One cigarette to unite them all: Congress, BJP MPs band together to fight tobacco warnings

The health ministry’s decision not to increase the size of statutory warnings on cigarette packets was less shocking than the justification it offered, which was that ’no Indian study’ has linked cancer to cigarettes. The source for the claim in most media reports BJP MP  Dilip Gandhi, who is the head of the parliamentary committee issued the recommendation after examining the provisions of the Cigarettes and Other Tobacco Products Act, 2003. However, to be fair, Gandhi was hardly alone in his spirited defence of tobacco companies.

What is striking about this controversy is the unexpected cross-party unity on this pro-tobacco stance.

MPs across party lines, including the Congress party have come forward to speak out against increasing the size of the warning on cigarette packets from 40 percent to 85 percent.

The Indian Express quoted Congress MP from Karnataka, SP Muddahanumegowda as saying, “We need to hear more from the tobacco farmers, tobacco manufacturers and tobacco consumers. That is why we thought the notification should be kept in abeyance till we have heard all these people. It was a universal decision. One or two people did express concern about the condition of consumers but they were not displeased or anything of that sort”.

The Express report also notes that Allahabad BJP MP Shyama Charan Gupta, who was a member of the panel that voted against increasing the size of images, had written to the committee in November 2014, making a case for bidis.

“Bidis are a natural product. It is very small compared to cigarettes and there is very little tobacco in each bidi, hence the harmful effects are nil as compared to cigarettes and chewing tobacco. There is no medical evidence that bidis cause cancer. Thus, the present size of pictorial warning i.e. 40% is sufficiently large and clear and conveys the message unambiguously. The new rule of 85% of horrific pictorial warning on bidi wrapper is unreasonable", he had reportedly said.

Gandhi himself said,“All agree on the harmful effects of tobacco. But there is no Indian survey report to prove that tobacco consumption leads to cancer. All the studies are done abroad. Cancer does not happen only because of tobacco. We have to study the Indian context, as four crore people in states like Madhya Pradesh, Andhra Pradesh, Maharashtra and Chhattisgarh are dependent on bidi-making through Tendupatta”.

Civil society activists, international and national public health experts and tobacco control advocates on Tuesday expressed shock at the decision, as well as the justification given for it.

Dr P C Gupta, Director, Healis - Sekhsaria Institute for Public Health told PTI that “The argument given by Dilip Gandhi that new studies should be conducted on the health effects of tobacco before implementing proposed warnings, makes us hang our heads in shame. When the whole world has agreed on the health effects of tobacco, even the tobacco industry does not contest those conclusions now and the MoHFW has already published numerous documents describing health effects, a demand for further study, can only imply unholy nexus.”

And what makes the claim even more remarkable is that a number of Indian studies themselves have linked cancer and other fatal illness to smoking cigarettes.

The Tobacco control report brought out by the government of India in 2004, noted that “the relative risk for death due to tobacco use in cohort studies from rural India is 40% to 80% higher for any type of tobacco use”, adding that “an urban cohort study in Mumbai found that the relative risk of dying was more than 50% higher for smokers and about 15% higher for smokeless tobacco users”. It added that overall, smoking currently causes about 700,000 deaths per year in India.

It also cited case control studies in India as saying tobacco chewing in its various forms is directly responsible for cancers of the oral cavity, oespohagus, pharynx, cervix and penis. “Beedi and cigarette smoking cause oral, pharyngeal, oesophageal, laryngeal, lung, stomach, gallbladder, urinary bladder and penile cancers”, it added.

According to the Global Adult Tobacco Survey India that was undertaken by the World Health Organisation, smoking causes about 30 percent of all cancer deaths. It said one person died every six seconds due to tobacco use, which accounts for one in 10 adult deaths and warned that up to half of current users would eventually die of a tobacco-related disease.

“India must act fast to protect its people, especially youth, from the dangerous effects of tobacco use and pictorial warnings are an effective way to communicate harms to those with poor literacy status,” said Dr Monika Arora, Director, Health Promotion and Adjunct Associate Professor, Public Health Foundation of India.

It also pointed to some shocking stats on the usage of tobacco in India:

Not all politicians however, are in favour of the committee recommendations. One of the panel members, Idris Ali of the TMC said that he did not agree with its conclusions. And within the BJP there are dissenting opinions. Prakash Javedakar said, “Do not listen to these things. Science is science. You cannot compromise on science".

With the clear outrage over the health ministry decision the question is whether voices like Javadekars will be given any precedence. Will public pressure prevail over tobacco lobbying? Or will tambaku carry the day?