Tobacco use claims 126,000 lives a year

Mohammad Al Amin

22 October, 2019 12:00 AM printer

Widespread use of cigarette and bidi on top of an expanding market of tobacco products in the country are making the public health experts concerned and worried.

Use of tobacco claims more than 126,000 lives each year in Bangladesh and incurs a financial loss of more than Tk 30,560 crore due to the illness and deaths it causes, according to PROGGA, a non-government organisation.

The country is nearing new health hazards as diversified tobacco products like e-cigarettes and Heated Tobacco Products (HTP) are getting popularity, particularly among the youths and teenagers day by day.

Health experts think that finalizing the National Tobacco Control Policy and its immediate implementation is crucial to control the use and expansion of tobacco and tobacco products in the country.

The draft National Tobacco Control Policy says controlling the supply chain is important alongside lowering the demand to contain tobacco consumption. It also proposed to restrict foreign direct investments (FDI) in the tobacco sector so that the supply of the harmful elements can be curtailed.

“A large number of people are suffering from various complicated diseases including heart disease and cancer due to consumption of tobacco. It is necessary to finalise the National Tobacco Control Policy and implement it as a public health priority,” said Professor Sohel Reza Choudhury, Head of the Department of Epidemiology and Research at the National Heart Foundation Hospital and Research Institute.

Addressing a press conference recently, secretary of medical education and family welfare division Shaikh Yusuf Harun said Prime Minister Sheikh Hasina has made an announcement to free the country of tobacco by 2040 and the draft of ‘National Tobacco Control Policy 2019’ has already been prepared. “This will be placed at the cabinet meeting soon.”

The World Health Organisation (WHO) said tobacco, a leading risk factor for several non-communicable diseases, is a global public health concern. “Every year, tobacco use kills more than 7 million people worldwide. This includes almost 900 000 deaths of non-smokers exposed to secondhand smoke.”

In Bangladesh, the burden from tobacco is alarming: 35 percent of adults are currently using tobacco either in smoked and or in smokeless form. Furthermore, 43 percent and 39 percent of adults are exposed to secondhand smoke at their workplaces and in their homes, respectively. Seven percent of youth aged 13 to 15 years use tobacco, the WHO said.

Tobacco kills up to half of its users and causes premature mortality and morbidity, contributes to health inequalities and exacerbates poverty.

The WHO Framework Convention on Tobacco Control (WHO FCTC) is an evidence-based treaty that asserts the importance of both demand and supply reduction strategies. Bangladesh ratified the WHO FCTC in 2004, and in 2005, enacted the Smoking and Using of Tobacco Products (Control) Act. The law was amended in 2013 to make it more compliant with the WHO FCTC.

The tobacco cultivation in Bangladesh poses a threat to health, the environment and food security.

According to Centers for Disease Control and Prevention (CDC) of the US, smoking leads to disease and disability and harms nearly every organ of the body. “Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis,” it said.

The CDC further said secondhand smoke causes stroke, lung cancer, and coronary heart disease in adults. Children who are exposed to secondhand smoke are at increased risk for sudden infant death syndrome, acute respiratory infections, middle ear disease, more severe asthma, respiratory symptoms, and slowed lung growth.

Tobacco usage among those aged 15 and above in Bangladesh dropped by 18.5 per cent in the last eight years, until 2017, finds the Global Adult Tobacco Survey (GATS). Anti-tobacco campaigners welcomed the significant reduction in tobacco usage, but observed that the progress was not enough to turn Bangladesh into a tobacco-free country by 2040.

According to a report of Global Adult Tobacco Survey (GATS), Tobacco usage among those aged 15 and above in Bangladesh dropped by 18.5 per cent in the last eight years, till 2017.

In 2009, over 43 per cent of the country’s population aged 15 and above (about 4.13 crore) used various smoking and smokeless tobacco products, like cigarettes and “jorda”. But it came down to 35.3 per cent (about 3.78 crore) in 2017, said the survey.

However, the reduction was mostly among the men — 46 per cent down from 58 per cent. Among women, it was reduced to only 25.2 per cent from 28.7 per cent as the smokeless tobacco which women mostly chew did not decrease, compared to smoking products.

“The consumption of biri has been decreased but cigarettes’ smoking is still very high. There is no alternative to take immediate strong action to control the tobacco use here,” Sohel Reza Choudhury said.

The WHO said through implementation of the legislation and comprehensive efforts for tobacco control, there has been an 18.5 per cent relative reduction in tobacco use in Bangladesh from 2009 to 2017. The absolute number of tobacco users among adults has also decreased from 41.3 million to 37.8 million.

“Tobacco control is one of the most important prevention strategies to avert death and reduce the risk of developing non-communicable diseases worldwide. Tobacco control can also contribute to breaking the cycle of poverty and promoting sustainable development of national economies of a country. It is therefore recognized as an essential component of the Sustainable Development Goals,” it added.

Anti-tobacco campaigners in Bangladesh have been raising voice to finalise the National Tobacco Control Policy soon, implementing it, enforcing other related laws, increasing awareness programmes and increasing prices of the tobacco products to control the use of tobacco here.

PROGGA said the price of cigarettes in Bangladesh is one of the cheapest in the world as the average price of the cheapest cigarettes is more than twice in India than it is in Bangladesh. “It is evident that there is no alternative to increasing this ‘cheapest’ price by introducing specific taxes on tobacco products, the statement added.

It said due to innovative marketing and attractive designing of electronic cigarettes, vaping, heated tobacco products as ‘safe alternatives’ to traditional cigarettes, it has already gained much popularity among school-going children and adolescents.

“Electronic cigarette, IQOS, electronic nicotine delivery systems, electronic non-nicotine delivery system, and production, trading, importing and marketing of all types of electronic devices for tobacco use will have to be banned that also proposed in the draft national tobacco control policy,” ABM Zubair, Executive Director of the PROGGA told daily sun.

“The government must stay clear of the influence and interference of tobacco companies and finalise and implement the National Tobacco Control Policy as soon as possible,” it added.