Often people remain oblivious of the menace of smokeless tobaccos as they speak of public health hazards caused by puffing cigarettes and bidis.
As people around the globe observe the World No Tobacco Day on Thursday, it’s a good time to revisit tobacco consumption pattern in Bangladesh where smokeless tobacco (SLT) products feature a less-discussed yet very prominent spot.
In Bangladesh, one of the largest tobacco consuming countries in the world, as many as 31.7 percent adults use SLT products but the impact is often undermined by the people and effective control measures in policymaking is far from adequate.
On average more people in Bangladesh use smokeless tobaccos comparing to their peers in other medium Human Development Index (HDI) countries. Many SLT products such as Zarda are considered as part of a tradition in traditional social gathering.
SLT products are the kind of tobaccos those are not puffed or smoke, rather chewed and can be spit or swallowed such as- Zarda, Gul, Sada Pataa, Khoinee and many others.
According to a study report published in 2017, SLT use is associated with age, sex, education, and socioeconomic status. SLT consumption has reportedly been associated with increased prevalence of heart diseases, stroke, and oral cancer and led to around 320,000 disability adjusted life years lost in Bangladesh in 2010.
Other studies also suggest that dry tobacco leaf (Sada Pata), Zarda, and Gul were found being popularly used in the country.
The study suggests that, although the prevalence of smoking is higher among males with 26.4 percent, than that of females, which is 1.5 percent, use of SLT is slightly higher among females than among males in the country.
SLT use among both men and women of 55 to 64 years old is higher than other age groups, said the report.
Prof. Dr. Golam Mohiuddin Faruque, Joint Secretary and Project Director of Bangladesh Cancer Society, said smokeless tobacco consumption is higher in Bangladesh rural regions where it’s a part of tradition.
He said it causes oral, jaw and throat cancer as people use to keep the tobacco longer time in mouth.
According to Dr Faruque, public awareness building along with tax increasing can reduce the tobacco use.
Using audio-visual presentation about the harms SLT causes to economy and health can also be an effective measure to aware people, he added.
Despite the high prevalence of use among adults in Bangladesh, SLT was not included in the Tobacco Control Law till 2013. Later, in an amendment made in the law on April 9, 2013, the scope of existing tobacco control measures including graphic health warnings on packaging, ban on advertisement of products, and restriction to sale and so on were extended to include SLT products.
Farida Aktar, convener of Women's Alliance in Tobacco Control, Bangladesh said, there has been a lack of awareness about the existing laws and regulations as the law enforcers are also not aware about its impact.
She also stressed to build awareness among people as the implementation of the law is weak while the use of SLT is culturally accepted in Bangladesh unlike smoking tobacco.
SLTs in Bangladesh are also used in combination with smoking products. According to the report published in 2017 on Indian Journal of Public Health, dual users constituted 20 percent among all tobacco users. Prevalence of “smoking only,” “smokeless only,” and “dual use” of tobacco in Bangladesh was found to be 40.6 percent, 15.2 percent, and 14.2 percent respectively.