Shimkhada Riti, Peabody John W
Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA.
Bull World Health Organ. 2003;81(1):48-52. Epub 2003 Mar 11.
Legislation to control tobacco use in developing countries has lagged behind the dramatic rise in tobacco consumption. India, the third largest grower of tobacco in the world, amassed 1.7 million disability-adjusted life years (DALYs) in 1990 due to disease and injury attributable to tobacco use in a population where 65% of the men and 38% of the women consume tobacco. India's anti-tobacco legislation, first passed at the national level in 1975, was largely limited to health warnings and proved to be insufficient. In the last decade state legislation has increasingly been used but has lacked uniformity and the multipronged strategies necessary to control demand. A new piece of national legislation, proposed in 2001, represents an advance. It includes the following key demand reduction measures: outlawing smoking in public places; forbidding sale of tobacco to minors; requiring more prominent health warning labels; and banning advertising at sports and cultural events. Despite these measures, the new legislation will not be enough to control the demand for tobacco products in India. The Indian Government must also introduce policies to raise taxes, control smuggling, close advertising loopholes, and create adequate provisions for the enforcement of tobacco control laws.
发展中国家控制烟草使用的立法工作一直落后于烟草消费的急剧增长。印度是世界第三大烟草种植国，1990年，在该国65%的男性和38%的女性吸烟的人群中，因烟草使用导致的疾病和伤害累积造成了170万个伤残调整生命年（DALYs）。印度的反烟草立法于1975年首次在国家层面通过，主要局限于健康警示，事实证明力度不够。在过去十年中，越来越多地采用了州立法，但缺乏统一性以及控制需求所需的多管齐下的策略。2001年提出的一项新的国家立法是一个进步。它包括以下关键的减少需求措施：在公共场所禁止吸烟；禁止向未成年人销售烟草；要求更显著的健康警示标签；以及禁止在体育和文化活动中做广告。尽管有这些措施，新立法仍不足以控制印度对烟草产品的需求。印度政府还必须出台提高税收、控制走私、填补广告漏洞以及为执行烟草控制法律制定适当条款的政策。
