I am sending this from the Indian Cancer Society, Delhi, India.We are a non-profit, non-Governmental organisation of some standing. We have worked in the field of Cancer Awareness and Detection for over 16 years now, in the capital city of New Delhi, and its immediate hinterland. WE HAVE SEEN THE STEADY RISE IN TOBACCO RELATED CANCERS OF THE MOUTHPaan Masala, a perfumed and flavoured form of tobacco is routinely served in homes as a mouth freshner after a meal.Again, there is shock when the housewife is told what its contents are. Manufacturers rely on this general ignorance to make fantastic claims for their products. The Government makes little or no effort to contradict this. We are still awaiting the result of our request to the Government of India to put public service advertising through the Government sponsored Department of A/V Publicity, (DAVP) on the early warning signs of cancer, put to the then Minister, over a year ago.

Name of Organisation making the Submission : The Indian Cancer Society, Delhi, India Scope of the Organisation & its Mandate : Cancer Awareness and Education, and the provision of affordable and reliable facility for Cancer Detection, and regular cancer screening, are the mandate of the Indian Cancer Society, Delhi (ICS(D)) Cancer Awareness programme is carried out by volunteer speakers, who are trained to address the key issues. They speak to audiences in schools and colleges, offices and factories, to women's groups, and through the good offices of Rotary and Lions'Clubs they reach out to transient labour and working class groups living in the urban slums. TOBACCO ABUSE IS THE MAIN THRUST OF THEIR TALKS.They are supported by excellent literature, posters and the occasional print message in newspapers highlighting the waening of cancer.We wish we had access to the TV medium, but cannot afford the luxury. The ICS(D) runs the only Cancer Dection Center and Mobile Service in Delhi. Between the two we are able to screen over 6000 persons a year. This year, we have determined to increase that figure manyfold.The Mobile Service in particular renders sterling service, carrying first class medical attention to far flung outskirts, and to communities who would otherwise have no access to either the awareness nor screening facility. Doctors work at the Cancer Detection Center, Monday to Friday, between 0900 and 1230 hours. They then take the Mobile Unit out on Saturdays and Sundays and on Monday and Thursday afternoons on request. We charge Rs 50/- (just about US$1/-) at the Center, and Rs 150/- (US$3/-) at the Mobile Service. Most often, the Service to villages and city slums are sponsored by well wishers. The Screening process covers a blood test, chest Xray, and physical examination by the 3 specialist doctors of Surgery, Gynaecology and ENT. Over 60% cases are picked up by the ENT specialist, and these are Tobacco related. Our interest in FCTC proceedings arise from our concern at the rising tide of tobacco related cancers.

* We are alarmed at the lack of awareness of the devastating effects of tobacco abuse, and at the casualness with which Government treats this threat.

* Public information and public education policies are essential to an effective anti tobacco programme. We see the difference we are able to make, even within the limitations of infrastructure and support that we work under. * The ICS can work WITH ministies, other NGO's, Schools, Primary Health centers and Community leaders. Its own efforts , however laudable, are a drop in the ocean. It cannot operate in isolation or in limbo, given the enormity of the task * .There is need for a well thought out and implementable national smoking control programme, which can succeed when there is coordination and interaction between Governments and concerned NGO'a like ourselves.

* A social environment has to be created which is favourable to a no tobacco culture. Tobacco has to be made a socially unacceptable habit.

Funding : The ICS(D) has no regular source of funding. We spend approximately Rs 16 lakhs( US$32,000/-)per annum in keeping our services running. For some years the Government of India gave us a small grant of Rs 5 lakhs (US$ 10.000) per annum. That was discontinued in 1996, when it was felt that no NGO should come to rely on this type of grant. The bulk of our funds have always come from the general public and philantropic groups, Trusts, etc. The only change that lack of Government aid has brought is that we now charge for services otherwise provided free of cost.Even with our extremely limited resources the ICS(D) has shown the way to providing quality services both in Awareness and in Detection facilities.If and when funds are available, we are ready and willing to expand our services.

Our Submission: Tobacco Control Programmes have to be targetted at 2 levels. 1. Aimed at changing the practice amongst persons engaged in manufacture, promotion, and sale of tobacco products. 2. Aimed at changing practice amonst persons using those products.

* The FCTC should set a basic minimum standard to be adopted by all nations in setting standards for maintaining national health against tobacco induced illnesses. There is an urgent need for NGO's to work in coordinated fashion with Government agencies and become an integral part of such planning. * Formulation of laws without a concentrated and well coordinated Awareness Campaign will have no meaning. Existing laws are flouted with impunity.NGO's, Teachers, Social leaders, and personalities from Cinema and the Sports world should be used to spread the word. Why not anti Tobacco Ambassadors, on the lines of the UNICEF Ambassadors ? * Give tobacco the same status /stigma under Law as Cocaine or Heroin. Make it socially unacceptable. * Ban production of tobacco. Disallow the Tobacco industry's incentives to farmers. Governments provide subsidies to many industries. Why not a subsidy for changing over to another suitable crop? * We are told there is an American law that makes the provision of equal free time, mandatory for TV companies, as the time taken for advertising of substances that affect the health of the nation. Why is this law not on the books of all nations? If such a law existed, TV companies would be forced to give time to arguments against the seductive lure of tobacco advertising. * Make it unacceptable for newspapers and magazines, TV and Cinema to carry tobacco advertising. Tax them at prohibitive rates.The Tobacco Council in India funds a magazine called "Tobacco Today", which actually extolls the virtues of tobacco as a cure for various ailments. * Ban "life style"advertising, using tobacco company logos and colours to avertise holidays and clothing in thinly veiled advertising campaigns. * Disallow sports persons from participation in international sport if they endorse a tobacco product. * Tax collected by Governments on tobacco products is blood money.Make it mandatory for Governments to spend it for provision of a coherant de-addiction programme, with centers for smokers desperate to stop. Let them spend a portion on creating awareness on tobacco abuse. And yet another portion in creating facilities for treatment of tobacco related disease such as cancer, respiratory tract distress, especially for infants who are the victim of their parents'folly.

Make anti smoking products such as gums and patches easily and cheaply available. They should find shelf space right beside the tobacco product, not in chemist stores as at present.

Each one of us is responsible in the war against tobacco. Let each one do his/her bit, rather than leave it to faceless governments. The ICS(D) is ready and willing to do its bit. We would be happy to make a personal submission if required, providing that the cost of such a trip is born by the WHO.

Wishing all delegates the best for fruitful discussions and a meaningful Framework,

Mrs. Jyotsna Govil, Hon. Jt Secretary, ICS(D), Q5A Jangpura Extension, New Delhi 110014