For policymakers
India's tobacco control has a prohibition problem — the evidence says the fix is regulation, not more bans
A structured case, built on India's own government data, international precedent, and the published record of what has and hasn't worked elsewhere — for anyone weighing India's options on tobacco harm reduction policy.
The status quo isn't working
A 2026 working paper by a member of the Prime Minister's Economic Advisory Council (EAC-PM), drawing on official National Sample Survey and Household Consumption Expenditure Survey data, found tobacco consumption has risen sharply over the last decade of prohibition-only policy — including a roughly sixfold rise in rural gutka use — not fallen:
Source: EAC-PM working paper (Shamika Ravi & Partha Protim Barman, 2026), reported in ThePrint. The finding covers all tobacco, not specifically PECA's e-cigarette ban — but it lands during the same decade e-cigarettes have been banned nationally, while gutka and khaini remain widely available. If the policy goal is reducing tobacco-attributable harm, the trend line says the current toolkit needs expanding, not just enforcing harder.
Where regulation has coincided with accelerated declines
Sweden
Decades of snus substitution produced Europe's lowest daily smoking rate (~5%) and 44% lower tobacco-attributable mortality than the EU average.
GSTHR country profile →Japan
Smoking prevalence fell from 32% (2000) to 19.4% (2022), with an accelerated decline specifically among the age groups with highest heated-tobacco uptake after HTPs entered the market in 2014.
GSTHR country profile →United Kingdom
An estimated 3.3 million adults have quit smoking using a vape; daily vaping has overtaken daily smoking for the first time on record, under a regulated-access model.
ASH UK data →New Zealand
Official position: vaping carries "much less risk than smoking cigarettes" — one of the clearest government-endorsed regulated-market approaches globally.
GSTHR country profile →Canada
Health Canada's position: "switching completely to vaping is a less harmful option" than continuing to smoke, underpinning a regulated national market.
Health Canada →Philippines
A July 2022 law created a differentiated framework — distinguishing vaping from smoking while restricting youth access — offered as a workable middle-ground model for other Asian countries by independent THR commentary.
See AVI's press coverage →Where prohibition hasn't worked
Brazil
Academic analysis found weak enforcement of Brazil's e-cigarette ban has left the country with a widespread, unregulated illicit market — prohibition alone failed to contain use or trade.
Read the analysis →Thailand
Thailand's illegal e-cigarette market was estimated at 3–6 billion Thai baht even years into a strict ban, with black-market devices carrying no safety standards at all.
Read the coverage →Mexico
Listed among the world's strictest vape-ban jurisdictions — without published evidence that the ban has measurably reduced smoking prevalence, and with a documented parallel illicit trade.
See the comparative data →Australia
A 2024 prescription-only model for vaping, paired with steep cigarette taxes, pushed both markets underground — fuelling over 220 arson attacks on black-market tobacco and vape retailers since 2023, per criminology researchers. Even a wealthy, high-enforcement state couldn't hold the line.
Read the report →India & Pakistan — smokeless tobacco
Oral cancer's primary cause — chewing tobacco — has been known since 1908, yet India accounts for 36% of the world's new cases and 42% of its deaths. A 2026 analysis found banning gutka didn't remove it — it drove "unbundling, surrogate advertising and an illicit market," with gutka-consuming rural households rising from 5.3% to 30.4% over roughly a decade.
Read Derek Yach's analysis →The pattern across all four: banning it doesn't remove demand — it moves that demand into an unregulated, untested, unsafe market the state has no visibility into, one that in Australia's case has turned violent. This is the mechanism India's own PECA ban risks reproducing at national scale.
A middle path: regulate, don't prohibit
China offers a contrast to outright prohibition: instead of banning e-cigarettes, it brought them under its tobacco-monopoly system in 2021 with a mandatory regulatory standard (2022) — licensed and regulated, not prohibited. Whatever one thinks of a state monopoly model, it proves "ban outright" isn't the only option for a large, complex market.
See coverage of China's regulatory standard →The financial and livelihoods case
India's existing tobacco economy is large, and the policy question is what happens to it — not whether it exists.
A regulated sector doesn't require abandoning this workforce. AVI's director has argued regulation "could enable India, as the world's second-largest tobacco producer, to explore leveraging its agricultural base for the production of pharmaceutical-grade nicotine" — repurposing existing capacity into a legal, taxed supply chain rather than treating farmers as an obstacle.
Read the full 2Firsts piece →A regulated market also generates tax revenue current policy forgoes entirely by pushing the category into an untaxed illicit market — the same dynamic documented in Brazil and Thailand above.
International backing for this position
INNCO's LMIC position paper
"10 Reasons Why Blanket Bans of E-Cigarettes and HTPs in Low- and Middle-Income Countries Are Not Fit for Purpose" — published by the International Network of Nicotine Consumer Organisations, the global federation AVI's own director served as president of from July 2020. Written in direct response to a 2020 call by The Union (a Bloomberg tobacco-control partner) for LMICs to ban ENDS and HTPs outright.
"In India for example, there are significantly more users of smokeless tobacco, often high-risk non-food grade smokeless tobacco, than cigarette smokers. Traditional cessation services may not work in such an environment and for all tobacco users … on behalf of those in LMICs, we say loud and clear — nothing about us without us."— AVI's director, INNCO Foreword
- Bans are an overly simplistic solution to a complex issue and will not work
- Prioritising the banning of reduced harm alternatives over cigarettes is illogical
- Reduction and substitution are valid goals for smokers in LMICs
- People who smoke have the right to choose to reduce their own risk of harm
- Reduced harm alternatives can significantly contribute to the aims of global tobacco control
- Lack of research in LMICs is not a valid reason to ban reduced harm alternatives
- The prohibitionist approach in LMICs is outdated, unrealistic and condescending
- Bans in LMICs lead to illicit markets, more crime, and no tax revenue — with real examples from Bhutan, Singapore, Mexico, Brazil and Thailand
- Banning reduced harm alternatives leads people back to smoking and greater harm — South Korea and Mexico both saw this after tightening HTP/ENDS rules
- Blanket bans in LMICs are a form of "philanthropic colonialism"
- 180+ documented positions from international medical, scientific and government bodies backing THR as a public-health strategy — WHO Europe, Cochrane, national medical academies, cancer and heart-disease bodies across a dozen countries. See the compiled list → (AVI did not compile this and cannot vouch for every entry individually)
- A model for what a formal submission looks like — independent THR policy analyst Clive Bates has filed detailed submissions to the Australian Senate, Health Canada, and the Irish government, among others, each grounded in the same evidence base cited on this page. See his submissions archive →
AVI's own record
A decade of policy engagement, not just commentary:
- Litigation — bans challenged across four states, on the evidentiary grounds set out on this page. Full record →
- Formal submissions — including a 34-source rebuttal to the draft PECA bill, filed 8 November 2019. Read it (PDF) →
- Public campaigns — a multi-city "Tobacco Harm Reduction" press conference series, and protests across six metros against the 2019/2020 ban. See coverage →
- Press & statements — letters and rebuttals to government bodies over the years. Press archive →
Not every submission AVI has sent is catalogued here yet — policymakers or researchers wanting the full history can contact us directly.
Open to discussion
We're available to share more evidence with lawmakers and policymakers
Everything on this page is a starting point, not the complete case. If you're weighing tobacco harm reduction policy for India — or anywhere else — AVI is available to walk through the underlying research, India-specific data, and international precedent in more depth.
Contact us →