Bangladesh ranks seventh in the world in terms of death rate due to lung diseases. About 65,000 people die of these diseases in the country every year. There are many reasons behind lung diseases, one of which is smoking and the other is air pollution.
Regular smoking damages the lungs. Inside the lungs are small hair-like cilia, whose job is to keep the lungs healthy by cleaning the germs. These become inactive as a result of smoking, which can cause any type of germs to infect the lungs. This increases the risk of pneumonia, influenza, tuberculosis and even Covid-19.Cigarette smoke contains carcinogenic mutants. This causes cancer of the mouth, trachea and lungs. Moreover, smoking causes narrowing of the airways and swelling of the lungs, which is called emphysema. This results in shortness of breath in the patient. In addition to respiratory diseases, smoking increases the risk of cancer and heart diseases.
Even in the current Covid-19epidemic, smokers are at higher risk of contracting coronavirus. This is because smokers touch the nose and mouth more often. Smokers are three times more likely to have complications after infection than non-smokers. The mortality rate of these patients is also higher in Corona. Moreover, notonly the smokers are affected but also non-smokers who come in contact with them can also become victims of indirect smoking and suffer from various complex diseases of the lungs.
There is no substitute for abstaining fromsmoking to stay safe from complex respiratory diseases. This requires personal will as well as state restrictions to reduce smoking rates. If a person voluntarily quits smoking, he and his family will be benefitted. On the other hand, if the government imposes strict measures to reduce the rate of smoking, it will be beneficial for all.
There are several recognized ways to reduce smoking around the world. One of these is the increase in the price of tobacco products through taxation. In general, if the price goes up, the demand for the product will go down and so will the tobacco products. The government every yearraises the prices of all types of tobacco products, including bidis and cigarettes, in the budget, albeit in small quantities, which is promising. However, this small increase in prices is not reducing the number of smokers as expected.
Realizing the adverse effects of tobacco, Hon'ble Prime Minister Sheikh Hasina announced at the closing ceremony of the South Asian Speakers Summit held in Dhaka in 2016 that Bangladesh will be tobacco-free by 2040. To achieve this goal, she also instructed to reform the existing tax structure and bring the Tobacco Control Act in line with the World Health Organization's Framework Convention on Tobacco Control — FCTC. Recently, the Ministry of Health has taken initiative to amend the Tobacco Control Act. But no visible progress has yet been made in reforming the tobacco tax structure.
The reality is that tobacco products are very readily available in Bangladesh due to the faulty tax structure, especially the 4 price tiers of cigarettes. According to a 2018 report by the World Health Organization (WHO), cigarettes are available in Bangladesh at the lowest prices in South Asia after Myanmar. And smokeless tobacco products like jorda and gul are cheaper. At present, a cigarette smoker has to spend an average of BDT 1077 per month in the country. And the cost for bidi is only BDT 341. This availability of tobacco products is one of the major obstacles to reducing tobacco use. According to the Global Adult Tobacco Survey (GATS) 2017, 35.3 per cent of the population over the age of 15 in Bangladesh, i.e. 37 million people, use tobacco.There is no alternative to raising prices to encourage this huge population to quit smoking. Because, in the context of different countries, when the price of tobacco is high, young people are discouraged to start using tobacco and tobacco users, especially the poor, are encouraged to quit. This method will surely be effective in Bangladesh as well. However, the amount of price increase must be consistent with the increase in per capita income and inflation. Increasing the price of tobacco products through taxation at a reasonable rate, on the one hand, will quit the current users, on the other hand, will keep the teenagers away from this deadly drug.
The writer is anex-Director, NIDCH and Executive Member, Bangladesh Lung Foundation