More men are smoking in India than ever before, with the number rising by more than a third from 79 million in 1998 to 108 million in 2015, report researchers in the journal BMJ Global Health.
Smoking rates haven’t increased for women, though, with 11 million women smoking in India in 2015, the study found.
Only China has more adult smokers — 300 million — than India, where more than one in four adults also uses smokeless and chewing tobacco.
Tobacco-control measures, such as banning smoking in public places, haven’t helped much. They led to a fall in smoking prevalence from 27% in 1998 to 24% in 2010 among men aged 15-69 years, but the modest gains were offset by rising population and incomes.
“During this period, India added about 1.7 million male smokers each year, with roughly an equal number smoking cigarettes and bidis,” said the study’s co-author Dr Prakash C Gupta, director, Healis-Sekhsaria Institute of Public Health, Mumbai.
The study found that 61 million Indian adult men smoked cigarettes (40 million exclusively) and 69 million smoked bidis (48 million exclusively).
Tobacco use, including smoking, accounts for 10% of all deaths in India. “In 2010, tobacco use caused about one million deaths in India, with about 70% of these deaths killing people in their prime, between ages 30 and 69,” said co-author Dr Prabhat Jha, professor at the Dalla Lana School of Public Health at the University of Toronto.
Smoking causes about 30% of all cancer deaths (including 90% of lung cancer deaths), 17% of heart disease deaths, and at least 80% of deaths from bronchitis and emphysema.
But cessation is uncommon in India. Last year, in the 45-59 age group, there were roughly four current smokers for every person who quit. In comparison, in the US and countries where cessation support is available, there are more quitters than current smokers.
“Raising tax on tobacco is the single most effective intervention to lower smoking rates, increase cessation and deter future smokers,” said Dr Jha.
The Tobacco Institute of India disagrees: “As a result of discriminatory taxation, the share of legal cigarettes in total tobacco consumption declined from 21% in 1981-82 to 11%, but overall tobacco consumption increased 38% during this period.”
For the BMJ Public Health study, researchers used data from three nationally representative surveys — Special Fertility and Mortality Survey (1998), Sample Registration Survey - Baseline data (2004) and Global Adult Tobacco Survey (2010) — covering about 14 million people from 2.5 million households, and made forward projections to 2015.