India’s tobacco crisis: DAAD survey highlights gaps in cessation efforts and calls for safer alternatives

India’s ongoing tobacco epidemic, where nearly four in ten households contend with smoking addiction, has led healthcare professionals to advocate for policy reforms and new strategies to combat tobacco use. The recent Doctors Against Addiction (DAAD) survey, conducted in partnership with Saizen Global Insights & Consulting, indicates a shift in doctors’ perspectives, with 65 per cent supporting the inclusion of safer cessation alternatives, including nicotine replacement therapies and Heat-Not-Burn products. The survey underscores an urgent call to prioritise research into the efficacy of these alternatives in reducing tobacco dependency.

Tobacco use in India results in over 930,000 deaths annually, with an estimated 2,500 people losing their lives daily due to smoking-related diseases. Padma Awardee Dr. Mohsin Wali, Senior Consultant at Sir Ganga Ram Hospital, commented on the survey findings, stating, “Tobacco addiction is India’s most pressing public health challenge, claiming over 930,000 lives annually. To combat this, we must prioritise scientifically permitted alternatives for tobacco cessation. The findings of the DAAD survey highlight a critical need for policy reform, increased public awareness, and the integration of modern technologies, and safer novel alternatives to support those struggling with addiction. As healthcare professionals, guiding patients toward safer options is crucial to saving lives and mitigating tobacco’s devastating impact.”

Dr. Manish Sharma, Chief Coordinator of DAAD, described the tobacco crisis as a “national emergency” that demands immediate action. He raised concerns about the lack of structured support for transitioning to novel safer alternatives and urged the adoption of statutory recommendations for scientifically-proven cessation methods. Referring to the DAAD survey of 300 healthcare professionals, he identified the “Quit Gap” as a significant obstacle, with over 70 per cent of doctors citing addiction severity and low motivation, and 60 per cent identifying a lack of cessation resources as barriers to quitting.

The survey reveals that smoking cessation in India faces obstacles including inadequate follow-up care and poor implementation of evidence-based approaches such as the 5As (Ask, Advise, Assess, Assist, and Arrange). Data shows that only 7.4 per cent of healthcare providers consistently provide cessation advice, and just 56.4 per cent arrange follow-up consultations, indicating substantial gaps in current cessation strategies.

Commenting on the DAAD survey findings, Dr. Pawan Gupta, Senior Consultant in Pulmonary Medicine at BLK-MAX Super Specialty Hospital, highlighted the importance of expanding beyond traditional approaches, saying, “Tobacco addiction needs multifaceted solutions. The rise of safer novel alternative products for cessation provides an opportunity to rethink our strategies. By integrating these cessation strategies and enhancing public knowledge about this, and around digital platforms and resources, we can drastically improve our intervention outcomes. The DAAD survey has rightly pointed to the need to relook into the existing policies and methodologies for cessation.”

Despite the challenges in current practices, the survey findings offer some optimism, as 65 per cent of healthcare professionals support the adoption of novel safer alternatives, with 90 per cent of those familiar with these products indicating they would recommend them if proven safe.

India’s tobacco cessation policies, experts argue, require urgent updates, with recommendations including digital tools, public awareness initiatives, and harmonised regulations. Strengthening collaborations among government agencies, healthcare providers, and NGOs is seen as essential to addressing the tobacco crisis.

India accounts for 40 per cent of the global tobacco-using population, and this public health issue requires immediate, collective action from policymakers, healthcare professionals, and communities, following the QuitVice-DAAD Survey’s roadmap.

Key Survey Findings:

• Policy update needed: Smoking cessation policies require modernisation to incorporate safer alternatives.
• Quitting barriers: Addiction severity, low motivation, and limited cessation resources hinder efforts.
• Untapped technology: Mobile apps and online platforms could increase cessation success, though awareness remains low.
• Collaborative approach: A unified effort among healthcare providers, policymakers, and the private sector is critical to combating the smoking epidemic.