Vote For Health Campaign and UP State Tobacco Control Cell Report Card on Implementation of Tobacco Control Laws

and other health and development policies in Lucknow

May 2013 Jointly organized by: Vote for Health campaign, Asha Parivar, CNS and UP governments State Tobacco Control Cell (STCC)

Youth participants (15) of Rights and Responsibilities Summer Training Camp:

Youth participants of Rights and Responsibilities Training Camp: Avnish Shukla, Udita Chandra, Anjali Verma, Rohit Kumar Kashyap, Gurudeep, Samarth Dwivedi, Nitish Tiwari, Ateendra Gupta, Mohd Haroon, Kapil Muni, Rahul Kumar, Surya Prakash Pathak, Ravi Singh, Subham Dwivedi and Mukta Srivastava

Faculty for Rights and Responsibilities Summer Training Camp 2013:

Professor (Dr) Rama Kant, Dr Sandeep Pandey, Shobha Shukla, Dr Madhu Pathak, Dr Shivani Sharma, Mr Manushresth Mishra, Mr Jaideep Dhondiyal and Ms Reshma from HOPE Initiative, Mr Sailendra Singh UP Bureau chief Delhi Press Prakashan, Bobby Ramakant and Rahul Dwivedi This report card is produced by some youth participants and faculty members of this training.

What we monitored in Lucknow? And Why? 1- Tobacco control laws:

The Cigarette and Other Tobacco Products Act, 2003, is one of the most comprehensive tobacco control laws in the world but its implementation is weak and appalling. The youth participants after the session on tobacco control laws in India, selected few salient features of The Cigarette and Other Tobacco Products Act, 2003, to conduct a reality check at some locations in Lucknow on their level of implementation: The salient features of The Cigarette and Other Tobacco Products Act, 2003, that were monitored and evaluated by the team included: 1) 2) 3) 4) 5) Sale of tobacco within 100 yards of any educational institutions is prohibited Pictorial health warnings on all tobacco products Advertising of tobacco products Point of sale advertising of tobacco products Sale of foreign cigarettes that are not complying with domestic pictorial warning law

6) Ban smoking in public places

2- Sanitation and hygiene:

We believe that poor waste management in our city is a breeding ground for diseases. We monitored and documented waste lying recklessly over days in densely populated residential locations in our neighbourhood. Similarly plastic wastes are also disposed of carelessly.

3- Alcohol advertising
Despite ban on alcohol advertising, we saw many billboards in Lucknow where major alcohol brands were displayed in the garb of musical nights, cassettes, fashion tour and CDs etc.

Sale of tobacco within 100 yards of any educational institutions is prohibited

Law: Sale of tobacco is not permitted within 100 yards of any educational institution according to the Cigarettes and Other Tobacco Products Act, 2003. There were several educational institutions (schools, colleges, tuition centres, coaching centres etc) where tobacco was being sold within 100 yards distance either through gumti shops or mobile thelas. Sale of tobacco to or by minors is also not permitted by law. These laws that will protect children and youth from having easy access to tobacco are important to enforce strictly. Violations are documented as photographs:

Ban on smoking in public places

Tobacco advertising
Since the ban of Gutka product came in effect in the state, gutka companies has adopted new ways of promoting raw tobacco packets along with paan masala by putting holding of pan masala product where as they have mentioned that Chhotu is available. When pan masala product name is clearly mentioned in the holdings then, What is Chhotu? Is this not a way of surrogate advertisement and clear violation of Cigarettes and Other Tobacco Products Act, 2003?

Pictorial health warnings on all tobacco products are mandatory by law

We appraise the government ministry of health and family welfares initiative of rotating existing pictorial warnings with newer and effective pictorial warnings on tobacco products from 1 April 2013. Whereas in our interrogation we found few foreign brand cigarettes which have not complied with domestic pictorial warnings. According to the Cigarettes and Other Tobacco Products Act, 2003, all tobacco products being imported in India from other countries should comply with domestic pictorial warning before beings marketed. This means, it is a clear violation of COTPA 2003.

Point of sale advertising of tobacco products

Point of sale means tobacco retail outlets/ shops/ gumtis or anywhere tobacco is being sold from. According to the Cigarettes and Other Tobacco Products Act, 2003, point-of-sale advertisement boards are permitted but shall not exceed 60 cm x 45 cm. Each of these boards should contain the specified health warning occupying the top edge of the board measuring 20 cm x 15 cm and the display boards shall only list the type of tobacco product (beedi, cigarette etc) at the point of sale, without any mention of the brand name or other promotional message or picture.

Sanitation and hygiene

Poor or no waste management increases risk of infectious diseases alarmingly. Piles of garbage in residential colonies in our neighbourhood of Lucknow, needs urgent attention and action from relevant authorities. Plastic waste was also lying recklessly.

Alcohol advertising
When we see an alcohol brand-name on a billboard, which consumer product we relate it to? Alcohol product or a music night, soda water, fashion tour CD music or any other alcohol product? Decide for yourself!

Recommendations
Since in most cases tobacco addiction begins before the age of 18 years, it is imperative to strictly enforce the ban on sale of tobacco to or by minors so that children and youth cannot have access to tobacco. Enforcing the existing law will have very positive public health outcomes as tobacco is the common risk factor for major non-communicable diseases (NCDs) such as heart diseases, stroke, cancer, diabetes, respiratory illnesses among others. The children and youth that are sadly selling tobacco should be in schools in this age of Right To Education (RTE) Act. Very few tobacco shops display the signage that sale of tobacco to minors is banned. The ban on sale of tobacco within 100 yards of any educational institution should be strictly enforced this will limit access to tobacco for minors and delay (or reduce the chances of) the onset of tobacco addiction. The sale of International brands of cigarettes in Lucknow such as Gudang Garam from Indonesia, Marlboro and other brands raises a serious question if they are legally imported in India then they must abide by Indian tobacco control laws (such as print pictorial warnings in Indian languages as per Indian law) and if they are not legally imported then not only India is losing on health of its citizens but also on revenues. Is this tobacco smuggling? It is the responsibility of the authorities to find this out and take legal action as early as possible in interest of public health. We appeal to the government authorities to seize such tobacco and take appropriate action against those responsible. We need to ensure that all advertisement of non-tobacco product containing paan masala should not promote any indirect message to promoting tobacco products. As banner of paan masala stating Chhotu is available should be removed and stringent action must be taken against the violators. We need stronger laws to ensure that non-alcohol products with same brand name as that of alcohol products should not be allowed to advertise. We need laws to stop alcohol advertisements under the guise of any other non-alcohol product such as soda water, music nights, etc; which have same brand names as that of alcohol products. When a person sees a brand, which product she or he associates it with, is very important. Waste management in Lucknow should be done with very scientific and evidence based methods so as not to pose any immediate, short term or long term adverse impact to our environment or public health. Government ends up paying much more money in managing diseases borne out of poor sanitation and hygiene than the resources required for proper waste management.

For further information, contact: Dr Sandeep Pandey, Shobha Shukla, Rahul Dwivedi, Bobby Ramakant C-2211, C-block crossing, Indira Nagar, Lucknow-226016. India Phone: +91-9839073355 Email: bobbyramakant@yahoo.com