India is among countries with the lowest quit rates for smoking. The quit rates for men are less than 20%, states a report released by ‘The International Commission to Reignite the Fight Against Smoking’, which makes specific recommendations to achieve the goal of ending smoking worldwide.

China and India are home to more than 500 million tobacco users between the ages of 16 and 64. India ranks second with 250,002,133 smokers between the age of 16 and 64. Tobacco prevalence in India is three times higher among men than women. India also accounts for some of the highest rates of smokeless tobacco use and oral cancer in the world.

The commission, which has members from the U.S., the U.K., South Africa, Indonesia and India, examines several important issues, including the trends in tobacco use, challenges to cessation efforts, the emergence of technological innovations, the role of physicians, the function of industry, economic and regulatory policy, smoking and youth, and lessons from the COVID-19 pandemic.

As per the study, nearly all countries ban marketing and direct sales of tobacco products to children, but in low-to-middle income countries, especially, these prohibitions are not rigorously enforced. The report cites data from Consumer Voice 2019, which states that despite prohibitions in India, a study of areas around 243 schools found nearby vendors displaying tobacco products in ways that are appealing to children and youth. Around 91% of the displays were at a distance of a metre (i.e., a child’s eye level.) An estimated 54% of the points of sale had no visible health warning; and 90% of the displays were beside candy, sweets and toys, items marketed to children.

“Smoking and its health impacts highlight a global public health crisis. This report offers trends in tobacco usage worldwide and makes recommendations to achieve the global goal of ending smoking. Technology and innovation are driving change and will play a key role in reigniting this fight against smoking. Misinformation and misunderstanding are key hurdles we face, as 58% of Indians responded that they believe e-cigarettes are equally or more harmful than combustible tobacco, while the study shows e-cigarettes are 95% less harmful than combustibles. We need to focus on research and policy interventions to achieve our goals of a smoke-free world,” says Ambassador James K. Glassman (retd), former U.S. Under Secretary of State for Public Diplomacy and Public Affairs and chairman of the commission .

Abhishek Kumar, partner at Indicc Associates and convenor of New, Indian Consumer Initiative, says the report provides all crucial dimensions to put together a holistic strategy towards tobacco harm reduction. “The number of tobacco users in India is considerable. For a country with the majority of the population in a low-income group, the health and economic burden from tobacco use is an important issue. Harm reduction from tobacco is therefore an imperative,” he says.

The report recommends adopting best practices to combat misinformation and build a healthier information environment to reduce harm from tobacco by leveraging multi-national, multi-disciplinary and participatory foresight studies and advocating risk-proportionate regulations as a means of making it easier for smokers to switch from combustibles and quit. It also aims to nudge expansion of access to tobacco harm reduction products in low-to-middle-income countries.