Tackling emerging threats to tobacco control

Tobacco control continues to remain a significant a public health challenge. Adding to the existing hurdles are new and emerging threats that are challenging conventional regulatory approaches.

Experts say there are growing concerns over the increased and easy access to tobacco products, especially among the young. The digital space is one of the biggest concerns for doctors and activists who have been working in tobacco control for several years, as early initiation means longer and lasting impacts on one’s health. There is an urgent need for better strategies to address these emerging threats, they say.

According to the World Health Organization, an estimated 37 million children aged 13 to 15 years worldwide use tobacco.

Tobacco use has to be prevented among the youth, stresses Surendran Veeraiah, professor and head, Psycho-oncology and Resource Centre for Tobacco Control, Cancer Institute (WIA), Chennai. “Initiation happens due to reasons such as curiosity and peer pressure. Policy-makers have to focus on these areas to safeguard the youth from industry tactics. The Cigarettes and Other Tobacco Products Act (COTPA) clearly prohibits the sale of tobacco to persons under the age of 18 and within 100 yards of educational institutions. The law is there but implementation is still a challenge,” he said.

Warnings on big and small screens

While scenes in movies and television programmes mandatorily carry an anti-tobacco warning, newer challenges have emerged, he said, adding: “The anti-tobacco health warnings are mandated on the silver screen. But now, we have come across videos of smoking on social media sites with zero warnings. How are these emerging challenges going to be addressed, especially considering the reach that social media has among the young?”

S. Cyril Alexander, State convenor, Tamil Nadu Peoples’ Forum for Tobacco Control added that though it was mandatory for OTT streaming platforms to display anti-tobacco warnings, not all platforms were implementing the 2023 notification. “Some OTT platforms have implemented the rule, while others have not. We have been closely following the issue and are continuously raising it with the authorities as these platforms are reaching several children,” he said.

Digital challenges

This is not all. Newer challenges have emerged in the past few years. “Consumers and products have become advanced but the enforcement is unable to keep pace. So, we are in reverse gear. Now, marketing of tobacco products is happening in the digital space, on social media and on WhatsApp,” said Mr. Alexander. He added that tobacco products including e-cigarettes are ordered online and directly delivered to the customers. “For instance, once we register on the product website, details are sought on Whatsapp. Once the online payment is made, the product is delivered directly to the customer. With more online platforms in play, accessibility to tobacco products has been easier,” he said.

Mr. Alexander added that his organisation has been studying digital marketing applications and have also lodged complaints. “Tamil Nadu is the only State with a valid Section 5 of COTPA (Cigarette and Other Tobacco Products Act) committee to take action against direct and indirect advertising but the committee is not functional. We need to go forward and ensure proper enforcement along with strengthening online surveillance. We cannot continue to use conventional methods of monitoring,” he said.

Dr. Veeraiah said that tobacco use is directly linked in one way or other to multiple non-communicable diseases such as cancers, diabetes, hypertension and cardiac ailments. Not to forget lung diseases caused by tobacco use. “Smoking can affect the digestive system too. It can cause bowel changes and can also affect the skin and eyes. The younger the age of initiation, the more will be the problems as they grow,” he said.

A public health official said that a multi-pronged strategy was required for tobacco control. “There needs to be a high level of awareness. Restriction of sales is crucial as we are facing the problem of use of tobacco products among school students. We also need to look at the commercial aspect and monitor the advertisement of tobacco and increase the warning labels on the packets,” he said.