Hyderabad: A new study published in the Journal of Nicotine and Tobacco Research has, for the first time, quantified the tremendous economic burden of secondhand smoke exposure in India. According to the findings, secondhand smoke causes INR 567 billion in health care costs annually, which accounts for 8 percent of total annual health care expenditures on top of the staggering 1773.4 billion Indian rupees ($27.5 billion) in annual economic burden from tobacco use.
For the first time, this new study sheds light on the immense financial toll of secondhand smoke to the Indian healthcare system. It also finds that the cost of secondhand smoke disproportionately affects India’s most vulnerable populations, including women, youth, and those with lower incomes. Researchers from the Rajagiri College of Social Sciences used public data sources and a prevalence-based attributable risk approach to quantify the healthcare cost of continued exposure to secondhand smoke among non-smokers aged 15 and older. The INR 567 billion figure represents only one part of the total economic costs of secondhand smoke exposure. It does not include the additional indirect economic costs due to lost productivity, morbidity, and mortality caused by illness and early deaths arising from secondhand smoke exposure that would further increase the final figure.
“The findings demonstrate the terrible economic toll that secondhand smoke takes on both the Indian health care system and the secondhand smoke exposed to non-smokers. Those most affected by these costs are often the most economically vulnerable – women, young people, and those with lower incomes. Action must be taken to reduce the health and economic impact of secondhand smoke in India,” according to Dr Rijo John, health economist and adjunct professor, Rajagiri College of Social Sciences, Kochi, author of the study.
Dr.Rijo John further added that secondhand exposure continues to be high in India because of the vast number of smokers and the gaps in India’s smoke-free law that still allow Designated Smoking Areas in public places like restaurants, bars, hotels, and airports. Both recommend that India strengthen its laws to effectively protect non-smokers from the health and economic impact of secondhand smoke.
Smoking and exposure to secondhand smoke kill nearly 1.2 million Indians each year. With more than 100 million smokers in India, non-smokers are exposed to secondhand smoke at home, at work, and in public places. There is no known safe level of exposure to secondhand smoke, a deadly mix of more than 7,000 chemicals that are known to cause premature death and disease in children and adults who do not smoke.
According to Dr K Sreekanth, Senior Consultant Surgical Oncologist, Yashoda Hospitals, Somajiguda, “While India has made progress in reducing tobacco use, smoking continues to impose a drastic health and economic burden. India can save millions of lives and reduce this overwhelming burden through stronger tobacco control policies. Strengthening the Cigarette and Other Tobacco Products Act to remove all designated areas from public places and raising taxes on all tobacco products will motivate millions of Indians to quit and prevent youngsters from initiating tobacco use.
The Government of India introduced the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) (Amendment) Bill, 2020, on January 1, 2021. Public comments were invited on the draft bill. The Ministry of Health & Family Welfare, Govt. of India needs to immediately introduce the bill in the Parliament if it wants to check the tobacco consumption and the related economic, social and death burden.
“I applaud the Government of India for starting the amendment process of tobacco control law COTPA 2003 as this is an important step towards improving public health. There is an urgent need to strengthen the provisions for making India 100 percent smoke free and protect millions of Indians from tobacco related diseases and deaths” said Dr Venkat Rao, State Project Manager, Voluntary Health Association of India.
India has the second largest number of tobacco users (268 million or 28.6% of all adults in India) in the world – of these at least 1.2 million die every year from tobacco related diseases. One million deaths are due to smoking, with over 200,000 due to second-hand smoke exposure, and over 35,000 are due to smokeless tobacco use. Nearly 27% of all cancers in India is due to tobacco usage. The total direct and indirect cost of diseases attributable to tobacco use was a staggering Rupees 182,000 crore which is nearly 1.8% of India’s GDP. Tobacco use in all forms, whether smoking or chewing, is associated with severe COVID-19 casualties as per advisories issued by the Ministry of Health and Family Welfare and ICMR.