It hurts people’s health and stains our cities

Alas, the red stains that pepper corners and walls stand out as eyesores.

India has banned gutkha in almost every state. Yet, anyone who walks past a street or bus stand would have seen evidence of it: shiny used sachets litter corners, coupled with splatters of vermillion nearby.

Sold under the counter, mixed with other chewing tobaccos, or disguised as ‘pan masala,’ gutkha has become one of India’s most stubborn public health and sanitation failures. These crimson eyesores across Indian cityscapes reflect not only civic neglect, but also a habit that is claiming the health of India’s youth.

Gutkha may look like a cheap and harmless pleasure, but multiplied across millions of users, it becomes a slow-moving public health disaster.

Just as small arms cause limited harm individually but mass destruction collectively, gutkha’s real danger lies in its scale. Narcotics attract headlines. Yet, this silent addiction quietly delivers disease and poverty one sachet at a time.

The economic consequences of this menace are staggering. The Indian Railways reportedly spends more than ₹1,000 crore annually on cleaning gutkha stains in railway coaches and stations.

Every year, over 70,000 Indians die from oral cancer—many of these cases are attributed to chewing tobacco. Treatment drains household savings and survivors often lose the ability to speak, eat or work.

The economic cost of lost productivity and healthcare spending is astonishingly high. Yet, gutkha is cheaper than a bus ticket. This begs the question, does India subsidize sickness while taxing health?

Why the ban has failed: The addiction is fuelled by a toxic cocktail of economics, culture and poor enforcement of the ‘ban’. For millions of daily-wage workers, gutkha acts as a cheap stimulant that suppresses hunger and keeps them awake—a tragic reflection of economic hardship as much as personal choice.

Manufacturers thrive because penalties are weak and enforcement uneven. Local police often look the other way and small traders earn easy profits by selling sachets discreetly.

Meanwhile, the industry has found loopholes. Companies sell ‘pan masala’ and ‘flavoured tobacco’ separately and let users mix them, resulting in a legal yet lethal combination. In other words, India has banned the product but not the problem.

How to end the gutkha menace: The fight against gutkha needs the same seriousness that India brought to polio or covid. Three steps are essential:

Make enforcement real: The ban must move from paper to practice. States need specialized anti-tobacco units with digital tracking of production, transport and retail sales. Just as liquor is tracked bottle-to-bottle, gutkha sachets must be traceable to the source.

Additionally, the workaround of selling pan masala and tobacco separately needs to be brought under the ban’s ambit.

Target demand: Awareness campaigns must move beyond fear-based advertisements. Real change comes from community-level interventions implemented through school programmes, village health workers and local champions who make quitting aspirational.

Crucially, we must replace shame with support. Remember, it is an addiction.

Offer alternatives and rehabilitation: For millions of users, gutkha is a coping mechanism for stress and exhaustion.

A serious strategy must include counselling, nicotine-replacement therapies and workplace initatives, especially for construction workers, drivers and factory labourers who form the largest user base.

India has the capability to show sensitivity to its most vulnerable citizens. The newly-launched Apna Ghar initiative, for instance, offers truck drivers hygienic and affordable resting rooms along highways. The next step is to ensure that their vehicles have air-conditioned cabins, helping reduce fatigue and heat stress that drive many towards gutkha.

We must take everyone along as a society, including daily-wage labourers who find gutkha helpful in the short-term but devastating in the long run.

And it’s not just the poor who need to change. The celebrity endorsers who lend their faces to this addiction economy must switch sides. Movie stars who glamorize these products owe the nation a moral correction.

Just as India’s celebrity stalwarts once helped popularize polio drops, they must now help stigmatize gutkha. India listens when its heroes speak. It’s time they spoke for health, not habit.

The authors are, respectively, assistant professor at Dhirubhai Ambani University and research scholar at Shiv Nadar Institution of Eminence.