The number of women in the country looking for a nicotine-fix in the country is on the rise. According to the global adult tobacco survey 2009-2010 (GATS), women using tobacco now make for 20.3 percent of tobacco users while the figure used to be 11.5 pc in 2005. The health ministry-conducted survey also says that there has been a drop of 10 pc in the number of male tobacco users in the same period - from 57.6 pc in 2005 to 47.9 pc in 2010.

At 274.9 million, nearly a third of India's population is tobacco dependent, reveals the survey, of which 59.5 pc chew it and 25.05 pc somke it.

Beedi somking is 9.2 percent, higher than the cigarette usage which is at 5.7 percent.

The survey was conducted in 29 states and two union territories (Puducherry and Chandigarh) in India in the year 2009-2010 covering almost 99.9 percent of the population.

Despite anti-tobacco laws in place and various methods adopted to discourage people from using tobacco like pictorial warnings and advertisements, the survey highlights an increase in tobacco consumption among women with usage higher in rural areas than in urban. 17.3 percent women use smokeless tobacco only while two percent use only smoking tobacco, the report says.

Inaugurating GATS, health minister Ghulam Nabi Azad said that if the present trend of smoking continues in India, deaths resulting from tobacco use will grow at an alarming rate.

“The tobacco industry has shifted its base to the developing countries due to stringent tobacco control initiatives by the developed countries. Countries like India are being targeted as potential markets by the tobacco industry,” said Azad. He added that the focus is gradually shifting to the younger generation, luring them into tobacco products.

“By 2030, six out of every 10 tobacco-attributable deaths are expected to be in the developing countries,” he said.

Tobacco is the single most preventable cause of death in the world after road traffic accidents. It causes nearly five million deaths across the globe and more than 80 percent of these deaths occur in the developing countries. In India, 8 to 10 lakh people die due to tobacco related diseases every year.

A major share of funds for GATS came from the health ministry and they designated the International Institute of Population Sciences (IIPS), Mumbai, as the nodal agency for conducting the survey. Technical assistance was provided by Centre for Disease Control and Prevention (CDC), the World Health Organisation (WHO), the John Hopkins Bloomberg School of Public Health and Research Triangle Institute International.

Of all the 29 states covered under the survey, Mizoram has the highest prevalence of tobacco use at 67 percent and Goa has the lowest at nine percent. The prevalence of tobacco use is higher than the national average in 14 states including Bihar, Chattisgarh, Jharkhand, Madhya Pradesh, Orissa, West Bengal, Sikkim and all seven north-eastern states. While smokeless tobacco users are more in rural than areas, urban areas see a higher prevalence of cigarette smoking.

In order to check tobacco consumption, Azad said, tobacco production in India is also of great concern as India is the among the top three tobacco producers in the world. Millions of farmers in India grow tobacco and an estimated 5.5 million are bidi workers, mainly among them are women and children, said Azad.

“We must work towards moving farmers and farm workers out of the tobacco industry. We cannot indefinitely tolerate a public health hazard in the name of protecting livelihoods. We must provide alternative livelihoods and encourage farmers cultivating tobacco to change to other cash crops,” he said.

Adding to what the health minister said, minister of state for health Dinesh Trivedi said that the health ministry needs to coordinate with other ministries to look for alternative crops tobacco farmers can switch to.

“I have written a letter to the agriculture minister on devising alternative products or cash crops for farmers who grow tobacco. There should be coordination between the two ministries. The agriculture ministry hasn’t replied yet,” said Trivedi. Calling all tobacco programmes in India “elitist”, he said that the focus should be on the rural areas.

The GATS recommends that the government should introduce targeted programmes addressing females, youth and children with special focus on cessation.  It adds that the tobacco control strategies should be mainstreamed with national health programmes such as National Rural Health Mission (NRHM). Coordination between various ministries and nationwide implementation of the National Tobacco Control Programme launched in 2007-08 in the 12th five year plan may help in spreading a strong message across.

Meanwhile, health secretary Sujatha Rao said that the ministry is planning to have councellors at the community health centres to train doctors and people on nutrition and tobacco issues. “This is the first time a programme for preventive education for the village community will be introduced,” she said.

GATS survey was conducted among people above the age of 15.

India is the second largest consumer of tobacco in the world with an estimated 274.9 million tobacco users.