In a major effort to lower the incidents of mouth cancer, India’s capital has banned chewing tobacco.

Tobacco companies have rapidly expanded in the developing world, even while regulations and health awareness have lowered demand in many nations. Almost a third of global tobacco related deaths are in India, and chewable tobacco is estimated to cause 90 percent of mouth cancer in the country. Health officials say about 1 million Indians die each year from diseases caused by tobacco use.

The Delhi government banned the sale, purchase and possession of all forms of chewable tobacco, even though tobacco manufacturers won a court stay against earlier bans. Increasing public pressure has led to the government pledging to enforce the new ban.

Police will conduct surprise checks on shops and retail outlets to ensure the ban is enforced. Violators can be imprisoned up to six months and fined up to 300,000 rupees (about $4,5000 USD). The potential penalty is very steep, particularly in a nation with an average income of about $5,833 USD (by purchasing power).

"This is a positive step by the government and we welcome it. The use of chewing tobacco is so widespread that India is often referred to as the oral cancer capital of the world," G.R. Khatri, president of the South Asia chapter of the World Lung Foundation, told Yahoo News.

 Health organizations have been running a massive awareness campaign about the health risks related to tobacco use. 10 years ago, the nation banned tobacco companies from advertising.

Still, over 20% of boys between the age of 13 and 18 years old report using either cigarettes or chewing tobacco, according to Khatri. “The ban on chewing tobacco in Delhi is a first step. We will mount a campaign to curb sales of cigarettes as well.”

Bans on harmful substances are hard to enforce (see drugs, etc). So the long term key to health in India, and across the world, will be educating the population about the health risks associated with tobacco use.