India Faces Severe Tobacco Addiction Problem as Medical Experts Push Nicotine Replacement Therapy

India has a high tobacco-related death rate, and experts are calling for better access to NRT to address cigarette smoking. However, there is currently debate over whether NRT should be treated as an OTC medicine or a prescription drug.

According to a report published October 6 by health website bwhealthcareworld, India has 100 million smokers and accounts for more than 20% of global tobacco-related deaths, affecting families, livelihoods, and national productivity. Indian medical experts emphasized that easier access to nicotine replacement therapy (NRT) can effectively help individuals quit smoking. 

Nicotine replacement therapy (NRT) becomes a key treatment tool 

According to a recent report, experts believe that addressing India’s tobacco addiction problem—which causes more than 1 million deaths each year and accounts for 9.5% of all deaths nationwide—requires a comprehensive tobacco control strategy. This includes improving access to smoking cessation methods, public education, and the use of approved therapies such as nicotine replacement therapy (NRT). NRT plays a critical role in this fight. It has been used for 25 years, and its success rate in helping people quit smoking is 50% higher than unassisted quit attempts.

The urgency of access 

Dr. Chandrakant S Pandav, former head of the Department of Community Medicine at AIIMS and a Padma Shri award recipient, emphasized: “We urgently need to improve public access to smoking cessation methods in India.” 

He said that 28.6% of adults in India use tobacco, and these challenges are even more persistent in remote and rural areas. Therefore, “NRT must be made available over the counter at pharmacies. Convenient access makes people more likely to quit successfully.” 

A combined psychological and physiological approach is needed 

Unlike the nicotine in cigarettes, NRT provides a temporary nicotine substitute that helps control cravings, relieves withdrawal symptoms, and supports the transition to a tobacco-free life. NRT ensures a gradual and controlled increase in nicotine levels in the bloodstream, helping prevent misuse. 

Dr. Sajeela Maini, a specialist in smoking cessation, alcohol cessation, and mental health at Gangaram Hospital in New Delhi, said: “Nicotine products that replace cigarettes are the most effective way to reduce cravings and withdrawal symptoms. We must address both the psychological and physiological aspects of tobacco addiction to ensure successful quitting.” 

However, a proposal by India’s Drugs Technical Advisory Board to change NRT from over-the-counter availability to prescription-only status has sparked intense debate in academic circles, as many believe such a move could reverse progress in combating tobacco addiction and run counter to the recommendations of major global health authorities. Medical experts advocating for NRT stress that making these smoking cessation products prescription-only would limit benefits for those ready to quit and hinder the government’s tobacco cessation goals.