If you had walked through the streets of an Indian city in the 1950s or 1960s, one sight would have been impossible to miss: bidis and cigarettes. They were everywhere. Men smoked while waiting for buses, chatting in tea shops, strolling through markets and even sitting at their office desks. Trains, restaurants, cinema halls and waiting rooms were often enveloped in tobacco smoke. Few objected because smoking was regarded as an entirely normal part of everyday life. The silver screen reinforced the habit. Black-and-white Indian films frequently portrayed heroes with cigarettes or cigars, symbols of confidence, sophistication and masculinity. Villains, meanwhile, were more likely to be shown with a glass of whisky in hand, and for an entire generation the label of VAT 69 became almost synonymous with wealth, decadence and moral ambiguity.
Looking back today, that world seems almost unimaginable. Smoking has not disappeared, but it has retreated from public life. Ashtrays have vanished from most public buildings. Smoking is prohibited in offices, restaurants, airports and railway stations. Tobacco advertising has all but disappeared, and every on-screen smoking scene now carries a prominent health warning. Young people are far less likely to regard smoking as fashionable than their grandparents did. Few public health campaigns have transformed everyday behaviour as profoundly as the campaign against tobacco.
The turning point came in 1964, when the United States Surgeon General released a landmark report concluding that cigarette smoking causes lung cancer and several other serious diseases. The report did not persuade millions of smokers to quit overnight. Habits built over generations rarely disappear so quickly. What it did accomplish was something far more enduring: it changed public understanding. For the first time, governments, physicians and ordinary citizens had an authoritative scientific foundation for treating smoking not as a harmless pleasure but as a major public health hazard.
The decades that followed brought warning labels on cigarette packets, restrictions on advertising, higher taxes, smoke-free public places and sustained public education campaigns. Gradually, smoking lost its aura of glamour and sophistication. It came to be associated instead with addiction, disease and premature death.
The statistics illustrate the scale of this transformation. In the United States, about 42 percent of adults smoked in the mid-1960s. Today, that figure is around 9 percent. Worldwide, the proportion of adults using tobacco has also declined significantly despite rapid population growth. More than a billion people still use tobacco, but they represent a much smaller share of humanity than they did only a few decades ago. Few public health initiatives have produced such a remarkable change in social behaviour.
The success of the anti-smoking movement naturally raises another question. Could alcohol be approaching a similar moment?
The World Health Organization has increasingly emphasized that no level of alcohol consumption can be regarded as completely risk-free, particularly with respect to several forms of cancer. This represents an important shift in public health thinking. For many years, moderate drinking was widely portrayed as relatively harmless and, according to some studies, even beneficial for cardiovascular health. More recent research has challenged many of those assumptions, leading health authorities to adopt a more cautious message.
Will drinking therefore decline in the same way that smoking has?
Perhaps—but neither as quickly nor as dramatically.
The comparison between tobacco and alcohol is instructive because the two substances occupy very different places in human society. Cigarette smoking has no known health benefits and causes harm at virtually every level of consumption. Alcohol presents a more complex picture. Heavy drinking unquestionably damages health, but the risks associated with occasional or light drinking are generally small. That makes public messaging necessarily more nuanced than the uncompromising case against tobacco.
Alcohol is also far more deeply woven into human civilisation. Fermented beverages have accompanied religious ceremonies, festivals and family celebrations for thousands of years across many cultures. Tobacco, by contrast, spread across the world only after the voyages of Columbus in the late fifteenth century. It never acquired the same historical and cultural roots.
There is another important distinction. Cigarette smoke directly harms those who choose not to smoke through passive exposure. This gave governments a compelling justification for banning smoking in workplaces, restaurants, aircraft and other public places. Alcohol usually harms others indirectly—through impaired driving, domestic violence, accidents or family disruption—rather than simply through its presence. That difference makes restrictions on drinking both more difficult to justify and more difficult to enforce.
Economic considerations further complicate the picture. Alcohol supports agriculture, manufacturing, hospitality and tourism while generating substantial tax revenues for governments. Policymakers therefore face the delicate task of reducing harmful drinking without imposing unnecessary burdens on economic activity.
Yet social attitudes are already beginning to evolve. Surveys in several developed countries indicate that younger generations are consuming less alcohol than their parents. The rapid growth of alcohol-free beers, wines and spirits suggests that many people increasingly value the social experience without necessarily wanting the intoxicating effects or the associated health risks.
India, however, occupies a distinctive position. Unlike many Western societies, it has never developed a universal drinking culture. For centuries, large sections of Indian society abstained from alcohol because of religious beliefs, family traditions or social customs. Even today, declining an alcoholic drink at a wedding, dinner or business gathering is perfectly normal and seldom requires an explanation. What has changed over the past four or five decades is not the disappearance of abstinence but the growing visibility and social acceptance of alcohol, particularly in urban India. Rising incomes, economic liberalisation, globalisation, changing lifestyles and the expansion of the hospitality industry have all contributed to increased consumption. State governments, too, have become increasingly dependent on alcohol excise revenues, creating an inherent tension between public health and fiscal interests.
This history may ultimately work in India’s favour. Unlike the battle against smoking, which began after tobacco had become deeply embedded in everyday life, efforts to reduce harmful drinking can build upon an already strong tradition of abstinence. Millions of Indians have never consumed alcohol, not because of legal restrictions but because their families and communities have long regarded abstinence as a perfectly respectable choice. Public health campaigns are often most successful when they reinforce existing cultural values rather than attempting to replace them.
History teaches that scientific evidence alone rarely transforms society. It must be reinforced by education, thoughtful public policy, responsible media portrayal and gradual changes in social norms. Cinema once helped make cigarettes appear glamorous; today it carries anti-smoking warnings whenever tobacco appears on screen. Alcohol may well undergo a similar reassessment, but India’s journey is unlikely to mirror that of the West. The country has a rare opportunity to act before harmful drinking becomes deeply entrenched in its social fabric. If science, public awareness and public policy work together, India may succeed in avoiding with alcohol what the world spent half a century trying to achieve with tobacco. That would not merely be a public health victory; it would demonstrate that the wisest reforms are those that draw strength from a society’s own cultural traditions rather than working against them. PT