New Delhi, Sept. 12: India has an extraordinarily high proportion of tobacco users who have no intention to quit their habit, public health experts said today calling it a “very disturbing” observation that indicates laws alone won’t save lives.

A new 20-country study analysing regulatory initiatives and tobacco use patterns has revealed that between 75 per cent and 94 per cent male smokers sampled from four Indian states, including Bengal, had no intention to quit smoking.

“The vast majority of smokers aren’t even thinking about it,” Geoffrey Fong, professor of psychology at Canada’s University of Waterloo, said today, presenting the findings of the study at an international conference on tobacco here. “It’s an enormous and terrible barrier in the fight to reduce tobacco use and tobacco-related disease and death,” Fong said.

The India arm of the study conducted by the Cancer Foundation of India, Calcutta, and three other collaborating institutions was based on face-to-face interviews with a sample of about 8,000 tobacco users and 2,400 non-users sampled at random in four cities — Calcutta, Indore, Mumbai and Patna.

The study found 83 per cent of the smokers in Bengal, 75 per cent in Bihar, 94 per cent in Madhya Pradesh, and 76 per cent in Maharashtra had no plans to quit. In contrast, China’s proportion of smokers with no quit intentions was 65 per cent, while the figure was 22 per cent in the US and 39 per cent in the UK.

Psychologists believe a conscious decision to quit is an important starting point towards cessation. “Many studies across health areas have demonstrated that intentions to do some behaviour is among the strongest predictors of future behaviour,” Fong said.

The study has also raised questions about the effectiveness of the pictorial warnings and cautionary messages against tobacco used on tobacco product packets and in films showing its use. Only 3.5 per cent of male smokers in Maharashtra, 8.7 per cent in Madhya Pradesh, 9.6 per cent in Bengal, and 23 per cent in Bihar said that such warning labels made them “think a lot” about the health risks of smoking.

“These are very disturbing findings, they should be a wake-up call for India,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids, an international NGO. “They show that passing laws is not enough to save lives.”

India has an estimated 270 million tobacco users. And public health experts have long cautioned that tobacco not only poses serious health risks to its users, its health consequences also impose severe financial stress on families and a huge economic burden on the nation. India’s last estimate on the direct healthcare costs of tobacco in 2004 touched $ 1.7billion.

The study titled “International Tobacco Control Policy Evaluation Project” has also found that the public continues to be exposed to second-hand smoke in restaurants across the four states — 58 per cent of smokers in Bihar, 45 per cent in Madhya Pradesh, 24 per cent in Bengal, and 14 per cent in Maharashtra reported that they had smoked in a restaurant during their last visit.

“What we’re seeing is the result of a combination of a failure to enforce regulations and weak warnings,” Myers told The Telegraph on the sidelines of the conference hosted by the Public Health Foundation of India, New Delhi, to discuss strategies to dramatically curb tobacco use.

“Proposed stronger warnings have been watered down under political pressure,” Myers said.

The study also found that during the period 2010-2012, only 49 per cent of smokers in Madhya Pradesh, 62 per cent in Maharashtra, 78 per cent in Bengal, and 86 per cent in Bihar were aware that smoking causes heart disease.

But in all four states, two-thirds of users of smokeless tobacco were aware that they were at risk for throat or mouth cancer, an indication that the health warnings on smokeless tobacco products have resulted in some awareness about the harms of tobacco.