How Taxing Tobacco, Alcohol and Sugary Drinks Could Transform Oral Health in India

India could significantly reduce oral diseases and other non-communicable diseases by raising taxes on tobacco, alcohol, and sugary drinks under the WHO’s “3 by 35” initiative and using the revenue for prevention and care. Even modest earmarking of these health taxes could fund oral healthcare for millions, turning taxation into a powerful tool for equity and universal health coverage.

Oral health rarely features in public debate, yet it affects hundreds of millions of Indians every day. Cavities, gum disease, tooth loss, and oral cancer are among the most widespread health problems in the country, closely linked to tobacco use, alcohol consumption, and high sugar intake. A new analysis by researchers from Jamia Millia Islamia’s Faculty of Dentistry and the Public Health Foundation of India argues that oral diseases are not just dental problems, they are early warning signs of India’s growing non-communicable disease crisis.

Despite this burden, oral healthcare remains largely outside India’s public health system. Most insurance schemes do not cover routine dental care, public clinics are understaffed, and preventive programmes are limited. As a result, people often delay treatment until pain or serious illness forces them to seek costly private care.

The WHO’s “3 by 35” Idea

The researchers built their case around a new global proposal from the World Health Organization called the “3 by 35” initiative. Launched in 2025, it urges countries to raise the prices of tobacco, alcohol, and sugar-sweetened beverages by at least 50 percent by 2035. These three products are major drivers of non-communicable diseases, including oral cancer, diabetes, heart disease, and stroke.

The idea is straightforward: higher prices reduce consumption, and the taxes collected can be used to strengthen health systems. According to WHO estimates, this approach could save millions of lives worldwide while generating large, predictable revenues for healthcare.

Why India Is a Key Test Case

India is one of the world’s largest consumers of tobacco, alcohol, and sugary drinks. More than 266 million adults use tobacco, most of it in smokeless forms that are strongly linked to oral cancer. Alcohol consumption, while uneven across states, includes dangerous patterns of heavy drinking. Sugary drinks are increasingly popular among young people, with intake often exceeding recommended limits.

India already taxes these products, but mostly to raise revenue rather than improve health. Recent GST reforms have increased taxes on cigarettes and sugary drinks and lowered taxes on essentials like toothpaste and toothbrushes. However, bidis and smokeless tobacco remain lightly taxed, alcohol is taxed unevenly by states, and overall tax levels are far below global health benchmarks. Crucially, most of this revenue does not go back into health or prevention.

A Missed Opportunity for Oral Health

The authors argue that this is a major missed opportunity. Even modest changes could have a big impact. Aligning tobacco taxes with WHO recommendations could generate up to ₹20,000 crore annually. Setting aside just two percent of that amount could fund basic oral healthcare for tens of millions of people through primary health centres and the National Oral Health Programme.

Such funding could support school tooth-brushing programmes, early screening for oral cancer, mobile dental clinics in rural areas, and better training for frontline health workers. It could also help integrate oral health into existing programmes for cancer, diabetes, and heart disease, where it is currently overlooked.

Challenges, But a Clear Choice

The path forward is not without obstacles. Industry lobbying, fears of illicit trade, and resistance from states that depend on alcohol revenue are real concerns. There is also the risk that higher taxes could burden poorer households if the money is not reinvested in services that benefit them most.

But the researchers argue that these challenges are manageable and far less costly than continuing on the current path. Oral diseases are painful, visible, and largely preventable. Treating them earlier and more equitably would reduce long-term healthcare costs and improve quality of life for millions.

As India looks toward 2035, the choice is clear. It can continue to treat oral health as an afterthought, absorbing rising disease and treatment costs. Or it can use health-focused taxes to fund prevention, reduce inequality, and strengthen universal health coverage. The tools already exist. What remains is the political will to use them.