While following the debates over health care reform in the U.S., and revisiting my own personal use of tobacco since re-enrolling in academia (after an 8 year hiatus of both school and tobacco), it got me thinking about the role of tobacco in India. What I learned about tobacco, in India, out and out shocked me.

According to WHO (World Health Organization), India has high smoking rates across the board:

Smoking rates in men is over 56% in the 12-18 year old range, and plateaus at 72% by the smokers 40’s. Smokeless tobacco (chew) in women is hard to gauge but estimates are as low as 15% (still very high when compared to U.S. chewing) and as high as 60%. Smoking rates among 13-15 year old school children range from 3% in Goa to over 60% in Nagaland (http://www.whoindia.org/LinkFiles/Tobacco_Free_Initiative_Executive_Summary.pdf).

Contrary to what many may think, this isn’t necessarily due to the burgeoning middle class in India. India has a long history of tobacco use, as Portuguese traders first brought tobacco to India in the 1600’s. In the early 20^th century India was second largest producer of tobacco, behind the U.S. And in fact, in the U.S. a popular and traditional method of tobacco consumption in India is becoming more and more popular stateside, as hookah bars pop up in trendy neighborhoods of major metro areas.

Apart from the hookah smoking, Indians’ use tobacco in a variety of ways. 42% of tobacco consumption is via Beedi smoking. Beedi’s are similar to cigarettes except they are tobacco rolled in another plants leaf, and must be puffed continuously to stay lit, like a cigar. They smoke cheroots, which are simply a loosely rolled tobacco leaf, also similar to a cigar. Indians also chew a couple of different forms of smokeless tobacco. Paan and paan masala are powdered tobacco with a variety of nut extracts and flavors. (Wikipedia)

Considering what we’ve seen recently in the U.S. in regards to health care reform, and what we’ve learned about the apparent bureaucratic processes of Indian governments, what will the economic impact of tobacco related illnesses in India be, as the population that can afford to use tobacco grows? Should they be concerned about the massive costs of health care for a society that heavily uses tobacco? Could you possibly conclude that newer, relatively healthier methods of tobacco use, such as modern cigarettes, should be pushed as means of tempering the unhealthier methods like beedi smoking.

- Chase Janvrin