Committing to Health

If there's one thing I've got to give the government of India, it is that when they commit to a public health message, they commit.

World No Tobacco Day

By Lillie Reed, B.S. Psychology & B.A. Global Health, 2014

Published June 6, 2013, last updated on April 7, 2020 under Voices of DGHI

A few days ago, I was alerted that it was World No Tobacco Day - mostly through Twitter during my effort to create a social media presence for the organization I work for. Tobacco use is very common in India. India contains 12% of the world's smokers, and almost 50% of men in this country with over a billion people smoke or chew tobacco. Overall, about 195 million Indians use tobacco products- and some studies say that this may actually be a large underestimation.

Yet what I have found so interesting about Indian tobacco culture is that I have not seen one person smoking a cigarette while I have been here. I know from my job that it is not because people in this area of India do not smoke. In fact, it may be that smoking has become more socially frowned upon. Likely, one of the reasons for this lack of public smoking is India's huge public health campaign against smoking. This campaign restricts advertising of smoking, which has been shown to reduce onset of use. Furthermore, the governement actually advertises against smoking. On television channels, before the beginning of any program or the return from any commercial break, a message comes across the screen that none of the makers or actors in films or TV shows "support or promote smoking" and declaring tobacco injurious to health. When tobacco is shown in a movie or TV show, similar messages will scroll across the screen, and in certain channels, alcohol and tobacco are blurred or cut out altogether. Whether this is the choice of the channel, the government, or a combination of the two, I am not sure, but it certainly shows a strong commitment to an anti-smoking message for the public.

These smoking ads have made me think a considerable amount about public health in the US. There are many public health campaigns in the United States. We all know of "got milk" and "90s kids" may remember the "Verb: It's What You Do" campaign for physical activity. However, no such messages are delivered with such urgency and consistency as the smoking advertisements in India. To me, this begs a few questions: Is this inundation in a message effective? And if so, why isn't it being implemented all over the world?

Yet I think the most important question is: why smoking? Or perhaps, better phrased: why just smoking? Smoking is assuredly injurious to health, but so is obesity and alcohol abuse, both of which are large and growing problems in India and other parts of the world. Moreover, what about other potentially harmful behaviors, such as interpersonal violence? With recent scandals in India regarding violence against women, I would be interested to see if the country focus some of its resources on creating campaigns that change norms about gender violence. Effectively, public health and media campaigns could be used to target almost any health behavior or message to affect change. Although it certainly needs evaluation and must constantly be flexible to the needs and thoughts of the public that it serves, India's commitment to the reduction of smoking is a good first step - a step that puts forth many possibilities for the future of public health in India and worldwide.