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Tobacco smoking of bidis and cigarettes causes about one million deaths a year in India. India's relatively high consumption is due in part to a historically low or no tax on bidis and an inefficient, complex system of taxing cigarettes. In the context of planned tax reforms in India, we provide specific recommendations to raise tobacco taxes and t...
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Citations
... These hand-rolled sticks, costing less than a fifth of the cost of cigarettes, are popular among the poor. 8 Taxes on bidis are so low 8 that small manufacturers can exploit small companies to avoid the taxes completely. The health risks from bidi smoking are equal to as those from the cigarette, as shown in a large Mumbai cohort study where the age-adjusted relative risk of all-cause mortality among male bidi smokers was 1.64 (95% CI 1.47 to 1.81) and among cigarette smokers, 1.37 (95% CI 1.23 to 1.53). ...
The South Asian region occupies a unique place in global tobacco control because of a broad spectrum of widely used tobacco products and the consequent mix of local and transnational tobacco industries. Cigarette use is especially high among males in many countries, while bidis are widely used in India, Bangladesh and Sri Lanka, and are very inexpensive. Smokeless tobacco use is a global problem, but the bulk of use is in South Asia and there is emerging promotion of newly developed tobacco and nicotine products across the region. With the transnational cigarette industry contributing a significant amount in taxes, the bidi industry employing millions of workers and many farmers engaged in tobacco farming, the industry is powerful and exploits this when countering proposed advancements in tobacco control policy. Despite industry interference and major challenges, this region has achieved remarkable successes in tobacco control, including large pictorial warnings that cover up to 80%–90% of the pack in some countries, stringent rules on depiction of tobacco in movies, bans on advertising and promotion, and smoke-free public places. Key challenges include increasing the tax component of retail prices and reducing tax concessions, regulating newly developed products and countering the aggressive tactics of the tobacco industry. Strategies to advance tobacco control in the region may also include standardised packaging of tobacco products, sustained mass media campaigns to warn the population of the harms of tobacco use and promote use of available cost-covered cessation services, and supply-side measures such as vendor licensing.
... Despite the overall progress India made in reducing tobacco consumption, it remains a public health priority, not only because of the situation in the north-eastern regions, but also because in India as a whole, the levels of tobacco use in 2015-2016 were largely comparable to the levels in 1998-1999 (Table S2), and smokeless tobacco and bidi consumption still play a major role in many parts of the country (Table S1). The complex tax structure in India has kept taxes on cigarettes relatively low, and taxes on bidis and smokeless tobacco products very low, compared to other countries [41,50]. Thus, bidis and smokeless tobacco products remain quite affordable. ...
... Whereas taxes on cigarettes account for approximately 38% of the retail price, taxes on bidis account only 9% of the retail price. These taxes are well below the tax rates on tobacco products recommended by the World Bank of 65-80% of the retail price [50,51]. In 2011 in India, the price of a single cigarette was US$0.026, whereas the price of a single bidi was US$0.0033 51,52 . ...
Background
Evidence regarding the progression of the tobacco epidemic remains fragmented in low- and middle-income countries. In India, most of the studies that examined tobacco consumption focused on one time point, on the country as a whole, and on men. Despite important gender differences in tobacco consumption, vast economic and cultural differences exist within India. We, therefore, assessed the progression of the tobacco epidemic in India on both the national and the regional level, by gender.
Methods
We use information on current tobacco use among Indians aged 15–49 from three rounds of the National Family Health Survey (NFHS) (1998-99, 2005-06, 2015-16) to estimate the age-standardized sex specific smoking and smokeless tobacco prevalence across India and its states.
Results
Age-standardized tobacco use prevalence in India increased between 1998-1999 and 2005-2006, and declined from 2005-2006 to 2015–2016, simultaneously for men and women. There are substantial spatial differences in the progression of the tobacco epidemic in India. While tobacco use declined in the majority of states, we observe high and increasing use for men in the north-eastern states of Manipur, Mizoram and Nagaland, and for women in the western state of Gujarat and north-eastern state of Manipur. We observed even more states with a recent increasing prevalence in either tobacco smoking or smokeless tobacco. Throughout, prevalence of tobacco use has been higher among men than women for all Indian regions, and remained higher than the national average in the north-eastern states.
Conclusions
Our results suggest that India and the majority of its states experienced a ‘compressed tobacco epidemic’ in which the prevalence of tobacco consumption increased and decreased simultaneously for women and men over a comparatively short period of time. Despite the overall progress India made in reducing tobacco use, further lowering tobacco consumption remains a public health priority, as the prevalence of smoking and/or smokeless tobacco use remains high in a number of states. We therefore conclude that tobacco regulations should be expanded with the aim of reducing the overall health burden associated with tobacco consumption across India.
... 3,4 India is home to 10% of the world's total smokers with bidi (85%) and cigarette (15%) as the two most widely used smoked tobacco products. 5 The bidis are usually smoked by the people of lower socioeconomic status and cigarettes are smoked by the higher socioeconomic status. 6 Sometimes smokers switch from cigarette smoking to bidi smoking when they are incapable of purchasing cigarettes because of their high price. ...
... 14 A study by Jha P et al has also found that from 1990 to 2011, the affordability of cigarettes and bidis has increased by 175% and 300% respectively in India. 5 Our study also found that the tax increase for cigarettes and bidis should be substantial as compared to an increase in the per capita GDP to overcome the effect of income growth on affordability. A study by Guindon G et al found that during the period from the years 2000e2018 the price of cigarettes and bidi s didn't increase much as compared to the increase in income which made a real increase in prices of these products relatively flat, thus making cigarettes and bidi 40% and 20% more affordable than they were in 2000. ...
Background
Easy affordability of tobacco products is one of the reasons for increased tobacco consumption. The study attempts to project the affordability of cigarettes and bidis from 2017 to 2025 in India.
Methods
The affordability was measured in terms of Relative Income Price (RIP) and the price of smoked tobacco products. RIP depends upon per capita gross domestic production (GDP) required to purchase 100 packets of cigarettes. The GDP per capita was calculated using data from National Accounts Division, Central Statistics Office, 2017. The price of cigarettes and bidis was calculated using data from WHO global report on tobacco epidemics, 2017. The projections were done from 2017 to 2025 assuming constant rise of per capita GDP as in the year 2017 (7%) and price rise of cigarette and bidis due to inflation (4%). Four and Six scenarios for cigarettes and bidis respectively, of different tax rises (0% -200%) in the years 2017 - 2025 were taken.
Results
Bidis were more affordable at lower increments in tax as compared to cigarettes. Affordability for cigarettes decreased to - 9.9 % after a 100% increase in tax whereas affordability of bidi decreased to - 8.61% after a 200% increase in tax by the end of 2025.
Conclusion
Since bidis are more easily affordable than cigarettes, an adequate increase in taxes of bidi should be made to make it less affordable.
... The widespread consumption of tobacco leads to higher incidences of tobacco-related illness and deaths. Tobacco use was estimated to have triggered one million deaths in India (2010), with 70% of the victims in the middle age groups (Rao, 2011). In addition, it has been shown that tobacco use is a modifiable risk for non-communicable diseases, such as heart disease and type 2 diabetes (Kumar et al., 2015). ...
... Higher use of tobacco among males, illiterates, economically weak, socially backward and alcohol users suggest the need for targeted efforts to raise their knowledge and awareness about the harmful effects of tobacco use and more vigorous enforcement of tobacco control policies (Pradhan et al., 2019). Modest action on tobacco taxes in India might well save millions of lives (Rao, 2011). Insights from the experiences of tobacco control programmes also show a need to monitor socio-economic and state-level inequalities in tobacco use in India. ...
Consistent tobacco consumption by large segments of the Indian population has resulted in a significant health burden for the country. Historical and cultural influences have influenced tobacco use to a considerable extent. As a general observation, its consumption is seen to be more prevalent among educated and working individuals. Despite the reduction in the prevalence of smoking, data shows that the proportion of male smokers aged 15–69 years has increased substantially over the last 15 years. The focus of the present study is on a state-level geo-spatial analysis of tobacco consumption and its cessation in working and non-working groups in the Indian population. Cross-sectional data from the Global Adult Tobacco Survey (2016–17) for India were used for analysis. Descriptive statistics and geo-spatial analysis were carried out. The findings show that substance use is higher in the hilly and coastal parts of the Indian states. Tobacco consumption was highest in Sikkim, the North-Eastern, Eastern and the Central states of India. However, on a positive note, the findings also show that, due to tobacco control or prevention programmes, more than 60% of the people from both working and non-working groups living in these high consumption states (excluding Karnataka Sikkim, Tripura, Nagaland and Manipur) were trying to quit the tobacco habit. Precisely targeted prevention and counselling services, nicotine replacement therapy, and medication are required to accelerate this trend. There is a need for more interventions to increase the present low levels of tobacco cessation.
... Relative to income, cigarettes, and bidis have become less costly in the last decade [13]. Moreover and most relevant for policy, India's complicated tax structure has kept overall taxes on cigarettes low relative to other countries, with particularly low taxes on the inexpensive, short cigarettes that compete with the bidi market [14][15][16]. ...
Introduction: Business Process Outsourcing (BPO) industry has been rapidly expanding in India over the last 10 years. While em
... Relative to income, cigarettes, and bidis have become less costly in the last decade [13]. Moreover and most relevant for policy, India's complicated tax structure has kept overall taxes on cigarettes low relative to other countries, with particularly low taxes on the inexpensive, short cigarettes that compete with the bidi market [14][15][16]. ...
... A 10% increase in tobacco price is estimated to reduce bidi consumption by 9.1% and cigarette consumption by 2.6%. In terms of socioeconomic differential impact, it is estimated that this 10% increase would reduce cigarette consumption by 3.4% in rural India and 1.9% in urban India, while it would reduce bidi consumption by 9.2% and 8.5% in rural and urban India, respectively [22]. ...
... Another study estimated that increasing the tax as a percentage of retail price to 33% for bidis and 58% for cigarettes would lead to about 14 million smokers quitting and 27 million children never starting, thereby saving about 69 million years of healthy life over the next 40 years. This tax increase would also raise about INR 73 billion, while incurring no or minimal economic harm [22]. Given the low average prices of both bidis and cigarettes, neither of these percentage increases is a very large price change in INR equivalents. ...
... However, bidis are least taxed among all tobacco products in India and this remains the biggest challenge in effective implementation of the tobacco taxation policy in India. Although prevalence of smokeless tobacco use is double that of smokers in India [26], reducing oral tobacco consumption through taxes, is not as feasible as reducing smoked tobacco consumption, due to the large and informal market of suppliers and very low price of smokeless tobacco [22]. Another disturbing fact is that higher income levels have expanded the tobacco purchasing power of Indian women and youth, and suggests that the present taxation system does not motivate quitting [27]. ...
... Tendu leaves are found abundantly in Jharkhand. They fetch the state around `500 crore, annually, in the manufacture of bidi (Nandi, Guindon, Jha, Joseph, & John, 2011). The figure can go up, exponentially, if the leaves are used to make cigars. ...
In all, about a billion people rely on forests for their food, fuel and income. In India alone, forests account for over a fifth of the country’s total geographical area. Of this, Jharkhand consists of 23,605 sq. km, that is, 29.61 per cent. Here, eight out of ten tribals live in and around forests. About 60 per cent of these tribals are dependent on forests. Despite this, it is a matter of extreme paradox that nothing is being done in the state to utilise forests and its minor produce though things are being done to strengthen the horticulture mission catering to only 17 per cent of cultivable land. This article brings out the facts how ‘value addition’ to minor forest produce (MFP) can not only generate income opportunity for tribals of Jharkhand but can also add to the state’s revenue in a huge way. Till date, MFP and its significance on ‘value addition’ have not even been flagged as an economic issue in Jharkhand. For instance, products made after ‘value addition’ done to an MFP like tendu leaves is generating a heavy revenue to the state. If the same is done to other MFPs such as lac and karanj, it can transform the economic condition of forest dwellers in the state. Figures reveal that value addition done to horticulture, globally, is around 70 per cent but what has been done in India forms a mere 5 per cent. To cater to this small portion, the Ministry of Food Processing Industries has been constituted at the Centre but for forest produce none exists. In Jharkhand too, Mega Food Parks are being developed and only recently, foundation for an agriculture university has been laid at Barhi. This research suggests that the state needs a forest-centric research institute. Why cannot we have a Jharkhand Forest University on the lines of Birsa Agriculture University? Thereafter, the article talks about how amendments need to be made in archaic forest laws making community forest rights more significant. It also shows how panchayats have a significant role to play in the protection of forests. Above all, the study depicts the way out as to how Jharkhand can be the epitome of forest-centric research in the country.
... 17 As Indian consumers' income grows, cigarettes have been gradually displacing bidis. 18,19 Although most existing studies find prices of at least one product negatively associated with demand, [11][12][13][14][15] how the price effects differ by products or different tobacco use margins (i.e., smoking onset and cessation) is unclear. 20,21 Evidence on the relationships among these products (i.e., whether they are substitutes or complementarities) is also mixed and indicates that such relationships may vary by socioeconomic status. ...
... 11,14 However, studies using more recent data suggest that cigarette taxes have a greater impact on reducing smoking and that cigarettes have been displacing bidis in recent years. 15,18,19 Given that we used historical price data from 1998-2011 linked with retrospective information on smoking initiation, it is not surprising that the associations between bidi prices and smoking onset were found to be greater than the associations between cigarette prices and smoking onset. In addition, because bidi prices have been much cheaper than cigarette prices, they may play a bigger role in smoking onset. ...
... There are studies documenting that cigarettes have been displacing bidis in recent years, which also support this hypothesis. 18,19 Second, we could not observe migration between rural and urban divisions in the survey data and assumed that respondents never moved during the study period. This assumption may be violated and thus lead to biased estimates if people who smoked became poor and as a result moved from urban to poorer rural districts. ...
Background
Tobacco use is prevalent among youth and adults in India. However, direct evidence on how increasing taxes or prices affect tobacco use onset is scarce.
Objective
To analyse the associations between cigarette and bidi prices and smoking onset in India, and how these associations differ by socioeconomic status.
Methodology
The Wave 1 of the Tobacco Control Policy Evaluation India Survey by the International Tobacco Control Project contains information on the age at smoking onset for cigarettes and bidis. Using this information, data were expanded to a yearly pseudo-panel dataset that tracked respondents at risk of smoking onset from 1998 to 2011. The associations between bidi prices and bidi smoking onset, between cigarette prices and cigarette smoking onset, and between bidi and cigarette prices and any smoking onset were examined using a discrete-time hazard model with a logit link function. Stratified analyses were conducted to examine the difference in these associations by rural versus urban division.
Results
We found that higher bidi prices were significantly associated with a lowered hazard of bidi smoking onset (OR 0.42, 95% CI 0.35 to 0.51). Higher cigarette prices were significantly (OR 0.87, 95% CI 0.83 to 0.92) associated with a lowered hazard of cigarette smoking onset among urban residents, but this association was non-significant when SEs were clustered at the state level. In addition, the association between increasing bidis prices and lowered hazards of bidi smoking onset was greater for urban residents than for rural ones (p<0.01).
Conclusions
Under the new regime of a central goods and service system, policymakers may need to raise the prices of tobacco products sufficiently to curb smoking onset.
... Because of the structure of the existing tobacco policies and state-owned tobacco industry, we believe that a priority should be placed on full implementation of all MPOWER measures [2] including comprehensive smoking bans and large excise tax hikes. Following India's differentially taxed cigarettes based on the length of cigarettes may help mitigate brand-switching and other compensating behaviors [73]. Higher taxes and workplace smoking bans can work well together and are complimentary: by having a mutually strengthening effect (eg, smoking bans impose social norms and enhance the price effect of taxes) they can reinforce each other to both lower consumption and bring large health and economic benefits to households. ...
Background
Tobacco taxation and smoke–free workplaces reduce smoking, tobacco–related premature deaths and associated out–of–pocket health care expenditures. We examine the distributional consequences of a price increase in tobacco products through an excise tax hike, and of an implementation of smoke–free workplaces, in China.
Methods
We use extended cost–effectiveness analysis (ECEA) to evaluate, across income quintiles of the male population (the large majority of Chinese smokers), the premature deaths averted, the change in tax revenues generated, and the financial risk protection procured (eg, poverty cases averted, defined as the number of individuals no longer facing tobacco–related out–of–pocket expenditures for disease treatment, that would otherwise impoverish them), that would follow a 75% increase in cigarette prices through substantial increments in excise tax fully passed onto consumers, and a nationwide total implementation of workplace smoking bans.
Results
A 75% increase in cigarette prices would avert about 24 million premature deaths among the current Chinese male population, with a third among the bottom income quintile, increase additional tax revenues by US$ 46 billion annually, and prevent around 9 million poverty cases, 19% of which among the bottom income quintile. Implementation of smoking bans in workplaces would avert about 12 million premature deaths, with a fifth among the bottom income quintile, decrease tax revenues by US$ 7 billion annually, and prevent around 4 million poverty cases, 12% of which among the bottom income quintile.
Conclusions
Increased excise taxes on tobacco products and workplace smoking bans can procure large health and economic benefits to the Chinese population, especially among the poor.
