Last week the Bollywood heartthrob film-star Aamir Khan was found smoking after the launch of the latest blockbuster movie 'Jaane tu … ya jaane na'. Earlier in June 2008, he was reported saying that he is back to smoking due to 'stress' related to the forthcoming release of 'Jaane tu …' film and he will quit smoking right after the film-release. Although the film has been successfully released and is doing well at box office, the cigarettes are hard to leave… and Aamir continues to smoke.
Tobacco is addictive, and some researchers feel nicotine is as addictive as heroin. It is not impossible to quit, but not easy too, because tobacco is so powerfully addictive!
India, luckily, has a strong tobacco control policy framework today, with a national parliamentary Act (The Cigarette and other Tobacco Products Act 2003) and is a party to the Framework Convention on Tobacco Control (FCTC) – the first global corporate accountability and public health treaty. But it is undoubtedly lagging too far behind in implementation of these tobacco control policies that are known to work.
Services to treat tobacco dependence are fully available in only nine countries with 5% of the world's population, and India is not one of them. India must establish and rapidly scale-up programmes providing low-cost, effective interventions for tobacco users who want to quit.
Scaling up tobacco cessation clinics by integrating it in present healthcare system and building upon the capacities of the existing healthcare staff to provide tobacco cessation counselling and services, is going to take much longer than we expect. Thankfully, India has well-equipped and trained healthcare personnel in a very limited number of tobacco cessation clinics (TCC). These existing TCCs should function as training resource centre to other primary, secondary and tertiary levels of private-public healthcare centres, and facilitate rapid scale-up of tobacco cessation services nation-wide.
The tobacco industry has failed to warn its customers of the harms caused by its products and instead has spent millions falsely portraying tobacco use as glamorous and appealing. Film-stars have tremendous influence on young-minds and this is one big reason why India's Health and Family Welfare Minister Dr Anbumani Ramadoss has been making repeated appeals to Bollywood film-fraternity to refrain from on-screen tobacco use.
We must move rapidly to protect health by requiring picture-based health warnings on tobacco products. Despite conclusive evidence, relatively few tobacco users understand the full extent of their health risk. Graphic warnings on tobacco packaging deter tobacco use.
Chandigarh, India's first city to go smoke-free on July 15, 2007, can potentially become a good example for the rest of the country to go smoke-free – only if government officials, civil society and other stakeholders effectively synergise to enforce existing tobacco control policies with due diligence. All people have a fundamental right to breathe clean air. Smoke-free places are essential to protect non-smokers and also to encourage smokers to quit.
Partial ban on tobacco advertising, promotion and sponsorship, do not work because the industry merely redirects its resources to other non-regulated marketing channels. The 'Red & White' bravery awards are an example of the surrogate advertising.
Raising taxes and therefore prices, has proven to be an effective way to reduce tobacco use, and especially to discourage young people from using tobacco. Only 4 countries, representing 2% of the world's population, have tax rates greater than 75% of retail price. India did raise the taxes on non-filter cigarettes but is clearly mandated to do a lot more on raising taxes of all tobacco products significantly.
In India about a million people die needlessly each year from tobacco use. The single most preventable cause of death worldwide is tobacco use. Tobacco use has been found to kill one-third to one-half of its users. When International tobacco companies like Japan Tobacco are applying to Government of India to increase their stake in tobacco business on Indian soil, there is all the more reason to team up and strengthen tobacco control policies in India.
The paramount influence film-stars have on young minds is well-documented. Quitting tobacco use by youth icons like Aamir Khan will inspire millions of youth in India to go smoke-free. Aamir demonstrated that influence with his movie 'Taare Zameen Par' which certainly increased the sensitivities of people towards dyslexia in one of the most powerful manner. Aamir should continue to be an inspiration.
Bobby Ramakant
(The author is a regional correspondent and a World Health Organization (WHO)'s Awardee 2008. He can be contacted at: bobbyramakant@yahoo.com )
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