Background and challenges to implementation:
GATS India 2009:10 estimated that India is a home to over 275 million tobacco users. During initial few years, implementation of national legislation for tobacco control (COTPA 2003) was suboptimal. Post-2010, Ministry of Health Government of India (GoI) took few bold steps to advance the tobacco control agenda and demonstrated commitment to reduce tobacco use and demonstrated early commitment to towards a tobacco endgame. We analysed recent policy papers and measures taken by Government of India towards joining the global call for tobacco endgame.

Intervention or response:
Ban on Gutkha (SLT) and display of specified pictorial health warning (PHWs) covering 85% of the principal display is among the boldest measures by the Government of India. Major focus was on law enforcement especially TAPS ban, smokefree rules, prohibition of sale to and by minors and banning outlets near educational institutions; introducing a toll-free helpline and raise in tobacco taxes and undertaking mass media campaigns.

Results and lessons learnt:
The prevalence of tobacco use has decreased from 34.6% in GATS -I in 2009-10 to 28.6% in GATS -II in 2016-17. The number of tobacco users has reduced by about 81 lakh. The prevalence of tobacco use among the young population has reduced from 18.4% in GATS-I to 12.4% in GATS -II which is a 33% relative reduction. As anticipated, industry challenged the Gutkha ban both inside and out of court, opposed TAPS ban and display of PHWs of tobacco products in India; however public health wins at the end of the day.

Conclusions and key recommendations:
India is in fairly advanced stage of implementing existing measures of MPOWER policies and national legislation; and is moving steadily towards a tobacco endgame. However, this may be the right time for India to think over the concept of tobacco free generation, regulating nicotine content and imposing a 'sinking lid' on tobacco supply.