How can we make companies pay for the damage they cause?
As the Covid-19 pandemic spreads, Stopping Tobacco Organizations and Products (STOP) -- a global tobacco industry watchdog, has strongly urged governments and civil society to hold tobacco companies accountable for the burden they have placed on people and health systems.
According to the World Health Organization (WHO), tobacco kills more than 8 million people globally every year, more than 7 million of them from direct tobacco use and around 1.2 million non-smokers exposed to second-hand smoke.
The Global Tobacco Control notes Bangladesh has a population of 162.9 million people; 26.2% of the adult population smoke tobacco products and 31.7% use smokeless tobacco. An estimated 113,670 people in Bangladesh die each year from diseases caused by tobacco use.
Covid-19 is an infectious disease that primarily attacks the lungs. Smoking impairs the pulmonary immune function, making it harder to fight off coronavirus and other respiratory diseases.
Studies by public health experts, recently commissioned by WHO, found that smokers are at higher risk of developing severe Covid-19 complications and death. Smokers may also be physically more vulnerable to contracting Covid-19, as the act of smoking involves contact of fingers with the lips, which increases the possibility of transmission.
Even before the Covid-19 pandemic, tobacco placed a massive burden on health care systems globally. A WHO 2018 study estimated that smoking resulted in $422bn in health costs in a single year.
With no end to the pandemic in sight and Bangladesh, Pakistan, and India being among the worst affected, the region’s under-par and over-worked health system is struggling to keep up with the sudden increase in demand for resources and manpower.
Much of the previous global focus on prevention and cessation focused around non-infective respiratory, cardiovascular, and cancer-related deaths. However, during pandemics like Covid-19, the risk of infectious complications becomes the predominant focus and concern.
Some countries have banned the sale of tobacco products during lockdown periods. Unfortunately, Bangladesh did not. Now, as health care systems rush to increase capacity for the surging number of patients, inadequate public health infrastructure will need even more funding.
The scenario is far worse for poorer countries: According to the Tobacco Atlas, the economic cost of smoking in Bangladesh amounts to Tk158,578m. This includes direct costs related to health care expenditures and indirect costs related to lost productivity due to early mortality and morbidity.
Tobacco companies should be held accountable if smoking results in disease and death. Nicotine is a highly addictive substance and quitting a struggle for most smokers. It has been proven beyond doubt that the tobacco industry is aware of the adverse effects of smoking.
Allegedly, it deliberately manipulates the amount of nicotine in cigarettes to maintain addiction and has attempted to conceal these issues. Ideally, the world should aim to be tobacco-free, but this is unlikely to happen in the near future. How then should the authorities deal with this problem?
Governments in South Asia that have ratified the Framework Convention on Tobacco Control, a global treaty, have the power to hold tobacco companies financially and legally accountable for their abuses.
Our government should use that power to regulate the industry and discourage smoking. The most effective way is a steep increase in taxes, resulting in a significant decrease in demand. These can also yield much needed revenue that can be allocated to support health care systems.
Research has shown that when tobacco prices increase, fewer people begin using tobacco, more people quit, and users reduce their consumption. This is especially true for youths and other price-sensitive consumers.
Governments can also levy fees on tobacco companies to fund quit-smoking programs. WHO suggests such fees may include licensing, registration, manufacturing and retail fees, and carry penalties for non-compliance.
Tobacco companies have been engaging in reprehensible PR gimmicks during the Covid-19 pandemic. They have supplied ventilators, masks, and PPE to health facilities and made donations to charities. These token gestures come nowhere close to compensating for the vast damage caused and the rich profits reaped at the expense of individuals and governments.
The Covid-19 pandemic has brought into sharp focus the immense human and financial costs of health care, economic recovery, and investments in better public health. Governments have the power to make tobacco companies pay for the damage they have caused before and during the pandemic and to use the revenue generated to fund critically needed health care system enhancement. Let us not delay any further.
Menin Rodrigues is a communications consultant.