The Hindu Editorial Summary

Editorial Topic : India’s Tobacco Challenge

 GS-2 Mains Exam : Health

Revision Notes

Question : Discuss the effectiveness of the Cigarettes and Other Tobacco Products Act (COTPA), 2003 in curbing tobacco consumption in India. Identify the key loopholes and suggest measures to strengthen the implementation of this Act.

Devastating Impact:

• Tobacco – the leading preventable cause of death globally.
• India – world’s second largest consumer, with nearly 26 crore users (as per 2016-2017 estimates).
• Health risks extend beyond consumers: over 60 lakh tobacco industry workers are exposed to dangers from skin absorption.

Environmental Costs:

• Tobacco cultivation depletes soil nutrients, requiring more fertilizers that further harm soil quality.
• Deforestation driven by tobacco – 5.4 kg of wood needed to process just 1 kg of tobacco.
• Significant waste generation – tobacco production and consumption create nearly 1.7 lakh tonnes of waste annually in India.

A Glimmers of Hope, But Concerns Remain:

• Positive trends: Surveys [(The Global Adult Tobacco Survey (GATS), the Global Youth Tobacco Survey (GYTS), and India’s National Family Health Survey (NFHS)] show a decline in tobacco use among surveyed demographics.
• Cause for alarm: Increase in female tobacco use (2.1% rise between 2015-2016 and NFHS 2019-2021).
• Crucial gap in data: No major surveys conducted since the COVID-19 pandemic.

Existing Measures and Implementation Gaps:

• FCTC signatory: India is committed to reducing tobacco use globally.
• National laws: Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply, and Distribution) Act (COTPA) (2003) regulates production, advertisement, distribution, and consumption of tobacco.
• National Tobacco Control Program (NTCP): Launched in 2007 to raise awareness, improve COTPA/FCTC implementation, and aid smoking cessation.
• Taxation: Used to deter use, but poorly implemented.
• Loopholes:
  • Smokeless tobacco (SLT) packaging often violates COTPA guidelines.
  • Smuggled tobacco (both smoked and smokeless) is prevalent.
  • Surrogate advertising (promoting a similar brand using a different product) bypasses COTPA’s advertising ban.
  • Cricket World Cup 2023 showcased problematic surrogate advertising for tobacco brands.

Affordability and Tax Evasion:

• Tax evasion: Lowers effectiveness of tobacco taxes. Methods include inter-state purchase and smuggling.
• Rising affordability: Study shows cigarettes, bidis, and SLTs became cheaper over the past decade due to:
  • Insufficient tax hikes to match income growth.
  • GST regime potentially making products more affordable.

The Power of the Tobacco Lobby:

• Arguments against high taxes: Lobby claims high taxes lead to tax evasion (disputed by evidence).
• Lobbying influence:
  • Bidi and small manufacturer tax exemptions repeatedly extended.
  • Government officials engage with the tobacco industry.
  • Government holds a stake in India’s largest tobacco company (ITC Ltd.).
  • India’s tobacco interference index score has worsened (indicating increased industry influence).

Recommendations:

• Stricter enforcement: Strengthen implementation of COTPA, PECA, and NTCP.
• Increased taxation: Raise tobacco product taxes in line with FCTC recommendations, inflation, and GDP growth.
• Supporting farmers: Help tobacco farmers transition to alternate crops with government support. Jowar cultivation offers higher returns than tobacco.
• Data collection: Gather up-to-date data on tobacco use trends to counter industry’s sales tactic adjustments.

Additional Information (Arora IAS Inputs)

Global tobacco consumption trends over the past 30 years:

• Decline: Overall, tobacco consumption has been on a gradual decline globally over the past three decades. This is primarily due to increased public health awareness campaigns highlighting the dangers of tobacco use, stricter tobacco control policies (including taxation and advertising bans), and access to smoking cessation resources.
• Regional Variations: The decline is not uniform across all regions. High-income countries have witnessed a sharper decrease compared to low- and middle-income countries. This is likely due to earlier implementation of tobacco control measures and higher socioeconomic development in these regions.
• Challenges Remain: Despite the decline, tobacco use remains a significant global public health concern. Millions still consume tobacco, and the industry continues to develop new and often addictive products like e-cigarettes. Additionally, some countries are lagging behind in implementing effective tobacco control measures.

Additional Source : World Health Organization (WHO) Report on the Global Tobacco Epidemic: https://www.who.int/publications-detail-redirect/9789240032095

 

 

 

 

The Hindu Editorial Summary

Editorial Topic : Inflammatory Bowel Disease (IBD) in children

 GS-2 Mains Exam : Health

Revision Notes

Question : Evaluate the current healthcare infrastructure in India for managing chronic diseases such as Inflammatory Bowel Disease (IBD) in children. What improvements are needed to enhance care and support for these patients?

Basic Concept

Imagine your digestive system as a long tube that breaks down food and absorbs nutrients. Inflammatory bowel disease (IBD) is like having an irritation or inflammation in the lining of this tube. This irritation makes it hard for the body to digest food properly and absorb nutrients.

There are two main types of IBD:

• Crohn’s disease: This type of inflammation can happen anywhere in the digestive system, from the mouth to the rectum (the end of the large intestine). It often goes deep into the layers of the digestive tract and can cause patches of healthy tissue next to inflamed areas.
• Ulcerative colitis: This type of inflammation only affects the inner lining of the large intestine (colon) and rectum. The inflammation is usually continuous, starting at the rectum and spreading upwards.

Think of it like this:

• Crohn’s disease: Like patchy and deep irritation throughout the whole digestive tube.
• Ulcerative colitis: Like continuous irritation only on the inner lining of the large intestine and rectum.

Both Crohn’s disease and ulcerative colitis can cause a variety of symptoms, such as:

• Diarrhea
• Abdominal pain and cramping
• Urgent need to go to the bathroom
• Rectal bleeding
• Weight loss
• Fatigue

 

 

Back to The Editorial Analysis

 

What is IBD?

• Chronic autoimmune condition affecting the gut.
• Body’s immune system mistakenly attacks healthy gut cells, causing ulcers.
• Symptoms: fever, abdominal pain, loose stools, bloody diarrhea.
• Two main types:
  • Ulcerative colitis (affects large intestine)
  • Crohn’s disease (affects any part of the gut)
• Indeterminate colitis: difficulty distinguishing between the two types.

Possible Causes (exact cause unknown):

• Weak or dysregulated immune system.
• Genetics (may run in families).
• Gut microbiota (microorganisms in the gut):
  • Plays a role in IBD.
  • Unique to each person and affects health.
  • Frequent antibiotics and westernized diet may alter gut microbiota, increasing IBD risk.

Treatment and Cure:

• Crohn’s disease:
  • Medications:
    • Steroids
    • Biologics (newer drugs)
  • Exclusive enteral nutrition (for milder cases): liquid diet to heal ulcers (without drugs).
  • Maintenance:
    • Immunosuppressant drugs (to keep disease under control).
    • Special Crohn’s disease exclusion diet (CDED).
• Ulcerative colitis:
  • Medications:
    • Aminosalicylates (for milder cases).
  • Exclusive enteral nutrition not effective.
• Both IBD forms:
  • Often chronic, requiring years of treatment.
  • Some children achieve long-term remission (disease control) even off medication.
  • Majority require medication for remission.
  • Minority with uncontrolled inflammation may need surgery.

Challenges and Importance of Awareness:

• IBD symptoms mimic other diseases like tuberculosis, leading to misdiagnosis.
• Increased awareness needed among both public and medical professionals.