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National Tobacco Control Programme


WORLD ANTI-TOBACCO DAY

Tobacco has been identified as the foremost cause of death and disease that is entirely preventable. Globally tobacco use is responsible for deaths of nearly 6 million people. As per WHO, if current trends continue, by 2030 tobacco use will kill more than 8 million people worldwide each year. It is estimated that 80 % of these premature deaths will occur among people living in low - and middle - income countries. Over the course of the 21 st century, tobacco use could kill a billion people or more unless urgent action is taken.


Nearly 8 - 9 lakh people die every year in India due to diseases related to tobacco use and as per the report of Indian Council of Medical Research (ICMR), nearly 50% of cancers in males and 25% cancers in females in India are directly attributed to tobacco use. Global Adult Tobacco Survey (GATS) 2009 - 10, conducted in the age group of 15 years and above 47.8% men and 20.3% women consume tobacco in some form or other.


Tobacco use is one of the main risk factors for a number of chronic diseases, including cancer, lung diseases, and cardiovascular diseases. India is the 2nd largest producer and consumer of tobacco and a variety of forms of tobacco use is unique to India. Apart from the smoked forms that include cigarettes, bidis and cigars, a plethora of smokeless forms of consumption exist in the country.

In order to protect the youth and masses from the adverse effects of tobacco usage, second hand smoke (SHS) and to discourage the consumption of tobacco the Government of India has enacted the national tobacco-control legislation namely, “The Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003” in May, 2003. India also ratified the WHO-Framework Convention on Tobacco Control (WHO-FCTC) in February 2004. Further, in order to facilitate the effective implementation of the Tobacco Control Law, to bring about greater awareness about the harmful effects of tobacco as well as to fulfill the obligations under the WHO-FCTC, the Ministry of Health and Family Welfare, Government of India launched the National Tobacco Control Programme (NTCP) in 2007- 08 in 42 districts of 21 States/Union Territories of the country.

Currently, the Programme is being implemented in all States/Union Territories covering over 600 districts across the country.

The main thrust areas for the NTCP are as under:

  • Training of health and social workers, NGOs, school teachers, and enforcement officers;

  • Information, education, and communication (IEC) activities;

  • School programmes;

  • Monitoring of tobacco control laws;

  • Coordination with Panchayati Raj Institutions for village level activities;

  • Setting-up and strengthening of cessation facilities including provision of pharmacological treatment facilities at district level.

NTCP is implemented through a three-tier structure, i.e. (i) National Tobacco Control Cell (NTCC) at Central level (ii) State Tobacco Control Cell (STCC) at State level & (iii) District Tobacco Control Cell (DTCC) at District level. There is also a provision of setting up Tobacco Cessation Services at District level.

NTCP has resulted in provision of dedicated funds and manpower for implementation of the Programme. State/District Tobacco Control components viz. STCC and DTCC Plan have been subsumed in the Flexi-pool for Non- Communicable Disease (NCDs) under National Health Mission (NHM) for effective implementation since 12th Five Year Plan.

Currently, the Programme is being implemented in all 36 States/Union Territories covering around 612 districts across the country.


Program objectives are following:

  • Public awareness/mass media campaigns for awareness building and behaviour change.

  • Establishment of tobacco product testing laboratories, to build regulatory capacity, as required under COPTA, 2003.

  • Mainstreaming the program component as a part of the health delivery mechanism under the National Rural Health Mission framework.

  • Mainstreaming Research & training on alternate crops and livelihood in collaboration with other nodal Ministries.

  • Monitoring and Evaluation including surveillance e.g. Global Adult Tobacco Survey (GATS) India.

Objectives

  1. To bring about greater awareness about the harmful effects of tobacco use and Tobacco Control Laws.

  2. To facilitate effective implementation of the Tobacco Control Laws.

  3. The objective of this programme is to control tobacco consumption and minimize the deaths caused by it. The various activities planned to control tobacco use are as follows:

  • Training and Capacity Building

  • IEC activity

  • Monitoring Tobacco Control Laws and Reporting

  • Survey and Surveillance

National Tobacco Control Cell (NTCC)

The National Tobacco Control Cell (NTCC) at the Ministry of Health and Family Welfare (MoHFW) is responsible for overall policy formulation, planning, implementation, monitoring and evaluation of the different activities envisaged under the National Tobacco Control Programme (NTCP). The National Cell functions under the direct guidance and supervision of the programme in-charge from the MoHFW i.e. Joint Secretary. The technical assistance is provided by the identified officers in the Directorate General of Health Services. The programme broadly envisages;

National level:

  • Public awareness/mass media campaigns for awareness building and behavioural change

  • Establishment of tobacco product testing laboratories.National level:

  • Mainstreaming research and training on alternative crops and livelihood with other nodal Ministries.

  • Monitoring and evaluation including surveillance

  • Integrating NTCP as a part of health-care delivery mechanism under the National Health Mission framework.

State Level:


Dedicated State Tobacco Control Cells for effective implementation and monitoring of tobacco control initiatives. The key activities include;

  • State Level Advocacy Workshop

  • Training of Trainers Programme for staff appointed at DTCC under NTCP.

  • Refresher training of the DTCC staff.

  • Training on tobacco cessation for Health care providers.

  • Law enforcers training / sensitization Programme


District Level:


Dedicated District Tobacco Control Cells for effective implementation and monitoring of tobacco control initiatives. The key activities include;

  • Training of Key stakeholders: health and social workers, NGOs, school teachers, enforcement officers etc.

  • Information, Education and Communication (IEC) activities.

  • School Programmes.

  • Monitoring tobacco control laws.

  • Setting-up and strengthening of cessation facilities including provision of pharmacological treatment facilities at the district level.

  • Co-ordination with Panchayati Raj Institutions for inculcating concept of tobacco control at the grassroots.

Benefits of quitting tobacco

  • In 8 hours: Oxygen levels return to normal.

  • In 24 hours: Risk of heart attack begins to decrease.

  • In 72 hours: Lung function improves.

  • In 1-9 months: Coughing and shortness of breath decreases.

  • In 12 months: Risk of heart disease is half as compared to tobacco user.

  • In 5 years: Stroke risk is reduced.

  • In 10 years: Risk of lung cancer is less than half as compared to tobacco user.

  • In 15 years: Risk of heart disease is similar to a person who never smoked.

  • Reduced risk of diseases attributable to tobacco use

  • Reduced health care expenditure means more money for other essential expenditures

  • You become a role model for your children as well as for your society


Major Achievements

  • The prevalence of tobacco use has reduced by six percentage points from 34.6% to 28.6% during the period from 2009-10 to 2016-17. The number of tobacco users has reduced by about 81 lakh (8.1 million).

  • The Government launched the National Tobacco Cessation Quitline Services (1800-112-356) which aims to guide tobacco addicts to quit tobacco.

  • Large specified health warnings on tobacco products covering 85% on both side of the principal display area of tobacco product packs and inclusion of Quitline Number (1800112356) in the specified health warnings for creating awareness among tobacco users, and give them access to counseling services to effect behavior change.

  • 'mCessation' initiative is being supported by Ministry to support tobacco users towards successful quitting through text-messaging via mobile phones (011 22901701).

  • Regulation of the use of Cigarettes and other tobacco products in films and TV programmes.

  • Acceded to the Protocol to Eliminate Illicit Trade in Tobacco Products under the Article 15 of WHO FCTC.

  • Issued an Advisory to ban Electronic Nicotine Delivery System (ENDS) including e-Cigarettes, Heat-Not-Burn devices, Vape, e-Sheesha, e-Nicotine Flavoured Hookah, and the like devices that enable nicotine delivery except for the purpose & in the manner and to the extent, as may be approved under the Drugs and Cosmetics Act, 1940 and Rules made thereunder.

  • Established three National Tobacco Testing Laboratories

  • Enacted The Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement) Act, 2019


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