The Global State of Tobacco Harm Reduction (GSTHR) team visited India in October 2019. Alongside local partners including advocacy group the Association of Vapers India (AVI), we hosted a series of tobacco harm reduction events in Mumbai (13th) and New Delhi (17th – 18th).

Every year, it is thought between 700,000 – 1 million people a year die in India from a smoking-related disease. There are approximately 80 to 100 million adult daily tobacco smokers in the country and in addition, about 240 million people consume a wide range of other tobacco products, either smoking tobacco in its alternative or local forms (e.g. bidis, hookah and chillum) or as chewed smokeless tobacco (SLT) products such as khaini, zarda, gutkha and others.

Even in the face of this ongoing public health crisis, proponents of tobacco harm reduction and, in particular, the use of e-cigarettes or vapes, are confronted by an extremely challenging environment in India at the time of writing. Legislation has banned the sale, import, manufacture and distribution of e-cigarettes and e-liquids, and reporting of court papers suggest the Indian government intend this to ‘imply’ that personal use is also banned. Researchers face a moratorium on any academic work focused on e-cigarettes.

In spite of the multiple challenges, the GSTHR team and our partners were able to engage with many people who recognise the potential of tobacco harm reduction to reduce India’s toll of non-communicable diseases and deaths caused by smoking.

In Mumbai, over 30 advocates, consumers, lawyers, and e-cigarette distributors and vendors were introduced to the GSTHR project and the No Fire, No Smoke: the Global State of Tobacco Harm Reduction report. The group then took part in a session entitled The role and potential of advocacy in public health in India. In New Delhi, a select audience of academics, drugs/HIV/AIDS harm reduction service managers, psychiatrists, medics and consumers took part in a session on The science and philosophy of harm reduction, as well as being introduced to the GSTHR and No Fire, No Smoke.

As with all GSTHR events, the primary aim is to build capacity and resilience in the local, national and regional networks of support for tobacco harm reduction. In Mumbai and New Delhi, new contacts were established and nurtured, and real cross-agenda capacity building was achieved.

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