Stronger deterrents, not pictures, will do the trick: Dr Sudarshan Ballal

If you were to ask me to name the single greatest health hazard among non-communicable diseases, my answer without a moment’s hesitation would be tobacco -- in any form, the commonest being smoking.

You name any non-communicable disease, whether cancer of different kinds affecting the various parts of the body, heart attacks, strokes, peripheral vascular disease leading to amputation, chronic lung disease or injury to an unborn foetus (in mothers who smoke), and tobacco would have its name printed on it boldly.

There is no question that tobacco use has to be curbed at all costs, but the trillion-dollar question is, how do we combat this serious menace? Obviously there are many ways to skin a cat and one of the proposed measures is to cover almost the entire cigarette packet with gory pictures of tobacco-related diseases.

But does this really help? On the contrary, I believe many people addicted to tobacco will continue to smoke, large pictorial warnings or not. Also, this measure will not affect the large number of people who chew tobacco or smoke beedies, which are equally harmful.

What we need is a multi-pronged strategy, which applies to both users and providers of tobacco on the lines of what is being done in the war against drugs. We should start off with a massive education programme to create awareness about the hazards of tobacco, especially among the young in schools and colleges, and also set up wellness centres and clinics in all healthcare centers to not only create awareness about the ill-effects of tobacco but to also help addicts kick the habit.

We could introduce punitive damages, too, for public smoking, including jail terms for repeat offenders, and impose a heavy cess on tobacco manufacturers and vendors. Some extreme measures that need to be considered are putting a stop to tobacco production and rehabilitating the tobacco growers by helping them cultivate alternative crops (like is being done for poppy growers).

I have always wondered why we have not considered prohibiting tobacco use like we do with alcohol in many states. I honestly believe that tobacco is as bad as, if not worse than, recreational drug use and needs to be tackled with the same seriousness and vigour. I hope we will experience the ‘luxury’ of a tobacco-free world in our lifetime for a safer and cleaner future.

Dr. Sudarshan Ballal is Chairman, Manipal Hospitals