Tobacco, Slow Violence, and a Policy Turning Point: How Grassroots Evidence from Varanasi Helped Shape India’s New Tobacco Tax Framework

“Every public opinion is not policy. For that, we need champions.”

— Dr. Lenin Raghuvanshi

On 7 December 2025, Hindustan Varanasi, Newspaper carried a stark headline: “Tobacco causes cancer in 51.2% of men.”

The report, based on district-level screening data, revealed that more than half of cancer cases among men in Varanasi are linked to tobacco use. Among women, tobacco-related cancers stood at a staggering 14.2%. According to the article, 57% of those screened came from rural areas, underscoring how deeply tobacco-related disease burdens India’s poorest and most underserved communities.

This data is not merely alarming — it is a call to action. It is against this backdrop that a broader movement for fiscal and regulatory reform has picked up pace. And at its center stands the persistent advocacy of Jan Mitra Nyas and the People’s Vigilance Committee on Human Rights (PVCHR).

From Community Testimony to National Policy

In July 2025, at the I Next–Jan Mitra Nyas Doctors’ Honour Ceremony in Varanasi, Dr. Lenin Raghuvanshi articulated a sharp truth: tobacco is not just a public-health issue — it is a weapon of slow violence.

It disproportionately harms the poor, deepens inequality, and drains families financially and emotionally.

That moment catalyzed a deeper engagement. Listening to frontline doctors and families who had lost breadwinners to tobacco-linked disease, PVCHR began translating lived experience into technical policy proposals.

Working with a taxation and tobacco-control specialist, PVCHR developed a concise, evidence-backed brief that made three actionable recommendations:

1. Place all tobacco products in the highest (40%) GST de-merit slab.

2. Introduce a dedicated Health Cess, with revenue ring-fenced for prevention, cessation, and NCD care.

3. Index taxes to inflation to prevent tobacco from becoming more affordable over time.

On 2 September 2025, PVCHR submitted formal letters to:

• The Chairperson of the GST Council

• The Union Finance Minister

• The Leader of the Opposition

These submissions were grounded in conservative calculations showing that even a modest price rise of 6–9% could significantly reduce tobacco use among youth and low-income groups.

A Rare Policy Window — And Civil Society Seized It

On 15 August 2025, the Prime Minister announced the “Next-Generation GST,” promising rationalised slabs and relief for households. This opened a narrow but critical window for public-health advocates to push for stronger measures on de-merit goods.

PVCHR responded quickly — and policymakers listened.

Outcome: The GST Council’s 56th Meeting Adopted Key Reforms

The Council’s decisions aligned strikingly with PVCHR’s recommendations:

• A dedicated 40% de-merit GST slab for tobacco and pan masala.

• Adoption of Retail Sale Price (RSP)-based valuation, closing loopholes that previously allowed companies to under-declare values.

• Creation of fiscal space for a Health Cess, which PVCHR argued must be ring-fenced for NCD prevention and cessation services.

This is a textbook example of evidence-based, community-rooted policy advocacy.

Why This Matters: The Human Story Behind the Data

The Hindustan Varanasi report is not simply statistics — it reflects household tragedies:

• Wage earners lost too early

• Families pushed into debt

• Children forced to leave school to support families

• Chronic illnesses that shrink future opportunities

Tobacco-related deaths in India exceed 1.3 million annually (WHO).

Most of these deaths are preventable.

Fiscal policy is one of the most powerful tools we have — and when combined with strong warning labels, cessation support, and enforcement, the impact multiplies.

Lessons from PVCHR’s Advocacy Model

1. Start with lived experience.
   Testimony from rural families shaped the moral direction of the policy ask.

2. Translate suffering into technical solutions.
   Policymakers need actionable rates, valuation methods, and timelines — not just moral appeals.

3. Move quickly when a policy window opens.
   Momentum created by the PM’s GST announcement accelerated civil-society influence.

4. Stay engaged beyond policy adoption.
   Implementation, monitoring, and protection against industry dilution are essential.

The Way Forward

India now has a stronger fiscal architecture for tobacco control — but this is only the beginning.

We must ensure:

• Effective implementation of RSP-based valuation

• Rapid rollout of the 40% de-merit slab

• Legal ring-fencing of any Health Cess

• Strengthened cessation services at the primary healthcare level

• Robust Front-of-Pack Warning Labels (FOPL) in Hindi and regional languages

• Protection against industry interference

Civil society, medical professionals, youth advocates, and policymakers must together ensure that this moment becomes a life-saving transformation.

As Dr. Lenin reminded the audience in Varanasi:

“Every public opinion is not policy. For that, we need champions.”

Thanks to persistent grassroots advocacy and smart technical engagement, India now has a stronger chance to curb the slow violence of tobacco — saving lives, protecting families, and securing a healthier future.