Millennium Post

Playing with peoples’ health

Health is wealth; this is an idiom most of us know. However a section of parliamentarians strongly believes in the reverse maxim--wealth is health. They have blatantly ignored all established scientific research that states that tobacco is harmful, dangerous and kills. Irresponsible and irreverent statements by these legislators, including BJP MPs, that there was no Indian study linking smoking to cancer (including bidis) have triggered (understandable) outrage.

Following pressure from tobacco lobbyists, the Centre has deferred its decision to increase the size of pictorial warnings on tobacco products, from 40 to 85 percent, which was to take effect from April 1. However, the Director General of Health Services has rejected the MPs claims. As the government speaks in different voices, the prime minister has advocated a 60-65 percent pictorial depiction.

Too many individuals with vested interests who are part of the government are playing with people’s health. They are oblivious to the fact that India has the highest prevalence of oral cancer in the world, with 90 percent of cancer patients being tobacco chewers. Tobacco use accounts for nearly half of all cancers among men, and a quarter of all cancers among women in India, which has about275 million tobacco users. Tobacco-related diseases kill about 2,500 people daily and one million every year. This figure could jump to 1.5 million by 2020, the International Tobacco Control Project estimates.

The general perception of smoking and its ill effects is related to cigarettes. On the other hand, smokeless tobacco has been associated with cancers of the lip, oral cavity, pharynx, digestive, respiratory, and intrathoracic organs, a study by Sekhsaria Institute of Public Health, in collaboration with the Union Health Ministry, has shown.

Also, bidis and other forms of tobacco (supari and gutka, among others) are more harmful than cigarettes. The incidence of oral cancer in bidi smokers was 42 percent higher than in cigarette smokers, says the study published by the medical journal, Cancer Causes and Control.

Despite the small quantity of tobacco they contain, bidis deliver more carbon monoxide than cigarettes. Bidis, the study states, necessitate deeper, more frequent inhalation as they extinguish more easily. An average bidi smoker puffs a cigarette nine times as opposed to a person who ends up puffing a bidi 28 times. This is harder on the lungs as compared to cigarette smoking. Besides, bidis contain more particulate matter as they do not have filters. They also have more nicotine, as compared to cigarettes.

Even passive smoking by bidi rollers causes significant health hazards. Bidi manufacturing is a traditional agro-forest based industry in India, highly labour-intensive and predominantly unorganised and thus enjoys several tax exemptions. As a result, bidi manufacturers have been evading taxes and exploiting impoverished bidi rollers. While the industry has grown in size and magnitude; and is one of the largest employers of workers (nearly five million) after agriculture, handloom and construction, the rollers’ condition has steadily deteriorated over time.

Bidi rollers, mainly women and children; handle tobacco flakes and inhale tobacco dust and tobacco’s volatile components in their work environment (often their homes) and are at risk for genotoxic (capable of altering DNA, thereby causing cancer or mutation) hazards. The International Labour Organisation cites ailments such as exacerbation of tuberculosis, asthma, anaemia, giddiness, postural and eye problems and gynecological difficulties amongst bidi workers.

Despite this grim scenario and the well known harmful effects of bidis, successive governments have not taxed bidis beyond a limit. They argue that imposing high consumption taxes would reduce demand and negatively impact economic growth. It would be anti-poor, leading to job losses and may eliminate the only source of livelihood for 40 million rural workers—including those working in tobacco cultivation. The hypocrisy is blatant as the workers are grossly exploited and underpaid, earning, on an average, Rs 8,870 annually (or nearly Rs780 per month). The loss in terms of employment is smaller than the large economic losses from the several hundred thousand deaths due to bidi smoking per year.

Further, the bidi industry contributes only Rs 500 crore as excise duties annually, out of the sum total of Rs 20,000 crore, of all tobacco products. Considering their relatively small economic footprint, higher excise taxes and regulations are unlikely to disrupt economic growth at an aggregate level, or lead to mass unemployment and economic hardship among small-scale bidi workers.

Arindam Nandi, a fellow at the Center for Disease Dynamics, Economics and Policy, who led a study on the bidi industry, says the positive gains from higher taxes and reduced bidi consumption, therefore, may well outweigh any temporary loss in economic activity. In addition, as with many declining industries, the displaced workforce could be rehabilitated in other industries, resulting is a net gain, he says.

The tobacco lobby’s only defence against the statutory warning is that it would imperil the jobs over 40 million workers, mostly children. Are they not aware that child labour is a punishable offence in India?

Do they not care that the economic cost of handling tobacco-related diseases in India is exorbitant and literally unaffordable to the national exchequer. According to a Health Ministry report, the country spends over Rs 23 billion yearly on treating tobacco-induced ailments in the 35-69 year age group. Ironically, a much lesser amount is spent on education.

The author is an independent journalist

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