Banning the sale of tobacco products to people born after 2000, the introduction of non–addictive cigarettes, the imposition of quotas on tobacco sales and imports–these are some of the strategies Indian policymakers are considering as part of a "tobacco endgame", a mission to reduce, if not eradicate, its consumption.

Such radical steps will advance measures already in place, such as the recent ban on consumption of gutkha–flavoured chewing tobacco–and a blackout of advertising on cigarettes and other products made out of the leaf. The government has also made it mandatory for cigarette packs to carry graphic images of damage done by smoking in addition to health warnings.

The United Nations and its World Health Organization (WHO) arm are seeking a 30% reduction in India’s tobacco prevalence by 2025 from current levels and a 25% cut in mortality related to non–communicable diseases by 2040 as part of the "endgame" strategy. The larger ambitious target is to reduce global consumption of tobacco–related products to less than 5% of current levels by 2040.

Tobacco use–largely cigarette smoking–remains the leading cause of preventable premature death and illnesses across the world. According to the Global Adult Tobacco Survey 2012, tobacco kills nearly six million people every year worldwide, of which more than 600,000 are non–smokers exposed to second–hand smoke. According to WHO, smoking killed 100 million people worldwide in the 20th century, and, with currently anticipated consumption patterns, will claim at least one billion lives in the 21st.

Cigarettes with nicotine content so low that they won’t cause addiction and a ban on the sale of tobacco products to those born after 2000 are expected to create a "tobacco–free generation", officials said. The so–called "sinking lid" strategy will lead to the imposition of quotas on the sale and import of tobacco, which would reduce supply and drive up prices, thereby deterring the purchase of tobacco.

The health ministry "is keenly following the discussion around tobacco endgame. We have already taken several initiatives in tobacco control", said Amal Pushp, director of National Tobacco Control Programme, ministry of health and family welfare. "We have already taken several initiatives in tobacco control. The conference will help us decide how best these strategies can be applied in the Indian context."

In September, India will host the first international conference on the tobacco endgame, which will be attended by WHO director general Margaret Chan and representatives from 30 countries.

"The endgame strategy is to strengthen the foundations for creating a tobacco–free generation of the future. This will be a historic step towards a global commitment for ending the tobacco threat by eliminating all forms of human consumption of tobacco by the latter half of the century," said K. Srinath Reddy, president of the Public Health Foundation of India.

Countries such as Australia and Singapore are already implementing some of the strategies that will be discussed at the conference.

Australia has introduced rules that require cigarettes to be sold in packs without manufacturer logos and carrying images of health damage from smoking. It also forbids retail outlets from publicly displaying cigarette packs. Singapore has recently banned the sale of tobacco products to anyone born after 2000, even if they demand it after growing to adulthood. New Zealand is looking at similar initiatives.

"Australia’s measures were drastic and commendable. They already had a comprehensive advertising ban in place, which they recently expanded to ‘point of sale’ and ‘on product’ as well," said Monika Arora, director of Hriday–Shan, a voluntary organization of social scientists.

"In India, advertising is allowed at point of sale and on packaging currently. The government has also worked at making the product ‘uncool’ by standardizing the packaging and taking away the appeal it had to the youth," she said. "Globally, this is the direction policymakers are moving in and India has taken a huge step by banning gutkha, which has majority consumption in our markets."

To be sure, taxes levied on cigarettes are a valuable source of revenue for the government in India as well as overseas. In his budget for fiscal 2014, finance minister P. Chidambaram raised excise duty on cigarettes by 18%, almost matching the previous year’s increase. This week, the Australian government announced a 12.5% increase in tobacco taxes

starting December to counter a shortfall in revenue as well as fight cancer caused by smoking.

"The pattern of tobacco consumption in India is unique and is dominated by non–cigarette products, which are not only cheaper, but also revenue–inefficient," said Nazeeb Arif, vice–president of corporate communications at India’s biggest cigarette maker ITC Ltd.

He cited the Global Adult Tobacco Survey 2010 conducted by the Indian health ministry, which found that while 34.6% of all adults in India used tobacco in some form, only 5.7% smoked cigarettes.

Per capita cigarette consumption in India is the lowest at 99 sticks per year compared with 1,840 in Japan, he said, citing the findings of The Tobacco Atlas.

"The discriminatory and steep taxes on the cigarette form of tobacco have reduced its consumption, and are driving consumers to shift to cheaper and revenue–inefficient forms of tobacco or to tax–evaded contraband," Arif said. "As a result, overall tobacco consumption has gone up in India, defeating the very objective of tobacco control."