Lok Sabha Question No. 1885 (UNSTARRED), answered on 2021-02-12
Subject: Impact of Beedi Smoking
Ministry: HEALTH AND FAMILY WELFARE
Asked by: V. Kalanidhi

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1885 TO BE ANSWERED ON 12 TH February, 2021

## IMPACT OF BEEDI SMOK ING

## 1885. DR. KALANIDHI VEERASWAMY:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) whether it is a fact that more than 70 percent smokers in the country smoke beedis and the economic cost of beedi smoking is more than Rs. 805 billion in the country, if so, the detai ls thereof and the reaction of the Government thereto;

(b) the details of steps taken by the Government to create awareness against harmful effects of beedismoking;

(c)  whether  the  Government  is  aware  that  beedi smoking  is  peculiarly  affecting  people  in Southern States with Thrombo Agnitis Obliterans (TAO) causing amputation of lower limbs in healthy adults, if so, the details thereof;

- (d) whether the Government has conducted any study regarding its prevalence in different States and has launched prevention or eradication programmes thereon; and
- (e) if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a): As per second round of Global Adult Tobacco Survey (GATS - 2, 201 6- 17) conducted in the age group for 15 years and above, out of the 99.5 million smokers in India, 71.8 smoke bidi.

As  per  independent  study  published  2018  in  British  Medical  Journal  (Tobacc Control), estimated total costs along with their diffe rent components for the age group 30 -69, the total direct and indirect costs attributable to bidi smoking amounts to INR 805.5 billion billion) or INR 1588 per capita in 2017.

- (b): Public Health being a State subject, the primary responsibility for regulation of tobacco products to reduce harm due to tobacco use, lies with the respective States/UT governm apart  from  implementation  of  the  provisions  of  Cigarettes  and  Other  Tobacco  Produ (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) (COTPA), 2003 and the Rules made thereunder.

Several steps have been taken by the Government to create awareness against harm effects of beedi smoking. Some of the major steps are as under;

· The Ministry of Health & Family Welfare has enacted a comprehensive legislation, namely Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Tr and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA 2003) to discourage the  consumption  of  tobacco  products  in  order  to  protect  the  masses  from  the  health  ha attributable to tobacco use.

· The National Tobacco Control Programme (NTCP) was launched by this Ministry in 2007 -08 with the aim to (i) create awaren ess about the harmful effects of tobacco consumption, (ii) reduc the  production  and  supply  of  tobacco  products,  (iii)  ensure  effective  implementation provisions  under  COTPA,  2003  (iv)  help  the  people  quit  tobacco  use,  and  (v)  facil implementat ion  of  strategies  for  prevention  and  control  of  tobacco  advocated  by  WH Framework Convention of Tobacco Control.

· The stakeholders are being made aware on a regular basis about the adverse effects of tobacco usage on health through various anti - tobaccocampaigns vide different modes of communication.

· Government of India has notified rules to regulate films and TV programmes depicting scenes of tobacco usage to spread awareness. Such films and TV programmes are statutorily requir run anti - tobaccohealth spots, disclaimers and static health warnings.

· Size of specified health warnings on tobacco products enhanced w.e.f. 1st April, 2016 to 85% of the principal display area of tobacco product packs. Quitline number has been included specifie d  health  warnings  which  came  into  effect  on  1st  September,  2018.  This  will  help creating awareness among tobacco users to change their behaviour and will increase the de for tobacco cessation.

·  The  Ministry has set up the National Tobacco Quitlin e services (toll free number 1800 - 112356)  to  provide  tobacco  cessation  services  to  the  community  and  has  launched  a  pan -India 'mCessation' initiative to reach out to tobacco users who are willing to quit tobacco use and to support them towards successful quitting through text - messaging via mobile phones.

- In order to encourage tobacco workers to shift to alternative vocations, the Ministry of Labour & Employment, Government of India in collaboration with the Ministry of Skill Development Entrepreneurs hip,  Government  of  India  has  initiated  'Skill  Development'  programme  for  bidi rollers to facilitate them to shift to alternative vocations.
-  Department of Agriculture and Cooperation & Farmers Welfare, Ministry of Agriculture and Farmers Welfare has extended Crop Diversification Programme (CDP), an on - going sub - scheme of  Rashtriya  Krishi  Vikas  Yojna  (RKVY)  to  10  tobacco  growing  States  w.e.f  2015 - 16  to encourage tobacco growing farmers to shift to alternate crops/cropping systems.
- The prevalence of tobacco use has reduced by six percentage points from 34.6% to 28.6% fro 2009- 10 to 2016 - 17 as per findings of second round of Global Adult Tobacco Survey.

(c) to (e): As per Monograph on Bidi Smoking and Public Health, 2008, Thromboangiitis Oblitera ns (TAO) is an occlusive disease of the arteries that mainly affects the legs. I claudication  and  can  even  lead  to  gangrene.  As  per  the  Monograph,  it  is  typically  fo younger men (20 - 40 years old) of low socioeconomic status who have been heav y bidi smokers from  childhood.  It  has  been  observed  that  the  risk  of  TAO  is  greater  with  bidi  smo compared to cigarette smoking.

No  estimates  are  available  for  prevalence  of Thrombo  Agnitis  Obliterans  (TAO)  in different States. There is no evidence that TAO is peculiarly affecting people in Southern States.