This comes against the backdrop of Gujarat, Karnataka, Maharashtra, Rajasthan and Tamil Nadu reporting the highest number of violations. This development takes on significance as tobacco remains the leading cause of death in India, killing 1.35 million people annually.
Based on the Global Youth Tobacco Survey (GYTS) 2019, children in India will start using tobacco in both smoked and smokeless forms, a finding highlighted in the World Health Organization’s 2024 report. Smokeless tobacco products (SLT) such as gutkha, khaini or zarda are the main form of early initiation, with 24% of children aged 13-15 surveyed years begins with their use before their seventh birthday. Smoked tobacco also contributes significantly to this early trend: 17.2% of children start smoking bidi and 11.4% of children start smoking cigarettes before reaching the age of seven.
In light of the crisis, the Center is launching a major enforcement drive to tackle tobacco use to strictly enforce the Cigarettes and Other Tobacco Products Act (Cotpa) and the ban on e-cigarettes (E-Cigarette Prohibition Act (Peca), 2019); with district-level teams under the National Tobacco Control Program tasked with stepping up raids. State drug controls were also tasked with monitoring nicotine-containing products on the market.
In the 2025-2026 fiscal year alone, 12,001 retail sales violations and 203 e-cigarette ban violations were reported.
In a letter to states/UTs reviewed by Mint, Union Health Minister Punya Salila Srivastava said tobacco use remains one of the leading causes of preventable disease and death in India, resulting in 13.5 lakh deaths annually. “What is alarming is that tobacco use is starting at an early age, with the age of initiation being reported as high as seven years in some states, which is very worrying,” Srivastava said.
To combat this crisis, the government has institutionalized an annual Tobacco Free Youth (TFYC) campaign from 2023 to educate and empower young Indians to resist or quit tobacco.
The crisis of tobacco use among Indian children is due to many interrelated factors as detailed in various medical journals such as PubMed and ResearchGate. Family influence is important because the habit is often initiated due to tobacco use by parents or older siblings, or when children are asked to buy tobacco products.
Peer pressure and social factors, including experimentation and peer influence, act as major drivers. In addition, the aggressive marketing and easy availability of nicotine products, especially from companies targeting adolescents in developing countries, is a major contributor to the problem. Socioeconomic predictors such as lower family income and low parental education levels increase the risk, compounded by gaps in awareness of the specific, serious health risks of tobacco.
The serious problem of early tobacco introduction in India is documented by the WHO GATS surveys. The Global Youth Tobacco Survey 2019 confirmed this trend, showing that a large number of adolescents (aged 13-15) who used tobacco started the habit before the age of 10.
Forced drive
This year’s strategies include strengthening compliance with the Guidelines for Tobacco-Free Educational Institutions (ToFEI), ensuring tobacco-free villages and strengthening enforcement of the Cigarettes and Other Tobacco Products Act 2003 and the Electronic Cigarette Ban Act 2019.
Inquiries sent to a spokesperson for the Ministry of Health remained unanswered on Saturday.
“The government has directed states/UTs to strictly implement the ToFEI guidelines. This includes several steps to create a tobacco-free educational environment: each educational institution must administer a ‘Tobacco-Free Commitment’, designate a faculty member, staff member or student as a ‘Tobacco Monitor’ and ensure that the campus and surrounding areas are clearly designated as tobacco-free zones. Mark the perimeter, making a 100-yard zone around schools and the university will become a target for enforcement drives,” said the official quoted above.
In addition, states have been directed to conduct intensive enforcement efforts to implement tobacco control laws with the support of specialized enforcement teams, the official added.
Tobacco kills half of its users prematurely. Almost 3,600 people die every day in India as a result of tobacco use. Tobacco deaths in India are estimated at over 1.3 million, with one million deaths attributable to smoking and the rest to smokeless tobacco use. According to the Indian Council of Medical Research (ICMR), tobacco use increases the risk of stroke by 78%, coronary heart disease by 85.2%, and increases the likelihood of tuberculosis and acute myocardial infarction. It is also responsible for 43% of esophageal cancer, in addition to increasing the likelihood of mouth and lung cancer.
Key things
- Children in Gujarat, Karnataka, Maharashtra, Rajasthan and Tamil Nadu are starting tobacco use as early as age seven, prompting urgent government action.
- The Union Government is launching a major push for strict enforcement of the Cigarettes and Other Tobacco Products Act and the E-Cigarette Prohibition Act.
- In the 2025-26 fiscal year alone, there were 12,001 violations of the retail ban and 203 violations of the e-cigarette ban, underscoring major compliance issues.
- The enforcement strategy includes rigorous implementation of the “Tobacco Free Educational Institutions” guidelines.
- Experts stress that to achieve long-term success, strong enforcement must be combined with key interventions such as ongoing school education, parental awareness and restrictions on surrogate advertising.
Compliance efforts
Malavika Kaura Saxena, chief marketing officer of Rusan Pharma, welcomed the stepped-up efforts, noting that the reported early onset of tobacco is a “deeply affecting public health issue” and that stricter enforcement of laws like Cotpa and Peca is a “critical step forward”. She pointed out that the growing demand for science-based Nicotine Replacement Therapies (NRTs) shows India’s readiness to move “from addiction to cessation”.
The demand for nicotine replacement therapy in India is experiencing significant growth, which is driven by key market and policy changes. The NRT market was valued at approximately USD 33 million in 2023 and is projected to reach USD 108 million by 2033, growing at a CAGR of approximately 12.5%. Nicotine gum dominates revenue share (84% in 2023) according to Grand View Research.
This increase is due to increased public awareness of the harmful effects of tobacco on health and government support, notably the inclusion of NRT in the National Essential Medicines List in September 2022. This move, along with services such as the National Tobacco Quit Line, improves accessibility and supports more than half of Indian adult smokers who intend to quit, with NRT potentially increasing their success rate by 50-6%.
Dr. Shivaraj Ajji, head of pulmonology at SPARSH Hospital in Bengaluru, said the nationwide crackdown was “a much-needed step to protect India’s youth from lifelong addiction and disease”. He emphasized that the issue points to significant gaps in enforcement and awareness. He concluded that while strict implementation of laws is essential, it must be combined with ongoing school education, parental awareness and a reduction in substitute advertising to make tobacco use socially unacceptable.
