Target 2040: Actions to achieve a tobacco free Bangladesh

Illustration: TBS

The government has set a target to make Bangladesh tobacco free by 2040 considering the extent of tobacco menace to public health and the economy. In order to achieve this goal, it is necessary to formulate and implement an action plan focusing on two issues.

One is to help existing users to quit smoking ,and the other is to refrain the youth from tobacco initiation. According to research conducted by Bangladesh Cancer Society, it is possible to make Bangladesh tobacco free by 2040. This can be achieved if no one takes up smoking henceforth, and if 1.8 million users quit tobacco every year.

Bangladesh is one of the biggest tobacco consuming countries in the world. In addition to smoking cigarettes and bidis, people in this country also use smokeless tobacco products like jorda, gul, etc. According to the Global Adult Tobacco Survey (GATS) 2017, about 35.3% (37.8 million) adults (15 years or older) in Bangladesh use tobacco. The prevalence of tobacco use is higher in rural areas (37.1%) than in urban areas (29.9%).

To achieve a tobacco free Bangladesh, this huge number of people must quit tobacco. Therefore, the most important thing is to build a national tobacco cessation service system.

One study found that about 70 percent of smokers need to visit a doctor at least once a year. And doctor's advice plays a strong role in people quitting tobacco. There is evidence that 2-4 percent of smokers quit smoking spontaneously after listening to a doctor's advice.

The benefits of quitting smoking can be reaped within a few months. It has been observed that after 1-3 months of quitting, the blood circulation in the body improves and the lungs can absorb 30 percent more oxygen than before.

One year after quitting tobacco, the risk of heart disease is halved. Not only that, if someone refrains from smoking for 15 years, the risk of heart disease is reduced as much as non-smokers.

According to GATS 2017, about two-thirds (66.2%) of current smokers and half (51.3%) of smokeless tobacco users want to quit. But there is no effective tobacco cessation service for patients in government hospitals or healthcare centres in Bangladesh.

The National Heart Foundation Hospital and Research Institute has been running tobacco cessation clinics for patients since 2010. Here, nurses have been trained on tobacco cessation. They advise patients to quit smoking.

It has also developed a mobile app called 'Tamak Asokti Mukti Sahayika' to provide online help to quit tobacco use. Anyone can download and use this app from Google App Store. Counselling and medication are effective in treating tobacco addiction, but in Bangladesh, the price of anti-tobacco drugs is high, and not easily available.

The government needs to take steps to produce and distribute such drugs free of cost. It is also important to set up tobacco cessation clinics in all health centres. The service can be initially introduced in district level hospitals where a large number of tobacco users will be able to avail the services.

In addition to setting up tobacco cessation clinics, telephone-based counselling services or national Quitline services may also be introduced. This is a telephone service where tobacco users can call and seek medical advice on quitting. With the introduction of such services, we will be able to reduce the number of tobacco users which will contribute to achieving a tobacco free Bangladesh.

The second aspect we need to look at in achieving a tobacco-free Bangladesh is to prevent the new generation from starting to use tobacco. In 2018, about 1 lakh 26 thousand people died of tobacco related diseases in Bangladesh.

In other words, tobacco companies lost their regular consumers. In order to fill the gaps of these buyers, tobacco companies run tactical campaigns targeting the young generation. So, the government should take several steps to keep the youth safe from tobacco by thwarting the tobacco company's efforts.

It is necessary to increase the price of tobacco products and take it out of the reach of teenagers. Among the SAARC countries, tobacco is the cheapest in Bangladesh, and bidi-cigarettes are sold as single sticks in this country. As a result, tobacco is easily affordable here.

In order to reduce the availability of tobacco, it is necessary to reform the tax structure and impose specific tax. At the same time, increasing the price of tobacco products in line with inflation and per capita income will be an effective measure.

In addition to this, the sale of single sticks should be banned by amending the tobacco control law. In consequence of such measures, teenagers and young people will not be able to buy a whole pack and will be discouraged from building a habit of tobacco use.

On the other hand, it is very important to stop the sale of tobacco products everywhere, and to ban the advertisement and display of tobacco products in the shops. A study by the Dhaka Ahsania Mission found that in Bangladesh, 81.8% of shops within 100 metres of school and playground display tobacco products.

If the law is amended to ban the display of tobacco products in shops, the chances of creating attraction towards tobacco among children and adolescents will decrease.

Finally, it can be said that Bangladesh will be free from tobacco by 2040 if the tobacco control laws are strengthened, the availability of tobacco products is reduced and all kinds of direct and indirect advertisements for tobacco are stopped.

Sohel Reza Choudhury is a professor and Head of Department of Epidemiology and Research in National Heart Foundation Hospital and Research Institute

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard