Tobacco is estimated to account for more than 1.2 million deaths.
India accounts for nearly three-quarters of the global burden of disease attributable to smokeless tobacco. Notably, more than 350,000 deaths annually are associated with smokeless tobacco use.
Various forms of tobacco use are responsible for an estimated 27% of all cancers in India in 2020.
Tobacco causes a substantial economic burden. Total economic costs attributable to all diseases and deaths in India in 2018-2019 for those above 35 years was USD 27.5 billion. Smoking contributed 74% and SLT use contributed 26% of the costs.
India signed and ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2004, thereby affirming its commitment to use the WHO’s MPOWER measures to curb tobacco use.
In that vein, the country was considered to have met targets to establish health warnings on cigarette packs and develop cessation programs and scored ‘moderately’ for monitoring of prevalence data, advertising bans, developing smoke-free environments and taxation. In 2020, tax-inclusive retail sales price for a pack of 20 most popular brand was INR 190 — 57.6% of the price was tax (total tax including excise, sales and the National Calamity Contingent Duty (NCCD)).
In 2011, India banned food products containing nicotine (e.g., gutkha), however a substantial number of people continue to use such products.
Tobacco harm reduction products such as e-cigarettes and heated tobacco products face a nationwide government ban.
TOBACCO PRODUCTION AND DIVERSIFICATION
In addition to being a major consumer of tobacco, India is second largest producer of tobacco in the world producing 761,335 tons, with the vast majority of tobacco production concentrated in three states and employing nearly 25 million across the production value chain.
The Indian Ministry of Agriculture, Cooperation, and Farmers Welfare implemented a Crop Diversification Scheme, part of the Rashtriya Krishi Vikas Yojna program, in states with high levels of tobacco production. The government reported in 2018 67,512 hectares or 8.7% of land in the designated area has been diversified away from tobacco since 2015-2016.