what the spread of tobacco has meant since it was brought into India from South America by the Portuguese in the start of the seventeenth century.

"It's a huge market in India and South East Asia. Tobacco companies are also targetting youth between 15-25. Two countries where it will zoom up is India and Indonesia," Dr Vaidya said.

Persistent drives saw a tough tobacco-control law passed in Goa, India's smallest state. But the angry tobacco industry hit back; after many months the law is still to be signed by the President. Despite the tobacco lobby's power, if it sails through, this could be the tightest anti-tobacco law across India. So far, there has been an unusually long delay though.

The Bill as passed by the Goa Assembly bans smoking and spitting in public places and vehicles. It blocks direct and indirect advertisement, the sale of tobacco products to those below 21, and to anyone within 100 metres of schools or places of worship.

Violation of the advertisement and sale curbs will lead to three months in jail; other offences will result in various levels of fines. Voluntary groups will have some powers in enforcing the law.

Affected interests first tried to delete the advert-ban clause, but, later, the bill was passed unanimously. Then, the Governors consent -- usually a mere formality -- was declined. The bill has now been referred to the President of India and it will become law only with his assent.

NOTE estimates that in India about 5500 to 6000 youth in their teens start using tobacco each day.

But unlike other groups, NOTE does not waste its breath telling you about the hundred-and-one ways of how tobacco could affect your health. It instead sees tobacco as an issue of economics, of politics, of power and of finances.

In Goa, tobacco is also linked with history. "Tobacco addiction in Goan society demanded regular supplies from Portugal (in past centuries)," writes historian Dr Celsa Pinto, author of a book on trade and finance in colonial "Portuguese India".

Since the seventeenth century, sailing vessels leaving Lisbon for India would collect tobacco rolls at Mozambique also a Portuguese colony -- for onward delivery at the port of Goa. Money obtained from tobacco sales would go to buy Indian cotton textiles for Portugal.

But that was all in the past. For the present, NOTE wants to get a "clear, effective and comprehensive law" for the whole of India to ban tobacco advertisements and sponsorship of sports. It is also working towards higher taxes on cigarettes and tobacco-related products and makes efforts to enforce laws that block the illegal sale of cigarettes to children.

NOTE closely interacts with bodies like the World Health Organisation, the World Bank and the American Cancer Society in its efforts to build public opinion. Using electronic-mail and the Internet, the small but active organisation keeps in touch with the latest debates on tobacco in the West.

"In today's world, theres more than enough scientific evidence about the ill-effects of tobacco, that it kills in the long-run," says Dr Vaidya. Even tobacco companies have now agreed that nicotine is addictive, he points out.

NOTE has shown how far-reaching the effects of tobacco are on society. Some time back, NOTE did a study which showed how advertising affected young minds. After tobacco-sponsored cricket matches, 15-20 per cent students surveyed felt that smoking and 'ghutka' improves memory.

"Students also felt that if you smoke, you will become a better cricketer," Vaidya reports. Such students were five times more likely to smoke than others.

Now, NOTE plans another drive: taking a flame through schools and villages across South Asia for one year from May 1999, to build awareness over tobacco at the turn of the century.

But if tobacco is really so bad, why does it still hold sway?

Dr Vaidya feels that in India the problem is that tobacco is classified as a legal and agricultural product, instead of being in the basket of narcotics.

Likewise, the Indian government has invested 33% in equity holdings of India's main tobacco companies, and even the life insurance bodies put earnings into such firms, he says.

Dr Vaidya questions the view that tobacco gives revenue to governments. Revenue from tobacco, needs to be balanced against the subsidies given to it by governments. "My hunch is this subsidy will be equal if not more than the revenue it generates," says Vaidya.

"Tobacco industry gets every type of subsidy from A to Z and from Z to A -- agriculture, seeds, transport, water, electricity, the works. The total estimates have never been calculated," he points out.

Vaidya is quick with figures: one of every two persons using tobacco will eventually die of it. Every increase of tobacco production by one tonne will kill one person in a lifetime.

Tobacco takes a heavy toll of 800,000 to 1 million voters in the country every year. Maximum deaths occur between the ages of 45-55.

Tobacco doesnt just kill people; it depletes the soil of its nutrients at a rate three times faster than food-crops. It needs twice to three times more water than other food crops. Soil erosion is twice that of food-crops since no weeds grow in tobacco fields.

Vaidya believes campaigns can help children stay off tobacco. He says figures from the small Indian federal province of Goa indicates cigarette sales are downfrom 450 earlier to 350 per headover eight years. Since 1993, he says, Indias campaign against tobacco has been really growing.

But reports in the British medical journal 'The Lancet' say that transnational tobacco companies, facing growing curbs in the USA and other affluent countries, are increasingly marketing their products in developing countries. And, more so among women and
adolescents.

Smoking rates in some industrialised countries are decreasing at about 1% a year, but growing in developing countries by some 3% per year. If current trends persist for the next 30 years, 7 million people from developing countries will die every year from smoking-related diseases.

Asian Consultancy on Tobacco Control (Hong Kong) director Judith Mackay has said that while smoking is decreasing in the West, transnational tobacco companies are turning to softer markets, specially in Asia, where health information is less well known.

For the past several years, corporations such as Philip Morris, RJ Reynolds, and British-American Tobacco have been expanding rapidly in Eastern Europe, Asia, Africa, and Latin America.

Frederick Noronha is a Goa-based journalist. Dr Vaidya can be contacted at Isgvaidya@bom2.vsnl.net.in or sgvaidya@goa1.dot.net.in

• 109 Tobacco