Tobacco epidemic continues and far from endgame

The tobacco industry’s strategy of targeting poorer countries with weak regulatory environments and pushing so-called ‘novel’ products into previously untapped markets with rising rates of tobacco smoking among children aged 13 to 15 in many countries and tobacco’s final game But progress is at risk. ,

This is a warning to all those who care about global health and economic development. Tobacco Atlas lead author Jeffrey Droop said that saving lives requires urgent and sustained efforts to aggressively regulate the harmful tobacco industry and its products and promote economic growth.

Tobacco use remains a global epidemic. In addition to being a major risk factor for non-communicable diseases, it causes an estimated 9 million deaths each year worldwide (approximately 8 million deaths due to tobacco use and 1 million deaths due to exposure to secondhand smoke) and an economic loss of about USD 2 trillion. Of these, 1.9 million (21%) deaths occur in the World Health Organization’s (WHO) Southeast Asia region, which includes 11 countries – Bangladesh, Bhutan, DPR Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand , and Timor-Leste.

With 26% of the world’s population, the Southeast Asia region reported the highest prevalence of tobacco use (28%) of all WHO regions globally in 2020. The region is not only one of the largest producers and consumers of tobacco products globally, but is also home to 20% of the world’s adult smokers (241 million) and the world’s youth population (13–15 years old). K is also home to 34% (14.8 million). In addition, it accounts for 82% (301 million) of global smokeless tobacco (SLT) users and claims to have the highest prevalence (7.3%) of SLT use among young people.

And this is despite the fact that all countries in the region, except Indonesia, have ratified the WHO Framework Convention on Tobacco Control (WHO FCTC), which aims to prevent all from the devastating health, social, environmental and economic consequences of tobacco use and exposure. is to protect. Tobacco smoke. The FCTC provides the basis for countries to implement and manage tobacco control through the MPOWER – a set of six cost-effective key strategies to fight the global tobacco epidemic. But compliance with these strategies remains poor.

Although current tobacco use among adults in Indonesia exceeds 34%, it is still lower than in Myanmar (54%), Timor Leste (49%) and Bangladesh (35%). In fact, current tobacco use among adults in the region is the highest in Myanmar.

Bhutan has gained praise for being the only country in the region (and in the world) that has banned the production, manufacture and sale of all tobacco products since 2004 – the same year it ratified the Global Tobacco Treaty (WHO FCTC). Was. Nevertheless, according to the Tobacco Atlas (2020) for the WHO Southeast Asian region, current tobacco use in Bhutan is 25%, compared to DPR Korea (22%), Thailand (21%) and Maldives (20%) is more. The region also has the second highest percentage of young tobacco users (22%), after Timor Leste (42%). The prevalence of tobacco smoking is also higher at 17%, second only to Indonesia (19%). Similarly in smokeless tobacco use, Bhutan is second only to Nepal (16%) with 13%.

One reason for this high tobacco consumption may be that its 2010 directive allowed heavy taxes and controlled imports of tobacco products. In addition, in 2020 it removed this ban, reportedly to reduce the risk of imported COVID-19 infection arising from cross-border smuggling of tobacco products.

Nepal is the only country in the Southeast Asia region which has banned the use of all types of tobacco products in public places, Including smokeless tobacco products, since 2011. However, this region has the highest prevalence of smoking among women (10%).

When it comes to youth (13–15 years), Timor-Leste boasts the highest prevalence of smokeless tobacco use at 42% as well as the highest prevalence of tobacco smoking at 35%.

Tobacco industry interference is dangerously high

Tobacco industry intervention is high, with three major international tobacco companies – Philip Morris International (PMI), British American Tobacco (BAT) and Japan Tobacco International (JTI) – dominating the South-East Asia region. The tobacco industry has a high degree of interference in policy development in Bangladesh, Indonesia and India. Their Tobacco Industry Intervention Index (on a scale of 100) is 83, 79 and 72 respectively.

The dominance of the tobacco industry and interference under the guise of their Corporate Social Responsibility (CSR) activities, and the involvement of governments with the industry through the ownership of their shares and the placement of key government officials in tobacco companies through the revolving door policy Nominating for is a barrier to proper implementation. Tobacco control measures, said barrister Shamim Haider Patwari, Member of Parliament (MP) of Bangladesh, who was speaking as a faculty at the Johns Hopkins School of Public Health’s South Asia Leadership Course on Tobacco Control. He called for a very strong political leadership, high political commitment, adequate resource allocation and a holistic approach at the national, regional and global levels for effective tobacco control initiatives in the region.

Dr. Tara Singh Baum, Asia Pacific Regional Director of the International Union Against Tuberculosis and Lung Disease (The Union), told CNS (Citizen News Service): “The tobacco industry’s strategy to thwart, dilute and delay tobacco control measures This can be countered by building a team that goes beyond the health sector and includes academia, media, teachers, politicians, lawyers, social volunteers. It should be teamwork. We need it through constant engagement with governments. We have to be persistent in our efforts to hold them accountable. They in turn hold the industry accountable. We need to build local leadership to support tobacco control efforts at national and regional levels.”

Good practices, but scale up is too slow

However, there are also some good practice examples. Tobacco advertising is banned in all countries in the region, and all countries, except Indonesia, have banned smoking in public places. Nepal, Maldives and Thailand have banned the advertising, promotional and CSR activities of tobacco companies.

E-cigarettes are banned in 6 of the 11 countries in the Southeast Asia region – Bhutan, India, Nepal, Sri Lanka, Thailand and Timor-Leste. Thailand imposes a very high tax of 78.6% on cigarettes.

Some countries have also made good progress in implementing large pictorial/graphic health warnings (PHWs) on tobacco products, an evidence-backed effective way to reduce tobacco use. Timor Leste implemented the largest PWH (92.5%) on tobacco packs, followed by Nepal (90%), Maldives (90%), India (85%) and Thailand (85%).

Nandita Murukutla, vice president, Research at Vital Strategies, calls for raising tobacco taxes because they can reduce smoking rates, prevent initiation among youth, and generate revenue that can be used for other health interventions. can pay. She cites graphic pack warnings and plain packaging as other proven high-impact, low-cost interventions, and emphasizes investing more in media because media campaigns can reshape social norms and help millions of people. can motivate you to leave.

Tobacco not only harms people’s health but also destroys our environment through the cultivation, production, distribution, consumption and post-consumer waste of tobacco products.

The theme of World No Tobacco Day 2022 is “Tobacco: A Threat to Our Environment”, which aims to raise awareness among the public on the environmental impact of tobacco and to “greenwash” their reputation by tobacco companies marketing themselves as environmentally friendly. efforts to highlight. This global campaign calls for reducing tobacco consumption as a key lever for achieving all Sustainable Development Goals, not just those directly related to health.

Source: Shobha Shukla – CNS (Citizen News Service)