Tobacco deaths in India: Tobacco kills an estimated 1.35 million Indians annually, yet quit rates remain stubbornly low despite widespread awareness.
With India spending over ₹ 1.77 lakh crore each year on tobacco-related diseases, clinicians are urging science-backed harm reduction alongside traditional cessation, including smoke-free nicotine alternatives.
“For patients with COPD or at risk for cardiovascular issues, every cigarette avoided is significant,” said Dr Pawan Gupta, senior consultant in pulmonary medicine at BLK-MAX Super Speciality Hospital. Citing reviews, including those by the Royal College of Physicians (UK), he noted that non-combustible nicotine delivery is associated with significantly lower risk than smoking. “That evidence cannot be ignored,” he said.
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Public Health England has previously estimated that smoke-free nicotine alternatives may be up to 95% less harmful than traditional smoking because they eliminate combustion and tar. Globally, nicotine pouches have gained ground as discreet oral products and are now sold in 34 countries, including Sweden, Norway, the US and Denmark.
“Traditional cessation tools often have limited success in India,” said Dr Sunaina Soni, Assistant Professor, Department of Physiology, AIIMS-CAPFIMS Centre. “Safer, tobacco-free nicotine alternatives could help smokers move away from cigarettes. No smoke, no tar, no combustion—that’s the critical difference.” She stressed that the products are not risk-free, but as substitutes, they could support India’s stated target of reducing tobacco use by 30% by 2025 under the WHO’s NCD goals.
As per the data, one in ten Indians dies prematurely due to tobacco-related disease, and, according to the CDC, only around 7% of smokers successfully quit unaided. Experts say that to bend the curve, India will have to implement marketing curbs, develop cessation support, and regulate harm-reduction options for those unable or unwilling to quit nicotine outright.
