India in the grip of a smoking epidemic: study

NEW DELHI: India is in the grip of a smoking epidemic likely to cause nearly a million deaths a year by 2010, according to a study released on Thursday.
   One in five of all male deaths and one in 20 of all female deaths between the ages of 30 and 69 will be caused by smoking, said the study. It was conducted by a team of doctors and scientists from India, Canada and Britain and published in the New England Journal of Medicine.
   “The results… surprised us, because smokers in India start later in life and smoke fewer cigarettes or ‘bidis’ than those in Europe or America, but the risks are as extreme as in the West,” said Prabhat Jha of the Centre for Global Health Research at the University of Toronto, the lead author.
Comprehensive study
   The study, one of the most comprehensive in India, sent 900 field workers to survey 1.1 million homes. They compared the smoking history of 74,000 adults who died from 2001 to 2003 with 78,000 living adults.
   The study says there are currently about 120 million smokers in India. More than 30 per cent of men and 5 per cent of women between 30 and 69 years of age smoke either cigarettes or ‘bidis.’ Bidis contain about one-fourth the tobacco of a regular cigarette, the study said.
Cost factor
   They are popular among poor Indians because they are significantly cheaper. A packet of 10 costs about Rs. 2, while the cheapest cigarette costs Re. 1.
Mr. Jha said the study found more than 50 per cent of smoking deaths are likely to be among poor, illiterate Indians. This suggested that pictorial health warnings on packages — instead of the current written warnings — may be part of an effective anti-smoking strategy. Raising taxes on bidis could also help, he said.
   The study found that two per cent of adult smokers in India quit before falling ill. “Typically people quit smoking only after disease strikes.”
A World Health Organisation official in New Delhi said the study was “very representative of India.” Poonam Khetrapal Singh, a Deputy Regional Director, said: “It’s going to be a good tool for advocacy and a good tool for policy intervention.”
Alarming findings
   Health Minister Anbumani Ramadoss said he was alarmed by the study’s findings. “The Government of India is trying to take all steps to control tobacco use — in particular by informing the poor and the illiterate,” he said in a statement.
   While an increasing number of countries prohibit smoking in public places, Indians freely puff away in playgrounds, railway stations, sidewalk cafes and even hospitals.
   Dr. Ramadoss, who is a medical doctor, has helped enact a number of laws banning smoking in various public places, but most are routinely ignored.
Last month he asked top movie actors to stop smoking on screen. A recent government effort to introduce pictorial health warnings recommended by WHO has run into legal delays. Tobacco companies are fighting to keep them off cigarette packets.
   According to a WHO study released last week, nearly two-thirds of the world’s smokers live in 10 countries led by China, which accounts for nearly 30 per cent, and India with about 10 per cent. They are followed by Indonesia, Russia, the U.S., Japan, Brazil, Bangladesh, Germany and Turkey. — AP