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Title: Global Adult Tobacco Survey : Second Round : India 2016-2017 Report
Authors: Tata Institute Of Social Sciences
Ministry Of Health and Family Welfare, Government of India
World Health Organisation
Keywords: Tobacco - Global Action
T. Sundararaman
Issue Date: 2018
Abstract: Tobacco use is the leading single preventable cause of deaths worldwide. Each year an estimated seven million deaths are attributed to the use of tobacco(1). On an average, tobacco users lose 15 years of life. Up to half of all tobacco users will die prematurely due to tobacco related causes by any year or time estimation. Most of these deaths will be in middle and low-income nations, which would account for almost 80 percent of all tobacco related deaths(2). The economic costs of tobacco use are enormous, totaling more than US$ 1.4 trillion in health care costs and resulting in lost productivity which is about 1.8 percent of the world’s GDP and over 40 percent of what the world spends on school education(3). Yet tobacco remains the single most widely available and purchasable addictive substance whose purchase is legal everywhere. The Framework Convention on Tobacco Control (FCTC) is the most important global initiative for tobacco control. One key strategy to implement FCTC is MPOWER, a technical assistance package developed by WHO that consists of six evidence-based tobacco demand reduction measures contained in the FCTC that includes: In the decade since the WHO introduced MPOWER and the monitoring of its progress began, there have been substantial advances in the adoption of strong tobacco control policies in all regions of the world and among countries of all income levels. Such achievements in a relatively short time have been impressive – nearly two thirds of the world’s people (4.7 billion) are now protected by at least one best-practice tobacco control measure, 3.6 billion more people than were similarly covered just a decade ago. However, 2.7 billion people still have no protection from the illness, disability and death caused by tobacco use and second hand smoke exposure, or from associated economic, environmental and social harms(4). India is the third largest tobacco producing nation and second largest consumer of tobacco world-wide. Mortality due to tobacco in India is estimated at upwards of 1.3 million(5,6). Out of these, one million are attributed to tobacco smoking and the rest to smokeless tobacco use. One feature of tobacco related mortality in India is the high incidence of oral cancer, exceeding even that of lung cancer and accounting for almost half of all oral cancers in the world(7). India has the highest burden of both tuberculosis (TB) and Multi-Drug Resistant (MDR) TB based on estimates reported in Global TB Report 2016(8). Smoking increases the risk of TB by more than two-and-a-half times. Smoking is also contributing in a major way to India’s increasing burden of non-communicable diseases. If current trends continue tobacco will account for 13 percent of all deaths in India by 2020(10). The Government of India has taken note of the tobacco epidemic and has responded by initiating several measures to contain the same. The Government’s regulatory action towards tobacco control began in 2003 with the enactment of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA). India has been one of the earliest nations to ratify the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2004. In 2007-08 India launched its National Tobacco Control Program. By legal provision smoking is completely banned in most public places and workplaces. All forms of tobacco advertising, promotion and sponsorship are prohibited. It is mandatory to have pictorial and text health warning labels on the tobacco product packages. On October 15, 2014, the government notified new larger warnings that increased the warning size from 40 percent of one side of tobacco product packaging to 85 percent of both front and back panels of tobacco packaging. Recognizing the importance of high quality information on tobacco use to guide its tobacco control policy and programs, the Government of India has also been in the forefront to undertake the global tobacco surveys. These surveys are part of the Global Tobacco Surveillance System (GTSS). So far, three rounds of Global Youth Tobacco Survey (2003, 2006 and 2009) and one round of Global School Health Survey (2007) have been completed. The major instrument for monitoring adult tobacco use and tracking key tobacco control indicators is the Global Adult Tobacco Survey (GATS). The first round of GATS was implemented in 2009-10 (GATS 1) and the second round was implemented in 2016-17 (GATS 2). Ministry of Health and Family Welfare, Government of India designated Tata Institute of Social Sciences, Mumbai as an Implementing agency for carrying out the GATS 2. The technical assistance for GATS 2 was provided by the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the Johns Hopkins Bloomberg School of Public Health, and RTI International.
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