India will release new graphic health warnings that cover 80% of tobacco packages on both sides and ban the sale, manufacture and use of e-cigarettes by the end of this month.
Graphic photographs of oral and throat cancers will occupy 65% of tobacco packages — such as cigarette packs — while 15% of the surface will be used for text warnings. Four photos have been shortlisted for the new warnings, expected on packs by April 1 next year.
“These are part of stringent rules introduced to lower tobacco addiction among the young, such as increasing the legal age for tobacco use to 21 years,” said Union health minister Harsh Vardhan.
India sees more than a million deaths due to tobacco each year, says data from the Indian Council of Medical Research, but has one of the world’s weakest tobacco warning regimes. Currently, official cautions appear only on one side of the package, covering a mere 20% of the entire packet.
The new rules also ban e-cigarettes since they’re not approved under the Drugs and Cosmetics Act. The battery-operated products use a heating element to vapourise liquid nicotine or other flavoured liquids.
The devices are marketed as less harmful than cigarettes and beneficial for those planning to quit smoking, but have triggered fears of adverse health effects in recent years.
“E-cigarettes are not approved by the Drug Controller General of India, therefore its sale and use is illegal in India,” said an official from the directorate of health services.
A typical cigarette contains 9 mg to 30 mg of nicotine and smoking one cigarette delivering roughly 2 mg of nicotine. “2 mg is used to treat withdrawal but e-cigarettes contain up to 10 mg/per cartridge, which has not been approved,” the official added.
Despite bans on advertising, sale to minors and smoking in public places, more than one in three adults use some form of tobacco in India.
According to a 2014 report by the Canadian Cancer Society to be released next week, India is ranked 136th among 198 countries listed according to the size of their health warnings. The country has slid from a ranking of 123 in 2012, with several countries implementing stronger warnings.
Other Asian countries are far ahead in this regard, with warnings covering 85% of the package on both sides in Thailand, 90% in Sri Lanka and 75% in Nepal.
Tobacco kills up to half of its users, killing nearly 6 million people – one death every 6 seconds – globally each year.
Unchecked, tobacco-related deaths from cancers, heart disease, lung diseases and stroke, among others, is expected to increase to over 8 million annually by 2030, 1.5 million of them in India.