The Union Minister of Health & Family Welfare, Shri Ghulam Nabi
Azad has said that while livelihood of tobacco growing farmers cannot be
endangered, we must work towards moving famers and farm workers out of the
tobacco industry. ‘We cannot
indefinitely tolerate a public health hazard in the name of protecting
livelihoods’, the Minister said after releasing the report of the first Global
Adult Tobacco Survey (GATS) – India 2010, here today.
Emphasizing the need for inter-sectoral
coordination for comprehensive tobacco control strategies, Shri
Azad informed about collaborations with Agriculture Ministry for a project on
alternative crops to tobacco and coordination with other stakeholders
Ministries such as Human Resource Development, Information and Broadcasting,
Rural Development and Labour Ministry. Speaking on the occasion, the Minister of
State, Shri Dinesh Trivedi called for clearer pictorial warnings and emphasis on
monitoring chewing tobacco use. He also
emphasized the need for alternative crops to tobacco. Minister of State, Shri
S. Gandhiselvan stressed the need for increasing
awareness among the people to combat the menace of tobacco use.
India provides information on both, tobacco smoking and use of smokeless
tobacco along with varied dimensions of tobacco use including use of different
tobacco products, frequency of use, age at the time of initiation and the
like. Additionally the report throws
light on the other aspects of tobacco use like, exposure to second-hand smoke;
cessation; the economies of tobacco; exposure to media messages on tobacco use;
and knowledge of health impact of tobacco use.
GATS India Highlights
Current tobacco use in any
form: 34.6% of adults; 47.9% of males and 20.3% of females
Current tobacco smokers: 14.0%
of adults: 24.3% of males and 2.9% of females
Current cigarette smokers: 5.7%
of adults: 10.3% of males and 0.8% of females.
smokers: 9.2% of adults: 16.0% of males and 1.9% of females.
Current users of smokeless
tobacco: 25.9% of adults: 32.9% of males and 18.4% of females.
Among daily tobacco users,
60.2% consumed tobacco within half an hour of waking up
Average age at initiation of
tobacco use was 17.8 with 25.8% of females starting tobacco use before the age
Among minors (age 15-17), 9.6%
consumed tobacco in some form and most of them were able to purchase tobacco
Five in ten current smokers (46.6%)
and users of smokeless tobacco (45.2%) planned to quit or at lease thought of
Among smokers and users of
smokeless tobacco who visited a health care provider, 46.3% of smokers and 26.7%
of users of smokeless tobacco were advised to quit by a health care provider
About five in ten adults
(52.3%) were exposed to second-hand smoke at home and 29.0% at public
places(mainly in public transport and restaurants)
About two in three adults
(64.5%) noticed advertisement or promotion of tobacco products.
Three in five current tobacco
users (61.1%) noticed the health warning on tobacco packages and one in three
current tobacco users (31.5%) thought of quitting tobacco because of the
In view of the high
prevalence of tobacco use in the country, there should be a national effort to
prevent any further increase in the prevalence of tobacco use, especially among
the vulnerable groups such as females, youth and children. There should also be targeted programmes addressing different types of tobacco use and
different user groups with special focus on cessation. There is a need to further strengthen the
implementation of Cigarettes and Other Tobacco Products (Prohibition of
Advertisement and Regulation of Trade and Commerce, Production, Supply and
Distribution) Act, 2003, at national, state and sub-state levels. Establishment of a comprehensive
implementation and regulatory structure at the national and state level is
Tobacco control strategies need to be mainstreamed with
other national health programmes, within the overall
framework of the National Rural Health Mission (NRHM). The multifaceted nature of tobacco problem in
for greater involvement and investment of various stakeholder
ministries/departments, eg. Human Resource
Development (Education), Finance, Agriculture, Labour,
Commerce, Rural Development, Information & Broadcasting, Women & Child,
etc. in addition to the Ministry of Health & Family Welfare, as also the Panchayati Raj Institutions, academic/public health
institutions, civil society groups, media, etc.
Findings from GATS India have
added substantially to the knowledge about the tobacco use status of India’s
population and will be a valuable source of information for strengthening and
modifying tobacco control policies and tobacco control and prevention programmes in the country.
use is a major preventable cause of death and disease causing 1 in 10 deaths
among adults worldwide. Approximately
5.5 million people die every year (globally), out of which close to 0.9 million
deaths occur in India due to
diseases related to tobacco use.
Majority of the cardiovascular diseases, cancers and chronic lung
diseases are directly attributable to tobacco consumption. Almost 40 percent of tuberculosis deaths in
the country are associated with smoking.
In India, both
smoking and smokeless tobacco use is prevalent.
A varied range of chewing and smoking forms of tobacco available at
different price points, reflect the varying socio-economic and demographic
patterns of tobacco us in the country.
Smoking tobacco products, include, bidis,
manufactured and hand-rolled cigarettes, pipes, cigars, hookah, water pipes and
other locally produced smoking tobacco products, e.g. chuttas,
dhumti and chillum, etc. Smokeless tobacco is used either by chewing,
applying to the teeth and gums, or sniffing.
Smokeless tobacco products used in India
include chewing tobacco products such as betel quid with tobacco, khaini, gutkha, paan masala, and other such products
like mishri, mawa, gul, bajjar, gudakhu,
India is the
second largest consumer of tobacco products and third largest producer of
tobacco in the world. The Adult Tobacco
Survey (ATS) is an important component of the country’s comprehensive tobacco
control programme and reflects an efficient and
systematic surveillance mechanism to monitor the tobacco epidemic through
collection of baseline data and study of key tobacco control indicators.
In order to arrive at an accurate level of prevalence of
tobacco use by age groups, gender and place of residence, a number of surveys
including the National Family Health Survey III (2005-2006), National Sample
Survey Organization (NSSO) 1995-1996 and Sample Registration System (SRS –
2004) were conducted in the country.
However, except the Global Tobacco Surveillance System (GTSS), tobacco
use per se was not the focus in all these surveys.
The survey was conducted under the stewardship of the
Ministry of Health and Family Welfare, Government of India, with the
International Institute for Population Sciences, Mumbai, an
autonomous organization of MoHFW acting as the nodal
agency. Technical assistance was
provided by the Centres for Disease Control and
Prevention (CDC), the World Health Organization (WHO), the Johns Hopkins
Bloomberg School of Public Health, and RTI International.
The Global Adult Tobacco Survey India (GATS India) was
carried out in all six geographical regions for both urban and rural areas of
29 states of the country and the two Union Territories of Chandigarh and Puducherry covering about 99.9 per cent of the total
population of India. The survey is based on a sample of households
which is representative at the national and state levels. GATS India
conducted interviews with 69,296 adults age 15 and above, 33,767 men and 35,529
women age 15 and above. GATS India is
unique in terms of its large sample size of 72,000 households and key survey
activities having been carried out in 19 languages. The standard GATS questionnaire was adapted to
on the prevailing pattern of tobacco use in the country and experiences from
previous surveillance of tobacco use in the country. This is the first time that hand-held
computers were used for conducting the survey.
GATS India is a
household survey of all Indian residents, age 15 and above, living in their
primary residence prior to the survey date.
The institutional population comprising of those living in collective
living places like, students’ dormitories, hospitals, hotels, prisons, military
barracks, etc. is not included in the survey.
The participation in the survey was purely voluntary.
The major objectives of the survey are as mentioned
to obtain estimates of
prevalence of tobacco use (smoking and smokeless tobacco)
exposure to second-hand smoke;
the economics of tobacco
media messages and knowledge, attitudes and perceptions towards tobacco use.
health impact of tobacco use.