India scores high in graphic health warnings, cessation bans: WHO report on global tobacco use
Health warnings are an effective way to help people quit tobacco use and India is among the countries identified as having best-practice-level graphic health warning labels in 2024, showed a WHO report released on Monday.
The World Health Organisation's Global Tobacco Epidemic 2025 report, which focusses on measures to warn people about the harms of tobacco, revealed that the most striking gains have been in graphic health warnings, one of the key measures under the WHO Framework Convention on Tobacco Control (FCTC).
The report focuses on six proven WHO MPOWER tobacco control measures to reduce tobacco use, which claims over seven million lives a year.
A total of 110 countries now require these measures — up from just nine in 2007 — protecting 62 per cent of the global population; and 25 countries have adopted plain packaging. Currently, 110 countries with a total of five billion people are protected by strong graphic health warnings. This is an increase of 101 countries and 4.7 billion people since 2007.
Of all MPOWER measures, large graphic health warnings on cigarette packages have seen the most progress since 2007 – both in terms of the number of countries and population covered by a best-practice policy. Not only are more countries adopting graphic health warnings, but the average size of warnings has increased from 28 per cent in 2007 to almost 60 per cent in 2024.
Dr Vinayak Mohan Prasad, head of the Global Tobacco Control Programme, at the World Health Organisation's (WHO) headquarters in Geneva, told The Indian Express that India has achieved the highest status in O and W (both in 2016) and is in the second highest category of other measures, including M (mass media). 'Health warnings on cigarette packs are among the largest in the world at 85 per cent. Only 10 countries have a larger graphic health warning,' he said.
While WHO officials said daily adult smoking prevalence in India was seven per cent in 2023, they have not made estimates for smokeless tobacco use. According to Dr Prasad, the prevalence of current tobacco use among adults in the country is trending down and is on track to meet the 2025 Non-Communicable Disease (NCD) GAP target.
'However, prevalence is still higher than the global average. The largest population survey (National Family Health Survey 2021) shows 38 per cent of men and nine per cent of women are current users of tobacco while the global average in 2021 was 35 per cent among men and eight per cent among women,' said Dr Prasad.
He explained that smoking rates were lower than smokeless tobacco use among adults. Among children aged 13-15 (Global Youth Tobacco Survey-2019), eight per cent are using tobacco with little difference between boys and girls.
Where India stands
Meanwhile, India has banned smoking at all indoor public places, but still allows designated smoking rooms at restaurants/drinking facilities/nightclubs with a seating capacity of 30 or more as well as at airports and hotels.
On the ˋW' measure, India has been in the highest group since 2016. Large pictorial warnings (85 per cent) are required on tobacco product packages and India should also consider adopting plain packaging, said Dr Prasad.
On the 'E' measure, India has banned direct and indirect tobacco advertising, promotion and sponsorships. However, there is no ban on internet sales and India should completely ban advertising of tobacco products at points of sale, the expert urged. The WHO report also warned that action is needed to maintain and accelerate progress in tobacco control as rising industry interference challenges tobacco policies and control efforts.
At a press conference, Dr Ruediger Krech, Director of Health Promotion, WHO, said significant strides have been made in protecting people from the harms of tobacco.
'Today, over 6.1 billion people, three -quarters of the global population, are covered by at least one life saving policy. Brazil, Mauritius, The Netherlands and Turkey have implemented the full MPOWER package. Seven more, including Ireland , Ethiopia and Mexico, are just one step away,' said Dr Krech.
However, Dr Krech also cautioned about some of the warning signs as 134 countries have failed to make cigarettes less affordable and the spread of e-cigarettes and tobacco products are being aggressively marketed to youngsters. 'We are calling on governments to act boldly and raise taxes to best practice levels,' he urged.
Tobacco tax least adopted MPOWER measure in India
India has implemented stringent measures to curb tobacco advertising, promotion and sponsorship (TAPS) across all forms of media, including television, radio, print and digital platforms. To restrict depiction of tobacco use in entertainment media, the Centre introduced the Tobacco-Free Films and Television Rules in 2012, focusing on traditional platforms such as cinema and television.
As more people shift towards using digital streaming platforms, India recognized the need to update its tobacco control policies. Coinciding with World No Tobacco Day on May 31, 2023, the government introduced an amendment to the 2012 legislation, extending its coverage to over-the-top streaming platforms. With this move, India became the first country in the world to apply tobacco control regulations specifically to digital streaming content.
The WHO report said that India is reinforcing its commitment to public health and positioning itself as a pioneer in adapting regulation to evolving media consumption trends. However, the current national TAPS ban can be further strengthened by prohibiting tobacco advertising at points of sale and fully banning tobacco industry sponsorship.
Tobacco tax is the least-adopted MPOWER measure, despite raising tobacco prices continuing to be the most effective and efficient way to reduce tobacco use. In India, cigarettes are still affordable, as per the report. In 2024, only 15 per cent of the world's population living in 40 countries were protected by tax at 75 per cent or more of the price of the most popular brand of cigarette.
Anuradha Mascarenhas is a journalist with The Indian Express and is based in Pune. A senior editor, Anuradha writes on health, research developments in the field of science and environment and takes keen interest in covering women's issues. With a career spanning over 25 years, Anuradha has also led teams and often coordinated the edition.
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