In­dia’s smok­ing prob­lem • A lost la­bor re­form op­por­tu­nity in France

Leaf-wrapped and string-tied bidis— not cig­a­rettes—are the way lo­cals light up

Bloomberg Businessweek (Asia) - - CONTENT -

Start­ing in April, the gov­ern­ment of In­dia will re­quire that cig­a­rette packs be largely cov­ered in graphic warn­ing la­bels. That’s smart; in other coun­tries, such warn­ings have ef­fec­tively pushed smok­ers to quit. The trou­ble is that cig­a­rettes aren’t In­dia’s big­gest to­bacco prob­lem.

Most In­di­ans who smoke light up a much cheaper, un­fil­tered prod­uct called a bidi: shred­ded to­bacco wrapped in a tendu, or ebony, leaf and tied with a string. Pop­u­lar among the poor—a pack can cost as lit­tle as 10¢—bidis in 2009 ac­counted for 85 per­cent of smoked to­bacco in In­dia. They have lower to­bacco con­tent than cig­a­rettes, but more nico­tine, tar, and car­bon monox­ide. Stick for stick, they’re dead­lier.

Yet suc­ces­sive gov­ern­ments have shied away from dis­cour­ag­ing bidi smok­ing. The new law re­quires warn­ing la­bels on only one side of bidi packs. And bidis are barely taxed. As of 2013, the ex­cise bur­den on bidis barely topped 5 per­cent; the World Health Or­ga­ni­za­tion rec­om­mends 70 per­cent. (Na­tional ex­cise taxes on cig­a­rettes, at less than 40 per­cent of the re­tail price, could stand to be some­what higher, too.) Hand­made bidis are taxed even less than ma­chine-made ones, and those made by the small­est pro­duc­ers are ex­empt al­to­gether. This en­cour­ages a sprawl­ing ru­ral in­dus­try in which women roll bidis at home for lit­tle pay.

De­fend­ers say higher taxes would make bidis un­af­ford­able to the poor­est In­di­ans. But that’s pre­cisely how a tax would ben­e­fit pub­lic health. In­dia has the world’s sec­ond-largest pop­u­la­tion of smok­ers af­ter China—more than 100 mil­lion peo­ple —and more than a mil­lion to­bacco-re­lated deaths each year. In 2011 the Min­istry of Health and Fam­ily Wel­fare es­ti­mated that the eco­nomic cost at­trib­ut­able to to­bacco use had reached $22.4 bil­lion, more than the cen­tral and lo­cal gov­ern­ments spent on health care that year.

Yet in In­dia, un­like in the U.S. and Europe, the num­ber of smok­ers con­tin­ues to grow. And fewer than 5 per­cent

of adult smok­ers in In­dia ever quit.

To get them to kick their habit, two things must change. First, bidis need to be brought out of the shad­ows to make them more tax­able. Elim­i­nat­ing the distinc­tion be­tween hand­made and ma­chine-rolled sticks would drive pro­duc­tion into fac­to­ries, where out­put could be ac­cu­rately mea­sured. And to­bacco grow­ers should be re­quired to re­port sales, and bidi­mak­ers to re­port pur­chases. Un­branded bidis—which ac­count for more than half of pro­duc­tion—should be banned out­right.

Then, taxes on bidis should be raised dras­ti­cally. Stud­ies sug­gest a 10 per­cent rise in prices could cut bidi con­sump­tion by more than 9 per­cent. Rais­ing bidi taxes to 98 ru­pees (around $1.50) per 1,000 sticks could pre­vent more than 15 mil­lion pre­ma­ture deaths, the WHO es­ti­mates.

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