No Smoking Day: Why India needs more than cigarette taxes to help smokers quit

India’s recent overhaul of cigarette and tobacco taxation—removing the GST compensation cess and introducing a mix of GST, excise duties, and a new “National Health Security Cess Act, 2025”—has been presented as a public health win. Evidence shows that higher prices can discourage tobacco use. However, helping users quit smoking requires more than price increases. According to the Global Adult Tobacco Survey 2 (GATS-2, 2016–17), 55 per cent of smokers and 50 per cent of smokeless tobacco users said they wanted to quit; yet the actual quit rate remains low, showing a gap between intent and real access to cessation ((expert support and treatments to help people quit tobacco and overcome nicotine addiction)) support.

Closing this gap requires well-funded programmes, including counselling, behavioural support, quitlines, nicotine replacement therapies, prescription medications, awareness campaigns, smoke-free spaces, and follow-up to prevent relapse. Without such structured support, many addicted users may struggle to quit despite higher costs.

As policymakers celebrate revenue collections, they risk ignoring the reality that cessation services in India are underfunded and poorly resourced.

Cessation services: a tiny fraction of revenue

Each year, India collects over ₹75,000 crore in tobacco taxes (Ministry of Finance, 2016–24). Yet funding for actual cessation support is very low. Between 2014–15 and 2022–23, Union budget allocations for tobacco control, including cessation programmes, ranged from ₹13 crore to ₹84 crore per year, totalling about ₹463 crore over eight years. This is less than 0.07 per cent of annual tobacco tax revenues, showing a big gap between revenue collection and investment in tobacco cessation. In some years, allocations were almost negligible compared with tobacco tax receipts. Since 2023, tobacco control spending is no longer listed separately in Union budget documents and is included under National Health Mission (NHM) under Non-Communicable Disease (NCD) flexipool, which is a broad program for prevention of cancer, diabetes, and cardiovascular diseases, etc., reducing transparency and accountability.

This shows a structural problem in policy. While part of tobacco taxation is called a “health cess,” the money is not legally set aside or tracked for tobacco control or cessation programmes. As a result, tobacco taxation mainly raises revenue rather than tobacco cessation.

Cessation services are limited and uneven

The National Tobacco Control Programme (NTCP) is India’s main anti-tobacco effort, including quitting support. It has over 675 tobacco cessation centres in district hospitals and runs the National Tobacco Quitline Service (NTQLS), offering counselling in multiple languages. In 2023–24 alone, more than 1.35 million counselling sessions were delivered. This is less than 0.5 per cent of the 274 million tobacco users who could use cessation services. Among those who do use the services, quit rates remain low, estimated at 6–12.5 per cent.

However, these rates are mostly self-reported and not very reliable. Without scientific checks or standardised follow-up, self-reports often overestimate quitting and fail to capture relapses. Current services are limited and mostly urban, leaving many rural and underserved people without help. To reduce tobacco use effectively, programmes must improve in reach, accessibility, and cultural sensitivity.

Central tax collection limits state control

Tobacco users need support close to home through clinics, community health centres, and even household outreach. Local control over quitting funding is important to ensure services meet local needs.

However, the new cigarette cess is collected centrally. States and urban local bodies, which deliver most health services, have no guaranteed share of this revenue for quitting support or staff expansion. Without fiscal decentralisation, states must fund cessation from general health budgets, competing with priorities like maternal health, immunisation, and non-communicable disease programmes.

High tobacco taxes alone cannot close the gap between quit attempts and successful quitting. Support such as counselling, medications, community outreach, and quitlines needs predictable, long-term funding that meets local demand. If the government’s goal is truly health-focused rather than revenue-focused, key reforms are needed:

Dedicated funding: Allocate at least 10 per cent of tobacco tax revenue to expand tobacco cessation, and another 10 per cent to improve tobacco production safety, track outcomes, and support farmers and beedi workers. Funds should be directly allocated to states based on local tobacco burden and demand.

Integration with health programmes: Include cessation support in non-communicable disease clinics, maternal and child health programmes, and school health initiatives.

Tailored interventions: Design cessation plans specific to product type, as smokeless tobacco users may need different support than smokers.

Capacity and resources: Equip clinics with trained staff, culturally sensitive counselling materials, and essential aids like Nicotine Replacement Therapy (NRT) patches, gum, and lozenges.

Finally, robust follow-up and support from community health workers (ASHAs, ANMs) are crucial, especially in underserved areas. Only then can higher prices be matched with real help for people trying to quit. Taxes may make people think about quitting, but only proper support makes quitting real.

Authors: D Dhanuraj, Director; Lakshmi Ramamurthy and Nissy Solomon, Senior Research Consultant, Civitas

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