But with research showing that India registers 80,000 new cases of oral cancer per year, representing 30 percent of the national cancer burden, Indian health officials are putting their foot down. Last week, Delhi's government extended a ban on all sale and possession of smokeless tobacco and announced a major enforcement drive. Those caught could be slapped with punishments as severe as a $4,500 fine and six months in jail (presumably for the most egregious cases of sale).

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Delhi joins a roster of Indian states that have implemented bans, and the Supreme Court recommended a nationwide ban of a kind of chewing tobacco called gutka, though not all states have complied.

The use of chewing tobacco is particularly prevalent among India's working class. Like the ever-available cup of chai — sweet, milky tea — chewing tobacco is a cheap diversion during a long day's work. Cigarettes are more expensive, and they don't last as long. Chewing tobacco can be kept in the mouth for hours. When mixed with betel nuts (also called areca nuts), it turns one's saliva bright red, and, over time, it does the same to one's teeth, while eating away at them gradually. Incidentally, the walls of train stations and government offices in India are as stained as the teeth of chewers. In some offices, people have resorted to affixing images of Hindu deities on walls to prevent would-be spitters.

Delhi officials are hoping that the new ban and greater enforcement will stop tobacco vendors from rampant circumvention. A 2011 federal law, the Food Safety and Standards Act, classified combinations of tobacco and "flavorants" as "food," which made the products illegal by default because "food" was not allowed to contain tobacco. Retailers sidestepped the law simply by selling tobacco and flavorants in separate sachets.

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The Indian government is also locked in a battle with the country's enormous tobacco companies over new regulations that stipulate that cigarette packets must be 80 percent covered by health warnings. Besides a line or two about the negative consequences of smoking, the warnings typically involve images of blackened lungs and cancer patients. The current minimum coverage is 20 percent of the packet. Reuters, citing BMJ Global Health statistics, said 1 million Indians die every year from smoking.