Tobacco control in India: present scenario and challenges ahead.

Tobacco imposes a colossal burden of disease and death leading to catastrophic health, social, economic and environmental effects. Prevalence and practices of tobacco use in India are varied and disparate. Tobacco consumption continues to grow at 2-3% per annum, and by 2020 it is predicted that it will account for 13% of all deaths in the country. India is now demonstrating a steely resolve to contain the menace of tobacco through a comprehensive control strategy that combines several demand and supply reduction measures. India's anti-tobacco legislation, first passed at the national level in 1975, was largely limited to health warnings and proved to be inefficient. The 'Cigarettes and Other Tobacco Products Bill, 2003' represented an advance in tobacco control. It included demand reduction measures like 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. India, as a signatory to FCTC, is actively involved in combating the menace of tobacco with renewed fervor. There is a need to devise innovative methods of mobilizing financial and human resources for tobacco control, establish efficient national coordinating mechanisms, integrate tobacco control into health and development programs and periodically evaluate these activities. The Government must also introduce policies to raise taxes, control smuggling, close advertising loopholes, and create adequate provisions for the enforcement of tobacco control laws.