According to GATS (Global Adult Tobacco Survey, India, 2009-10) survey, more than one-third (35%) of adults consume tobacco products in different forms in India. Among them 21 percent adults use only smokeless tobacco, 9 percent only smoke and 5 percent smoke as well as use smokeless tobacco.
Based on these, the estimated number of tobacco users in India is 274.9 million, with 163.7 million users of only smokeless tobacco, 68.9 million only smokers, and 42.3 million users of both smoking and smokeless tobacco. The prevalence of overall tobacco use among males is 48 percent and that among females is 20 percent. Prevalence of smoking among males is 24 percent whereas the prevalence among females is 3 percent. The extent of use of smokeless tobacco. products among males (33%) is higher than among females (18%). Among both males and females, the prevalence of cigarette smoking is higher in urban areas but the prevalence of all other smoking products is higher in rural areas. The prevalence of each of the smokeless tobacco product is higher in rural than urban areas, however, gutkha is almost equally prevalent in both urban and rural areas. Ironically 5500 people mainly children are picking up this habit of tobacco daily. (Government of India, 2010a). Currently around 2500 people are dying every day in India due to tobacco and its consequences. Every year nearly 8–9 lakh people die due to diseases related to tobacco use in India. Tobacco consumption continues to grow in India at 2-3% per annum which will account for 13% of all deaths by 2020 (Government of India, 2010a).
Among the northern states of India prevalence of tobacco use within Punjab is among the lowest because smoking is strongly against the Sikh tenets. Punjab has 22 districts with approximately 27.74 million people living here. About 12% of population in Punjab uses tobacco in any form. These users in Punjab include 11.7% adults; 21.6% males and 0.5% females in Punjab. In Punjab, 21.6% men and 0.5% women in the age group of 15-49 years used some form of tobacco and 12.7% men and 0.4% women smoked cigarette or bidi. Considering the population of 2.75 Crores, 33 lakh population in Punjab uses tobacco in some form or the other. About 48 persons of Punjab die every day due to tobacco use (Government of India, 2010a; Government of India, 2010b).
To assess and measure level of compliance to various provisions of COTPA, a robust survey using scientific protocols was conducted by School of Public Health, PGIMER, Chandigarh in collaboration with Department of Health and Family Welfare, Government of Punjab and The Union South-East Asia (The Union) in February-March, 2016 in 10 districts of Punjab. The study is instituted by Generation Saviour Association. The survey covered both urban and rural areas of these districts. The mean compliance to major indicators of Section 4, 5, 6 (a), 6 (b), 7, 8 and 9 of COTPA was 84.6%, 84.3%, 77.6%, 87.2% and 84.3%, respectively. The overall compliance to all Sections of COTPA (based upon mean of major compliance indicators) was 83.6. The district where over 75% compliance with respect to mean of major compliance indicators for every sections of COTPA were Gurdaspur, Sangrur, Patiala , Roopnagar and Jalandhar. To emphasize key findings of the study concisely facts-sheets are being prepared and shared.