Sangram Keshari
Tobacco Use in India: A National Crisis
Tobacco consumption in India has reached alarming levels, with nearly 267 million users across the country. Among adults aged 15 and older, a staggering 28.6% of the population uses some form of tobacco—42.4% of men and 14.2% of women. Smokeless tobacco dominates the scene, with 21.4% of adults relying on it (29.6% of men and 12.8% of women). Smoking, while slightly less prevalent, still affects 10.7% of adults, with 19.0% of men smoking compared to only 2.0% of women.
Bidis, a cheaper and widely available form of tobacco, remain the most popular smoking product, with 7.7% of adults regularly smoking them. Even more concerning is the tobacco use among youth aged 13–15, with 8.5% currently using some form of tobacco. Alarmingly, both smoking and smokeless tobacco use stand at 4.1% for this age group.
Secondhand Smoke: The Hidden Threat
Secondhand smoke is a significant health risk for non-users and adds to the burden of tobacco in India. Approximately 30.2% of adults are exposed to secondhand smoke in indoor workplaces, while 7.4% experience it in restaurants and 13.3% on public transportation.
The situation is equally dire for youth aged 13–15, where 21% are exposed to secondhand smoke in enclosed public spaces, and 11% are exposed at home. This involuntary exposure worsens the already devastating effects of tobacco use, impacting the health of millions across the country.
Health Consequences: A Heavy Burden
Tobacco use and exposure to secondhand smoke are responsible for the loss of 1.2 million lives in India every year. The country also bears 70% of the global burden of smokeless tobacco, with over 230,000 deaths annually attributed to its use. Tragically, nearly 90% of oral cancers in India can be linked directly to smokeless tobacco consumption.
The impact of tobacco is profound. Smokers, on average, lose 6–10 years of their lives compared to non-smokers. Additionally, 27% of all cancers in India are directly tied to tobacco use, making it one of the most significant health crises in the country.
Economic Costs of Tobacco Use
Beyond the devastating health consequences, tobacco imposes an enormous economic burden. Between 2017–2018, tobacco-related illnesses and deaths cost India approximately INR 1773.4 billion (USD $27.5 billion). Of these, 22% were direct healthcare expenses (INR 387.1 billion or USD $6 billion), while the remaining 78% stemmed from lost productivity due to illness and premature deaths.
Premature deaths alone accounted for 75% of the total costs, equaling 1.04% of India’s GDP. This staggering figure highlights the heavy toll tobacco takes not only on individuals but also on the nation's economy.
The Tobacco Industry in India
India’s tobacco market is dominated by ITC Ltd, which controls 79% of cigarette sales, followed by Godfrey Phillips India (11%) and VST Industries (7.7%). Interestingly, bidis outsell cigarettes by a ratio of 8:1, reflecting their affordability and accessibility.
The bidi industry operates as a cottage-based enterprise, employing predominantly women and children. While it provides economic support to many families, it perpetuates dependency on a product that harms public health.
India’s Efforts to Control Tobacco Use
India has taken meaningful steps to address its tobacco crisis. The country ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004, which introduced measures to regulate advertising, packaging, and taxation. Despite these efforts, the pervasive nature of tobacco use in India calls for more aggressive public health interventions.
Tobacco use in India is not just a personal habit—it’s a national crisis. It affects the health, economy, and future of millions. Addressing this challenge requires a collective effort to reduce consumption, support affected individuals, and create a healthier society for generations to come.
