India could prevent over nine million deaths due to cardiovascular disease over the next decade if it implements smoking bans and levy higher tobacco taxes, a new study has found.
Smoke-free laws and increased tobacco taxes would yield substantial and rapid health benefits by averting future cardiovascular disease (CVD) deaths, researchers said.
"Smoke-free legislation has not been consistently implemented, one in three adults reported being exposed to smoking at work in 2009 and 2010, varying from 15.4% in Chandigarh to 67.9% in Jammu and Kashmir," according to the study published in the journal PLOS Medicine.
"Tobacco cessation programmes have received limited government financial support, and cessation advice by health care professionals is provided infrequently. Tobacco taxation remains very low, at around 38% of cigarette and 9% of bidi prices, far below the minimum of 70% the WHO recommends," the research said.
The results of this study, led by Sanjay Basu and colleagues of Stanford University, US, suggest that specific tobacco control strategies would be more effective than others for the reduction of CVD deaths over the next decade in India and possibly in other low- and middle-income countries.
The authors investigated which tobacco control measures could best reduce the burden of CVD effectively in low- and middle-income countries by using a mathematical model.
Their microsimulation model estimated the effects of various tobacco control measures and pharmacological therapies on deaths from heart attack and stroke in India between 2013 and 2022.
Five different tobacco control measures were compared in the model: smoke-free legislation, tobacco taxation, provision of brief cessation advice by health care providers, mass media campaigns, and advertising bans.
In addition, other factors such as increased access to aspirin, antihypertensive drugs, and statins were simulated for their effect on deaths from heart attack and stroke.
The authors conclude that, based on their model, smoke-free legislation and tobacco taxation are expected to be the most effective strategies for reducing heart attack and stroke deaths over the next decade.
These two measures alone could prevent about 9 million deaths from heart attack and stroke in India by 2022, and a combination of tobacco control policies and pharmacological interventions could prevent even more deaths, researchers said.
"One of the advantages of using large-scale surveys to inform these models is that we can account for unique populations who have different risk factors from places like the United States and the United Kingdom," said Basu.
"For example, many Indians smoke informal cigarettes called 'bidis' which are highly risky to health but are often missed by standard models focusing only on manufactured cigarettes," said Basu.