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Anti-tobacco movement needs EMPATHY and not CONCERN alone. This realization dawned on me one day.

The day was a sloppy one with me sitting alone in my world - my room which has been everything for us, call it office, bedroom, home, or whatever - and perhaps, this was one of the periods when the pace slackens. And mindlessly I flipped through the Frontline (Jan.19 2001) lying on my table, and decided to do some reading. The cover story was an interview with Arundhati Roy, whom I am really fond of, done by no one less than N.Ram (Editor: Frontline, The Hindu) himself. The piece was entitled "SCIMITARS IN THE SUN". The ball was set rolling and I got glued to this piece. Arundhati was simply brilliant, her inherent intelligence dazzling, as always, and by the time I had finished off reading the piece, a new life, spirit and belief was throbbing within me.

The missing link, in my efforts, was beautifully underlined in her essay I have concern, not empathy. And so goes true for most of the anti-tobacco activists, which is a big reason for the campaign not picking up. The difference between the two, CONCERN and EMPATHY, has been wonderfully brought out by Arundhati. Moreover the segregation of anti-tobacco activists with those who face the brunt of the epidemic, is also distinct in her description of those displaced, and those who decide. It also explicitly brings out the losing relevance of the movement to the power wielders because there is NO umbilical cord connecting the 2 worlds, just like tobacco users and anti-tobacco campaigners are NOT working together, rather are mostly at the loggerheads - 2 Worlds apart.

She says: "There is no egalitarian social contact - whatsoever - between the 2 worlds. Deep at the heart of the horror of what's going on, lies the caste system: this layered, horizontally divided society with no vertical bolts, no glue - no intermarriage, no social mingling, no human - humane - interaction that holds the layers together. So when the bottom half of society simply shears off and falls away, it happens silently. It does not create the torsion, the upheaval, the blowout, the sheer structural damage that it might, had there been an equivalent of vertical bolts. This works perfectly for the supporters of these projects. But even those of us who do understand and sympathise with the issue, even if we feel concern, scholarly concern, writerly concern, journalistic concern - the press has done a reasonably persistent job of keeping it in the news - still, for the most part, there is NO REAL EMPATHY, with those who pay the price.

Empathy would lead to passion, to incandescent anger, to wild indignation, to action. Concern, on the other hand, leads to articles, books, Ph.Ds., fellowships, foreign trips. Instead what is happening now is that the relationship between concern and empathy is becoming oppositional, confrontational. It means, concern has become a professional enterprise, a profitable business, that is protecting it's interests like any other. People have put up shops, they don't want the furniture disturbed. That's when this politics becomes murky, dangerous and manipulative.Every emotion must be stifled, must appear at the high table dressed for dinner. Nobody's allowed to violate the dress code or, God forbid, appear naked. The guests must not be embarrassed. The feast must go on"

Although Arundhati Roy said this in context of Narmada Bachao Andolan and Supreme Court ruling against it, still the analogy it draws with the ailing anti-tobacco movement is classic. Most of us possess CONCERN, a deep one. As Arundhati puts it, academic concern, Clinical concern, oncologic concern, scholarly concern, journalistic concern, theatrical concern, and we write articles, research papers, presentations (multimedia?), projects, books, PhDs, fellowships, and of course, not to forget, do foreign tours. But where did we lose that umbilical cord linking us with those millions of people ailing with tobacco-related hazards, or dying in agony? Where did we lose track or contact (if we ever had in the first place) with those millions of children and adults, working in inhuman conditions manufacturing tobacco products and suffering the severe brunt of the whole industry? Where did we lose contact with those struggling to quit tobacco?

Doubtlessly Arundhati could not have been more ruthless about those of us who are deriving their entire sustenance by working for social causes or anti-tobacco campaigns when she said that "concern has become a professional enterprise, a profitable business that's protecting it's interest like any other. People have set up shops" My piled up sentiments or anguish when years before I went to several NGOs working on public health with tentacles sensing my 'grant-giving-potential' found their release after long suppression. They have set up shops. Cancer Control programmes are being led by those who have industrialized cancer treatment and care. World leaders in pharmaceuticals, prominent oncologists, health professionals, senior bureaucrats and officers, and of course, small scale city level businessmen who herald the banners of Lions, Rotary, and such clubs, are the ones active in cancer control and prevention programmes. The cancer control, tobacco control, health awareness camps and medical camps, are like a ritual for them which they do without being conscious of their act. Some pursue community work with a dream to win laurels, awards, honours, 'coveted' posts or just because they felt like doing it. It is like builders of large dams lead the anti-dam movement. We have to accept that health movement in India of whom I am a part of, is essentially not a public movement. It is not a mass campaign where ordinary people can associate themselves with.

Moreover I have to confess that this realization dawned upon me at the right juncture when even I was unconsciously just about to slip towards making tobacco control my profession, or source of sustenance. I was about to 'open a shop' where my generations to come would have done tobacco control. I was about to industrialize public health 'shop' (Tobacco Control Private Limited company?) Never before I had this sense of shame so overpowering. But then, this may impart new impetus and directions for future course my life takes. Let me embarrass the guests, now.

"The guests must not be embarrassed. The feast must go on" is a classic statement which Arundhati puts in another context (definitely not in the context I am using in). We do tend to 'behave' with tobacco users grotesquely violating the prohibitory orders in railway trains, platforms, public places and transport, and instead ask them as politely as we can, (if at all we ask) to stop smoking, if they don't mind please. We really tend to be as 'dressed up as possible' in enforcing these prohibitory orders or legislative bans. Most of us continue to 'behave' and remain 'socially acceptable' in our campaigns. Because the rule of thumb is, 'guests or smokers, must not be embarrassed'. And of course, 'the feast must go on'

There is no doubt that the magic to ignite the movement against tobacco doyens will coyly unfurl when empathy seeps in. (or oozes out?). And again, as Arundhati suggests in another context, "Empathy will lead to passion, incandescent anger, wild indignation, to ACTION". That is exactly what is missing, ACTION. And even the legend Nelson Mandela had stated categorically at ICC, Durban in July last year that "we must move from RHETORIC to ACTION, and ACTION at an unprecedented scale".

All of us are so vocal and at our oratorical best when advocating against tobacco. But when it comes to take action, or do something concrete, we freeze. We all (me including), barring few exceptions of course, consider that taking ACTION is someone else's job, our work is essentially contained in our rhetoric melodrama on the microphones, in the press meets, or at public functions. Like Nelson Mandela commented, we, including me, have to move from rhetoric to action, and action at an unprecedented scale.

We really have to spread the message as convincingly as possible and as fast as possible, because tobacco industry is luring us all - adults, aged, and children alike 'at an unprecedented scale'. Tobacco business is a game of deceit where even children are not spared and lured to gory world of addictions by wrongly linking tobacco usage with enviable personality traits and lifestyles in misleading advertisements.

Tobacco DOES NOT give us any revenue, rather the sum-total of costs which our country incurs on management of tobacco-related cancers EXCEEDS the total annual revenue earned from tobacco (source :ICMR).

Tobacco, is the single-largest preventable cause of disease, disability and death worldwide. And those who raise doubts on authenticity of tobacco-related health hazards, I will like to quote WHO SEARO report "There is no product in the world, on which so much of research has been done in the entire history of mankind than the research done on tobacco, with over 70,000 research publications published in International Journals over the last 50 years".

Tobacco is a dirty game of money, power and deceit. And 'anti-tobacco' movement is (or should be) purely a SATYA-GRAH (assertion of Truth). Can we really afford to be silent? 'decent'? 'well-behaved'? Concern alone, will not lead us far in our search of a tobacco-free world. We need EMPATHY to ignite us all, to galvanize enough force within us to work collectively towards decimating this biggest challenge to public health worldwide.

Contact Details of Bobby Ramakant

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