New Delhi

The Indian Council of Medical Research (ICMR) has announced a focused strategy to tackle smokeless tobacco use by identifying 100 high-burden districts across 14 states. These districts, which together account for nearly 68% of the country’s users, will see a range of measures aimed at reducing consumption and curbing related health risks.

Smokeless tobacco use in India

According to national health data, over one in five Indians consume smokeless tobacco in various forms, including gutka, khaini, and betel quid with tobacco. Unlike cigarettes, smokeless tobacco products are often chewed or applied to the gums, but they carry equally harmful health consequences.

India records more than 3.8 lakh deaths annually linked to smokeless tobacco, with men accounting for around 2.37 lakh of these fatalities. The products are a major cause of oral and throat cancers, coronary heart disease, and chronic respiratory illnesses.

Districts identified for action

The National Institute of Cancer Prevention and Research (NICPR), under ICMR, analysed data from the National Family Health Survey-5 (2019–2021) to pinpoint the worst-affected districts. States with the largest concentration of these districts include:

  • Madhya Pradesh: 15 districts

  • Odisha: 14 districts

  • Bihar: 11 districts

  • Uttar Pradesh: 11 districts

  • Gujarat: 10 districts

    • By concentrating efforts in these areas, officials expect to reduce overall national prevalence by a significant margin.

    Target and goals

    The intervention aims to achieve a 30% reduction in smokeless tobacco consumption in the identified districts. If successful, India’s national prevalence could fall from 27.4% to about 22.8%.

    Key measures planned

    The strategy involves both regulatory enforcement and healthcare integration. Measures include:

    • Setting up district-level enforcement task forces trained in tobacco-control laws.

  • Strict enforcement of bans on advertising and sales, particularly near schools.

  • Community-led awareness campaigns using local influencers and peer educators.

  • Integration of tobacco-cessation services into primary healthcare systems.

  • Introducing extended producer responsibility for manufacturers to handle waste and associated public health costs.

    • Health and societal impact

    Experts stress that reducing smokeless tobacco use would not only save lives but also ease the burden on India’s overstretched healthcare system. Oral cancer treatments and other tobacco-related illnesses create a significant financial strain on both families and government-run hospitals.

    Public health specialists note that while the plan is comprehensive, challenges remain. Surrogate advertisements, cultural acceptance of chewing tobacco in certain communities, and easy availability could hamper progress.

    Conclusion

    India’s move to target high-burden districts marks a significant step in addressing smokeless tobacco use, which has long been a silent health crisis. If the programme succeeds, it could serve as a model for tackling other public health challenges with region-specific strategies.