August 19, 2016

Act tough against tobacco

Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region
Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region

Tobacco kills 150 people every hour and 1.3 million annually in the WHO South-East Asia Region. The use of tobacco in the Region is unacceptably high, and is increasing alarmingly.The Regionhas 260 million smokers and 290 million smokeless tobacco users.One-third of the population is exposed to tobacco smoke. The effects of tobaccoare not confined to users alone.Second hand and even third hand smoking is impacting thehealth offamilies and the people around the smokers.
The impact of tobacco is much beyond health. Increased expenditure on healthcare, deaths and diseases cause productivityloss,affects the quality of life and has economic cost to the society. There is a close association between poverty and tobacco. Tobacco use is more prevalent among the socioeconomically vulnerable groups. One in 10 students in the Region is offered free tobacco as per the recent Global Youth Tobacco Survey. Somecountries have seen an increase in tobacco use among 13 to 15 years old since 2003. Other countries in the Region have not seen any decline.The situation is grimand getting worse.
It has been a decade since the WHO Framework Convention on Tobacco Control (FCTC) was developed. Ten of the 11 countries in the Region signed the WHO FCTC.All countries are implementing measures against tobacco. Clearly, what we are doing is not enough. We need to redouble our efforts to outpace the tobacco epidemic.
The use of tobacco is a major risk factor for non-communicable diseases (NCD) which account for 62% of the deaths in the Region. NCDs are also on the rise. A large proportion of these diseases and deaths and their socio-economic consequences are preventable with effective tobacco control and prevention measures.
To accelerate efforts against tobacco, countries adopted the Dili Declaration on Tobacco control at the Regional Committee meeting of WHO South-East Asia Region in Timor-Leste on 7 September. All 11 member countries pledged a full-on war against tobacco.
This renewed commitment needs to be reinforced with stronger measures to prevent and control tobacco use. The most cost-effective and appropriate are the best-buys, which include increasing taxes on all tobacco products. Making all products equally less affordable would discourage people from switching from an expensive tobacco product to a less expensive one. Taxing all smokeless tobacco products, which are highly toxic and addictive, is equally important.
Countries need to develop, implement and strengthen legal frameworks, regulatory mechanisms, policies and sale of tobacco products. We now need policies and regulations for e-cigarettes – to ban and restrict their sale, promotion, advertising and sponsorship.
Robust public campaigns against tobacco and large graphic warnings on cigarette packs and other tobacco products need to be implemented at the earliest. Countries need to ensure smoke-free workplaces and public spaces.
Health systems need to be strengthened to address tobacco control and prevention. Tobacco cessation services should be provided at all health care levels.
Another area where governments need to start focusing attention is creating alternative livelihoods for tobacco growers and workers.
Implementing stronger measures need firm and continuous political commitment.National, regional and inter-country collaborating mechanisms are needed for regularly sharing best practices on tobacco control. Most importantly, countries need to supportcross-border control of tobacco related trade and marketing.
Countries in the Region have unanimously committed to achieving 30% reduction in tobacco use by 2025. To get there we need to act now, firmly.


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