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Philip Morris takes aim at young people in India, and health officials are fuming

The tobacco giant is pushing Marlboros in colorful ads at kiosks and handing out free smokes at parties frequented by young adults – tactics that break India’s anti-smoking laws, government officials say. Internal documents uncovered by Reuters illuminate the strategy.

http://www.reuters.com/investigates/special-report/pmi-india/

S. K. Arora spent more than three years trudging through the Indian summer heat and monsoon rains to inspect tobacco kiosks across this sprawling megacity, tearing down cigarette advertisements and handing out fines to store owners for putting them up.

But as fast as he removed the colorful ads, more appeared.

The chief tobacco control officer at the Delhi state government, Arora asked the major cigarette companies to put a stop to the cat-and-mouse routine. In official letters and face-to-face meetings, he told them India’s tobacco control laws barred such public advertising and promotion of cigarettes.

That included the Indian arm of Philip Morris International Inc, the world’s largest publicly traded tobacco company. Early last year, Arora said, he met with a Philip Morris director for corporate affairs in India, a man named R. Venkatesh, and told him the signs were an unequivocal violation of Indian law.

Like other tobacco companies, Philip Morris kept up its ad blitz.

Venkatesh says Philip Morris is doing nothing wrong. In response to questions from Reuters, he said the company’s advertising is “compliant with Indian law” and that Philip Morris has “fully cooperated with the enforcement authorities” on the matter.

But Indian government officials say Philip Morris is using methods that flout the nation’s tobacco-control regulations. These include tobacco shop displays as well as the free distribution of Marlboro – the world’s best-selling cigarette brand – at nightclubs and bars frequented by young people.

In internal documents, Philip Morris International is explicit about targeting the country’s youth. A key goal is “winning the hearts and minds of LA-24,” those between legal age, 18, and 24, according to one slide in a 2015 commercial review presentation.

As with the point-of-sale ads at kiosks, public health officials say that giving away cigarettes is a violation of India’s Cigarettes and Other Tobacco Products Act and its accompanying rules.

Philip Morris’ marketing strategy for India, which relies heavily on kiosk advertising and social events, is laid out in hundreds of pages of internal documents reviewed by Reuters that cover the period from 2009 to 2016. In them, Philip Morris presents these promotions as key marketing activities. In recent years, they have helped to more than quadruple Marlboro’s market share in India, where the company is battling to expand its reach in the face of an entrenched local giant. Reuters is publishing a selection of those documents in a searchable repository, The Philip Morris Files.

The company’s goal is to make sure that “every adult Indian smoker should be able to buy Marlboro within walking distance,” according to another 2015 strategy document.

In targeting young adults, Philip Morris is deploying a promotional strategy that it and other tobacco companies used in the United States decades ago. A study published in the American Journal of Public Health in 2002 found that during the 1990s, “tobacco industry sponsorship of bars and nightclubs increased dramatically, accompanied by cigarette brand paraphernalia, advertisements, and entertainment events in bars and clubs.”

With cigarette sales declining in many countries, Philip Morris has identified India, population 1.3 billion, as a market with opportunity for significant growth. “India remains a high potential market with huge upside with cigarette market still in infancy,” says a 2014 internal document.

According to government data, India has about 100 million smokers. Of those, about two-thirds smoke traditional hand-rolled cigarettes. Tobacco use kills more than 900,000 people a year in India, and the World Health Organization estimates that tobacco-related diseases cost the country about $16 billion annually.

Philip Morris is not alone in using marketing methods that Indian officials say are illegal. The country’s largest cigarette maker, ITC Ltd, uses similar tactics, such as advertising at kiosks. British American Tobacco Plc and Indian state-run companies have large, passive stakes in ITC, which controls about 80 percent of the market.

Tobacco-control officer Arora, a short, mustachioed man with a gruff demeanor, sent a letter to Philip Morris and other tobacco companies in mid-April, giving them until the end of the month to remove all advertisements. “Legal action will be initiated against the company” if it did not comply, he wrote in the letters, copies of which were reviewed by Reuters.

A day after Arora’s deadline passed, he and his team conducted a raid in an affluent area of cafes and coffee shops in New Delhi that showed his letters did not have the desired effect.

On that hot afternoon in May, the team cut down about a dozen advertisements for Marlboro and various ITC brands. As word of the raid spread, worried vendors covered their ads with newspapers or took them down.

One kiosk owner, Rakesh Kumar Jain, removed his Marlboro ads before Arora’s team arrived. Jain said the signs had been put up by Philip Morris representatives. In return, he said, he received free cigarettes each month worth about 2,000 rupees (about $30). Jain knew that putting up the posters was illegal, but they helped improve sales, he said.

About a dozen kiosk owners interviewed by Reuters said that tobacco companies paid them a monthly fee for advertisements and product displays, with the amount determined by factors such as location, volume of business and type of promotional material.

In payment receipts seen by Reuters, Philip Morris’ India unit promised to pay 500 Indian rupees ($7.50) a month to a cigarette seller with a small roadside kiosk in New Delhi for putting up Marlboro ads. The receipts were signed by a company representative.

During the raid, fines were issued to some vendors, many of them repeat offenders, and they were threatened with court action if the ads went up again.

Like Philip Morris, ITC says that it is in full compliance with India’s 2003 tobacco control law. If it wasn’t, the company said in a statement to Reuters, then “the relevant government authorities would have initiated action.”

Since Arora’s threat of legal action in April, there are fewer Philip Morris advertisements outside cigarette shops in the capital. But both Philip Morris and ITC say that advertising inside a shop is allowed.

“Advertisements of tobacco products at the entrance and inside the shops selling tobacco products are clearly and categorically permitted,” ITC said in response to questions from Reuters.

Arora, however, said all advertising is prohibited – “There are no two ways about it,” he insisted – but he can’t start legal proceedings until getting further guidance from the federal government. He has yet to receive an answer.

Federal health officials say in interviews that the ads are out of bounds. Amal Pusp, a director for tobacco control at the health ministry, told Reuters that “there is no confusion”: All advertisements – inside and outside shops – are illegal.

The 2003 law allows tobacco companies to advertise at shops, but subsequent rules issued by the government prohibit it.

“India remains a high potential market with huge upside with cigarette market still in infancy.”

From a 2014 internal Philip Morris document

In 2004, India became one of the first countries to ratify the World Health Organization’s Framework Convention on Tobacco Control (FCTC) treaty. The pact has 181 members and contains a raft of anti-smoking provisions, including tobacco taxes, warning labels on cigarette packs and advertising bans. The country enacted its national tobacco control law the year before ratifying the FCTC, and since then the government has added rules to strengthen the law in line with the treaty’s provisions.

The health ministry published rules in 2005 that banned any display of brand names, pack images or promotional messages. The rule specified that tobacco retailers could only display a 60-by-45 centimeter board, roughly 24 by 18 inches. The sign can have a description of the type of tobacco products sold – such as cigarettes or chewing tobacco – but cannot include any brand advertising and must carry a large health warning.

The health ministry’s rules were challenged in court by a group of cigarette distributors and put on hold by a state-level High Court for seven years. They finally came into force in 2013 on orders of India’s Supreme Court.

The High Court had overlooked the fact that advertisement of tobacco products “will attract younger generation and innocent minds, who are not aware of grave and adverse consequences of consuming such products,” the Supreme Court said in its ruling.

Philip Morris has lobbied against the passing of stricter tobacco control rules by the Indian government. In documents detailing the company’s plans for the biennial FCTC treaty convention in India last November, Prime Minister Narendra Modi emerges as a prime target. A key goal: to pre-empt Modi from taking “extreme anti-tobacco measures” before delegates were to gather from around the world for the treaty meeting, according to a 2014 corporate affairs PowerPoint presentation.

Excerpts from the Philip Morris Files

Reuters reviewed hundreds of pages of internal Philip Morris International documents relating to India. These excerpts show the company’s marketing and lobbying tactics, which are aimed at bolstering the Marlboro brand among young adults and blocking the “enactment of extreme anti-tobacco measures.” Letters from Indian officials detail the government’s efforts to enforce the country’s tobacco control regulations. (Some documents include highlighting by Reuters.)

A slide from a Philip Morris training manual shows the kinds of people the company aims to target for Marlboro sales in India. LAS = legal age smokers.

A slide from a Philip Morris training manual shows the kinds of people the company aims to target for Marlboro sales in India. LAS = legal age smokers.

A slide from a 2014 strategy presentation shows Philip Morris’ goals for marketing Marlboro Red in India. LA-24 = legal age to 24-year-old smokers.

A slide from a 2014 strategy presentation shows Philip Morris’ goals for marketing Marlboro Red in India. LA-24 = legal age to 24-year-old smokers.

This slide from a 2012 marketing presentation shows where Philip Morris planned to target 18-to-24-year-old smokers in India.

This slide from a 2012 marketing presentation shows where Philip Morris planned to target 18-to-24-year-old smokers in India.

A Philip Morris training manual lays out rules for how those marketing its cigarettes should look. FWP = field work personnel.

A Philip Morris training manual lays out rules for how those marketing its cigarettes should look. FWP = field work personnel.

Another slide from the Philip Morris training manual includes instructions for company representatives handing out free cigarettes at kiosks as part of brand promotion. (IPM = India Philip Morris; GPI = Godfrey Phillips India; POS = point of sale.)

Another slide from the Philip Morris training manual includes instructions for company representatives handing out free cigarettes at kiosks as part of brand promotion. (IPM = India Philip Morris; GPI = Godfrey Phillips India; POS = point of sale.)

Kiosk owners in Delhi say that Philip Morris pays them a monthly fee to put up its advertisements. Names have been redacted on this Philip Morris receipt.

Kiosk owners in Delhi say that Philip Morris pays them a monthly fee to put up its advertisements. Names have been redacted on this Philip Morris receipt.

Keshav Desiraju, then a senior health ministry official, wrote to state governments in January 2013, instructing them to stop all tobacco advertisements.

Keshav Desiraju, then a senior health ministry official, wrote to state governments in January 2013, instructing them to stop all tobacco advertisements.

 In April, S.K. Arora, the chief tobacco control officer in Delhi, warned Philip Morris International in a letter that it could face legal action over its advertising.

In April, S.K. Arora, the chief tobacco control officer in Delhi, warned Philip Morris International in a letter that it could face legal action over its advertising.

An excerpt from a 2013 letter from a health ministry official to state governments shows specifications for the board that can be displayed at shops selling tobacco products. According to Indian law, the board cannot include any brand names. Beedis are traditional hand-rolled cigarettes.

An excerpt from a 2013 letter from a health ministry official to state governments shows specifications for the board that can be displayed at shops selling tobacco products. According to Indian law, the board cannot include any brand names. Beedis are traditional hand-rolled cigarettes.

Ahead of the World Health Organization’s global tobacco control treaty meeting in India last November, Philip Morris planned to engage Prime Minister Narendra Modi in an effort to head off new anti-tobacco measures. The slide is from a 2014 corporate affairs document. CoP7 = Conference of the Parties, the biennial treaty meeting.

Ahead of the World Health Organization’s global tobacco control treaty meeting in India last November, Philip Morris planned to engage Prime Minister Narendra Modi in an effort to head off new anti-tobacco measures. The slide is from a 2014 corporate affairs document. CoP7 = Conference of the Parties, the biennial treaty meeting.

The company planned to gain Modi’s ear through those close to him. It identified several people in this group, including Commerce Minister Nirmala Sitharaman, Health Minister Jagat Prakash Nadda, and Amit Shah, president of the ruling Bharatiya Janata Party.

Modi and the other politicians didn’t respond to requests for comment. Philip Morris International also didn’t comment on the plan.

The tobacco giant’s efforts to fend off anti-smoking steps have had limited impact so far. Last year, for instance, India ordered manufacturers to cover 85 percent of the surface of cigarette packs with health warnings, up from 20 percent. The rule, which is still being challenged in a state court by the tobacco industry, including Philip Morris’ India partner, was implemented by order of the Supreme Court.

Marlboro has just a 1.4 percent share of the almost $10 billion cigarette market in India. The industry is dominated by ITC, which has a strong grip on distributors and retailers.

One major method Philip Morris is deploying to gain ground, the marketing documents show, is the free distribution of cigarettes at bars and nightclubs – known as Legal Age Meeting Points, or LAMPs, in company jargon. The hiring of young women and men to work at these gatherings is outsourced to event management companies, according to people with knowledge of the gatherings.

Some of the recruiting takes place online. “Hey girls…We are searching A++ Hot & Gorgeous girls for the Marlboro pub activity…Pay: 2000/day…Work: Promotion in clubs in Delhi,” read one post on a Facebook public group in June last year. There was no company name attached to the ad.

At several parties attended by Reuters in Delhi and Mumbai, young women dressed in the colors of the latest Marlboro variant handed out packs of cigarettes. During one party at a nightclub in a Delhi hotel, a young woman walked around with a tablet showing an ad that highlighted Marlboro features. A television screen played a video promoting the brand: “For trendsetters, for forward thinkers, a smooth and balanced smoking experience.”

In many ways, it was right out of the Philip Morris 1990s playbook. The American Journal of Public Health study, drawing on previously secret industry documents, found that Philip Morris ran bar promotions in 1990 using racing jackets, and added “neon message boards and cocktail trays” in 1991. The study described methods for collecting names for a company database “to generate smoker profiles, direct mailing campaigns, and conduct telephone research studies after the bar events.”

At the parties in India, people who took the Marlboro packs were asked their names, ages and preferred brands. Philip Morris calls this distribution of free cigarettes “sampling,” which it says in an internal document is allowed under the law.

The company has spent millions of dollars on these activities. In 2014, for example, Philip Morris estimated it spent $1.6 million on LAMP events and sampling at kiosks in India, according to the 2015 commercial review presentation.

The company planned to use LAMPs in 2015 to generate 30,000 “trials,” or samplings of cigarettes. And it planned to generate another 500,000 trials that year through sampling at cigarette shops and kiosks, according to the 2015 strategy document.

The company instructs employees to watch their words. An undated training manual for market researchers says: “Do not say this is a ‘PROMOTION’ or ‘ADVERTISING’.”

Indian health ministry officials say that anyone who hands out free cigarettes, whatever the circumstances, is breaking the law.

The Health Ministry’s Amal Pusp says the law against distribution of free cigarettes is unambiguous. He cites Section 5 of the country’s tobacco control act, which says: “No person, shall, under a contract or otherwise promote or agree to promote the use or consumption of” cigarettes or any other tobacco product. The law carries a fine of up to 1,000 rupees (about $15) and a sentence of up to two years in prison for a first conviction.

“We believe we market our products in a responsible manner, and in compliance with Indian regulations,” Philip Morris’ Venkatesh said, without elaborating.

In October last year, the month before India was due to host delegations from around the world at the biennial FCTC tobacco control conference in Delhi, tobacco-control officer Arora said he suddenly started getting traction.

The cigarette ads vanished and Delhi was “cleaned,” he said.

That success couldn’t have come at a better time for Arora and his colleagues at the federal health ministry: They wanted to make sure foreign delegates visiting India saw the country was serious about its tobacco regulations.

Weeks after the FCTC delegates left town in November, however, kiosks in the capital were again displaying ads for Marlboro.

STOREFRONT ADS: Marlboro advertisements can be seen on this kiosk in a marketplace in New Delhi in April. Despite warnings from health officials, Philip Morris has continued to advertise its Marlboro cigarettes. REUTERS/Adnan Abidi

STOREFRONT ADS: Marlboro advertisements can be seen on this kiosk in a marketplace in New Delhi in April. Despite warnings from health officials, Philip Morris has continued to advertise its Marlboro cigarettes. REUTERS/Adnan Abidi

Additional reporting by Aditi Shah in New Delhi, and Abhirup Roy and Swati Bhat in Mumbai.

The Philip Morris Files
By Aditya Kalra, Paritosh Bansal, Tom Lasseter and Duff Wilson
Design: Troy Dunkley
Photo Editing: Tom White and Altaf Bhat
Edited by Peter Hirschberg

Himachal govt bars its officials from participating in tobacco industry’s activities

The circular has been issued recently in view of the fact that different government departments end up taking sponsorship from tobacco industries, knowingly or unknowingly.

http://www.hindustantimes.com/india-news/himachal-govt-bars-its-officials-from-participating-in-tobacco-industry-s-activities/story-4YLg9v87SRBtgk0Rw5411I.html

Himachal Pradesh government has issued a circular barring its officials from participating in any activity related to tobacco industry.

“All the heads of departments in Himachal Pradesh are instructed not to participate in any event organised by tobacco industry and also not to accept any kind of direct or indirect sponsorship or funding from corporate engaged in tobacco business,” the circular read.

The circular has been issued recently in view of the fact that different government departments end up taking sponsorship from tobacco industries, knowingly or unknowingly.

“Sponsorship from tobacco companies will weaken our tirade against tobacco, in which, Himachal is doing really well,” director health safety and regulation department Raman Kumar Sharma said.

Sharma said there are some events organised by tobacco companies where doctors are invited as technical experts. “Head of departments should refrain from participating in such events. It is equal to endorsing their products,” he added.

The directions have been issued in view of the implementation of The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) or COTPA Act, 2003.

“Under the act, the direct and indirect advertisement of tobacco product is prohibited. But some tobacco giants sponsor government programme, which is a kind of endorsement of their activities,” health activist Ramesh Badrel said.

Investing in tobacco firms not banned, LIC tells Bombay HC

Mumbai city news: LIC was replying to a public interest litigation objecting to public sector insurance companies investing in firms manufacturing tobacco products

http://www.hindustantimes.com/mumbai-news/investing-in-tobacco-firms-not-banned-lic-tells-bombay-hc/story-ceFSeRSF8q5YNeiRTPRfKL.html

Investing in tobacco companies indirectly is neither prohibited nor banned by any authority, the Life Insurance Corporation of India (LIC) said in an affidavit filed in the Bombay high court.

LIC was replying to a public interest litigation objecting to public sector insurance companies investing in firms manufacturing tobacco products.

“Secondary investment in tobacco companies is neither prohibited nor banned by any authority,” says the affidavit filed by Vikas Chaturvedi, assistant secretary (investment operations) of LIC. “LIC is a corporate body and must function on business principles as far as possible. Ninety-five per cent of its surplus goes to policy vendors,” added the affidavit.

It added that the investment was in accordance with the provisions of the LIC Act, the Insurance Act and guidelines laid down by the Insurance Regulatory and Development Authority, and other prevailing rules and regulations. “LIC looked at several companies with a good track record for investment options,” said the affidavit, adding, “ITC is one such company.”

The affidavit was filed in response to a PIL by anti-tobacco activist Sumitra Pednekar and doctors attached to Tata Memorial Hospital. Meanwhile, the court allowed Karnataka state branch of Indian Medical Association to assist it by listing the ill-effects of tobacco.

Centre wants to stub out airport tobacco shops

Welcome move: The Ministry also ordered that tobacco shops are not located to smoking rooms. In a significant move to discourage smoking at airports, the Union Health Ministry has written to the Airports Authority of India (AAI) Chairman, the Union Ministry of Civil Aviation Secretary, and CEOs of Chhatrapati Shivaji International Airport, Indira Gandhi International Airport and Rajiv Gandhi International Airport to ensure that tobacco shops at airports are not located near smoking rooms. Punishable offence Besides tobacco shops at airports displaying signage stating that “sale of tobacco products to a person below the age of 18 years is a punishable offence”, they shouldn’t sell non-tobacco products, the letter adds. In the May 26 letter, the Health Ministry brought to the notice of the AAI and the Civil Aviation Ministry that provisions of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act (COTPA), 2003, were being violated at airports by shops selling cigarettes and other tobacco products. These shops, in contravention of provisions of COTPA, display tobacco advertisements and are located just outside smoking rooms or in food courts, thus facilitating tobacco use among non-smokers, especially children. ‘No signage displayed’ The letter highlighted that certain tobacco products are also sold at shops selling souvenirs, food articles, books and comics, thus enabling easy access to non-smokers, especially children, to these shops and tobacco products. These shops also do not display the signage stating that “sale of tobacco products to a person below the age of 18 years is a punishable offence”. An anti-tobacco activist said, “The Health Ministry had earlier issued a notification banning the use of hookah in any smoking area or space provided for smoking.

https://www.nyoooz.com/news/delhi/831807/centre-wants-to-stub-out-airport-tobacco-shops/

It had also directed owners, proprietors, managers, supervisors or in-charges of affairs of the hotel, restaurant or airports shall display at the entrance of smoking areas or spaces a board of minimum size of 60×30 cm with a white background the messages — “Tobacco Smoking is Harmful To Your Health and The Health of Non-Smokers” and “Entry of Person Below The Age of Eighteen Years Is Prohibited” — in English and an Indian language in black colour.”. . .

Yikhum village bans sale/use of tobacco

After successfully enforcing the ban on use and sale of tobacco products and alcohol within the for about 5 years, Yikhum Village under Wokha district has been recognized and formally declared as ‘Tobacco Free Village’ by the District Tobacco Control Cell (DTCC) under the National Tobacco Control Programme on May 31 on the occasion of World No Tobacco Day at Wokha Town. This was informed through a press note by Yikhum Village Council chairman, Robin Kithan.

http://www.nagalandpost.com/ChannelNews/State/StateNews.aspx?news=TkVXUzEwMDExNTU0OQ%3D%3D

“Seriously considering the fatal menace of the use of hazardous elements, the Village council with the mandate of the general public imposed a total ban henceforth,” the note stated. Therefore, anyone found selling/using openly the banned substances including alcohol within the village shall be fined Rs. 1000 (seller) and Rs. 200 (user), along with “stringent punitive” actions.

Smoking may cause bone degeneration, osteoporosis in youngsters

Smoking as a habit typically begins in high school or the college years, when bones are still developing. It also interferes with calcium and vitamin D absorption in the body.

http://www.hindustantimes.com/fitness/smoking-may-cause-bone-degeneration-osteoporosis-in-youngsters/story-loCO9GllLujrar6epnuDbI.html

Youngsters who smoke may be at risk of developing low bone density — a condition that may lead to an increased risk of developing osteoporosis, experts say.

“Smoking has a negative effect on the bones, causing loss of bone mass and, eventually, premature osteoporosis when young people take up smoking,” Raju Vaishya, senior orthopaedic surgeon, at Indraprastha Apollo Hospitals, said in a statement on Wednesday.

Smoking as a habit typically begins in high school or the college years, when bones are still developing. It also interferes with calcium and vitamin D absorption in the body.

Besides, in case of a bone injury, a person who smokes is more likely to have a longer period of recovery and greater risk of complication, doctors noted.

“Smoking during the years of bone-building puts you at risk of osteoporosis in later stage. Smoking after 30 will speed up loss of bone mass almost twice as faster,” Vaishya added.

Smoking kills over one million people in the India annually, according to The Global Adult Tobacco Survey (GATS) India report. The economic burden of tobacco consumption is around Rs 104,500 crore per annum.

In a study, recently published in the journal Annals of the American Thoracic Society, smoking was found to be an independent risk factors for low bone density among both men and women.

Each additional pack-year of smoking raised the odds of having low bone density by 0.4%. The participants with normal bone density had an average of 36.6 pack-year of smoking, while those with low bone density had an average of 46.9 pack-years of smoking history.

Mumbai: Over 40 NGOs, Tata Hospital join hands against tobacco

Mumbai: To mark ‘World No Tobacco Day’ which falls on May 31, more than 40 Non-Governmental Organisations, (NGOs) in collaboration with the Tata Memorial Hospital, Parel have formed a coalition to reduce the consumption of tobacco in India.

http://www.freepressjournal.in/mumbai/mumbai-over-40-ngos-tata-hospital-join-hands-against-tobacco/1077580

Dr. Pankaj Chaturvedi, professor and surgeon of Tata hospital, said that every third person in India consumes tobacco in different forms. He stated that the theme, ‘Tobacco- a threat to development’ specifically highlights the link between the use of tobacco products, tobacco control and sustainable development.

Dr. Chaturvedi further said that 33 per cent of tobacco users die a premature death due to cancer, heart attack, lung diseases, stroke etc. A smoker loses 8 years of his life due to this addiction.

“Tobacco is responsible for nearly 50 per cent cancers in India and 90 per cent of mouth cancers. Half of the mouth cancer patients die within 12 months of diagnosis,” said Dr. Chaturvedi.

Dr. Vijay Satbir Singh, additional chief secretary Public Health Department said that the main aim is to regulate the consumption of tobacco by implementing the Cigarettes and Other Tobacco Products Act (COTPA Act).

“The main challenge is to enforce traders to implement the warning signs and stop selling loose cigarettes. Stern action will be taken against those who are not following the law,” said Dr. Singh.

What is COTPA Act?

The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 was enacted in 2003 to prohibit advertisement of tobacco products and to regulate them in India.
The Act prohibits smoking of tobacco in public places, except in special smoking zones in hotels, restaurants and airports and open spaces.
Advertisement of tobacco products including cigarettes is prohibited.
Tobacco products cannot be sold to person below the age of 18 years, and in places within 100 metres radius from the outer boundary of an institution of education.
Tobacco products must be sold, supplied or distributed in a package which shall contain an appropriate pictorial warning, its nicotine and tar contents.

World No Tobacco Day: Effects of shisha or hookah on the heart

Did you know 163.7 million in India consume these smokeless variants and are prone to cardiac ailments?

http://www.thehealthsite.com/news/world-no-tobacco-day-effects-of-shisha-or-hookah-on-the-heart-b0517/

According to statistics, about 6 million people in India die every year due to tobacco consumption and approximately 163.7 million users consume only the smokeless variants like sheesha (shisha or hookah). But still, the number of people dying due to tobacco consumption every year is higher than that due to tuberculosis, HIV-AIDS, and malaria put together. Be it tobacco smoking or use of smokeless tobacco like hookah, every form of tobacco contains more than 30 cancer-causing substances along with nicotine which can cause irreparable damage to the body.

Effects of Shisha on the heart

Dr Manoj Kumar, Associate Director & Head, Cardiac Cath Lab, Max Super Specialty Hospital, Patparganj, New Delhi, says, ‘Smokeless tobacco and sheesha affect the heart in multiple ways. Inhalation of the high levels of carbon monoxide reduces the oxygen-carrying capacity of the blood, leading to an overall drop of oxygen circulating in the body. This causes a drastic increase in the heart rate and blood pressure leading to a lot of exertion on the cardiovascular system. People addicted to such forms of tobacco are more prone to cardiac arrest, high blood pressure, stroke, haemorrhage, blood clot and other heart-related ailments. People with a risk of cardiac ailments or a history of cardiac arrest have twice the risk of mortality if they continue the usage of snuff or other smokeless tobacco products even after an attack.” Here are more side effects of hookah.

Is a sheesha bad for you?

There is no safe form of tobacco. Smokeless tobacco and sheesha, two other variants of tobacco, are equally harmful to heart health. Those forms of tobacco which are not burnt are termed as smokeless. Sheesha, on the other hand, is a form of fruit-flavored tobacco which is roasted in a foil along with charcoal and passed into a small chamber of water through a glass-bottomed pipe, which is then inhaled slowly. The WHO points that the total volume of smoke and carcinogens inhaled during an hour-long session of sheesha is equivalent to smoking 100 to 150 cigarettes with an average sheesha user inhaling approximately one-sixth of a litre of smoke in just one inhale.

Dr Santosh Kumar Agarwal, Senior Interventional Cardiologist, Kailash Hospital and Heart Institute, Noida, says “All forms of tobacco are dangerous to smokers and non-smokers alike. The nicotine in tobacco is what makes people addicted to it. Whether it is smoking or chewing, tobacco damages blood vessels, temporarily raises blood pressure and lowers exercise tolerance. It also reduces the oxygen-carrying capacity of blood and increases the tendency for blood to clot. Blood clots in the arteries can further cause a range of heart problems, which ultimately result in a stroke or sudden death.’ Read more on hookah or cigarettes, which is more harmful?

How to quit smoking hookah?

Here are some tips to try and quit this deadly habit.

1. Try short-acting nicotine replacement therapies such as nicotine gum, lozenges, nasal sprays, or inhalers. These can help you overcome intense cravings.

2. Identify the trigger situation, which makes you smoke. Have a plan in place to avoid these or get through them alternatively.

3. Chew on sugarless gum or hard candy, or munch raw carrots, celery, nuts or sunflower seeds instead of tobacco.

4. Get physically active. Short bursts of physical activity such as running up and down the stairs a few times can make a tobacco craving go away. Also read about 7 simple ways to control the urge of ‘just one puff’!

Disclaimer: TheHealthSite.com does not guarantee any specific results as a result of the procedures mentioned here and the results may vary from person to person. The topics in these pages including text, graphics, videos and other material contained on this website are for informational purposes only and not to be substituted for professional medical advice.

Doctor honoured for fight against tobacco

Cancer specialist U.S. Vishal Rao of Bengaluru has been honoured with the 2017 Judy Wilkenfeld Award for International Tobacco Control Excellence for his role in combating tobacco use. Dr. Rao was presented the award on Wednesday at an event organised by the Campaign for Tobacco-Free Kids in Washington D.C.

http://www.thehindu.com/todays-paper/tp-national/tp-karnataka/doctor-honoured-for-fight-against-tobacco/article18443143.ece

His efforts led to a ban on gutka, chewing tobacco and e-cigarettes in Karnataka. However, the State government recently overturned the ban on chewing tobacco.

Dr. Rao is a member of the High-power Committee on Tobacco Control instituted by the government of Karnataka. He is the inventor of a Rs. 50 voice box prosthetic for throat cancer patients whose larynx has been removed.

Speaking over telephone from Washington DC, Dr. Rao said, “The committee gave the award in recognition of the steps taken towards implementing the Cigarette and Other Tobacco Products (Prohibition) Act, and how Karnataka led the way. Another was implementation of the ban on gutka and chewing tobacco by the government of Karnataka.”

The Wilkenfeld Award was established in honour of Judy Wilkenfeld, founder of Tobacco-Free Kids’ international program. Dr. Rao is the second Indian to receive the award, the first being Pankaj Chaturvedi of Tata Memorial Hospital in 2013.

Government releases new pictorial warnings for tobacco products

Replacing the existing images, the Health Ministry has released a new set of pictorial warnings for mandatory display on packets of cigarettes, bidis, and chewing tobacco with effect from April 1 this year. Under the new rules, manufacturers will now need to display graphic pictures of throat cancer on cigarette and bidi packets and pictures of mouth cancer on chewing tobacco packets.

http://www.newindianexpress.com/nation/2017/apr/04/government-releases-new-pictorial-warnings-for-tobacco-products-1589510.html

According to the public notice on the Health Ministry’s website, the government notified the new health warnings on October 15, 2014 and issued a notification dated September 24, 2015 for mandatory display of new health warnings covering 85 per cent of the principal display area on all tobacco products from April 1, 2016.

“As per Rules, during the rotation period of 24 months, two images of specified health warnings as notified in the Schedule, shall be displayed on all tobacco product packages and each of the images shall appear consecutively on the package with an interregnum period of 12 months.

“Further as per notification dated March 24, 2017, all tobacco products manufactured on or after April 1, 2017 shall display the second image of specified health warning,” the notice said. It further said any person engaged directly or indirectly in production, supply, import or distribution of cigarettes or any other tobacco products shall ensure that all tobacco product packages have these specified health warnings.

“Violation of the provisions is a punishable offence with imprisonment or fine as prescribed under section 20 of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act 2003,” it said.

India is third among countries with the largest pictorial warnings on tobacco products, according to a recent report. The Health Ministry has implemented, from April 2016, large pictorial health warnings occupying 85 per cent of the principal display area of tobacco packs and on all forms of tobacco.