Delhi is the latest among the dozen-odd states that have clamped a welcome ban on the production, sale and consumption of gutka and other flavoured, chewable tobacco-based products. These bans aren’t precisely successful anywhere; these products continue to be readily available under the counter at most places. In other words, their purpose is not being served — but states have had to forgo revenue accruing from the Rs 20,000-crore gutka industry anyway. Chewable tobacco and other ingredients in gutka and its variants, such as pan masala, khaini and zarda, can cause cancer of the oral cavity, throat and oesophagus — besides hypertension, peptic ulcers and even heart trouble. Their consumption is linked, also, with stomach problems, appetite loss, restlessness and insomnia. Unsurprisingly, India has a very high incidence of such cancers since the country is home to over 80 per cent of the world’s smokeless tobacco consumers — in addition to, of course, an ever-swelling population of smokers.
The major states that have proscribed gutka, albeit with poor results, include Maharashtra, Madhya Pradesh, Bihar, Rajasthan and Kerala, among others. However, Uttar Pradesh, one of the largest producers of gutka, with over a quarter of its population also consumers of this harmful product, is yet to fall in line. This aside, Odisha, where the consumption of non-smoking tobacco is believed to be the single-largest cause of cancer, is yet to take a call on curbing its production and use. Unless these and the other states where the gutka industry thrives prohibit the manufacture and sale of gutka products and check their smuggling to other areas, the bar on the consumption of non-smoking tobacco cannot succeed anywhere. Delhi’s ban runs a particularly high risk of failure, as the neighbouring UP district of Ghaziabad is one of the largest hubs of gutka production. The Union health ministry, therefore, suggested a nationwide ban on gutka during the recent review meeting on the National Rural Health Mission.
Like any such drastic measures, a nationwide gutka ban could have unexpected and unplanned-for results. One possibility is the emergence of surrogate and spurious tobacco products in the market, which could be equally harmful. And, of course, the non-availability of gutka would just drive tobacco addicts to switch to smoking bidis or cigarettes. What next? The total prohibition of tobacco consumption, both chewing and smoking? That would, after all, be the logical next step for the objectives the health ministry has in mind. But that would need far stronger political will than banning gutka — apart from the ability to implement it, and the question of whether it is an intrusion into the private sphere of choice, the revenue implications for governments would be severe. And what would the country do with millions of recovering tobacco addicts coming off their addiction simultaneously? Withdrawal symptoms can be acute in many cases: they include restlessness, anger and frustration besides lack of concentration and sleep. Some cases will require psychological counselling; others treatment at nicotine and tobacco cessation clinics. At present, these facilities are rare and mostly privately owned, and they are definitely priced out of reach for most tobacco consumers. The utility and effectiveness of such bans, therefore, need to be closely questioned.
