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New Delhi, May 15: Union Health Minister Harsh Vardhan has appealed to all states and Union Territories to ban the sale of smokeless tobacco products and spitting in public places in line with the orders of the Rajasthan and Jharkhand governments to prevent the spread of coronavirus infection.

In a letter to all state health ministers, Vardhan said smokeless tobacco users have a tendency to spit in public places or otherwise and therefore, increase health risks especially those of spreading contagious diseases like COVID-19, tuberculosis, swine flu, encephalitis and others.

"Use of smokeless tobacco also creates an unhygienic environment which further spreads the diseases. The large gathering at the retail outlets where smokeless tobacco products are sold, also pose the risk of spread of COVID-19," he said.

In the letter dated May 11, the Union minister underlined that tobacco use is a major threat to public health globally. He also mentioned the Indian Council of Medical Research's (ICMR) appeal to the public not to consume and spit smokeless tobacco products in public places.

Chewing tobacco products and areca nut increases the production of saliva followed by a very strong urge to spit. Spitting in public places could enhance the spread of the COVID-19, Vardhan said.

"By banning spitting in public places, states and UTs can help in achieving not only Swachh Bharat but also Swasth Bharat (Clean India and Healthy India)," he said.

Vardhan also mentioned the May 1 guidelines issued by the Union Home Ministry under the National Disaster Management Act, 2005, which stipulate that "spitting in public places shall be punishable with fine as may be prescribed by the state/UT local authority and consumption of liquor, pan, gutkha, tobacco etc in public places is not allowed".

Appreciating the efforts of Rajasthan and Jharkhand in this direction, the Union Health Minister urged all states to take similar measures and create widespread awareness regarding the harm of spitting in public places.

The Rajasthan government had by an ordinance banned spinning in public places and sale of paan, gutka and tobacco in the wake of the coronavirus outbreak. The Jharkhand too has imposed a complete ban on all types of tobacco products to prevent spitting in public places that could increase the spread of coronavirus infection.

"I am happy to note that the governments of Jharkhand and Rajasthan have already completely banned the sale of tobacco products and spitting in public places. Therefore, I urge upon you to take similar measures and also create widespread awareness in your state/ UT regarding harms of spitting in public places.

"It is also requested that the directions of Ministry of Home Affairs in this regard may be implemented scrupulously and effectively," Vardhan said in the letter.

Tobacco smoking is a known risk factor for many respiratory infections and increases the severity of related diseases. A review of studies by public health experts convened by WHO on April 29 found that smokers are more likely to develop severe diseases, compared to non-smokers, said Binoy Mathew, senior programme officer of Voluntary Health Association of India.

It is one of the main risk factors for a number of chronic ailments, including cancer, lung and cardiovascular diseases, he said, adding that according to the Global Adult Tobacco Survey, with 268 million or 28.6 per cent of all adults in India, the country has the second largest number of tobacco users in the world.

At least 12 lakh die from tobacco-related diseases every year, Mathew said.

Those keen to quit smoking and smokeless products can avail of free of charge telephone-based services launched by the government. The Ministry of Health has set up a National Tobacco Quit Line Services to provide counselling services to help tobacco consumers quit the habit.