M. A. Jabbar :
Bangladesh, as a member-country of the WHO will observe World No Tobacco Day on 31 May like all the previous years. WHO member-states will observe the day to draw attention of policy-makers, health personnel, NGOs, civil society and in fact, every individual and take action from their respective places to tackle the threats of tobacco and achieving health and socio-economic targets of their respective countries.
Every year a theme is selected by WHO for the day. The theme of the World No Tobacco Day for 2017 is Tobacco – A threat to Development. The theme highlights that tobacco industry is an obstacle towards the substantial development of all countries, including health and economic well-being of the people of the countries.
Facts about tobacco: WHO facts reveals that tobacco use is responsible for 6 million death every year globally which is predicted to grow 8 million by 2030. Tobacco is responsible for loss of national economies enormously through increased health-care costs and decreased productivity. It also worsens health inequalities and creates poverty as the poor people spend less on essentials like food, education and health care. It is found that some 80 percent premature deaths from tobacco use occur in low or middle income countries. Beside this, tobacco growing requires large amounts of pesticides and fertilizers which can be toxic and pollute water supplies. As per WHO data tobacco growing each year require 4.3 million hectares of land, as a result of which global deforestation occurs between 2% to 4%. It is estimated that tobacco manufacturing produces over 2 million tonnes of solid waste.
Not only the smokers, but also tobacco causes harms to non-smokers: A non-smoker cannot be safe so long, there are smokers around. Non-smokers are vulnerable to the deadly habit of the smokers’ smoking, which is called second-hand smoke without any fault of the non-smokers. They happen to inhale the air polluted by tobacco smokers and they run the same risk as the smokers. WHO facts reveal that there are more than 4000 chemicals in tobacco smoke of which at least 250 are know to be hrmful and more than 50 are known to cause cancer. In adults, second-hand smoke causes serious cardiovascular and respiratory disease, including coronary heart disease and lung cancer. In infants, it causes sudden death and in pregnant women, it causes low birth weight. Almost half of children regularly breathe air polluted by tobacco smoke in public places. Over 40 percent of children have at least one smoking parent.Tobacco users who die prematurely deprive their families of income, raise the cost of health care, and hinder economic development.
According to WHO in addition to saving lives and reducing health inequalities, comprehensive tobacco control is a tool to deter tobacco growing, manufacturing, trade and development and thus tobacco control can break the cycle of poverty, contribute to ending hunger, promote sustainbale agriculture and economic growth and combat climate change. As such, WHO is calling on all the member states to inclue tobacco control in their national response to 2030 Agenda.
According to WHO tobacco control helps achieve health and development of the citizens of the countries in a way of protecting their citizens from the harms of tobacco use and reducing its economic losses on national economies. According to WHO the aim of the Sustainable Development Agenda and its seventeen goals is to ensure that no one is left behind. As per WHO data tobacco control has been enshrined in the Substantial Agenda which is seen as one of the most effective means of achieving SDG target 3.4 of one-third reduction globally by 2030 of premature deaths from non communicable diseases(NCDs) including cardiovascular disease, cancer and chronic obstructed pulmonary diseases. As such WHO is calling its member-states to prioritize and accelerate tobacco control efforts as a signatory of of the 2030 Agenda for Substantial Development.
The WHO Framework Convention on Tobacco Control (WHO FCTC) which is an international treaty with 180 parties (179 countries and the European Union) acts as guide towards global fights against the tobacco epidemic. Today more than half of the world countries representing about 40% of the world population (2.8 billion) have implemented WHO FCTC’s policies and strategies in the tobacco control programme. Member-countries are using tax approach as per FCTC guidelines as high taxes contribute to revenue generation for governments and reduce demand for tobacco. It is estimate that through increasing cigarette taxes worldwide by US$1, an extra US$190 billion could be raised for development.
As per Article 11 and 13 of WHO FCTC, Plain packaging is a key method to reduce the attractiveness of tobacco products, restricts use of tobacco packaging as a form of tobacco advertising and promotion, limits misleading packaging and labelling by the tobacco companies and increases the effectiveness of health warnings.
According to Article 11 of the FCTC, the use of Graphic Health Warning (GHW) on tobacco packs is obligatory by the WHO member countries.
The use GHW on tobacco packs remind the tobacco users every time about the harmful effects of tobacco when they use it and help them to refrain from this deadly habit. Example shows that the GHW has played significant role in reducing tobacco use in many countries of the globe. This was introduced first in Canada in 2001 and so far, over 77 countries have introduced GHW on tobacco packets. Data reveals that 90% GHW is used in Nepal, being the largest space, India 85%, Thailand has alloted 85%, Sri Lanka uses 80% and in Indonesia 40% of all forms tobacco packs contains graphical health warnings.
In Bangladesh, 43% of adults use some form of tobacco. Smokeless tobacco is used by 28% of women and 26% of men, whereas 45% of men and 1.5% of women smoke cigarettes. Nearly one lac people die every year from tobacco related diseases and 3,82,000 people were suffering from diseases and disabilities due to use of tobacco. Economic losses of tobacco is also alarming, as data reveals that every year 1 percent of GDP is spent for cigarette and 0.4 percent of the same is spent on purchase of bidi. It is estimated that the country produces 8000 crore-stick cigarette and 5000 crore-stick bidi every year and cultivable land for crop production is diminising due to tobacco production and for longer period of tobacco cultivation, land fertility is at stake.
The situation becomes aggravated when tobacco cultivation on the both side of bank of rivers and thereby mixing of tobacco chemicals with water during rainy season causes water pollution and seriously effect the water resources. Tobacco preparing cost is also alarming as for burning one ton of tobacco leaf, it is estimated that 5 ton of energy wood is burnt which is certainly a great loss to the economy.
Bangladesh anti-tobacco law 2005 more is more effective with its amendment in the year 2013 which is a milestone in the history of tobacco control programme in the country. Section 10 of the amended law directed the tobacco companies for printing the graphical health warnings on top of both sides of tobacco packets, cover, and box covering at least 50 percent of the total area of each. It also says that if the section of the law is violated, the punishment contains rigorous imprisonment less than six months or monetary fine less than taka two lac.
Multiple approaches are essential to eradicate tobacco. There should be extensive application of taxation on all forms of tobacco alongwith graphic health warnings. Tobacco taxes are the most effective way to reduce its use, especially among young and poor people. WHO facts reveal that a tax increase that increases tobacco prices by 10 percent helps decreases tobacco consumption by about 4 percent in high-income countries and by upto 8 percent in low-and middle-income countries. Therefore, taxation on tobacco should be encouraged and applied extensively on all forms of tobacco and tobacco products.
It is worth to mention that tax structure on cigarettes in Bangladesh is based on 4 stages, the lowest being 40% and the highest 60%. The supplementary duty/tax on bidis ranges between 20% and 25% depending on whether it has filter or not. There should be a tax increase upto 200 percent on low-grade cigarettes and bidis, which will help increase government revenue and decrease demand particularly among the poor people. iii. Adequate steps should be taken to stop tobacco cultivation and supply chain be stopped. This should be materialized with priority basis and by providing loan to farmers on easy terms. iv. Smoking be prohibitted at all workplaces, factories, and industries and support center for the non-smokers including smokers who desire to quit smoking may be established in factores and industries.
Study among the tobacco users indicates that most of them are aware of the dangers of tobacco and want to quit the deadly habit. As nicotine exists in tobacco, it becomes difficult on the part of the smokers to quit. In this regard counselling, cooperation from the near and dear ones, medication and various awareness measures can help a smoker to quit the habit.
National Tobacco Control Cell (NTCC) under the Ministry of Health and Family Planning is playing important role in the tobacco control programme. We have the support and strength of the head of the government. This has been reflected when the hon’ble Prime Minister Sheikh Hasina said at the South Asian Speakers’ Summit that tobacco use would be eradicated by 2040, which refers that tobacco use will be brought below 5 percent and ultimately could be eliminated totally from the country.
The World No Tobacco Day theme this year has created opportunites for achieving sustainable development goals for all. Alongwith government’s efforts, everybody on an individual level can contribute to make tobacco-free world for sustainable development.
(M.A.Jabbar is executive secretary of ADHUNIK, national anti-tobacco organization of Bangladesh.)
