India needs separate taxation policy to control smokeless tobacco

The researchers examined 11 electronic databases and grey literature spanning from January 1, 2005, to September 20, 2021. It stated that 57 countries have implemented policies specifically targeting smokeless tobacco, with 17 of them having policies beyond the scope of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC). 

Countries like Bhutan, Singapore, and Sri Lanka have enforced a complete ban on smokeless tobacco, including cultivation, manufacture, distribution, and sale of such products. Partial import and sale bans on specific forms of smokeless tobacco were reported by Australia, Bahrain, Brazil, India, Iran, Tanzania, Thailand, New Zealand, and the UK. Furthermore, bans on tobacco use in public places were implemented in Guam, India, Myanmar, Nepal, Pakistan, and the USA. 

The review demonstrates that policy initiatives based on the WHO FCTC have led to reductions in smokeless tobacco prevalence, ranging from 4.4% to 30.3% for taxation and 22.2% to 70.9% for multifaceted policies. 

India, in particular, has taken a comprehensive approach to tackle the use of smokeless tobacco products, but more needs to be done. 

The review revealed significant research gaps and limited evidence regarding smokeless tobacco policies, their descriptions, and impact evaluations. It emphasized the need for continuous updating of guidelines 

and frameworks to incorporate new evidence on effective smokeless tobacco control measures. While policies on smokeless tobacco prevention and control exist in various countries, there is a lack of comprehensive research and assessment of their impacts, with limited publication in prominent tobacco reports or scientific literature. 

“The paper has clearly pointed out that smokeless tobacco requires FCTC efforts and additional measures beyond FCTC. Prevalence of Smokeless tobacco use over the years has remained stagnant or has increased which means that we need to do something extra for addressing smokeless tobacco. However, countries like India have made extra efforts like gutkha ban, sale and spitting ban during covid. Then there are countries who have imposed partial ban or complete ban of smokeless products. Some states have also banned all types of smokeless tobacco. So those policies are showing impact according to our review,” said Prof. Monika Arora, Vice-President (Research) PHFI who is the lead author of the report . 

“What needs to be done is that policy guidelines should be updated on how to tackle smokeless tobacco a bit differently. In India, provisions like higher taxation is required on smokeless tobacco as our review has shown reductions in smokeless tobacco prevalence, ranging from 4.4% to 30.3% for taxation. WHO recommends 75% of retail price for taxation but smokeless tobacco have a low base price so this percentage does not make the product unaffordable.” she said. 

Prof Arora further added that article 6 on taxation and pricing needs to be treated differently and tobacco advertisement should be implemented strictly. “However, in India we do have COTPA, but recently we have seen so much surrogate advertising and celebrity endorsement happening. So, we need to act on this aspect as well. Besides, this pictorial health warning put on tobacco product packages has a huge impact on motivation to quit tobacco. But smokeless tobacco is such small packs that such warnings are hardly visible on those packs. So, we need to think about the packaging laws and whether the size of these products needs to be increased or how we can make it more effective. So, these are the interventions we need to enforce if we want to reduce the prevalence of smokeless tobacco,” she said.