Linking Global Youth Tobacco Survey 2003 and 2006 data to tobacco control policy in India

BACKGROUND: India made 2 important policy statements regarding tobacco control in the past decade. First, the India Tobacco Control Act (ITCA) was signed into law in 2003 with the goal to reduce tobacco consumption and protect citizens from exposure to secondhand smoke (SHS). Second, in 2005, India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). During this same period, India conducted the Global Youth Tobacco Survey (GYTS) in 2003 and 2006 in an effort to track tobacco use among adolescents. METHODS: The GYTS is a school-based survey of students aged 13-15 years. Representative national estimates for India in 2003 and 2006 were used in this study. RESULTS: In 2006, 3.8% of students currently smoked cigarettes and 11.9% currently used other tobacco products. These rates were not significantly different than those observed in 2003. Over the same period, exposure to SHS at home and in public places significantly decreased, whereas exposure to pro-tobacco ads on billboards and the ability to purchase cigarettes in a store did not change significantly. CONCLUSIONS: The ITCA and the WHO FCTC have had mixed impacts on the tobacco control effort for adolescents in India. The positive impacts have been the reduction in exposure to SHS, both at home and in public places. The negative impacts are seen with the lack of change in pro-tobacco advertising and ability to purchase cigarettes in stores. The Government of India needs to consider new and stronger provisions of the ITCA and include strong enforcement measures.