Reducing adolescent smoking in India
Authors: Mrinal Prakash Barua, Vivek Mishra, Subodh Kumar
Journal: The Lancet Global Health (2017)

David P Thomas and Marita Hefler1Thomas DP Hefler M How to reduce adolescent smoking in low-income and middle-income countries.Lancet Glob Health. 2016; 4: e762-e763Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar suggest ways to reduce adolescent smoking in low-income and middle-income countries, in response to the Article by Bo Xi and colleagues (November, 2016).2Xi B Liang Y Liu Y et al.Tobacco use and second-hand smoke exposure in young adolescents aged 12–15 years: data from 68 low-income and middle-income countries.Lancet Glob Health. 2016; 4: e795-e805Summary Full Text Full Text PDF PubMed Scopus (121) Google Scholar We suggest some additional measures to reduce adolescent smoking in India. There are largely two groups of adolescent smokers in India. One group can afford cigarettes, and for this group increased taxation might be somewhat effective. The range of cigarettes available in the market is very wide, in terms of quality as well as price. Taxation makes sense but adolescents will probably switch to less expensive versions of cigarettes. We think a ban should be imposed on manufacturing and marketing the so-called mild and ultra-mild cigarettes because use of such branding conveys the deceitful impression of reduced harm. Selling loose cigarettes could be an issue because it makes buying cigarettes more affordable and makes cigarette use easier to hide for first-time smokers. Therefore, we feel that the sale of loose cigarettes should be regulated; the Government of India has proposed a ban on the sale of loose cigarettes but it is yet to take effect. The other group of adolescents are economically and socially (also educationally) restricted and resort to bidi or biri (tobacco wrapped in a tendu leaf). The cost of a single stick of bidi ranges from US$0·0075 to $0·015, so imposition of high excise duty or tax might not have any significant effect on affordability for a first-time user. The bidi industry is largely home-based, unregulated, and therefore untaxed.3Sunley EM India: the tax treatment of Bidis.http://www.worldlungfoundation.org/ht/a/GetDocumentAction/i/6574Date: Jan, 2008Google Scholar The 2016 Indian Budget did not increase excise duty on all types of bidi.4Receipt budget—tax revenue (2016–17).http://indiabudget.nic.in/ub2016–17/rec/tr.pdfGoogle Scholar Shops and street hawkers selling cigarettes and bidi are widespread. A viable targeted solution to reduce adolescent smoking is to adopt the organised liquor retail model (liquor shops) for tobacco as well. Liquor shops require a liquor license and are strictly regulated by the government. This measure would make tobacco accessibility difficult for adolescents. We feel that a tightly regulated retail model for tobacco would do wonders for India. We declare no competing interests. Tobacco use and second-hand smoke exposure in young adolescents aged 12–15 years: data from 68 low-income and middle-income countriesTobacco use and second-hand smoke exposure were frequent among young adolescents aged 12–15 years in low-income and middle-income countries. Parental tobacco use and second-hand smoke exposure were strongly associated with young adolescents' tobacco use. The data emphasise the need to strengthen tobacco control interventions and programmes in young adolescents from low-income and middle-income countries. Full-Text PDF Open AccessHow to reduce adolescent smoking in low-income and middle-income countriesBased on current trends, smoking is predicted to cause 1 billion deaths in the 21st century.1 Nevertheless, there are signs of hope. Although the number of smokers has increased worldwide due to population growth, daily smoking prevalence among men fell from 41% in 1980 to 31% in 2012, and from 11% to 6% in women in the same time.2 52 years since the first US Surgeon General's report on smoking and health, the academic and policy debate is increasingly about the most efficient strategies for the tobacco endgame and a world where less than 5% of the adult population use tobacco. Full-Text PDF Open AccessReducing adolescent smoking in India – Authors' replyHistorically, most of the smoked tobacco in India has been in the form of bidis, because they are cheap and locally manufactured. Evidence suggests that tobacco use rates are increasing in India, with a clear shift in consumption away from bidis to cigarettes among adults, particularly young adults aged 15–29 years.1 However, there is no such evidence for a consumption shift in adolescents aged 13–15 years despite high bidi smoking rates in this population. We appreciate Mrinal Barua and colleagues' interest in our paper,2 and for proposing social class-specific strategies to reduce adolescent smoking in India. Full-Text PDF Open Access