Report Card on Implementation of Tobacco Control Laws and other health and development policies in Lucknow

30 May 2012 Youth participants (15) of Rights and Responsibilities Summer Training Camp:
Youth participants of Rights and Responsibilities Training Camp: Abhishek Choudhary, Ankur Verma, Deepak Kumar Mishra, Diya Pandey, Hitesh Pandey, Rakesh, Rupesh Verma, Sanjay Kumar Verma, Shikhar Agarwal, Shikha Srivastava, Sarvesh Shukla, Satyam Tiwari, Shubham Dwivedi, Somya Arora, Udita Chandra.

Faculty for Rights and Responsibilities Summer Training Camp 2012: Professor (Dr) Rama Kant, Dr Sandeep Pandey, Shobha Shukla, Dr Shivani Sharma, Professor (Dr) Gourdas Choudhuri, Biju Mohan, Rahul Dwivedi, Bobby Ramakant
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 pictorial warning law

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’ etc. 4. Chewing gums: We monitored samples of chewing gums being sold in our neighbourhood in Lucknow and listed their content, sugar and other warnings or notifications written on their labels.

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:

Tobacco advertising
We believe non-tobacco products with SAME BRAND NAMES as those of tobacco products should not be allowed to advertise – is this not surrogate advertising? COTPA 2003 bans direct, indirect and surrogate advertising but rulings have loopholes

Pictorial health warnings on all tobacco products are mandatory by law

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, gutkha, etc) at the point of sale, without any mention of the brand name or other promotional message or picture.

Sale of foreign cigarettes violating Indian tobacco control laws
There were no pictorial warnings on some cigarette packets made in foreign countries on some tobacco retail outlets we made a reality check on.

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’, ‘CD music’ or anyother alcohol product? Decide for yourself!

Chewing Gum
We were surprised to note that it nearly forces us to use a magnifying glass to read prints on most chewing gums being sold in Lucknow. Some alarming important notices were printed on labels of chewing gums in very small font size and ‘difficult to read colours’ such as ‘Not Recommended for Children’. Ironically it is the children who are featured with shiny teeth in TV advertisement commercials of that brand.

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 stronger laws to ensure that non-tobacco products with same brand name as that of tobacco products should not be allowed to advertise. For instance, most companies making chewing tobacco also sell non-tobacco containing ‘paan masala’ which is also hazardous to health. We need laws to stop advertisement of ‘paan masala’ and other non-tobacco products which have same brand names as that of tobacco products. When a person sees a brand, which product she or he associates it with, is very important. 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. Chewing gums must prominently display important information such as their ingredients, notices such as ‘not recommended for children’, etc. Font size should be proportionate to that of the brand name and such important information printed in clear, readable, legible, contrast colours, in English and other local vernacular languages. 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

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