The government of Maharashtra, a state in western India, has banned the sale of loose cigarettes and beedis — thin cigarettes made of tobacco wrapped in tendu leaves — with the aim of reducing tobacco use, deemed a health hazard.

The reason behind the ban is that loose cigarettes and beedis, unlike packaged cigarettes, come without a graphic health warning. Now, smokers will have to buy entire packs, which come imprinted with health warnings.

“The role of the image on the pack may have shock value for the first time. After that, people overlook the message,” said Dr. Sylvia Karpagam, a public health physician and researcher. “The messages delivered through TV and other mass media may be more effective for a longer duration than an image on the packs.”

Surveys show that most smokers are aware of the risks involved. Over 90 percent of smokers believe smoking causes serious illness, according to a 2016-17 fact sheet from the Global Adult Tobacco Survey (GATS 2).

India in 2004 ratified the World Health Organization’s Framework Convention on Tobacco Control, regulating the packaging and labeling of tobacco products and product disclosures.

A GATS survey in 2009-10 found that 34.6 of adults (47.9 percent of males and 20.3 percent of females) in India used tobacco in any form. It also states that three in five (61.1 percent) current tobacco users “noticed the health warnings on tobacco packages, and one in three (31.5 percent) current tobacco users thought of quitting tobacco because of the warning label.”

The central state of Chhattisgarh banned the sale of loose tobacco products earlier this year, and the southern state of Karnataka banned them in 2017.

Maharashtra accounts for an average 26.6 percent of total tobacco consumers in the country. In Chhattisgarh the figure is 39.1 percent, and in Karnataka , 22.8 percent, according to information from Statista. The state of Tripura in northeast India accounts for the highest consumption of tobacco at 64.5 percent.

Some argue that the recent ban will result in greater tobacco use, since it forces people to buy whole packs, instead of loose units.

“Usually, when people want to reduce smoking, they are advised to buy one cigarette at a time,” Karpagam said. “If a person has a 10-cigarette pack, they can easily light up whenever they feel like it. But if they had to go out and buy one each time, it would take more effort. Also, single cigarettes work out more expensive than a pack. So, people tend to be more conscious.”

The ban may also be more costly to lower-income consumers who buy loose cigarettes. People who smoke beedis pay between INR 3 and INR 20 (5 cents to 83 cents). A pack of cigarettes costs about INR 300 to 500 ($4 to $7), depending on the brand.

The average monthly expenditure on cigarettes (for daily smokers) is INR 1,192.5 ($16.25), while the average monthly expenditure on beedis (for daily smokers) is INR 284 ($3.87), according to the GATS 2 survey.

“The rise in prices negatively impacts consumption,” said Dr. Pankaj Chaturvedi, a surgeon at Tata Memorial Hospital. “That is why the government raises taxes. Purchase of loose cigarette dilutes the impact of this tax hike.”

Prathmesh Ausekar, a resident of Pune — a city in Maharashtra — believes the aim of measures to reduce consumption can only be achieved if they are implemented at the grassroots level. “Here in Pune, if you go to a small cigarette shop, they will give you a loose cigarette. This goes for every other place.”

Ausekar, who has been smoking for a few years, said he had never properly looked at the graphic warning on the pack. “It is very clear to everyone that smoking is bad for you. In my opinion, the graphic warning doesn’t help.”

Also, he said, “Having cigarettes lying around [in a pack] means you’ll pick up one mindlessly and start smoking.”

Karpagam, the public health doctor, believes increasing the cost of cigarettes might help more than a ban on loose cigarettes.

“How will the government enforce the ban on selling of loose cigarettes by a local vendor? It may just go underground.”

The ban was issued on Sept. under the Cigarettes and Other Tobacco Products Act (2003).

(Edited by Siddharthya Roy and Judy Isacoff.)



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