THE Supreme Court should be complimented for issuing the recent directive to all States and Union Territories immediately to issue orders banning smoking in public places. (As reported, public places include "bus stops, trains, public transport, hospitals, health institutes, public offices, court buildings, educational institutions, libraries and auditoriums"). If smoking is injurious to the health of human beings (as has been proved conclusively by the best medical evidence), there is no doubt whatever that the court’s order will lead to an improvement in the health of the Indian public, generally speaking. It is not only the smokers who will be benefited (by being prevented from smoking in certain places) but also non-smokers through the agency of "passive smoking".

Even so, questions have been asked about whether such a preventive measure will actually lead to a decrease in smoking thereby resulting in an improvement in public health. Let us first see what the World Bank has to say on the subject. In a study on tobacco consumption, two effects of bans on smoking in public places have been pointed out.

First, "the most obvious benefit of these restrictions is clearly to non-smokers, who are spared exposure to the health risks and nuisance of environmental tobacco smoke".

However, the point is also made that since "most non-smokers" exposure to others’ smoke is not in public places or workplaces, but in the home", the restrictions therefore "represent only a partial means of addressing the needs of non-smokers".

Second, the study says that the restrictions have the effect of "(reducing) some smokers’ consumption of cigarettes and induce some to quit". It cites the example of the US where "such restrictions have reduced tobacco consumption by between 4 and 10 per cent, according to various estimates".

However, the study also says that, for such restrictions to work, "it appears that there must be a general level of social support for them, and an awareness of the health consequences of exposure to environmental tobacco smoke". The study adds that "outside the United States, there are comparatively few data on the effectiveness of indoor smoking restrictions".

The discerning mind will at once detect the point that there is no one line of policy action that will be effective in cutting-down on smoking in all countries. In fact, the World Bank study has itself referred to this caveat when it says that. "All governments recognise that, in forming their policies, they take account of many factors, and not only economics", and that "tobacco control policies are no exception".

The bottomline of any effort to control tobacco consumption with a potential for success must be "social support", a point which has rightly been emphasised by the World Bank study already referred to. It says : "To be effective, any Government that decides to implement tobacco controls must do so in a context in which the decision has broad popular support". The study adds that "Governments alone cannot achieve success without the involvement of civil society, the private sector, and interest groups. Programmes are more likely to succeed if there is collective agreement in and ownership of them across a broad coalition of social interests with the power to implement and sustain change".

More fundamentally, the study says : "In implementing a package, each country would probably give different emphasis to different interventions, depending on the country’s circumstances. For example, a country whose cigarette tax rates are currently lower than those of its neighbours is likely to see a particularly strong effect of tax increases on cigarette consumption.

Similarly, a relatively well-educated and affluent population will respond less to price, and more to new information, than less educated and poorer populations. Cultural factors, such as a history of totalitarian rule, might also affect the ease with which some measures, such as smoking bans in public places, are accepted". The study concludes that although "these generalisations are simplistic", policymakers may find them "a useful starting point".

In these circumstances, what is absolutely essential is that, since there is bound to be political opposition to the sort of change contemplated, the "key stakeholders on both the supply and demand sides in each country" should be identified by the authorities. To quote the study once again, "For example, policymakers might note that winners, such as non-smokers, may be a scattered and dispersed group, while losers, such as tobacco farmers, may have a powerful political and emotional voice". What is, therefore, required is "careful planning and political mapping" to facilitate "a smooth transition from reliance on tobacco to independence from it, whatever the nature of the economy and the national political framework".

There is little doubt that the ultimate success or failure of the Supreme Court’s interim directive in achieving the objective of reducing tobacco consumption in the country (on health grounds) will depend on how thoroughly the Government has done its homework along the lines pointed out by the World Bank study. Given the prevailing tobacco consumption scenario in India, it would appear that homework has not been done at all. Briefly, the target of the Government’s current campaign against tobacco consumption appears to be the cigarette-manufacturing industry which, however, is accountable for just 16 per cent of total tobacco consumption in the country, a proportion that has been declining in recent years. The question is : What have the authorities done to curb tobacco consumption of the other types, namely, the "bidi-smoking" and chewing varieties ? In fact, in India at least, the principal threat to the population’s health generated by tobacco consumption is to be found in "bidi-smoking", which accounts for 32 per cent of total tobacco consumption, and chewing-tobacco, which covers as much as 48 per cent of such consumption.

In recent years, the consumption of chewing-tobacco has shot up from just 27 per cent to its present level while bidis and cigarettes have declined from as high a level as 52 per cent and 19 per cent, respectively.

Certainly, a beginning should be made to curb the menace of tobacco consumption in the country. But, in the process, the Government should not be seen to be discriminatory in its approach which, in this specific case at least, would be tantamount to disfiguring a worthy campaign, both at the national and international levels.