|Year : 2018 | Volume
| Issue : 4 | Page : 394-398
The tobacco trade and trail in Karnataka
Punith Shetty1, Roomani Srivastav2, Arpan Debnath3, R Murali3, A Shamala3
1 Department of Community Oncology, Indian Cancer Society, Bangalore, Karnataka, India
2 Department of Public Health Dentistry, ESIC Dental College and Hospital, Delhi, India
3 Department of Public Health Dentistry, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
|Date of Web Publication||28-Feb-2019|
Department of Community Oncology, Indian Cancer Society, Bangalore, Karnataka
Source of Support: None, Conflict of Interest: None
CONTEXT: Tobacco use is a major public health challenge in India with 275 million adults consuming different tobacco products. Despite innumerable laws, the overall picture of the current system is not clear and the menace of tobacco persists. What does it take to stop this menace? The present study made an attempt to throw some light on the prevailing discrepancy in the current system. AIMS: The aim of the study was to explore the knowledge and attitude of people involved in growth and sales of tobacco. MATERIALS AND METHODS: This qualitative research was aimed at farmers growing tobacco in Mysore district and vendors selling tobacco in Bangalore. Snowball sampling technique was used to select the farmers. Simple random sampling technique was used to shortlist vendors selling tobacco products in Bangalore. Data were collected using semistructured questionnaire through interviews which were recorded using an audio recorder. RESULTS: Inductive analysis was conducted for the present study and the responses were divided into three categories, that is, awareness of laws, compliance to laws, and opinion regarding banning tobacco. Ninety percent of the growers and all the tobacco vendors (100%) were aware of the laws governing them; however, the compliance was poor in both the populations (32% and 20%, respectively). CONCLUSIONS: Implementation of law is an area that needs to be strengthened. Violations of these laws are not adequately reported; this matter should be dealt with. It was seen that the system which creates the laws itself promotes the growth and thereby the distribution of the tobacco products.
Keywords: Cancer, stakeholder, tobacco
|How to cite this article:|
Shetty P, Srivastav R, Debnath A, Murali R, Shamala A. The tobacco trade and trail in Karnataka. Indian J Cancer 2018;55:394-8
| » Introduction|| |
Tobacco use is reaching pandemic levels and it is the main cause for rise in noncommunicable diseases such as cardiovascular diseases, stroke, and cancers., According to the Indian Council of Medical Research, the apex body of research in India, tobacco-related cancers account for nearly 35% to up to 69% of all cancers among males in some districts. Among females, tobacco-related cancers account for up to 45% cancers in certain states. It is estimated that tobacco consumption kills directly or indirectly 1 million adult Indians every year., The Global Adult Tobacco Survey (GATS), 2016–2017, shows the prevalence of tobacco use in India to be as high as 28.9%, which is a six-point decrease from the prevalence recorded in the first GATS survey done in 2010. Despite this improvement, tobacco remains a massive social, economic, environmental, and, of course, a health-related problem.
Over the years, India has developed many policies and laws to control the menace of tobacco. The Cigarettes and Other Tobacco Products Act (COTPA) passed in 2003 has seen many amendments to introduce stricter rules. India has also ratified the international treaty, that is, the Framework Convention for Tobacco Control (FCTC) which is the first of its kind of in terms of uniting nations worldwide in the fight against tobacco. The cultivation of tobacco is a key factor in the entire tobacco trade and consumption; however, there are very few laws that regulate this. While many studies have evaluated the status of tobacco use in India, there are very few which have attempted explore the factors affecting the trade and cultivation of tobacco. Thus, the present study is a qualitative study to identify the loopholes in the tobacco control system in India. The laws for tobacco growers have seen small changes compared to the law for tobacco products since the formation of tobacco board act of 1975.
The theoretical perspective on which the present study is based is that the tobacco control measures in India are not complete and those existing are not followed to effect; moreover, the viewpoint of main stakeholders of the entire tobacco trade has not been taken into consideration when formulating laws for the control of tobacco trade and use. The objectives of the study were to explore the viewpoint of tobacco farmers/land owners and vendors at the point of sale, that is, the stakeholders at the two ends of the tobacco trail.
| » Materials and methods|| |
This was a formative qualitative research which was conducted in two levels, one was among the tobacco farmers/land owners and Tobacco Control Board officials of the Mysore and Hassan district and the other was among the shop vendors of the Bangalore City. Ethical approval was obtained from Ethical Review Committee of K.L.E. Institute of Dental Sciences and required permissions were obtained from the Tobacco Control Board to interview farmers. Written informed consent in local language was obtained from the participants for recording their responses. A total of 50 participants were selected for the first part of the study, that is, from among tobacco growers, farm owners, and Tobacco Control Board officials. The sampling method used was snowball sampling. New participants were enrolled until redundancy of data was achieved and answers from the participants were reflecting similar themes. Triangulation was achieved in data collection by using the three methods of observation, personal interview, and focus-group discussion. In the second leg of the study, 50 vendors were selected by simple random sampling in 2 zones of Bangalore City which were located around the educational institutions. Only direct observation (for checking for compliance to various COTPA sections) and individual interviews were conducted in this part of the study. In both the levels, the semistructured interviews were conducted with open-ended questionnaire using a dictaphone.
Questions related to laws, legislation, licensing, and trade were asked to the tobacco growers and the vendors. Observations were made at point of sales to determine their compliance with various laws. Inductive analysis was conducted and the responses were divided into three categories, that is, awareness of laws, compliance with the concerned laws, and opinion regarding banning tobacco.
The researcher followed the interview schedule to cover predefined themes for discussion and allowed novel themes to emerge freely in both focus groups and interviews.
Both focus group and interview data were analyzed in accordance so as to allow for themes to emerge from the data, alongside analyzing preexisting concepts inferred by the researcher. Separate analysis of focus groups and interviews was considered; however, in view of the identical research question and predefined themes explored, this appeared to yield little more than formal value. Analysis involved transcribing each interview verbatim and familiarization with the data through multiple readings of the transcripts.
Two trained coders coded a random sample of three transcripts from each part of the study, that is, from farmers group and vendors group to establish intercoder agreement through subjective assessment, which is a common practice in qualitative methods for the purpose of determining themes that emerge from the responses. Discrepancies between the coders were discussed with a third coder and resolved. The remaining transcripts were divided among the three coders and coded individually. The themes and codes that emerged were largely related to the Economics of Trade with references to the rules and laws governing tobacco control in India. Section 5–7 of COTPA  was asked and evaluated for the same at the vendor's level.
| » Results|| |
It was seen that 57.5% of farmers and 50% of the vendors were in the age group of 31–40 years and most of the farmers and vendors had education up to high school [Figure 1].
The qualitative analysis results of focus group discussions, interviews, and direct observation by investigator at both levels have been presented below. In general, the findings were consistent with the theoretical perspective with which this study was conducted.
The economics and laws of tobacco trade
The farmers were asked questions which explored the trade of tobacco at the grass-root level such as who buys the tobacco leaves, system of payment, admissible quantities at the auction for sale of tobacco leaves, and profit and loss from such sales.
The farmers revealed that auction for selling of tobacco leaves is done only once a year and that is the time when they can earn from this. Each farmer is supposed to have a license to sell at this auction. The color, quality, and level of curing of leaves determine the rate. Each farmer can sell only up to 1800 kg of leaves with one license. This equals to growth on 3 ac of land; however, it was observed that each farmer had on an average about 5 ac of land for growth of tobacco. The system of payment in auction is completely transparent, and thus, the additional yield enters the illicit trade market as by the law it cannot be sold at the auction and also because the illicit trade is much more lucrative [Figure 2] and [Figure 3]. Hence, it was concluded that although the farmers were aware of the various rules and regulations of the Tobacco Control Board, their compliance to these rules was poor [Figure 4].
This tobacco is mostly utilized in the manufacture of bidis and other undocumented tobacco products. Many farmers stated that the rise in taxes in order to increase the price of the end product has a cascading effect and has hit their profits as well. The impact of rising taxes is more on farmers due to small profit margins than on the companies that sell the end product.
Knowledge about ill effects of tobacco
Most of them were unaware that tobacco smoking and chewing cause various diseases and are not good for health, but they continue to cultivate it for lack of other options. They also wrongly believe that the raw form of tobacco leaves is in fact beneficial for health as it is bitter in taste. This implies that they are unaware that tobacco in its raw form can lead to green tobacco sickness, especially among children.
Opinion on banning tobacco and shifting to alternative cash crops
Most of them were in favor of banning tobacco as they realize that tobacco is the number one cause of preventable deaths in the world. However, they have their own handicaps such as the profit given by tobacco growth is irreplaceable. If provided with adequate compensation and alternatives of the other cash crops, they are willing to support the ban of tobacco.
For instance, on the idea of banning tobacco, one of the farmers said “No problem as such, if we get proper compensation from the government then why not, as it is we are getting very less price for our crop every year due to various taxes being implemented … but the government should come forward…. and take initiative as we have nothing else to do…. other than growing tobacco.”
Overall findings of the first part of the study were consistent with the premise of the study that tobacco control laws are not followed to the hilt and also gave an insight to the point of view of farmers.
Tobacco product vendors
Acquiring products for sale and demand for tobacco
From individual interviews, it was revealed that products were brought from the main markets in Bangalore. It was observed that even tobacco leaves were available for sale in such markets, whereas they are not supposed to be sold loose anywhere. Such tobacco leaves are then used in hand-rolled cigarettes and bidis which again forms a part of the illicit trade.
When asked whether the demand for tobacco products has reduced or not, they stated that despite rising taxes, the demand from their regular consumers has not stopped, they may move to a cheaper cigarette but they will still smoke.
Awareness and compliance to COTPA sections
Most of the vendors were aware of COTPA sections pertaining to smoking in public places, sale to minors, point of sale advertising, etc. However, hardly 20% of those interviewed complied with all the laws [Figure 4].
Results of observation of point of sales were as follows: violation of Section 5 was seen in 47% of tobacco retail outlets. About 62% of the educational institutions had tobacco vendors within 100 yards and 85% of educational institutions did not have boards suggesting that tobacco use is prohibited within 100 yards in violation with Section 6 of COTPA. Many of the tobacco vendors agreed to have sold tobacco to minors less than 18 years age. When asked whether they ask the consumer's age before selling products to them, one of the vendors replied “we do ask but we still give it to them because if I don't sell to them someone else will … and then it is my loss….”
The vendors did not even report people smoking in public places. There was no display of pictorial warnings outside their shops as is the mandate. Around 14 tobacco vendors had beedis without proper pictorial warning with them which violated Section 7 of COTPA.
Knowledge about ill effects of tobacco and effect of pictorial warnings on smokers
All were aware of ill effects of tobacco; however, very few knew that passive smoking is also harmful. It is important for the vendors to know about tobacco smoking as they are constantly exposed to it due to customers smoking around their shop. They also pointed out that pictorial warnings are not having the desired effect and does not deter one from smoking or using tobacco in any form.
Opinion on banning tobacco
The vendors also echoed the views of the farmers in this regard that sale of tobacco products was not giving them a great profit margin and they earned more from other things. One of them was noted saying “Ban or no ban it does not matter, we know its bad but along with Tea, Customers ask so we keep, the margin we get from these cigarettes is very less. You ban it we will not keep otherwise we will keep….”
The present study attempted to explore the various aspects of the trade of tobacco. To understand the flaws in the system, it is first important to understand the legalities of the trade as on paper, which was determined by interviewing the Tobacco Control Board Officers. First, a license is required to grow tobacco (which can be for a maximum of 3 ac), as of today, no new license been issued and only the old ones have to be renewed. The farmers auction their yield in the Tobacco Control Board, the prices for which are set by the regional manager of the Tobacco Control Board, and after leveeing the taxes, the profit to the farmers is reduced. Registered buyers buy these products and the billing is accounted for as payments are made by check. From here, it goes into packaging and manufacturing and reaches the vendors through registered distributors. Apart from this system, there is yet another illicit trade system which was explored in the present study. Instead of the licensed 3 ac, each farmer in the present study was growing at least 5 ac of tobacco and the surplus yield is sold in the local markets devoid of taxes; in this manner, they get ready cash and better profit for their produce, most of this unaccountable produce goes to the bidis manufacturing market. Finally, when it reaches the vendors who also buy these products, they are sold in a very less price, thus indirectly contributing to major portion of the illicit trade of tobacco in India.
Overall, the results of the second leg of the study reiterated the premise that tobacco control laws in India are merely on paper and existing policies are not serving the purpose.
| » Discussion|| |
In the first leg of the study, the point of view of tobacco farmers was explored on three important counts: the trade of tobacco, their knowledge on its ill effects, and their opinion on banning its production. It was brought to light that the rules of the Tobacco Control Board are often violated and illicit trade of tobacco takes shape. There are no official estimates available, but recent studies suggest that about 7–14% of cigarettes consumed are untaxed and about 52–70% of bidis consumed were untaxed. This is the evidence of this existing illicit trade; however, the root cause of this, which is at the level of the farmers, has seldom been explored.
Regarding knowledge of ill effects of tobacco, the farmers were aware that consuming tobacco causes various diseases, but they were not aware of the direct effect on their health due to handling raw tobacco leaves over a long period of time which may cause GreenTobaccoSickness.,,
With respect to banning the crop altogether, the farmers were in agreement, provided they receive financial support to grow other cash crops. It has been suggested by the FCTC to phase out tobacco growth slowly, and few countries have acted upon it as well; Sri Lanka for instance has announced that they will ban the crop by 2020. However, this move has been questioned by various segments of the society for various economic purposes., India should follow the same course of action. However Tobacco Farmers should be provided with Viable alternatives before completely banning as it would promote illegal cultivation and smuggling of Tobacco products.
In the second leg of the study, we explored the viewpoint of tobacco vendors. Chaudhry et al. found that the most common violation of point of sale was that the advertisement boards were larger in size than permitted by law. Similar results were obtained in the present study.
The compliance of laws among the tobacco growers “perceived effectiveness of policies and services,” consistent with other qualitative research, participants had unfavorable attitudes toward tobacco control measures and highlighted the perceived ineffectiveness of policies such as smoking in public places, cigarettes, and hidden sales displays. The growers of tobacco farmers know the laws and at the same time also know that these laws are not stringent and have been repeatedly failed to comply with it. The lack of any concrete laws for the tobacco growers has been the major reason for this lax attitude.
Nonexistence of the statutory display boards prohibiting sale of tobacco products outside schools in the states of Rajasthan, Maharashtra, Kerala, Karnataka, Bihar, and Delhi was reported in 78%, 98%, 82%, 71%, 93%, and 62%, respectively.,,,,, This was found to be 85% in the present study.
The compliance to Sections 4–6 in District of Alwar, Rajasthan, was found to be high which was not in accordance with in the present study.
The taxes on tobacco products have been levied by the government with the intention to decrease the consumption of tobacco products, but during the study, it was found to be otherwise. It was noted that any tobacco product price increase needs to be substantial in order to have a real impact on motivations, despite research demonstrating the effectiveness of this policy as it currently stands, although some research has shown that price increases may lead to an increase in contraband tobacco use in smokers who feel highly addicted.
There are no stringent laws for farmers of tobacco hence a bill should be passed so that there are laws for the farmers who grow tobacco. Education regarding the ill effects of tobacco must be explained to the farmers and the vendors. An option of growing alternate crops should be encouraged among the farmers and sufficient compensation should be given to these farmers. The law should become more stringent with continuous monitoring at all the levels of trade and trail of tobacco.
A small sample was recruited which limits generalizability; however, this was the first exploratory step toward informing the shortcomings of tobacco prevention. It is recommended to recruit a larger sample and conduct a quantitative study in order to replicate and further generalize these results.
| » Conclusion|| |
There are numerous studies about percentages and numbers about who complies with the laws and who is not, but the point of view of actual stakeholders of this business is actually lost within these numbers. A nationwide study to explore their views may provide a whole new insight that may enable us to combat this menace more effectively.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]