Women vulnerable to alcohol abuse

 Women are more vulnerable to many sided health hazards of alcohol. According to the WHO status report on health and alcohol, “there is evidence that women may be more vulnerable to alcohol-related harm from a given level of alcohol use or a particular drinking pattern.

omen are more vulnerable to many sided health hazards of alcohol. According to the WHO status report on health and alcohol, “there is evidence that women may be more vulnerable to alcohol-related harm from a given level of alcohol use or a particular drinking pattern. The vulnerability of females to alcohol-related harm is a major public health concern because alcohol use among women has been increasing steadily in line with economic development and changing gender roles and because it can have severe health and social consequences for newborns….

However, for health outcomes such as cancers, gastrointestinal diseases or cardiovascular diseases, the same level of consumption leads to more pronounced outcomes for women.” The vulnerability of women may be explained by a wide range of factors. For example, women typically have lower body weight, smaller liver capacity to metabolize alcohol, and a higher proportion of body fat, which together contribute to their achieving higher blood alcohol concentrations than men for the same amount of alcohol intake. Women are also affected by interpersonal violence and risky sexual behaviour as a result of the drinking problems and drinking behaviour of male partners. Moreover, alcohol use has been shown to be a risk factor for breast cancer.

Also many societies hold more negative attitudes towards women’s drinking alcohol than men’s drinking, and especially towards their harmful drinking, which, depending on the cultural context, may increase women’s vulnerability to social harm. Finally, women who drink during pregnancy may increase the risk of fetal alcohol spectrum disorder (FASD), and other preventable health conditions in their new-borns. In some cultures women have been protected from alcohol consumption by strong traditional values. For example, in the WHO region which includes India and nearby countries only 5 per cent of women consume alcohol whereas in the WHO region where the USA and nearby areas are included, more than 50 per cent of women consume alcohol. Imagine the public health and social disaster that could result if alcohol consumption by women in India reaches the level of the USA. Yet, promoting alcohol consumption among women as a sign and symbol of liberating modern trends is widely practiced in India. According to the WHO, alcohol consumption in adolescents, especially binge drinking, negatively affects school performance, increasing participation in crime and leads to risky sexual behaviour. The WHO quotes growing scientific evidence that has demonstrated the special harmful effects of alcohol consumption prior to adulthood on brain; mental; cognitive and social functioning of youth and increased likelihood of adult alcohol dependence and alcohol related problems among those who drink before physiological maturity. The WRVH says especially in the context of youth violence that drunkenness is an important immediate situational factor that can precipitate violence. In a Swedish study on youth-violence, about three-quarters of violent offenders and around half the victims of violence were intoxicated at the time of the incident. Several surveys indicate high end rapidly increased consumption of alcohol amongst youth. What is particularly worrying is high consumption at a very tender age which is likely to be very harmful for the brain and also lead to much higher risk of alcohol dependence in later years.

For example, in the UK, binge drinking thrice or more a month is reported among 33 per cent of adolescents in the 15-16 age groups. Binge drinking levels affecting between 25 to 40 per cent of youth are quite common now. Among elderly people the possibility of alcohol reaching and affecting sensitive organs including brain, liver and muscles is higher compared to younger people. The WRVH report says that reducing the availability of liquor can be an important community strategy to reduce crime and violence as research has shown alcohol to be an important situational factor that can precipitate violence. In a 4-year study conducted in New Zealand, crime rates in situations of high and low availability of alcohol were compared.

This study revealed that crime rates fell significantly for two years in areas of reduced alcohol availability. According to a report prepared by the National Council on Alcoholism and Drug Dependence, USA (NCADD), alcohol and drugs are implicated in an estimated 80 per cent of offences leading to incarceration in the USA such as domestic violence, driving while intoxicated, property offences, drug offences and public order offences. Alcohol is a factor in 40 per cent of all violent crimes and according to the Department of Justice, 37 per cent of about 2 million convicted offenders currently in jail report that they were drinking at the time of the event. Alcohol, more than any illegal drug, was found to be closely associated with violent crimes including murder, rape, assault, child and spousal abuse.

About 3 million violent crimes occurred each year in the USA in which victims perceived the offenders to have been drinking and statistics related to alcohol use by violent offenders show that about half of all homicides and assaults are committed when the offender, victim or both have been drinking. This report by NCADD points out that alcohol is often a factor in violence where the attacker and the victim know each other. Two thirds of victims who were attacked by an intimate (including a current or former spouse, boyfriend or girlfriend) reported that alcohol had been involved. More than 1 million are arrested for driving while intoxicated in a year in the USA. Drinking and drugged driving is the number one cause of death, injury and disability of young people under the age of 21.

Keeping in view all health and social impacts it is clear that the high levels of consumption of alcohol and various intoxicants is very harmful. In developing countries like India as well in some of the poorest countries and regions, millions of families are being devastated economically too because of the consumption of alcohol and intoxicants, both in terms of the money they pay for intoxicants and also in terms of the ruin of health. The various stages of the cycle of manufacture, sale and consumption of various intoxicants also involves very heavy ecological costs. Hence there is a very strong case for public campaigns being carried out with continuity and sincerity in rural as well in urban areas to reduce the consumption of alcohol and other intoxicants as much as possible

Bharat Dogra

Source: The Statesman, 16/03/24

Alcohol consumption in India: trends across states, age groups

 

Of all states, Arunachal Pradesh has the highest proportion of both men (53%) and women (24%) who drink alcohol.

Alcohol consumption among both men and women is higher in rural India than in urban India, the National Family Health Survey-5 (NFHS-5), 2019-21 has found. Overall, 1% of women aged 15 and over drink alcohol, compared to 19% of men in the same age group. This breaks up into 1.6% (rural) and 0.6% (urban) among women, and 19.9% and 16.5% respectively among men.

 Source: NFHS-5

Of all states, Arunachal Pradesh has the highest proportion of both men (53%) and women (24%) who drink alcohol. Among women, Arunachal Pradesh is followed by Sikkim (16%); among men, it is followed by Telangana (43%). Besides Arunachal and Telangana, alcohol consumption among men is higher (40% and above) in upper Brahmaputra region of Assam, districts in Jharkhand and Bastar region of Chhattisgarh, and the Chhota Nagpur region of Jharkhand and Odisha.

 Source: NFHS-5

The level of alcohol consumption among men is 30-40% in parts of Chhattisgarh, Uttarakhand, Manipur, Meghalaya, Tripura, and a few districts of Odisha. It is below 30% in the remaining parts of India, and the lowest in Lakshadweep (0.4%).

Alcohol consumption is more common among those from the Scheduled Tribes than from any other caste/tribe groups; this is true of both women (6% consumption among STs) and men (33%). Among religious groups, the proportion of men who drink alcohol is higher among those belonging to “other religions” (47%) than among those belonging to the Hindu (20%), Muslim (5%), Christian (28%), Sikh (23.5%), Buddhist/Neo-Buddhist (24.5%) and Jain(5.9%) religions.

Source: Indian Express, 17/05/22

93% of alcohol consumed in India is hard liquor

Chittaranjan Tembheka

Mumbai:





Around 93% of al cohol consumed in India is hard liquor. Tipplers in the country love their spirits and are yet to warm up to beer, the chilled beverage that the rest of the world prefers.The consumption of beer (alcoholic content up to 9%) stood at only 7% leaving wine consumption with a statistical ly negligible figure of 0.1%, ac cording to a survey by All India Brewers Association (AIBA).
Interestingly, consump tion pattern in richer coun tries show beer and wine scor ing higher, says an AIBA white paper on the beer industry .
One of the reasons for low beer consumption in India is attributed to high taxation Higher VAT, service tax and excise duty leads to beer be ing priced as much as IMFL or at times even more, prompt ing people to go for spirits which give them stronger “kick“ than beer or wine.
Estimates from an NSSO survey show that at the nation al level, per capita per week consumption of toddy and country liquor was almost twice (1.9 times) the consump tion of beer, foreign liquor and wine combined. “For Rs 100 one can buy 180ml of loca whiskey , which works out to about Rs 1.3 per ml of alcohol The same amount will buy a 650ml bottle of strong beer, but because of the lower alcoho level, people pay over twice as much per mlr,“ the AIBA pa per said. “Beer if taxed ratio nally , positioned more liberal ly, viewed more positively wil wean people away from hard liquor. This will therefore do immense good to society at large, if beer is delinked from hard liquor in terms of perception, taxation, availability and distribution.“
“Neither the law protects people from such intoxication nor there is any policy that promotes other beverages than those containing larger amount of pure spirits to prohibit bad effects on health.Over and above the taxation is so high that beer prices are at an all-time high forcing people to drink hard liquor, which they apparently like more for the `kick',“ said sources. It has been observed that an average Indian pays five to six times the manufacturing cost, making liquor prices significantly higher than 95% of other countries and more so in case of beer.
“India needs to differentiate between distilled alcoholic beverages (high strength alcohol products) from fermented alcoholic beverages like beer. Moderation or responsible consumption must be encouraged by counselling and enforced by policing,“ said AIBA director general Shobhan Roy . Roy de manded pricing formula based on alcoholic content to place beer at level-playing field in the Indian market.“Beer has much lower content of alcohol compared to IMFL and country liquor, itsModerate consumption of beer as against other forms of alcohol products may lead to reduction in the level of intoxication and hence, positive societal impact.
Therefore, there is a strong case for the government authorities to provide necessary policy support for facilitating a shift in alcohol consumption from hard liquor to beer. Kerala has made an attempt and we need to support it,Beer taxation is becoming volume and price driven without considering the low alcohol content. This is the crux of the dichotomy that low alcoholic beverages like beer are declining and high spirits are progressing leading to social issues.“ he added.
As per the AIBA data, the major market for the beer is the southern states of Andhra Pradesh, Tamil Nadu and Karnataka, which account for almost 50%. Maharashtra and Madhya Pradesh were the other big markets.
The paper pointed out that the beer market in India was valued at USD 4.13 billion (about Rs 24,000 crore) in 2013, contributing significantly to GDP and boosting tax revenues of the government. The industry had a compounded annual growth rate of over 12% between 2004 and 2013, but it declined to 3.3% in 2012-13.
For the full report log on to http:www.timesofindia.com

Source: Times of India, 9-02-2016

Sounding the smoke alarm

The high consumption of tobacco products by children under 18 is a warning that not enough is being done to spread awareness about health or enforce specific laws

Thanks to the Juvenile Justice (Care and Protection of Children) Act, 2015, tobacco companies in India may find it hard to lure children below the age of 18 into the tobacco habit. According to the Act, anyone who sells these products to underage children will face rigorous imprisonment up to seven years and a fine up to Rs. 1,00,000.

For long there has been a need to impose tougher punishment on those peddling dangerous substances to children, as existing legal provisions have been largely ineffectual. For instance, under the Cigarette and Other Tobacco Products Act, 2003, a paltry fine of Rs.200 was imposed on those who sold tobacco products to minors; this obviously did little to serve as a deterrent. Despite a ban on the sale of tobacco products to minors being in place since 2003, access to and availability of tobacco products was never a problem for children aged 13-15, according to the 2009-2010 Global Youth Tobacco Survey (GYTS), as over 56 per cent of those polled “bought cigarettes in a store were not refused purchase because of their age”. Most 15- to 17-year-olds were also able to purchase tobacco products.

Increase in consumption levels

Easy access to and availability of tobacco has had a direct impact on consumption levels. The GYTS found that nearly 15 per cent of children (19 per cent of boys and over 8 per cent of girls) in India as young as 13-15 years used some form of tobacco in 2009; another 15.5 per cent in the same age group who had never smoked before were likely to begin smoking the following year. The overall tobacco use among school students aged 13-15 increased from 13.7 per cent in 2006 to 14.6 per cent in 2009.

These startling figures on tobacco consumption by minors may still be a gross underestimate. By virtue of being school-based, the survey failed to take into account the most vulnerable population of children who are outside the schooling system and who are probably the earliest and most extensive users of tobacco. Several studies have found higher consumption levels of tobacco among uneducated children, among those with only primary-level education, and among those from the lower income strata.

Besides this, the 2010 Global Adult Tobacco Survey (GATS) report showed that nearly 10 per cent of children in India in the 15-17 age group consumed tobacco in some form. According to an August 2015 paper published in the journal Global Health Promotion, there are nearly 4.4 million children in India in the 15-17 age group who use tobacco daily.

Like in the case of the GYTS, the GATS report too suffers a major shortcoming. It does not have information on tobacco users from “many States”, the paper notes. Yet, taken together, the two surveys reveal that a quarter of children below the age of 18 consumed tobacco in some form or the other in 2009.

The data highlight how successful tobacco companies have been in employing multiple strategies to continually entice children into using tobacco at a very early age. For instance, tobacco companies offering free cigarettes to 13- to 15-year-old children, tobacco advertisements on billboards, the strategic placement of tobacco products inside shops, and the use of advertisement boards that do not meet the point-of-sale display specifications are some of the strategies employed by companies, according to a study published early last year in the journal, Asian Pacific Journal of Cancer Prevention.

That these strategies have been effective is evident: the average age at which there is daily initiation of tobacco in those above the age of 15 years is 17.8 years. This includes 14 per cent of those who smoke (cigarettes and bidis) and nearly 30 per cent of those who use smokeless tobacco.

Vulnerability of children

Why do companies target children? As the 1994 U.S. Surgeon General’s report had stated, companies are fully aware that the younger a person is when s/he begins to smoke, the more likely it is that s/he continue to smoke as an adult. Those who use tobacco at a younger age are more addicted to it and are less likely to quit the habit than those who begin using it later. Early use is also invariably associated with more frequent use. Early users are also less ignorant about the effects, making them easier prey for the tobacco companies.

While the Ministry of Women and Child Development’s initiative to disincentivise the sale of tobacco products to children through stiff penalty is commendable, the real challenge will be in its enforcement. Unlike in the developed countries where cigarettes are sold in licensed shops and outlets, “over 76 per cent sale of tobacco products in India is restricted to unlicensed small shops and kiosks found in every street corner”. Policing them will be a huge challenge.

Hence, a multipronged approach is necessary to keep the young ones away from tobacco. To start with, in accordance with India’s Cigarettes and Other Tobacco Products Act, 2003, enforcing the ban on the sale of tobacco within a 100-metre radius of schools coupled with a ban on advertisements on tobacco near schools should be a priority, as several studies have shown a link between availability and consumption.

Schools can also spread awareness about tobacco use among students to make the product less appealing. For instance, according to a 2012 paper in PLOS ONE, a unique programme in Mumbai that focussed on imparting life skills and creating awareness on tobacco among economically disadvantaged schoolchildren helped prevent more than 50 per cent of them from taking up the habit.

Meanwhile, more effective measures such as increasing taxes on tobacco products and introducing shocking pictorial warnings that cover 85 per cent of the front and back of packets are easily enforceable and would go a long way towards reducing consumption levels.

Since the Indian taxation structure is not linked to income growth and inflation, tobacco products get cheaper relative to income affordability. As an annual systematic inflation-adjusted increase in tobacco tax is not built into the process, there is a strong case to increase taxes every year. A steep increase in price will certainly prevent an overwhelming percentage of children from starting the habit and force many to quit. The negative impact on tobacco sales and consumption levels seen after an increase in taxes in the last two consecutive budgets serves as a pointer.

prasad.ravindranath@thehindu.co.in

Keywords: Smoking, Smoking among children, Juvenile Justice (Care and Protection of Children) Act, Tobacco companies, cigarette advertisements

Source: The Hindu, 28-01-2016

India drinks and smokes less now

However, it is among the highest consumers of smokeless forms of tobacco

The preliminary findings from National Family Health Survey (NFHS-4) released last week have given anti-tobacco campaigners a reason to smile. The survey has found that across the board, people — both men and women — in India are smoking less than they were a decade ago. Not just tobacco, even alcohol consumption among Indians has fallen.

According to the NFHS-4 data, in the 13 States surveyed, tobacco use among men has fallen from 50 per cent in 2005-06 to 47 per cent in 2015. Similarly, alcohol consumption among men has fallen from 38 per cent to 34 per cent. Over the last decade, consumption of alcohol among men has fallen in Madhya Pradesh, Bihar, Uttarakhand, Haryana, West Bengal and Meghalaya.

The data comes at a time when India is on the verge of implementing stricter tobacco control laws. From April 1, 2016, the Indian government will be implementing ‘plain packaging’ as directed by the Allahabad High Court, following a writ petition on the matter.

Plain tobacco packaging
The public health community has been demanding implementation of ‘plain tobacco packaging’ — which means standardised packaging of tobacco products without any exclusive branding like colours, imagery, corporate logos and trademarks.

The laws will only allow the manufacturers to print the brand name in a mandated size and font. Australia, the first country to implement these laws, had passed the plain packaging legislation in November 2011.

According to the Global Adult Tobacco Survey (GATS) India report, smoking kills over one million people in the country annually and is the fourth leading cause of non-communicable diseases (NCD) such as cancer and heart diseases, which account for 53 per cent of all deaths in India. According to the Health Ministry, the economic burden of tobacco consumption is around Rs.1,04,500 crore per annum.

India became a party to the WHO Framework Convention on Tobacco Control (FCTC) on February 27, 2005. Since then India has implemented a series of measures leading to the current status of increased social awareness. Soon after signing the WHO FCTC, smoking was completely banned in many public places and workplaces in India — with the new law permitting establishments to create smoking zones within restaurants, airports and hotels having 30 or more rooms.

The Indian government has also clamped down on promotion of tobacco consumption, with a complete ban on advertising under the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA).

Production too falls

It is no surprise that despite an increase in women smokers, the overall consumption of cigarettes has fallen in India. As per the health ministry statistics, 93.2 billion sticks were consumed in 2014-15, nearly 10 billion less than in 2012-13. The production of cigarettes too fell from 117 billion to 105.3 billion sticks in the same period. However, there is a caveat. While the decline in tobacco consumption is worth a pat on the back, one needs to factor in that India is among the highest consumers of smokeless forms of tobacco — zarda, gutka, and so on. SLT use is an imminent public health problem, which is contributing to high disease burden in India.

It is a “unique” tobacco product due to its availability in myriad varieties, easy access, and affordability, especially for adolescents. It has been studied to be a “gateway product and facilitates initiation,” writes Dr. Monica Arora in a 2012 paper on consumption of SLT in India.

According to ‘Economics of Non-Communicable Diseases in India’, a 2014 report by the World Economic Forum and the Harvard School of Public Health, tobacco use has been cited as a risk factor for cardiovascular diseases and many types of cancer. In fact, research finds that tobacco-related cancers constitute roughly 40 per cent of all male cancers in India.

Smoking also significantly increases the risk of tuberculosis, and several studies using mortality data from the 1990s through early 2000s have shown tuberculosis to be the single biggest cause of death among smokers in India.

vidya.krishnan@thehindu.co.in

rukmini.s@thehindu.co.in

Keywords: National Family Health Survey, smoking, alcohol consumption, tobacco

Source: The Hindu, 25-01-2016

All in the spirit of equality

Regardless of what our respective moral positions on policies of prohibition might be, and regardless of the potential efficacy of such programmes, the judgment on the validity of Kerala’s liquor policy militates against the fundamental promise of equal concern and treatment under the Constitution.

As virtually its last significant act of 2015, on December 29, the Supreme Court of India delivered its judgment on the validity of Kerala’s newest liquor policy, which seeks to prohibit the sale and service of alcohol in all public places, save bars and restaurants in five-star hotels. Regardless of what our respective moral positions on policies of prohibition might be, and regardless of the potential efficacy of such programmes, the new law, as is only plainly evident, militates against the fundamental promise of equal concern and treatment under the Constitution. In placing five-star hotels on a pedestal, the law takes a classist position, and commits a patent discrimination that is really an affront to the underlying principles of our democracy. Regrettably, though, the Supreme Court’s judgment, in The Kerala Bar Hotels Association v. State of Kerala, eschews even the most basic doctrines of constitutionalism, and, in so doing, allows the state to perpetrate a politics of hypocrisy.

Kicking off the excise policy
Since 2007, the Kerala government has sought to tighten its Abkari (excise) policy with a view to making liquor less freely available in the State, ostensibly in the interest of public health. At first, the State sought to amend the policy by permitting new bar licences to be granted only to those hotels that were accorded a rating of three stars or more by the Central government’s Ministry of Tourism. In 2011, these rules were further changed. This time, all hotels that had a rating of anything below four stars were disentitled from having a licence issued to serve alcoholic beverages on their premises. However, those hotels with existing licences were accorded an amnesty, which permitted them to have their licences renewed even if they did not possess a four-star mark.

The Supreme Court held, in a convoluted judgment, in March 2014, that the deletion of three-star hotels from the category of hotels eligible for a liquor licence was, in fact, constitutionally valid. The court provided a rather bizarre rationale for what appeared to be a palpable act of favouritism. Even hotels without a bar licence, it said, were entitled to three-star statuses under the Ministry of Tourism’s rules and regulations.

In August 2014, the Kerala government sought to further intensify its Abkari policy, by making its most drastic change yet, in purportedly trying to enforce complete prohibition. Only hotels classed as five star and above, by the Union government’s Ministry of Tourism, the new policy commanded, would be entitled to maintain a bar licence. To give effect to this rule, the Abkari Act, a pre-constitutional enactment that was extended in 1967 to Kerala, was duly amended, and the State’s excise commissioners issued notices to all hotels of four stars and below, which served liquor, intimating them of the annulment of their respective bar licences.

The new policy was immediately challenged in a series of petitions filed in the Kerala High Court by hotels of various different denominations. In May last year, after a division bench of the High Court had ruled in favour of the State, the hotels filed appeals before the Supreme Court. They raised two primary grounds of challenge, both predicated on fundamental rights guaranteed under Part III of India’s Constitution.

Fundamental rights

First, the hotels submitted that in cancelling their bar licences, and in prohibiting them from serving and selling liquor on their premises, the State had infracted their right, under Article 19(1)(g), to practise any profession, or to carry on any occupation, trade or business. Second, they pleaded, in separately categorising hotels of five stars or more, and in permitting those hotels alone to serve liquor in public, the new Abkari policy had made an unreasonable classification, by treating persons on an equal standing unequally, and therefore violated Article 14 of the Constitution.

The first argument was admittedly going to be a difficult one to maintain. The liberty to freely carry on any trade or business is subject to reasonable restrictions that may be imposed by the state in the interest of the general public. The Constitution itself, in Article 47, requires States to make an endeavour towards improving public health, including by bringing about prohibition of the consumption of liquor. Therefore, quite naturally, any policy in purported furtherance of such goals would almost always be viewed as a legitimate limitation on any freedom to do business. In fact, in 1994, a constitution bench of the Supreme Court, in Khoday Distilleries Ltd. v. State of Karnataka, explicitly questioned whether any right to trade in alcoholic beverages even flowed from our Constitution.

“The State can prohibit completely the trade or business in potable liquor since liquor as beverage is res extra commercium,” wrote Justice P.B. Sawant. “The State may also create a monopoly in itself for trade or business in such liquor. The State can further place restrictions and limitations on such trade or business which may be in nature different from those on trade or business in articles res commercium.” Therefore, the court, in The Kerala Bar Hotels Association case, perhaps, had little choice but to hold the Abkari policy as being in conformity with the right under Article 19(1)(g).

Such a holding, though, ought not to have precluded the court from scrutinising the liquor policy with further rigour. The mere fact that a commodity is res extra commercium — a thing outside commerce — does not give the state absolute power to make laws on the subject in violation of the guarantee of equal treatment. While a law might represent a valid constraint on the freedom to trade, it nonetheless must confirm to other constitutional commands, including Article 14, which assures us that the state shall not deny to any person equality before the law or the equal protection of the laws within the territory of India.

The point of classification

Equality, as the legal philosopher Ronald Dworkin once wrote, is a contested concept. But it is however, in its abstract form, a solemn constitutional pledge that underpins our democracy. The Supreme Court, in some of its earliest decisions, interpreted Article 14 as forbidding altogether any law that seeks to make distinctions based on class, except where reasonable classifications are made in a manner that does no violence to the provision’s core promise. The court also crystallised a basic two-prong test to determine what constitutes such a classification: there must be, it held, an intelligible differentia, which distinguishes persons or things that are grouped together from others left out of the group, and this differentia must have a rational relation to the object sought to be achieved by the law in question.

Hence, in determining whether Kerala’s Abkari policy violated the right to equality, the question was rather simple: has the State made a reasonable classification in consonance with Article 14 by permitting only five-star hotels and above to serve liquor? When we apply the test previously laid down by the Supreme Court, there is little doubt that the distinction that the policy makes between hotels on the basis of their relative offering of luxuries constitutes a discernible intelligible differentia between two classes of things. But a proper defence of the law also requires the government to additionally show us how this classification of five-star hotels as a separate category bears a sensible nexus with the object of the law at hand. The changes in the liquor policy were ostensibly brought through with the view of promoting prohibition, and thereby improving the standard of public health in the State. Now, ask yourself this: how can this special treatment of five-star hotels possibly help the Kerala government in achieving these objectives?

The Supreme Court, as it happened, made no concerted effort to answer this question. This could be because, however hard we might want to try, it’s difficult to find any cogent connection between classifying five-star hotels separately and the aim of achieving prohibition. The court, therefore simply said, “There can be no gainsaying that the prices/tariff of alcohol in Five Star hotels is usually prohibitively high, which acts as a deterrent to individuals going in for binge or even casual drinking. There is also little scope for cavil that the guests in Five Star hotels are of a mature age; they do not visit these hotels with the sole purpose of consuming alcohol.” Given the palpable inadequacies of such a justification — and also given its validation of a manifestly classist position — the court also used the State government’s excuse of tourism as a further ruse to defend the law. But when a policy exists to promote the prohibition of the consumption of liquor, it’s specious to use an extraneous consideration, in this case, tourism, to defend a classification made in the law, regardless of how intelligible such a classification might be.

Prohibition often has a polarising effect on the polity. But the criticisms of the ineffectuality of such policies apart, Kerala’s new law ought to have been seen for what it is: paternalism, at its best, and, at its worst, an extension of an ingrained form of classism that is demonstrably opposed to the guarantee of equality under our Constitution. The judgment in The Kerala Bar Hotels Association case is therefore deeply unsatisfactory, and requires reconsideration.

(Suhrith Parthasarathy is an advocate practising in the Madras High Court.)

Keywords: Kerala liquor ban, Abkari policy, The Kerala Bar Hotels Association case

Source: The Hindu, 4-01-2016

Smoking dips 10% in 2 yrs but women smokers up sharply

Atul Thakur & Rema Nagarajan





Double In 30 Yrs, Highest Number Here After US

Cigarette consumption in India is falling steadily even as the number of women smokers is rising, making it home to the second largest number of female smokers after the United States.According to the latest data given by the health ministry in Parliament, cigarette consumption in 2014-15 was 93.2 billion sticks -10 billion less than in 2012-13. Production fell from 117 billion sticks to 105.3 billion in the same period.
In the face of this good news is the sobering finding of a global tobacco study , which showed that the number of women smokers in India went up from 5.3 million in 1980 to 12.7 million in 2012. The study , titled `Smoking Prevalence and Cigarette Consumption in 187 Countries 1980-2012', was carried out by the Institute for Health Metrics and Evaluation at the University of Washington and released last year.This jump in numbers consti tutes only a marginal increase in prevalence (percentage of smokers in the above 15 population) from 3% to 3.2%. But it has been flagged as an area of concern by anti-tobacco activists who point out that it runs against the global trend of the rate of decline among women smokers being consistently faster than in men.
Incidentally , unlike most countries where cigarettes constitute over 90% of tobacco consumption, in India, it is just about 11%. Hence, while the decline is a positive development, its impact on burden of diseases caused by tobacco remains limited as consumption is dominated by chewing tobacco, followed by bidis.
According to a 2009-10 survey by the health ministry, 24% of men and 17% of women use smokeless tobacco, much higher than the proportion of smokers in that age group ­ 15% and 2% respectively. About 9% of men and 1% of women both chew tobacco and smoke it. The survey also showed that tobacco use was higher in rural areas ­ 52% among men and 24% among women, compared to 38% and 12% in urban areas. In the US, where almost a third of the population were smokers in 1980, ground-breaking re search on diseases caused by tobacco use and sustained campaigns by the government and non-profit agencies has managed to bring down prevalence to around 17% of the adult population.
“Every kind of tobacco product consumption ought to be taxed, including the small-scale bidi and gutka manufacturers,“ said Bobby Ramakant, an anti-tobacco activist with Corporate Accountability International.“This, along with pictorial warnings and adequately funded programmes to help people quit us ing tobacco, is the only way the National Tobacco Control Programme will work. It all depends on the government's commitment to reduce non-communicable diseases. Tobacco use is a huge risk factor for many of these diseases, especially cancer.“

Source: Times of India, 28-12-2015

Ban on gutka made 53% users quit: Study

Mumbai Mirror Bureau mirrorfeedback TWEETS @MUMBAIMIRROR





Gutka ban has led to a decrease in its consumption in the state, a study conducted by the Johns Hopkins Center for Communication Programs (CCP) and Centre for Communication and Change India (CCCI), New Delhi with support from the Johns Hopkins Bloomberg School of Public Health's Institute for India for Global Tobacco Control (IGTC) and the World Health Organization (WHO) Country Office revealed. The study aimed to understand the impact of state laws that ban the sale and distribution of gutka.The study was conducted in eight states -Assam, Bihar, Delhi, Gujarat, Odisha, Madhya Pradesh, Maharashtra and Karnataka.Stringent laws banning gutka have had a positive impact on the users in Maharashtra and many have agreed that they consume less since the ban was enforced.
Optimistic facts like these were revealed at the Tata Memorial Hospital when findings, specific to the state of Maharashtra, were released from a study that had been conducted across the country to understand the impact of state laws that ban the sale and distribution of gutka. Maharashtra's state report is part of a larger eight state research study undertaken last year. In Maharashtra, surveys were conducted in the districts of Thane and Mumbai with current and former gutka users and tobacco product retailers to determine the impact and effectiveness of the ban. In addition, observations of 60 retail environments and indepth interviews with government officials, enforcement officials and citizens working with civil society groups were conducted to find out different stakeholders' reaction to the ban. Considering the harmful effects of gutka and paan masala, the state government disal lowed the sale, manufacture, distribution and storage of ghutka from July 19, 2012. Of the respondents who con tinue to use prepackaged gutka, a considerable portion ­ about 83 per cent reported that they consume less since the ban.
The study also showed that there is a universal agreement that gutka ban is good for the health of the youth in the country with 99 per cent responding affirma tively in support of the ban. Of the respondents who quit since ban, more than half 51 per cent reported to having attempted to stop using it after the ban came into place. Fifty three per cent of respondents agreed that gutka bans would help people to quit.
FDA commissioner Harshadeep Kamble said, “Though gutka is banned in Maharashtra, we recently seized huge a quantity of the product. During the investigations it was found that gutka is manufactured in Gujrat for its supply in Maharashtra.“

Source: Mumbai Mirror, 5-11-2015

Alcohol consumers in India face higher health risk, mortality

Alcohol use is responsible for about 4 per cent of global burden of disease. But current drinking has been found to disproportionately raise the risk of cardiovascular disease, cancer and injury in people living in low-income countries (LICs) such as India and Zimbabwe and lower-middle-income countries (LMICs) such as China and Colombia.

Till date, all epidemiological studies on impact of alcohol consumption on health have been restricted to high- and middle-income countries. For the first time, a study published today (September 17) in the journal The Lancet looked at its impact on people living in countries of all income levels.

“Our study did not look at the association between alcohol and one disease but at the overall effect of alcohol,” said Dr. Rajesh Kumar a co-author of the paper from the Chandigarh-based Postgraduate Institute of Medical Education and Research, School of Public Health (PGIMER).

While 38 per cent current drinking was associated with increased risk of cardiovascular disease, cancer and injury in lower-income countries (LICs and LMICs combined), it was only 16 per cent in the case of higher-income countries (high-income and upper-middle-income countries combined).

The higher risk in people living in lower-income countries compared with those living in higher-income countries was seen despite the fact that more than three-quarters of participants in higher-income countries consumed alcohol vis-à-vis just one-eighth in lower-income countries.

Despite the lowest prevalence of drinking in lower-income countries, participants from these countries had the highest prevalence of high-intake and heavy episodic drinking. Both high-intake and heavy episodic drinking were associated with increased risk of overall mortality. “Our study confirms that high alcohol consumption is associated with increased risk of mortality, cancer, and injury, and a non-significantly reduced risk of myocardial infarction,” they write.

A reduction in heart attack risk was seen with low or moderate intake but not with high intake of alcohol. If any, there was a heightened risk of mortality with high intake of alcohol.

Another major difference between current drinkers in lower-income and higher-income countries was concerning the type of alcohol that they consumed. For instance, the percentage of people consuming liquor and wine was 89 per cent and 3 per cent respectively in countries like India (lower-income countries) compared with 10 per cent and 61 per cent respectively in higher-income countries.

People who consumed liquor seemed to have “higher hazards of mortality, stroke, cancer, injury, admission to hospital and the composite” compared with wine or beer consumers. “Wine drinkers generally had the lowest hazards for cardiovascular disease, including a significantly reduced risk of myocardial infarction, compared with never drinkers,” they write.

Current drinkers in lower-income countries like India were younger, more likely to be male, less educated and more likely to be current smokers, and have lower body-mass index and higher blood pressure than those in higher-income countries.

“Although current drinking was associated with a 24 per cent reduced risk of heart attack, there was no reduction in risk of mortality or stroke, and current drinking was associated with a 51 per cent increased risk of alcohol-related cancers and a 29 per cent increased risk of injury in current drinkers,” notes a release.

The data came from 12 countries participating in the Prospective Urban Rural Epidemiological (PURE) study, a prospective cohort study of individuals aged 35-70 years. The median follow-up was 4·3 years and current drinking was reported by 36,030 individuals from all income levels.

Keywords: Alcohol consumers, health hazards, drinking

Source: The Hindu, 18-09-2015

Good in principle, tough to practise

The ill-effects of indiscriminate liquor consumption on standards of living and public health are well-known. It is for this reason that the Directive Principles of State Policy of the Constitution require the state to endeavour to bring about prohibition of intoxicating drinks and drugs except those for medicinal purposes. After the decision of the Kerala government to close down bars other than those in five-star hotels and to introduce prohibition in a phased manner, political parties in Tamil Nadu are increasingly talking of pushing for a ban on liquor if they come to power. TheDravida Munnetra Kazhagam has now joined the Pattali Makkal Katchi in campaigning for a ban, with its president M. Karunanidhi promising total prohibition if voted to power. Actually, it was Mr. Karunanidhi who in 1971 withdrew prohibition in Tamil Nadu, going back on the policy formulated by DMK founder and former Chief Minister C.N. Annadurai. At that time, his argument was that prohibition cannot work in isolation. Although Kerala has taken a huge step toward restricting consumption, Tamil Nadu is by no means surrounded by liquor-free States. For instance, Puducherry, not far from Chennai, is known as a tippler’s paradise. Moreover, the State’s finances are shored up by revenue from liquor sales. Many of the government’s freebie schemes actually run on revenues from duties and taxes levied on liquor. Also, political functionaries at the lower levels of the hierarchy benefit hugely from bootlegging and the sale of illicit liquor during periods of prohibition. While many women’s groups support prohibition, the political will to crack down on illicit liquor will doubtless be weak in such circumstances. Any ban on liquor sales will necessarily have to co-exist with a spurt in bootlegging and illicit distillation.

As a policy, prohibition has met with little success anywhere in India. Even when it has helped bring down overall consumption, prohibition has led to loss of lives in hooch tragedies. The high levels of enforcement required for prohibition result in a severe drain on the State’s finances. Prohibition enforcement agencies often become enmeshed in corruption. Tamil Nadu, like Kerala, has had a history of hooch tragedies. In recent years, with the easy availability of liquor in rural areas, the State has been free of such deaths. Indeed, in 2002 the AIADMK government encouraged manufacturers to introduce cheaper liquor to wean away rural workers from hooch. If history offers any lessons, it will require enormous resources and tremendous political will for prohibition to succeed. So far, political parties have not shown the necessary political will, and governments have been unable to muster the needed resources.

Keywords: Liquor prohition, Tamil Nadu, TASMAC outlets, DMK, Karunanidhi, Kerala, AIADMK government

Loosening tobacco’s deadly grip

A few months after steeply increasing taxes on tobacco products, the government has come up with another much-needed measure to contain tobacco consumption. Thanks to a recent amendment to the Cigarettes and other Tobacco Products (Packaging and Labelling) Rules of 2008, pictorial warnings are all set to achieve the desired results. Beginning April 1, 2015, all tobacco products will carry a pictorial warning and text message that occupy at least 85 per cent of the front and back of a package. The pictorial warning alone will take up 60 per cent of the space and the written message the remaining 25 per cent. With this change, India will catapult itself to the No.1 position in the world, alongside Thailand, on the international ranking based on the area dedicated to the warning. Aside from more than doubling the statutory warning area on a package from 40 to 85 per cent, both sides of a package will carry the warning; currently, it is displayed only on one side. In contrast to the completely ineffectual pictorial warnings now being used on cigarette packets and chewing tobacco pouches, the chosen images can at once shock and educate consumers of the risks of tobacco use. By also mandating that images be rotated every 12 months, the government has ensured that India follows the WHO Framework Convention on Tobacco Control labelling requirements in letter and spirit. Incidentally, the pictorial warning that is currently being used has remained the same since December 2010 with just one rotation after it was introduced on May 31, 2009.

The use of pictorial warnings turns the power of packaging on its head — from building and reinforcing a brand, packages become a vehicle for increasing awareness about tobacco’s health risks. It is proven beyond doubt that the use of graphic images along with written messages has the potential to significantly deter people from taking up the habit and also prompt existing users to cut the amount of tobacco consumed and even quit smoking. Tobacco companies are well aware of the power the pictorial warning wields and how much it could affect their bottom line. They may well, on grounds of the health of the industry and the livelihood of the workers, seek to get the government to dilute the amendment. After all, the industry had successfully gone through the process before; it had persuaded the previous government to backtrack on nearly every provision till the warnings became ineffectual. How well the government resists such pressure will show how determined it is to win the war against tobacco. Since one million people in India die each year because of tobacco use, the government should not sacrifice proven and obvious health benefits at the altar of commercial advantage.

Keywords: tobacco products, pictorial warnings, Tobacco Control, WHO Framework Convention, tobacco companies

Sep 11 2014 : The Times of India (Delhi)

Soon, Rs 20,000 fine for smoking in public

DurgeshNandan Jha

New Delhi:





Panel Suggests Banning Sale Of Loose Cigarettes, Increasing Age Limit For Tobacco Consumption

A fine of 20,000 for smoking in public, banning the sale of loose cigarettes and increasing agelimit for tobacco consumption from 18 to 25: these are some of the recommendations of the expert panel appointed by health ministry to review and suggest changes to the Cigarettes and Other Tobacco Products Act 2003 (COTPA). Other suggestions include making public smoking a cognizable offence.If accepted, these suggestions could soon be a part of amendments the government is planning to intro duce in the winter session of parliament to curb tobacco consumption.
Tobacco use accounts of 40% of all cancers in India. It is also associated with higher morbidity and mortality caused due to respiratory problems, heart diseases and Tuberculosis among others.
“This is the first time we have seen any government which is so aggressive about tobacco-control measures.
We are hopeful that they will consider the changes suggested,” said Dr G K Rath, one of the experts appointed by the health ministry.
He said the existing antitobacco law has many loopholes and the manufacturers of tobacco-products are using them to market it to the vulnerable population. On implementation of the changes proposed, Dr Rath said the government needs to push for bigger changes only then it can achieve the minimum. “Ten years ago, who would have thought that people will stop smoking in offices or at airports? It has happened. Similarly , we can reduce tobacco sale by introducing stringent measures like this,“ he said.
Health minister Harsh Vardhan, senior officials in the ministry said, is on a visit to Bangladesh and he will return on Friday . “The minister has taken up the curbing tobacco consumption issue on campaign basis. The recommendations of the expert panel will be reviewed by him for further action and deliberations before it is included in the draft of amendments,“ the official said.
About 275 million Indians (35% of adult population and 14.1 % of children aged 13-15 years) are tobacco users, mainly smokeless tobacco.
According to a recent report prepared by the Public Health Foundation of India, total economic costs attributable to tobacco use from all diseases in India in the year 2011 amounted to a staggering Rs 1, 04,500 crores -12% more than the combined state and central government expenditure on health care in the same year.

May 15 2014 : The Times of India (Mumbai) BOOZER'S DIARY Avg Indian male consumes 33 litres of alcohol/yr: WHO Kounteya Sinha London: TNN   An average Indian male drinker is over 15-yearold and consumes 33 litres of alcohol a year. For women, in the same age group, the average liquor consumption is 11 litres a year, says a study by the WHO. The study found that alcohol consumption not only leads to liquor dependence, but also puts people at a higher risk of developing over 200 diseases, including liver cirrhosis and some cancers. It was also found that 93% of Indians drink hard liquor -whisky or vodka while only 7% drink beer. India's wine drinking population is very low, only 1% of alcohol consumers. Though 60% of Indian men and 90% of women abstain from alcohol, drinking habits in India have increased over the last few years. WHO found that 32% of men and fewer than 11% of women in India over the age of 15 drink alcohol. On an average, every person in the world aged 15 years or older drinks 6.2 litres of pure alcohol per year. But as less than half the population (38.3%) actually drinks alcohol, it means that those who drink, consume on average 17 litres of pure liquor annually . The report also shows that a higher percentage of deaths among men than women are from alcohol-related causes. For men, the figure stands at 7.6%, and for women 4%, though there is evidence that women may be more vulnerable to some alcohol-related health conditions compared to men.