India’s cancer crisis and how a ₹5 gutka habit leads to lakh-rupee medical bills

The effects of consuming gutka or beedi — products that cost just ₹5–₹10 — often lead to medical bills running into lakhs of rupees and, for many, death within five years of an oral cancer diagnosis.

Gutka and other tobacco products claim 1.35 million lives every year in India. These products place a burden of ₹1.77 lakh crore on the healthcare system, equivalent to one percent of the nation’s GDP.

Oral cancer caused by tobacco use is the primary driver behind the current policy push. India accounts for more than one-third of all global oral cancer cases. In 2022 alone, the country recorded 1,43,759 cases and 79,979 deaths.

Workers in brick kilns and similar work sites often rely on the temporary euphoria, heightened alertness, and hunger suppression caused by gutka to work longer hours without food. Yet, the five-year survival rate for this disease is only 37.2 percent.

To confront this public health crisis, the central government has changed how it collects revenue from tobacco products. New bills presented on December 1 increase taxes on tobacco.

Unmanufactured tobacco will now attract 70 percent excise duty, up from 64 percent. Chewing tobacco, zarda, and related preparations will now face 100 percent duty.