Effects of a 2008 Indo-Pakistani Nuclear War

After the Mumbai attacks of November 2008, India and Pakistan became embroiled in a tense military standoff as it became clear that the terrorists who had committed the attacks were trained and supported by the Pakistani intelligence services. In OTL, the crisis was defused.

However, what if it had not? Suppose India mounted a retaliatory attack on Pakistan that eventually escalated into a full-scale nuclear war between the two nations? The oft-cited "Five Million Tons of Smoke in the Stratosphere" study predicts that a 100-warhead scenario between India and Pakistan would directly result in 20 million deaths on the Indian subcontinent and indirectly cause the deaths of hundreds of millions more due to ozone destruction and food shortages in the following years.

http://www.nucleardarkness.org/warconsequences/fivemilliontonsofsmoke/

What effects would such an event and it's aftermath have on a world on the cusp of entering the 2010s? On the incoming Presidency of Barack Obama? The New START treaty? The North Korean and Iranian nuclear programs? On the Arab Spring? On pop culture?
 
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