The Health Impact of the Smoking Problem in India

As one of the most populated countries in the world, there are a large number of smokers in India. This has led to a smoking problem within the country, in some cases at epidemic levels.

Many smokers have developed tobacco-related illnesses and as a result, almost 900,000 people die each year.

Ever since tobacco was first introduced in India in the 17th Century, it has seen a massive increase in the number of people who use it.

This leads to health-related problems such as cardiovascular diseases and lung cancer.

The Indian government has tried to reduce the number of smoking-related health issues by imposing a nationwide public smoking ban as well as pictorial warnings.

However, the problem remains peculiar, especially because there is a variety of smokeless and smoking forms like E-Cigarettes that are prevalent in India.

Other forms include beedi which is inexpensive and the most common form of smoking in India.

Then there is weed which presents a number of legal problems as it is illegal in India but not enforced. There are also a number of health problems.

The health impact it has on society and the reasons behind the large demographic of smokers is a priority to look at.

Demographics in Smokers

With over 1.3 billion people living in India, the proportion of smokers is relatively high.

According to the World Health Organisation (WHO), there are 120 million smokers in India, which is 12% of the world’s smokers.

It is estimated that 70% of men in India smoke, while the figure for women is much lower, to be around 15%.

These figures are lower than what it was in 2010. In the space of nine years, 8.1 million people have quit smoking.

This may be due to the fact that India has taken anti-tobacco measures to reduce the number of smokers. This includes large pictorial warnings on packets, higher taxes and an intensive awareness campaign.

They have had an impact as 55% of smokers have said that they have plans to quit.

Bhavna Mukhopadhyay, chief executive of the Voluntary Health Association of India said:

“The reduction in consumption shows the government’s strong commitment to tobacco control.”

While the number of smokers is still high, there are signs of improvements as more people each day are quitting for good.

Smoking Bollywood Stars and their Influence

Bollywood stars such as Shahrukh Khan and Amitabh Bachchan have a huge impact on their followers with many people idolising them.

Fans of these stars sometimes replicate their favourite actors and actresses. This even includes smoking.

Many celebrities are depicted on-screen smoking or spotted out with a cigarette. Bollywood has a strong effect on Indian culture and influences approximately 15 million people who go to see Bollywood films.

The link between Bollywood and smoking has had a long history with tobacco being portrayed in 76% of Bollywood films, according to a WHO study.

For a long time, smoking was glamorised and this shaped people’s minds on an actor’s image, both on-screen and off-screen.

It especially affects youths as they tend to have a strong relationship with Bollywood. The different characters who smoke create false images and associations of using the product for the viewers.

Shahrukh is a prime example of someone young people would want to emulate. When looking at his characters on-screen, he has the highest number of smoking incidents from 1991-2002.

The number of times he has been depicted smoking, it would influence a young fan to think about smoking.

Off-screen, the actor has also admitted being a chain smoker. As a result, SRK would be an ideal target for a celebrity endorsement from tobacco companies. People idolise him and want to mimic what he does.

Shisha

It is debated where the origin of shisha smoking took place. Some say it originated in Mughal India shortly after tobacco was introduced in the country.

Others have claimed it originated in the Safavid dynasty of Persia.

Shisha smoking was not only a custom, but it was also a sign of prestige during Mughal rule in India.

It became less popular but began attracting attention and it became popular in cafés and restaurants where it is offered as a consumable.

It consists of whole-leaf tobacco which has been dried, soaked, crumbled and then scented.

The bowl of the hookah pipe is then filled with the moist product and fired by smouldering charcoal or coals. The tobacco smoke passes through a water basin before inhalation.

While shisha smoking is a traditional custom in many Indian villages. It has become an increasing trend among young people in India who tend to smoke tobacco-molasses.

Shisha smokers believe that it is a safer alternative to smoking cigarettes but doctors dismiss the claims. Compared to one cigarette, a hookah session delivers 125 times the smoke and 10 times the carbon monoxide.

WHO stated: “A typical waterpipe tobacco smoking session may deliver over 20 times the smoke volume of a single cigarette.”

Shisha smoking has a number of health risks such as exposure to the toxic chemicals which are not filtered by the water.

In addition, infectious diseases such as tuberculosis and hepatitis can occur as hookah pipes are typically shared.

As a result of the dangers, shisha smoking has been banned in a number of states including Bangalore and Gujarat. Although bans have been implemented, hookah pipes can be bought or rented for personal use or organised parties.

Smoking among Minors

However, there is a concern for minors as 90% of those aged 16 or lower have used some form of tobacco in the past, and 70% are still using tobacco products.

More than 625,000 Indian children aged between 10 and 14 are smoking cigarettes every day, according to The Tobacco Atlas.

They stated that India’s young smokers include over 429,500 boys and 195,500 girls. It is a huge problem especially as around 13,000 men and 4,000 women are dying every week due to chronic tobacco use.

Smoking regularly at an early age causes a range of immediate health problems, as well as laying the foundations for the development of serious diseases in adulthood.

The most common health risk is asthma as it increases the risk in developing it and makes existing asthma worse in adolescents. It also causes wheezing severe enough to be diagnosed as asthma in children and teenagers.

Active smoking is also associated with respiratory problems including shortness of breath and coughing. Even occasional smoking has been found to cause shortness of breath following regular activity in young people.

Combatting cigarette smoking among children is difficult when companies such as Philip Morris have increasingly turned their attention to targeting young Indians.

They used strategies which previously worked in the US, such as sponsoring nightclubs and bars to reel in Indian minors.

The number of young people smoking is a concern and one which has made clear that smoking is a public health emergency.

It is one which requires the government to review the measures to protect young boys and girls.

Potential Health Issues

Smoking and tobacco use in India may have declined but 267 million people continue to be affected by health problems, especially as cigarettes remain cheap and fairly easy to get a hold of. Many small street shops sell single sticks.

The cheap and simple access to these products has lead to large numbers of people purchasing them and smoking.

The ingredients within tobacco products can increase the risk of stroke, cardiovascular disease and smoking-related cancers.

It is said tobacco smoke contains approximately 7,000 chemicals, many of which are poisonous and over 60 are known to be cancer causing.

The main ingredients include nicotine, the addictive substance which makes it difficult to quit.

Tar is the sticky brown substance that forms when tobacco cools and condenses. It collects in the lungs and can cause cancer.

Carbon monoxide enters the bloodstream when inhaled and interferes with the working of the heart and blood vessels. Up to 15% of a smoker’s blood can be carrying carbon monoxide instead of oxygen. This results in the shortness of breath.

It is not just cigarettes, smokeless tobacco products like gutka are very popular in India and can also cause lung disease and other infections.

Gutka is chewed and it is a mixture of tobacco, areca nuts, slaked lime, catechu, paraffin wax and other flavourings.

Despite it being marketed as a safer alternative to cigarettes, it can be argued that it is more harmful than any other form of tobacco.

This is because the mixture directly enters the body through the oral cavity. This is compared to 20% of the harmful chemicals that reach the lungs when smoking.

Passive Smoking

It is not just direct smokers who are at risk of developing health problems, even non-smokers are not exempt as they are exposed to second-hand smoke.

According to a study by WHO, around 40% of Indian adults are exposed to second-hand tobacco smoke within the home. This makes them vulnerable to a number of diseases.

Passive smoking can cause subtle changes in lung function which has resulted in causing asthma and making it slightly worse.

Not only is passive smoking a health problem within the home, but it is also an issue in public as some smoke-free areas are attached to smoking areas.

Smoke-free places in India include public transport and the workplace. However, designated smoking rooms in offices and restaurants are often attached to smoke-free spaces.

This creates an intense smoking environment and non-smokers are directly exposed to the smoke.

It is a problem which must be changed to reduce the number of smoking-related health problems in India.

K. Srinath Reddy, president of the Public Health Foundation of India said:

“There are architectural requirements that need to be followed while creating even separate smoking rooms. For instance, there should be separate ventilation systems.”

Dr Kewal Krishan, of Max Healthcare Institute, said passive smoking is especially harmful to children and can significantly increase a non-smoker’s risk of getting lung cancer.

Mr Reddy added: “There is conclusive evidence and there is no dispute that exposure to second-hand smoking is harmful for health and can lead to respiratory problems in children, cancer and heart diseases in adults.”

Globally, passive smoking is responsible for over 600,000 deaths per year, including 165,000 children aged five or younger.

Health problems that are the result of smoking are happening in different ways. They can affect everyday life and can escalate until they become life-threatening.

It is a problem which is everywhere in India, especially as such a large number of people in the country are smokers.

While there are measures to reduce the risk of health problems and some are taking it into account, issues still remain.

Smoking continues to have a health impact on Indian people and it will be a long process before there is a significant reduction in the number of people developing health problems.