The laws must be amended if we are to achieve this goal by 2040
On January 30, 2016, a two-day long South Asian Speakers’ Conference on achieving the Sustainable Development Goals was held at Hotel Sonargaon in Dhaka. The Inter-Parliamentary Union (IPU) and Campaign for Tobacco Free Kids (CTFK), in cooperation with the Bangladesh National Parliament, organized the programme which was attended by, among others, speakers and participants from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka, and Myanmar.
“How to control the spread of tobacco” was the focal point of the program. At the closing ceremony of the function on January 31, the prime minister of Bangladesh, Sheikh Hasina, delivered her speech, where she declared the decision to make Bangladesh a tobacco-free country by 2040.
The declaration was befitting and groundbreaking, as no leader from any other country had ever declared such a decision to eradicate tobacco from their country within a fixed time frame. The declaration was highly applauded by other statesmen, leaders, anti-tobacco activists, and alliances.
The Bangladesh government enacted the Smoking and Tobacco Products Use (control) Act in 2005, based on the framework convention on tobacco control (FCTC) by the World Health Organization (WHO). The law underwent some changes and amendments in 2013, and in 2015, the Smoking and Tobacco Product Usage (Control) Rule was finally enacted and enforced.
However, as we all know, over time our demands change, creating difficulties. Such changes in demand present us with new challenges. Tobacco companies change the ways of promoting their products. It is true that, after the inception of the Tobacco Products Use (control) Act in 2005, tobacco consumption rate had decreased. To carry on this development and make the prime minister’s declaration a success, it is necessary to make some amendments of the existing law.
The Global Adult Survey (GATS) in 2017 revealed several shocking facts about tobacco production and consumption. According to the survey, a half of tobacco consumers have to embrace premature death inevitably. Among the top eight preventable deaths, tobacco is responsible for causing six of them. Tobacco consumers often suffer from complications related to the heart. The rate of suffering from heart attacks, strokes, and COPD due to use of tobacco products is also very high and frequent.
A tobacco consumer has 57% higher chances of being afflicted with lung cancer compared to a non-tobacco user. Also, tobacco consumers run 109% higher risk of being afflicted with cancer-related diseases compared to non-tobacco users. At least 161,000 people die every year in Bangladesh because of various tobacco-related diseases.
The shocking fact is that more than 35% of adults are addicted to tobacco, which is more than 30 million among the total population of the country. The industry has engulfed teenagers as well, since the study revealed that 6.9% of teenagers are addicted to tobacco.
Those who do not smoke are not safe either, as they fall victims to second-hand smoking. The number of victims of second-hand smoking is even higher than the number of smokers, which is more than 40 million (four crores). Moreover, reports by the Global Tobacco Survey done in 2009 and 2017 show that Bangladesh has benefited a lot from the enforcement of the Tobacco Usage Law. Tobacco consumption has now reduced by 18.5% in comparison to 2009.
Enforcement of the law has reduced smoking by 22%, and smokeless tobacco usage has been reduced to 24%. Though the overall population has increased, an estimated 35 lakh people gave up using tobacco products including cigarettes, bidis, and chewing tobacco. The rate of smoking in a public place has also been reduced by 30% in restaurants, 19% in the workplace, 11% in hospitals, and 10% in public transport.
While I was working as the health minister in 2013, our government changed the existing Tobacco Use (control) Law considering public health. The execution of the law has revealed that there are still certain loopholes in the law that should be amended.
A WHO report on the global tobacco epidemic from 2019 shows that we are lagging behind in achieving a standard position in establishing smoking-free public places and banning tobacco advertisements. For example, there is no specific law for emerging tobacco products like e-cigarettes that mostly attract the young generation.
It was fixed that 50% of the packages would hold a graphic health disclaimer explaining the dangers of smoking, aiming to curb tobacco usage, but the measurement of the packages has not been defined. The tiny disclaimer on the packages fails to warn people of the dangers related to tobacco consumption.
The existing law allows designated smoking areas in public transportation and restaurants that often put the non-smoker in an uncomfortable situation. Advertisements have not been banned in point of sales, and single stick sales of cigarettes are always allowed. The issue of e-cigarette export-import regulation has not been addressed. The corporate social responsibility activities carried out by tobacco companies have not been banned.
Again, the WHO report shows that 43 countries along with Nepal, Bhutan, and Thailand have banned the advertisements of tobacco products in points of sales. Similarly, 86 countries in the world have banned single stick sales, something that is not discussed in our law.
The good news is that our government has included the issue of tobacco control in their eighth 50-yearly plan. However, to address the issue as a whole there is no alternative to law amendment. The government and the authorities concerned must take necessary steps for law amendment to fulfill the honourable prime minister’s dream of making Bangladesh tobacco-free by 2040.
AFM Ruhul Haque is Member of Parliament and former health minister of Bangladesh.