title: In harm's way: tobacco industry revenues from sales to underage tobacco users in India.
abstract: BACKGROUND
  In 2010, the global adult tobacco survey (GATS) for India revealed that nearly 40% of current smokers and 42% of current chewers had initiated tobacco use before they were of the legal age (18 years old or over). Global evidence shows that those who initiate earlier have a lower probability of quitting the use of tobacco during their lifetime. In order to sustain its profits, the tobacco industry will make every effort to recruit underage users who become lifelong users of their products.
  
  
  OBJECTIVE
  We estimate the consumer expenditure on tobacco products by underage users in India.
  
  
  METHODS
  Using nationally representative data we estimated the number of daily underage tobacco users for a year and their annual expenditure on different types of smoked and chewed tobacco products.
  
  
  RESULTS
  There are nearly 4.4 million underage daily tobacco users (age group 15-17 years old) in India. Approximately 7.2% of the population in the 15-17 age group are current daily users of tobacco (0.1% cigarette smokers, 0.5% bidi smokers and 6.6% tobacco chewers). Underage users spend nearly US$16.9 million and US$270.8 million respectively on smoking and chewing tobacco products.
  
  
  CONCLUSIONS
  There is a substantial expenditure on tobacco products by underage individuals in India. A significant number of new users are added every year that provide an estimate for the size and nature of the future of the tobacco epidemic, one on which the tobacco industry depends on for its sustenance. The government of India's efforts to reduce sale to underage users has had limited effect and needs to be strengthened.
authors.affiliation: The Union South-East Asia Office, International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, India.
authors.forename: Pranay
authors.initials: P
authors.lastname: Lal
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, India.
authors.forename: Sonu
authors.initials: S
authors.lastname: Goel
authors.affiliation: The Union South-East Asia Office, International Union Against Tuberculosis and Lung Disease (The Union), New Delhi, India drdeepakpgimer@gmail.com.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
mesh_terms: D000293:Adolescent; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D019460:Tobacco Industry / Q000191:economics*; D064424:Tobacco Use / Q000191:economics / Q000453:epidemiology*; D014030:Tobacco, Smokeless / Q000191:economics* / Q000706:statistics & numerical data
keywords: children; health promotion; tobacco; youth