National Tobacco Control Programme

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National Tobacco Control Programme Dr. Jagdish
Kaur Chief Medical Officer Directorate General of
Health Services Ministry of Health Family
Welfare Government of India jagdish.kaur_at_nic.in
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Nearly Two-Thirds of Worlds Smokers Live in Just
10 Countries
Source MPOWER package, 2008
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Constituents of Tobacco Smoke
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Most Recent Scientific Evidence Active Smoking
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Diseases and Adverse Health Effects Caused by SHS
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TOBACCO USE IN INDIA
Prevalence of tobacco use
Source NFHS 3, 2005-06
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National Family Health Survey III, 2005-06

• High prevalence among poor vulnerable sections
• 35 of rural men smoke in comparison to 29 urban
  men
• Prevalence of any tobacco use
• Men 57 Women 10.8
• Currently smoke (Cigarette/Bidi)
• Men 36.5, Women 8.4
• 8.5 of pregnant women use tobacco
• gt8/10 men in Mizoram consume some form of tobacco

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Tobacco

• Tobacco Kills

• Issues involved
• Health
• Social
• Cultural
• Economic
• Environmental

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Tobacco Control Initiatives

• Legislations by state govts.
• Tobacco Control Act , 2003.
• Ratification of FCTC, 2004.
• Awareness campaign/ WNTD activities
• Setting up of Tobacco Cessation Clinics

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Challenges

• Second largest consumer, third largest producer
• Various forms of tobacco products in use in
  different regions of the country
• More prevalent among persons with low literacy
• Part of socio-cultural aspect in many regions

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Challenges

• Low awareness regarding health effects of tobacco
  use and indulgence in tobacco product
  manufacturing
• Low awareness regarding legislation
• Low awareness regarding basic rights
• Poverty prone to exploitation

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National Tobacco Control Program

• Pilot Phase (2007-08)
• 9 states (18 districts)
• Assam - Jorhat and Kamrup (Metro)
• M.P. - Gwalior and Khandwa
• Tamil Nadu - Villupuram and Kanchipuram
• Delhi - New Delhi and East Delhi
• Gujarat - Surat and Anand
• West Bengal Murshidabad and Coochbehar
• U.P. Kanpur and Lucknow
• Rajasthan Jaipur and Jhunjunu
• Karnataka - Gulbarga and Bangalore (urban)

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New Proposed States

• Andhra Pradesh Sikkim
• Arunachal Pradesh Orissa
• Uttarakhand Nagaland
• Goa Tripura
• Jharkhand Maharashtra
• Mizoram Bihar

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National Tobacco Control Program
MoHFW
State Tobacco Control Cell
District Tobacco Control Units
IEC
Monitoring tobacco control laws reporting
Tobacco Cessation
Training
School Programs
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Main Components

• Setting up of State/district level tobacco
  control cells
• Establishment of tobacco products testing labs
• IEC/Mass media campaign
• Research and Training
• Monitoring and Evaluation

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State Tobacco Control Cell

• Manpower
• 1 Consultant
• 1 Program Assistant

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State Action Plan

• Reporting violations of any provisions of the Act
  and taking appropriate action.
• Regular monitoring to keep a check on and prevent
  smoking in public places.
• Ensuring ban on sale of tobacco products to
  minors and sale around educational institutions.
  Boards/signage to be duly installed.
• Ensuring removal/confiscation of hoardings and
  other material which amount to advertisement of
  tobacco products etc.
• Develop State/Dist. specific IEC Strategy/media
  plan.

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District Tobacco Control Cell

• Manpower
• 1 Social Worker
• 1 Psychologist

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District Tobacco Control Program

• Training Training of School teachers, health
  workers, health professionals, law enforcers,
  NGOs, women SHGs on tobacco control measures

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District Tobacco Control Program

• IEC Local/Folk media, BCC strategies, in
  collaboration with NGOs/CBOs/SHGs/PRIs. IEC
  material being updated/prepared.

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District Tobacco Control Program

• School Program involving awareness/education
  campaigns, training of school teachers, Tobacco
  Free Schools initiatives. Guidelines for NGOs
  issued.

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District Tobacco Control Program

• Monitoring - Formation of District level
  committees/District Action Plans for Enforcement
  of Tobacco Control Laws, evolving district
  specific monitoring and implementation
  mechanisms.
• Tobacco Cessation Centres Extending cessation
  facilities to the community level.

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Integration with ongoing progms

• National Rural Health Mission
• National Cancer Control Program
• RNTCP
• School Health Program
• National Mental Health Program
• CVD/stroke/DM control program.

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Do-ables

• Establishing State/District Tobacco cells
• Awareness generation/advocacy
• Training
• Establishment of enforcement mechanism for
  implementation of smoke free rules
• Tobacco Free Schools
• Smoke Free hospitals/work places/campuses
• Tobacco Cessation Centres/facility

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Other measures

• Highlight successes and failures of every
  department/organization.
• Provide for non-monetary incentives such as
  commendation letters, etc.
• Mainstream the Rules and regulations in regular
  training/Orientation of officers and staff
  working in any Public place.
• Encourage the vast majority of non smokers, to
  recognize their right to life and health
• Take stock of situation by holding regular
  meetings of State / District level Monitoring
  Committees.

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• Let us all work together to fulfill the vision
  of a healthy, Tobacco Free India