Tobacco harm reduction in India
A market larger than any other — and none of it regulated for harm reduction
India has more tobacco users than any country outside China, split across smoking and smokeless tobacco in a way most global tobacco policy doesn't account for. Here's where the numbers, the law and the litigation currently stand.
The bigger picture
A crisis being managed backwards
The scale of it
India has more tobacco users than any country outside China — roughly 100 million smokers and 200 million smokeless tobacco (SLT) users: 10.7% of adults smoke and 21.4% use SLT (GATS-2 fact sheet, 2016–17). By habit, that's smoking-only 7.23%, SLT-only 17.94% and dual use 3.44% — not the single habit most tobacco policy assumes (Nayak et al., 2023). Smokeless tobacco, in full →
Bans that close the off-ramp
PECA, 2019 bans e-cigarettes outright — production, sale, import, advertisement. Nicotine pouches and snus have no lawful sale pathway either. Removing the lower-risk alternative doesn't make nicotine use disappear — it removes the off-ramp, pushing existing users toward an unregulated illicit market instead. The law, in full →
A government invested in the status quo
The state regulating this market isn't a neutral referee — it's a shareholder in it. LIC, SUUTI and other public-sector insurers together hold roughly 28% of India's largest cigarette maker (The Print, 2023). A government profiting this directly from cigarette sales has little incentive to let a genuinely lower-risk competitor in.
Research and even discussion, restricted
In December 2023, the National Medical Commission directed doctors to secure Health Ministry approval before researching e-cigarettes or heated tobacco at all (The Tribune). Even policy discussion hasn't been spared: a 2023 panel that named nothing specific was branded "promotion" by the Health Ministry anyway.
Four ways into this section
Current law
What PECA and related rules actually say today — for e-cigarettes, nicotine pouches, and NRT for contrast.
Read the law →Litigation
The legal challenges to state and national bans AVI has organised and fought since 2017, and their outcomes.
See the cases →Evidence library
The published research behind AVI's position, including India-specific studies on smoking and SLT use.
Browse the evidence →Submissions to policymakers
Letters, rebuttals and calls to action AVI has sent directly to India's health ministry and Parliament.
Read the submissions →