Tobacco cessation in India-Current status, challenges, barriers and solutions

The attention to tobacco cessation (TCs) has increased globally by WHO through the Framework Convention on Tobacco Control (FCTC) and MPOWER. In India, NTCP (National Tobacco Control Program), the National and three Regional Quitlines and mCessation, some apex national institutes, and professional dental bodies and others have eased an access to quit, the proportion of the former users has been dismally low-below 2% at population level. The challenges of not having: (1) TCCs at secondary and tertiary care as well as in the larger private healthcare setups; (2) participatory health system and healthcare professionals; (3) motivated tobacco users to quit even in short-term; (4) focused NTCP due to convergent NHM (National Health Mission); and, (5) optimal coverage to the health-insured "need a priority attention". Also, there is need to eliminate the barriers existing: (a) at all levels in the governance, health system and other stake-holding sectors; and, (b) due to the interference of the tobacco industry. Overall, (i) setting the norm of quitting since all tobacco users are actually patients; (ii) increasingthe awareness of benefits of quitting and incentivizing it; (iii) establishing a systems approach in all health facilities of screening, treatment and follow-up of the treated tobacco users besides coding them; plus (iv) amending COTPA (the Cigarettes and Other Tobacco Products Act of 2003) can increase the quit rates in India and LMICs.