Delivering news to tobacco control professionalsMaadhyam

p2 Tobacco Control Updates- India

p4 Global Tobacco Control Updates

p5 Publications

p6 Workshops & Programmes

Vol. 2 April - June 2010

WHAT'S NEWTobacco-Free Commonwealth Games Delhi 2010

The Ministry of Health & Family, GOI has approved and circulated 'Tobacco Free Commonwealth Games (CWG) Delhi 2010' guidelines. The guidelines, which follow a stepwise approach, are intended to assist officials at all CWG venues, residential complexes and transport systems in implementing a tobacco free games policy.

Global Adult Tobacco Survey (GATS)

For the first time, a survey on adult tobacco use in India has been conducted by the International Institute for Population Sciences (IIPS), GOI in collaboration with the Ministry of Health & Family Welfare (MoHFW), GOI, U.S. Centers for Disease Control and Prevention (CDC) and WHO. GATS is a standard global survey designed to measure and monitor adult tobacco use. GATS India was conducted in 2009-10 as a household survey of persons aged 15 years old and over, in 29 states and 2 UTs to obtain estimates of prevalence of tobacco use, exposure to tobacco use through media etc. GATS India results will be released by MoHFW soon.

Protests against Global Tobacco Networking Forum 2010

Tobacco control organizations have organized themselves to collectively lobby against the Global Tobacco Networking Forum (GTNF) sponsored by the Tobacco Board of India, Ministry of Commerce & Industry, GOI, in Bangalore in October 2010.

The first issue of HRIDAY's tobacco control newsletter 'Maadhyam: Delivering news to tobacco control professionals' was released on World No Tobacco Day (May 31) this year. The intent has been to initiate a medium of information sharing on the status of tobacco control in India, and also globally, to various stakeholders across the country. Another important premise of this quarterly publication has been to reach out to as many grassroots level organizations and government officials as possible, as they may not have access to information on tobacco control that other national and state level organizations do on a regular basis.

Thus, a thorough dissemination strategy was developed to send out over a thousand copies of Maadhyam all across the country to NGOs, government officials, legal professionals, law schools, academic researchers and all members of the Advocacy Forum for Tobacco Control (AFTC) and to a number of international organizations as well. An electronic version of the newsletter was uploaded on the HRIDAY website and e-mailed to partners as well.

Over the weeks following the release, the newsletter received very constructive and encouraging feedback from various quarters. This volume has attempted to incorporate many of the creative suggestions that were sent, in order to maintain Maadhyam's collaborative spirit. HRIDAY is thankful to all partners and individuals who have contributed to making the first issue a success. Also, the success of subsequent issues of this newsletter and for Maadhyam to become a significant repository of information on tobacco control, continued support from all partners in the field is crucial.

This second issue of Maadhyam includes updates on activities organised during this World No Tobacco Day across India, the Advocacy Forum for Tobacco Control Networking Conference 2010, litigation related to violations of the tobacco control law, international events promoting tobacco control and various research publications on studies related to tobacco control.

“I want to show my appreciation to HRIDAY for coming up with a quality newsletter. It is well-conceived and rightly targeted. It rises above several publications that one sees on the topic, which usually recycle news and articles. The division into national and international news and events is well-taken. I certainly think that it is classy as a newsletter. So congratulations HRIDAY”.

Dr. Mira Aghi (Behavioural Scientist & AFTC Advisory Committee Member)

“This is an excellent initiative from HRIDAY. The newsletter is very informative and provides a good picture of some of the tobacco control initiatives that are underway in the country. I look forward to more thematic coverage in future volumes.”

Dr. Vinayak Prasad (Senior Advisor, WHO Tobacco Free Initiative, Geneva)

“Congratulations on the publication of the first quarterly newsletter. It looks and reads well. I'm sure it will be a very useful update for people in India and abroad.”

Patricia Lambert (Director, International Legal Consortium, Campaign for

Tobacco Free Kids, USA)

Some of the encouraging comments received on Maadhyam -

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World No Tobacco Day – May 31, 2010

This year, World No Tobacco Day (WNTD) was observed to create awareness about the risks of marketing tobacco to women and young girls. Women who use tobacco (chew or smoke) are at double the risk of death from a tobacco related disease as compared to men who use tobacco in any form. Recognizing this, the WHO global treaty on tobacco control recommends the prohibition of promotion, advertising and sponsorships by tobacco companies in any way. Therefore, this World No Tobacco Day was devoted to generating awareness about tobacco marketing to women, so that women can make more informed and healthy decisions. Tobacco control organizations across India including Jan Jagran Kendra, Gram Shikshan Foundation, Rajasthan Cancer Foundation, West Bengal Voluntary Health Association, Indian Cancer Society, Institute of Public Health, Tata Memorial Hospital, Centre for Multidisciplinary Development Research, Generation Saviour Association and Institute of Research and Development for the Rural Poor Trust planned numerous activities to mark the event and raise awareness about the effects of tobacco use, especially on women.

A number of organizations including HRIDAY laid emphasis on sensitizing the media on the theme of this year's WNTD and also the tobacco epidemic in general. HRIDAY worked with journalists from leading national newspapers to create comprehensive accounts of the status of tobacco control and various trends of tobacco use in India. In an effort to highlight tobacco control issues through electronic media, experts and youth volunteers from HRIDAY collaborated with India's national broadcaster, Doordarshan, for a show on women and tobacco. Some other WNTD 2010 activities –

• With support from The Union, four government territories across India were declared smoke-free on WNTD 2010. Although previously, a number of cities like Chandigarh have become smoke-free, Sikkim became the first Indian state to be declared smoke-free on May 31, followed by cities of Coimbatore and Shimla and the district of Villupuram in Tamil Nadu.

• Public Health Foundation of India (PHFI) was awarded five million dollars by the Bill & Melinda Gates Foundation to strengthen the National Tobacco Control Programme in two states of India, namely Gujarat and Andhra Pradesh in collaboration with the state governments.

• Cancer Patients Aids Association organized an “Anti Tobacco Awareness Drive” with the aim of educating people about cancer and what they can do to prevent it by changes in lifestyle habits. Two students in their 20's disseminated information about the harmful effects of tobacco in various schools while riding on motorbikes along 6000 kms. of the Golden Quadrilateral. The bike-athon which began in Mumbai covered Surat, Jaipur, Delhi, Varanasi, Kolkata, Bhubaneshwar, Vishakapatnam, Chennai, Bangalore and Pune.

Advocacy Forum for Tobacco Control (AFTC) Networking Conference June 23 – 25, 2010

A three – day residential AFTC Networking Conference was organized in Mumbai from June 23-25, 2010 by Healis – Sekhsaria Institute for Public Health in collaboration with HRIDAY (Secretariat of AFTC). Fifty-two of the 63 member NGOs from across India participated in the event, to strategize collaborative advocacy around issues related to tobacco control such as smoke-free public places, tobacco taxation, pictorial warnings, advertising ban and tobacco industry tactics. The scientific programme of the conference, which included a series of panel discussions and presentations, was developed by HRIDAY, in consultation with the AFTC Advisory Committee following an extensive needs assessment exercise will all AFTC members. The completed needs assessment forms were systematically analyzed to include the priority areas of interest of the organizations. A set of pre-and post-conference evaluation tools were developed to gauge the participants' response to the agenda and their expectations from the conference, in particular and AFTC, in general.

Tobacco Control Updates - India

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lThe Central Government continues to challenge Bollywood Director Mahesh Bhatt on smoking on screen: Mahesh Bhatt filed a petition in the Delhi High Court against the ban of indirect advertisements of tobacco products in movies/TV serials. The Delhi High Court in its judgment struck down the Centre's notification which bans smoking scenes in films, saying onscreen smoking was part of an artist's creative license and allowed indirect advertising in the print media, saying that films and print media cannot be classified differently. This judgment was announced after a two-judge bench had given a split verdict February 7, 2008. Against the order passed by the Delhi High Court, the Union of India filed an appeal in the Supreme Court. The writ petition in appeal was filed by UOI in the Supreme Court in February 2009. In this case, Supreme Court by an order dated April 2, 2009 put an interim stay on the impugned orders of the High Court of Delhi till further date. The writ petition is coming for hearing on July 26, 2010.

A National Conference on Tobacco or Health (NCTOH) is being held at Tata Memorial Hospital in Mumbai from September 23-25, 2010.

Legal Updates

lDelay in implementation of newly notified pictorial warnings for tobacco product packages: The Ministry of Health and Family Welfare in a notification dated May 17, 2010 has deferred the implementation of the pictorial warnings from June 1 to December 1,

th2010. This notification came despite the 39 Parliamentary Standing Committee Report, which observed the non-implementation of the National Tobacco Control Programme and the Indian Tobacco Control Law. A number of civil society organizations have been stressing on the urgency of implementing more effective pictorial warnings as a strong tobacco control measure and the delay comes as a major setback.

l“Point of Sale” up for hearing: The validity of the Cigarettes and Other Tobacco Products Act and its enjoining rules has been challenged in the writ petition in cases: Sridhar Kulkarni Vs. Union of India (UOI) and Namdeo Kamathe & Ors. Vs. UOI pending at Bombay High Court. Rules dated May 31, 2005 concerning point of sale advertisements have been questioned in these cases. The Honourable Bombay High Court vide order dated December 19, 2005 and March 27, 2006 had given an ex-parte (in the absence of one party) interim order staying the implementation of relevant provisions of the enjoining rules to COTPA. An application to vacate the ex-parte order has been filed by the Union of India and is up for hearing on July 27, 2010.

During the conference, the tobacco control professionals resolved to combine all efforts towards tobacco control and voiced their deep concern regarding the delay in implementation of new pictorial health warnings on tobacco products to the media. The Networking Conference provided a platform to the organizations from all corners of India to come together and collaborate on their collective mandate of tobacco control.

In the weeks following the Conference, the AFTC Secretariat received a wide range of positive feedback for the Networking Conference. Advisory Committee of AFTC includes Dr. Mira Aghi, Dr. P.C. Gupta and Dr. K.S. Reddy.

The AFTC Team at the Secretariat: Monika Arora, Convenor (AFTC), Radhika Shrivastav, Abhinav Bassi, Amit Yadav, Deepti Singh, Priyanka Dahiya (on study leave) and Manjusha Chatterjee.

MoHFW reconstitutes Steering Committee on violations related to tobacco advertising and promotion: The Ministry of Health and Family Welfare (MoHFW) through a notification on June 9, 2010 has reconstituted the Steering Committee formed in supersession of the notification dated October 17, 2006 where the committee was first formed. The Steering Committee will look into specific action regarding violations under Section 5 which deals with ban on tobacco advertising and promotion.

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Global Tobacco Control Updates

Tobacco control groups world over raise concern over IDRC chief's association with the Canadian tobacco

industry

The Canadian government has received severe public acrimony over a recent revelation that the Chairperson of the Board of the

International Development Research Centre (IDRC), Canada's foremost public health institution, Babara McDougall, served as a top

executive of the Board of Imperial Tobacco for six years until April 2010. The IDRC has been actively funding tobacco control initiatives

across the world. However, following this information, a number of tobacco control bodies including the Asia Pacific Association for

Control of Tobacco (APACT) and the Africa Tobacco Control Alliance (ATCA) have refused funding from IDRC. The Bill & Melinda Gates

Foundation withdrew the remainder of its multi-million dollar grant to the IDRC project in Africa. In an editorial in CMAJ dated June 21,

2010, leading global tobacco control activists like Dr. Prabhat Jha and Dr. K.S. Reddy (President, Public Health Foundation of India) have

highlighted 'Canada's perceived lack of leadership on global tobacco control' and urged the government to take stringent measures.

(Refer Hébert, Reddy, Jha; CMAJ 2010. DOI:10.1503/cmaj.100850)

World Congress of Cardiology held in Beijing from June 16-19, 2010

The World Congress of Cardiology (WCC) 2010, which witnessed a

confluence of over 10,000 cardiologists, offered an international stage for

the latest developments in science and public outreach in the field of

cardiovascular health. WCC presented a key forum to tackle the growing

epidemic of cardiovascular disease in developing nations and strive to

unite the voices of societies, foundations and partners to take steps to

reverse these trends. The World Heart Federation (WHF), which organized

the Congress, worked specifically in partnership with the Global Smokefree

Partnership (GSP) to strengthen scientific content on tobacco and develop

the event as a platform for global tobacco control. Over the three-day

Congress, GSP devoted a number of sessions on tobacco control including

women and the tobacco epidemic; the impact of medical practice and

healthy policy for tobacco control; the role of Cardiologists in the era of the

WHO Framework Convention; lifestyle

modifications for cardiovascular disease

(CVD) prevention and more. A specialized

session on worksite cardiovascular disease prevention, which focused on

the opportunities, needs and benefits for tobacco free worksites, was

chaired by Dr. K.S. Reddy, President, Public Health Foundation of India. Case

studies on tobacco control research from a number of countries like

Bangladesh, India, Ghana and Eritrea were presented through poster

sessions. An experts-press meet was organized by Tobacco Free Kids (TFK).

One of the highlights of the tobacco control efforts showcased at the event

was the launch of a short film titled “Warning: Secondhand Smoke Is

Hazardous To Your Heart”, which explored the link between tobacco and

heart disease and how cardiologists can take action. (The film is available

on the following link -

http://globalsmokefreepartnership.org/heart/data/index-9721.html)

Leading Heart experts at the WCC 2010 in Beijing

Director of WHO Tobacco Free Initiative, Douglas Bettcher at the press meet

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Study reveals relationship between westernization and tobacco use among youth in Indian city

A cross-sectional study was conducted by HRIDAY to investigate the relationship between “westernization” and tobacco use among adolescents living in Delhi. Multiple types of tobacco commonly used in India (e.g., cigarettes, bidis, chewing tobacco) were considered and the

th thstudy included 3512 students in classes 8 and 10 enrolled in 14 private and government schools in Delhi, India.

The results suggest that young people's identification with Western influences may increase their risk for tobacco use, while their maintenance of traditional Indian ways of living confers some protection. Boys benefitted more from protective effects than girls and negative effects related to identification with Western ways of living were, in contrast, consistent across gender and grade level. The study concluded that future interventions designed to curb youth tobacco use in India may benefit by paying closer attention to cultural preferences of these young consumers. (Refer Stigler et al, Westernization and tobacco use among young people in Delhi, India, Social Science & Medicine, online publication June 2010)

Publications

Smoke Free FIFA World Cup 2010 held in South Africa in June-July 2010

The International Federation of Association Football (FIFA) enforced a smoking ban this June in all stadium stands and areas around the football pitch during the Football World Cup 2010 held once every four years. The South African government, which initiated the smoke-free policy, also banned smoking on all public transport to and from the venues. The month-long football tournament which kicked off on June 10, 2010 in South Africa witnessed over one million foreign visitors. The anti-smoking lobby in South Africa has been working towards making all sports facilities across the country smoke-free. In 2002, FIFA's World Cup in Korea and Japan started on World No Tobacco Day making the event officially smoke-free.

Australia moves towards plain packaging for cigarettes by July 2012

In May 2010, Australia became the first country to demand plain cigarette packaging as recommended in Article 11 of the FCTC. It is envisaged that by July 2012, the only significant and visible on the cigarette packaging in Australia will be a strong pictorial health warning with the brand and product names in standard colours, fonts, position and style. No logos, brand imagery and colours will be used. The Australian government believes that plain packaging will act as a deterrent to tobacco use.

The Round 8 Call for Proposals for the Bloomberg Initiative to Reduce Tobacco Use Grants Program has been announced on July 5, 2010. (http://www.tobaccocontrolgrants.org/Pages/46/Call-for-Proposals)

Upcoming Events

lThe Asia Pacific Association for the Control of Tobacco (APACT) is organizing the “Asia Pacific Conference on Tobacco or Health” in Sydney, Australia from October 6-9, 2010. The theme for this year's event highlights FCTC in the Asia Pacific: Change, Challenge & Progress. The conference attracts a wide range of public health specialists, government officials, NGOs etc. from up to 50 countries in Asia and the Pacific region.

lThe fourth session of the Conference of Parties (COP) to the WHO FCTC is scheduled to be held in Punta del Este, Uruguay from November 15-20, 2010.

F C CTWHO FRAMEWORK CONVENTIONON TOBACCO CONTROL

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Workshops & Programmes

Series of Journalist to Journalist workshops to sensitize media persons about tobacco control

Indian Media Centre for Journalists (IMCFJ) organized a Journalist to Journalist workshop on April 21, 2010 in Patna, Bihar. Fifty-six journalists, including eighteen female journalists, participated in this workshop. The workshop included discussions on the responsibility of the media to take tobacco control issues to the readers, so that the society can be safeguarded from the adverse effects of tobacco. Mr. Ashutosh Singh, President IMCFJ highlighted how the media can create stories on various issues concerning tobacco control from different perspectives.

Mr. Amit Yadav, Legal Officer, HRIDAY emphasized the need for proper implementation of tobacco control laws and suggested that the state government's commitment along with the support of media would lead to the desired results in terms of tobacco control in the state. The workshop motivated the journalists to write more frequently on tobacco control issues so that it can create an impact on the readers and the policy makers alike as a step towards a tobacco free society.

Separately, a similar workshop was held in Jaipur, Rajasthan on May 1, 2010 where HRIDAY's Legal Officer Priyanka Dahiya stressed the importance of bringing media attention to the issue of tobacco control.

Media persons at the Journalist to Journalist workshop in Patna

Community-based methods effective in preventing tobacco use among disadvantaged adolescents in urban slums of India

A paper has been published by HRIDAY to highlight research conducted in two phases among economically disadvantaged adolescents in two urban slums of Delhi. In Phase I, qualitative research was used to explore and understand the determinants influencing tobacco use among these adolescents. It was found that prevalence of tobacco use was higher among boys than girls due to factors like peer-pressure, easy availability and affordability. In Phase II, which was based on an intervention model, a significant difference in current use of tobacco was observed with the intervention group showing a reduction in use, compared with an increase in use among the control group. There was also significantly lower fresh uptake (0.3%) of tobacco use compared with the control group (1.7%). It was concluded that community-based interventions can be effective in preventing adolescents from initiating tobacco use in a low-resource setting such as India.

(Refer M. Arora et al, Community-based model for preventing tobacco use among disadvantaged adolescents in urban slums of India, Health Promotion International, Vol. 25, Issue 2, June 2010)

Study finds that prevalence of unrecognized tobacco use among young adults high

A U.S. study has found that at least 1 in 5 young adult smokers may be considered a “previously unrecognized smoker”, who would not have been identified as a cigarette user according to the standard adult definition. The study, which was conducted to evaluate prevalence of smoking among young adults, showed that prevalence was 39 % using the adolescent definition in contrast to 32 % using the adult definition, proving that future studies to gauge prevalence should use both adolescent and adult measures.

(Refer S. Foldes et al, The Prevalence of Unrecognized Tobacco Use among Young Adults, American Journal of Health Behavior, Pg 309-321,Vol 34, Issue 3, May/June 2010)

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Advocacy workshop with lawyers in Chennai

The Government of Tamil Nadu under its Smoke Free Chennai (SFC) Project

organised an advocacy workshop on May 25, 2010 for various stakeholders

for effective implementation of COTPA. Given the importance of legal

professionals in fostering effective partnerships and supporting effective

legislation, and the significant role of the judiciary, a workshop was

conducted exclusively for advocates to share the ideas within the fraternity

for effective implementation of COTPA. A number of government officials

and nearly 35 lawyers attended the event. HRIDAY Legal Officer Amit Yadav

shared various technical inputs during the workshop.

Objectives of the workshop included:

• Improving the support of advocates and creating an enabling environment in the judicial system for effective implementation of

COTPA.

• Sharing knowledge and experience in handling tobacco cases against tobacco manufacturers and to know how to lobby the

issue through judicial system.

• To make all courts smoke-free zones by following the guidelines of COTPA.

The workshop informed the advocates about actions taken by Government of Tamil Nadu against the litigations filed by the tobacco

companies and the violation of tobacco control laws. Experience from various tobacco control litigations in the country and the state in

particular was also shared with the lawyers. They were urged to support tobacco control efforts in the state. The discussions in the

workshop considered that tobacco industries should be compelled to pay compensation to those suffering from tobacco use for which

class action suits, like in other countries, needs to be advocated before the Indian courts as well.

NTCP Assam workshop on implementation of tobacco control law

NTCP Assam organized a two-day State level Training Workshop on the Effective Enforcement of Comprehensive Tobacco Control Legislation and Policies of the Act on May 4-5, 2010 in Guwahati. The training workshop aimed to ensure implementation and enforcement of tobacco control laws and monitoring the compliance of the rules of the Act at the district level.

HRIDAY's Legal Officer Deepti Singh attended as resource person to elaborate on the Sections 4, 5, 6, 7 of the tobacco control law, the legal aspects of the rules, compliance, violations, and enforcement. Some of the key decisions taken were:

• NTCP will receive resource support from the State Health Ministry and National Rural Health Mission.

• The programme will integrate all on-going health and other government department projects by building in a component of tobacco control in their planning.

• Emphasis will be given on public awareness, training/orientation/sensitisation of key personnel of Food, Drug, Police, and Education - teachers and student union members, media and other vertical health programmes.

• Monitoring of smoking in public places, advertisement rules and Sections 6 and 7.

Participants at the NTCP Assam workshop

Panelists at the workshop for advocates in Chennai

Next Issue Highlights

Contact Us:

We would be happy to receive feedback on this initiative. Please e-mail your comments/suggestions to Ms. Manjusha Chatterjee (manjusha@hriday-shan.org). If there is a tobacco control event that you are planning to organize or have any other updates, please share them with us for inclusion in future editions. Remember – this newsletter is based on your inputs.

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C-1/52, 3rd Floor Safdarjung Development Area, New Delhi, India-110016 Tel No.: 91-11-26850342, 26511840,

Fax: 91-11-26850331 Website: www.hriday-shan.org

This document has been produced with the help of a grant from the World Lung Foundation. The contents of this document are the sole responsibility of the authors and can under no circumstances be regarded as reflecting the positions of the International Union Against Tuberculosis and Lung Disease (The Union) nor those of the Donors.

On June 3, 2010, the Smoke-free Delhi Initiative by Delhi Government organized a training workshop for enforcement officers of New Delhi Municipal Corporation. The training brought to light important health aspects of tobacco consumption, highlighting the exposure from secondhand smoke. HRIDAY's Legal Officer Priyanka Dahiya elaborated on the tobacco control legislations with special emphasis on Sections 4 and 6 of this law.

The Government of Delhi in collaboration with the Delhi Judicial Academy organized a training workshop for the newly appointed judges under Delhi Judicial Services on June 4, 2010 at the Delhi Judicial Academy. The training highlighted the global and national tobacco burden with a focus on health rights of non-smokers with respect to exposure to secondhand smoke. The training had elaborate sessions on Indian tobacco control law with special emphasis on establishing a challaning (fine) mechanism under important sections of COTPA. The legal team from HRIDAY conducted the sessions on the tobacco control law and facilitated the group sessions where the budding judges discussed practical problems faced by legal professionals in implementing this law.

Another series of training workshops to make Delhi smoke-free

• Civil society efforts to oppose the Global Tobacco Networking Forum (GTNF) in Bangalore in October 2010

• GATS India results

• Workshops and Programmes