Smoking Current Affairs - 2019
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India was ranked 5th among 206 countries in Cigarette Package Health Warnings: International Status Report 2018 released by Canadian Cancer Society. The ranking of the countries was in terms of largest pictorial warning on cigarette packs. In India, 85% of both sides of cigarette packets are covered with warnings.
In 2018 report, Timor-Leste has the largest warnings on cigarette packages in the world with 92.5% on front and back, followed by Nepal and Vanuatu with 90% and New Zealand at fourth with 87.5%. India secured the fifth rank jointly with Hong Kong and Thailand for 85% warnings.
The report documented global progress on plain packaging and ranked 206 countries and territories based on size of their health warnings on cigarette packages, and lists countries and territories that require graphic picture warnings.
It was the sixth Canadian Cancer Society international report on cigarette package health warnings. Previous reports were published in 2008, 2010, 2012, 2014 and 2016. It was released in Geneva at 8th session of Conference of Parties to WHO Framework Convention on Tobacco Control (FCTC)
Key Findings of report
The report has found that 118 countries worldwide have made pictorial warnings mandatory, representing global public health achievement and 58% of the world’s population is covered by this regulation. Canada was first country to make picture health warnings mandatory in 2001.
It also found that there is tremendous international momentum for plain packaging of tobacco. There are now 25 countries and territories moving forward with plain packaging, with nine having adopted measure and 16 working on it.
Total of 107 countries pictorial warnings cover at least 50% of the package, both front and back (on average), up from 94 in 2016 and 24 in 2008. 55 countries/jurisdictions have made mandatory for at least 65% (on average) of the package, front and back, be covered with warning.
The current regulation of pictorial warnings in India on both sides of packages of cigarettes, bidis and all forms of chewing tobacco products came into effect in April 2016 upon direction of Rajasthan High Court and subsequently Supreme Court. India has demonstrated global leadership by implementing quit-line number on all tobacco packages.
Union Ministry of Health and Family Welfare issued advisory to all states and Union Territories to not allow manufacture, sale and advertisement of e-cigarettes and other Electronic Nicotine Delivery Systems (ENDS). It also has issued warning that use e-cigarettes and other ENDS devices pose great health risk to public at large, especially to children and pregnant women. Punjab, Karnataka, Kerala, Mizoram, Jammu and Kashmir, Uttar Pradesh and Bihar already have prohibited manufacture, import, sale and distribution of e-cigarettes and ENDS.
e-cigarettes and ENDS
ENDS are devices that heat solution to create aerosol, which also frequently contains flavours, usually dissolved into propylene glycolor and glycerin. e-cigarettes (electronic cigarettes) are most common prototype of ENDS. These devices do not burn or use tobacco leaves but instead vaporise solution, which user then inhales. The main constituents of solution are nicotine, propylene glycol (with or without glycerol and flavouring agents).
Health Ministry Advisory
According to World Health Organisation (WHO) report on Global Tobacco Epidemic 2017, 30 countries like Mauritius, Australia, Singapore, South Korea, Sri Lanka, Thailand, Brazil, Mexico, Uruguay, Bahrain, Iran, Saudi Arabia and UAE have already banned ENDS.
ENDS including e-cigarettes, heat-not-burn devices, vape, etc. are great health risk to public at large, especially to children, adolescents, pregnant women and women of reproductive age. ENDS are not approved as NRTs (nicotine-replacement therapies) under Drugs and Cosmetics Act and rules made thereunder.
ENDS solutions and emissions contain other chemicals, some of them considered to be toxicants. They contain nicotine, addictive component of tobacco products. In addition they contain metals, including lead, chromium and nickel and chemicals like formaldehyde with concentrations equal to or greater than traditional cigarettes.
Use of ENDS may affect development of foetus during pregnancy. It may contribute to cardiovascular disease to people who use ENDS. Moreover, nicotine may function as ‘tumour promoter’ and seems to be involved in biology of malignant diseases. Foetal and adolescent nicotine exposure have long-term consequences for brain development, potentially leading to learning and anxiety disorders.