Prime minister Sheikh Hasina has a vision to make Bangladesh smoke free by 2040. This ambitious goal will aim to curb a major public health concern which causes a wide range of health conditions such as cancer, heart disease, stroke, lung disease, and diabetes. Every year, over eight million people die from tobacco use. But the problem goes deeper.
Secondhand smoke (SHS) exposure, which occurs when people inhale smoke emitted from the burning end of smoked tobacco products and the smoke exhaled by the person smoking, accounts for more than 10% of those deaths. In Bangladesh, around 18% of adults smoke tobacco, and just over 4 in 10 adults are exposed to SHS at their workplaces and while using public transportation. So, it is clear that smoking affects all of us whether we choose to smoke or not.
Policies in place
Smoke-free policies protect people from SHS and create an overall healthier environment. Smoke-free laws vary across the world; while 55 countries have implemented comprehensive smoke-free laws, some nations like Bangladesh allow designated smoking areas (DSAs) in certain public settings.
The Bangladesh Tobacco Control Act 2003, which was amended in 2015, allows DSAs in hospitality venues and public transportation with some restrictions. The law restricts the location of DSAs within the venues, establishes requirements for fire extinguishers, tobacco disposal, and signage, and bans smoking and ashtrays in non-smoking areas.
While DSAs are intended to provide a designated space for people who smoke, the reality is that smoke still spreads to other parts of the environment, exposing others to toxic chemicals and carcinogens.
Study finds low compliance
A recent study conducted by PROGGA (Knowledge for Progress) and the Johns Hopkins Bloomberg School of Public Health sheds light on how designated smoking areas in hotels, restaurants, and trains can still leave non-smokers vulnerable to secondhand smoke. Out of the 526 venues visited, the study examined 41 designated smoking areas (DSAs). None of them fully complied with the required measures outlined in the tobacco control law. Clearly, DSAs are not protecting people who do not smoke.
The study found that among 18 DSAs observed across 118 hotels, seven did not have proper physical separation from the non-smoking areas, making the separation of no use. Moreover, seven hotels required patrons to walk through the DSAs to reach the services, and 17 of them did not display the required signage, further undermining compliance with the law.
Similarly, 21 out of the 53 reviewed trains had DSAs. Within these DSAs, food items and drinks were sold in seven trains, posing harm to people who do not smoke who had to endure smoke while making purchases.
We can protect people better
The present regulations for DSAs in public places in Bangladesh have not been effective. Compliance with laws has been discouragingly low among venues that have established DSAs.
Our research shows that DSAs do not protect the people of Bangladesh from the harmful effects of SHS. Policymakers, venue owners, and relevant authorities should focus on eliminating DSAs to create 100% smoke-free environments that protect the health of Bangladeshis and their families. DSAs are not a solution to health risks. Eliminating DSAs can pave the way for the Prime Minister's vision to achieve a tobacco-free Bangladesh by 2040.
Sejal Saraf, BDS, MPH, is a Senior Research Program Coordinator, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health.