Plain tobacco packaging in India: a giant leap for global public health

The world is watching Australia progress toward tobacco plain packaging. A number of developed countries have said they will follow suit. But as tobacco companies lose their grip in developed countries, it’s likely they’ll increasingly target emerging markets with their poison.

If the world is watching Australia (with its mere 22 million people) move towards plain packaging, imagine how people might sit up and listen if India, the second-largest producer and consumer of tobacco products in the world, developed a similar policy!

So, when the Australia-India Institute tobacco control taskforce held a high-level launch of its policy document on plain packaging at the Constitution Club of India in New Delhi, we all waited intently for a response from the Ministry of Health and Family Welfare.

We were more than encouraged by the response.

Support from the India representative of the World Health Organization and a number of politicians was expected. But we were very pleased that the Joint Secretary of the Ministry of Health and Welfare said the ministry would deliberate on this position as a possible policy measure in consultation with other important stakeholders within government and civil society.

Steps in the right direction

Just as in Australia, Indian tobacco control law largely prohibits advertisement and promotion of tobacco products. But this currently excludes packaging and point-of-sale displays so the industry increasingly relies on packaging for promotion.

We’re sure the support of the Indian Ministry of Health and Family Welfare was not missed by the big tobacco companies. After all, this is a policy that would affect a fifth of the world’s population and a quarter of the world’s tobacco users.

Given the multiple vested interests and a powerful tobacco lobby, we’re aware that introducing such a policy in India will be challenging. It will take a few years and require significant, persistent advocacy and research.

At the launch of the policy document, the Joint Secretary of the Ministry of Health and Welfare also said the ministry was closely watching the progress in Australia, and we can only assume that the Ministry of Health and Family Welfare was encouraged by the High Court ruling last week. We believe that India can learn from this and other Australian experiences in moving toward plain packaging.

A helping hand

Australia is giving India technical assistance in research and advocacy through the Australia-India Institute taskforce, which was convened with the idea of sharing experiences and utilising its significant expertise and experience on plain packaging.

This taskforce has been fuelled by considerable enthusiasm from the international tobacco control community and, encouragingly, from the taskforce members within India. Indeed, the keenness of the Indian partners has prompted us to go beyond our original mandate and undertake research on the acceptability of plain packaging as well as producing an advocacy pack.

We have also developed a useful toolkit to further disseminate our work.

Local knowledge

We released the preliminary findings from market research by the taskforce through the Public Health Foundation of India on the acceptability of plain packaging and attitudes toward packaging, brands and package colouring at the launch.

It showed that children’s interest in tobacco is significantly influenced by pack colours and branding. And, it demonstrated the importance of India-specific research before adopting such initiatives. We found, for instance, that Indians see dark grey as the least attractive colour whereas in Australia, the chosen colour is olive-green.

The research also revealed that the context in India is complex, with multiple forms of non-smoked and smoking tobacco, and various forms of the latter. All of these forms of tobacco must be included in any legislation because tobacco companies will find loopholes and substitute one product for another.

In India, 5500 children try tobacco for the first time every day. Attractive packaging is designed to make sure it will not be the last time. This policy initiative, if implemented along with other proven interventions in tobacco control, will save thousands of lives and prevent thousands of young people from becoming addicted to a substance that kills more people worldwide than any other.

We are confident that our taskforce can assist Indian organisations such as the International Union against Tuberculosis and Lung Disease and Public Health Foundation of India to work towards plain packaging. But we need collaboration between health and tobacco control organisations, government departments and the community if we are to see plain packaging become a reality on the sub-continent.

This article has been amended by request of the author. The changes were minor and have not affected the substance of the article.

Nathan Grills works for the Nossal Institute, the PHFI and the CHGN Uttarkhand Cluster all of whom receive support to undertake tobacco control activities. We receive funding from AusAID and the Australia India Institute for work on plain packaging in India.

Amitabh Mattoo does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.