You might be shocked to know that around 1.4 million new cases of cancer, with an incidence rate of 100.4% per 100,000 people, were reported in India in 2022. It means that every 1 out of 9 Indians suffers from cancer in their lifetime. The horrifying fact is that despite knowing that cigarettes are the main reason for growing cancer concern in India, Indians love to take “sutta breaks” in their free time and are used to smoking.
It became so common in India that people light up outside of tea stalls, office buildings, college canteens and even hospitals. In the workplace setting, non-smokers are also exposed to second-hand smoke. The irony? While cancer spreads silently, the smoke that fuels it is loud and proud.
Tobacco causes #Cancer, Stroke, Heart Attack, Chronic Lung disease and death.
— Office of MLA Prasad Abbayya (@AbbayyaFans) May 31, 2025
It's time to quit #Tobacco and live a healthy life. – @MLAAbbayyaINC#WorldNoTobaccoDay🚭 pic.twitter.com/AsMFR3gnCW
Tobacco Smoking and Chewing: The Cultural Norm in India
Tobacco became a cultural norm in India; every Indian smokes loudly and proudly, which is not surprising. But do you know who introduced this cancer-fueling substance in India? In the 17th century, the Portuguese were first introduced to the substance with the qualities of calming and relaxing elements that were considered a sort of stimulant. Over the years, the trend of using the substance through chewing and smoking became so common that it has been promoted openly in the market.
Every stall, paan shop, and roadside vendor sells packets of “khaini”, “bidi”, “chutta”, and cigarettes openly. It became a ritual in India that we need a cigarette with the morning chai, “khaini” in long commutes or “bidi” after a meal. As per the GATS (Global Adult Tobacco Survey), around 28.6% of Indian adults use some form of tobacco in their daily work.
Around 42.4% of men and 14.2% of women used to smoking or chewing tobacco in the forms of gutkha, khaini or bidi. This is shocking, right? But it is obvious. If you are a non-smoker, chances are you have still seen it up close from your uncle, cousin or even your parents.
Tobacco became the cultural norm in India because it is marketed online and offline. You might have seen big celebrities like Ajay Devgan, Akshay Kumar, and Shah Rukh Khan promoting pan masala brands, who are cleverly rebranding for tobacco products. “Bolo Zubaan Kesari” or “Zubaan Wali Baat” became the tagline of these brands that openly and loudly promote the substance.
Not only this, but consider the example of any movie or series from India, where Bollywood glamorises tobacco. Take “Gangs of Wasseypur,” where they showcased “gutkha culture” as a social culture of rural India. Or you can also be considered “Dabangg” series, the big and famous actor of Bollywood, Salman Khan, uses cigarettes to portray his macho look.
You know what the irony is here? If you step out, you can purchase a packet of cigarettes for only ₹10 (approximately $0.12), whereas the price of a healthy snack or juice is typically not less than ₹50-₹100 (roughly $0.60-$1.20). Yes! Affordability also plays a significant role in making the “gutkha culture” common in India.
Hence, the substance is no longer perceived as a health hazard in India; it is viewed as an integral part of Indian life, providing stress relief and serving as a social bridge.
Tobacco: The Cancer Carrier
We have talked about the normalisation of tobacco in Indian society; now let’s understand its contribution to the cancer epidemic in the country. Smoking and chewing of the substance are the single most significant reasons for cancer and cancer-related deaths in India. The smoker and the non-smoker are exposed to this harmful substance that damages DNA and leads to uncontrolled cell growth in human bodies.
The total population of India is 1.4 billion, and 267 million people among them use tobacco. 8.5% of youth use some form of smoking, among which 9.6% are boys and 7.4% are girls. Around 30.2% of adults and 21% of youth are exposed to second-hand smoke, with 7.4% exposed in restaurants, 11% at home, and 13.3% in public transportation.
WHO (World Health Organisation) has reported that around 40% of cancers in India are linked to the consumption of tobacco. People are reporting to have oral cancer, lung cancer, throat cancer and oesophageal cancers, only because of smoking and consuming smokeless substances. Around 30% of people suffer from oral cancers, which is higher than the global average, because of the normalisation of smoking.
People need to be aware and responsive towards this deadly reality. Cancer is an unpreventable disease, if it is diagnosed in delay. This decreases the survival chances of people drastically—every year, over 9.1 lakhs people die from cancer. Over 90-95% of cancers are caused by environmental and lifestyle problems.
Government Regulations and the Gap
The Indian government has implemented different anti-tobacco laws under the Cigarettes and Other Tobacco Products Act 2003 (COTPA). This Act was passed before India joined as a Party to the WHO Framework Convention on Tobacco Control. The Ministry of Health and Family Welfare granted this Act under Section 31 of COTPA.
This Act introduces some strict laws. Under this Act, it is mandatory to add health warnings on product packaging, ban advertising, and restrict smoking in public areas, hospitals, schools, colleges and government facilities. Sales restrictions through vending machines have also been imposed. Heated Tobacco Products (HTPs) are also prohibited in India.
Now, you might be thinking, if there are several strict laws in India, then why has smoking become a cultural norm in Indian society? What is the gap? Well, the gap is a lack of consistent monitoring and implementation of the laws in every corner of the country. In the rural and semi-urban areas, a packet of gutkha or pan masala is easily available in paan shops, roadside vendors and even in trains. There are no routine inspections.
Corruption, political tensions, weak coordination between government departments and limited resources are increasing the gap. Tobacco companies use these loopholes and sell their products openly and securely. ITC Limited hold 70-80% market share in India and in 2024, it generated sales of around ₹305 billion (around $3.5 billion) in revenue, where the cigarettes business contributes around 45% of the total earnings. So, you can assume how the loopholes have been used and why tobacco is causing the cancer epidemic in India.
What Should We Do?
We need a cultural detox. People should be aware that gutkha is not a “desi swag.” Some NGOs have already started the cultural detox. HRIDAY (Health Related Information Dissemination Among Youth) and many other NGOs like this are spreading awareness and helping people develop life skills to say no to tobacco. We can support these NGOs by giving them small grants.
India has now become the digital hub. Let’s use this advantage to spread awareness. Use social media and create and share memes, reels, street art and films to present tobacco as a harmful substance rather than “desi swag.”
It is necessary to start at an early stage. Every school, college and social platform needs to openly talk about the real costs of tobacco and spread awareness of a healthy lifestyle.
