Note: World Lung Foundation united with The Union North America. From January 2016, the combined organization is known as “Vital Strategies.”
(April 2nd, 2015, New Delhi, India and New York, USA) – World Lung Foundation today called on the government of India to dismiss tobacco industry misinformation and implement large graphic health warnings on tobacco packs without further delay, in fitting tribute to the bravery of Sunita Tomar who died yesterday. After a diagnosis of tobacco-related oral cancer and major surgery at the Tata Memorial Hospital, Sunita – with the support of her family – agreed to tell her story in a Public Service Announcement (PSA) to raise awareness of the harms of tobacco and to help prevent others from suffering her fate. World Lung Foundation’s team in India came to know Sunita as it supported the Ministry of Health and Family Welfare in India in the filming of the PSA and the development and launch of the campaign.
Large graphic warnings, like hard-hitting mass media campaigns, are proven to be highly effective in warning people about the health harms of tobacco, irrespective of the audience’s level of literacy. Large graphic warnings also transcend language barriers in countries like India, where different languages and dialects are used across a large national population. In addition, large graphic warnings can play an important role in helping to prevent children from initiating tobacco use. A study published last year in the Journal of Public Health – based upon research in India and several other low and middle income countries – found that current small or text-only warnings on tobacco packs do not help children understand the real harms of tobacco. Critically, the study found that of all the countries surveyed, children in India exhibited the lowest levels of awareness of health warnings on tobacco packs.
Nandita Murukulta, Country Director, India and Director – Global Research and Evaluation, World Lung Foundation, said: “We were saddened to hear of the death of Sunita Tomar yesterday. Sunita was in many ways an Everywoman. From a small town called Bhind in Madhya Pradesh, she married at fourteen, had two young sons, lived with her parents-in-law and aspired for more for her children. Like many women, Sunita began to chew tobacco in the form of an oral dentifrice, ignorant of the lethal effects of a supposed dental hygiene product. Within a few years, she developed oral cancer. Hers is not an uncommon story. Sunita was exceptional in her desire to warn others about the harms of tobacco; to provide them with the information and knowledge she didn’t have; to help them make better, healthier choices.”
Vaishakhi Mallik, Program Manager, India worked closely with Sunita during the filming of the PSA and recalls, “ Sunita was a true fighter. During the filming she was frequently tired and uncomfortable, but she overcame her physical and emotional pain to speak with dignity and clarity to the media, never flinching in the face of all that scrutiny. She wanted to fight for a tobacco free world that would save her children and others from the suffering she experienced.”
Dr. Pankaj Chaturvedi of Tata Memorial Hospital was Sunita’s surgeon and was with her in her final days and hours. He said, “Sunita wanted to see government commitment to tobacco control. To her that meant implementing strong tobacco control measures, including large graphic warnings. It looked like the government had heeded that call, but duplicitous tobacco industry tactics and misinformation – which stand in clear contrast to Sunita’s honesty and bravery – is delaying progress. Sunita believed that Indians deserve to know the truth, and large graphic warnings are one of most effective ways of communicating the reality of tobacco’s harms. Rapid implementation of these warnings, rather than delays motivated by the tobacco industry’s desire to keep it profits high, would be a fitting tribute to this brave woman.”
Tobacco use in India – a growing health and economic problem
According to The Tobacco Atlas, nearly a quarter (23.2%) of adult males, 3.2% of adult females, 5.8% of boys and 2.4% of girls smoke tobacco in India. In addition, more than a quarter (25.9%) of adults use smokeless tobacco. In total, more than 2,542,000 children and more than 120,000,000 adults in India use tobacco each day. As the use of all forms of tobacco has increased, so has tobacco-related disease and premature death. Tobacco is the cause of 14.3% of male deaths and 4.7% of female deaths in India, killing over 981,100 Indian citizens every year. The government of India acknowledges that tobacco-related disease costs the Indian economy over 1.4 trillion rupees every year – just among adults aged between 35 and 69. The total cost across all age groups – including illness caused by tobacco use and exposure to second-hand smoke among children and the elderly – would be higher.
Tobacco use is the leading preventable cause of mortality in the world today, and is responsible for more than five million deaths each year—one in ten preventable deaths worldwide. The implementation of graphic pack warnings is one of the World Health Organization’s M-P-O-W-E-R (W=Warn) strategies to reduce tobacco consumption. MPOWER strategies are endorsed and promoted by the Bloomberg Initiative to Reduce Tobacco Use, of which World Lung Foundation is a principal partner.