Tobacco to kill eight million people by 2030

Oral cancer is one of the most devastating forms of cancer and is the greatest concern associated with smokeless tobacco use. Those who survive often experience a significant impact on their quality of life

One of the main and preventable causes of premature death and disease is the use of tobacco. About 54 lakh people die every year due to tobacco-related diseases. By 2030, the annual death will rise to 8 million. More than three-fourths of these deaths will occur in lower and middle-income countries. So the picture of tobacco-related death and damage in Bangladesh is horrific. According to Tobacco Atlas-2018, in Bangladesh every year one lakh sixty thousand two hundred people died from tobacco-related diseases.

In our country, tobacco use is two types - smoking and smokeless. Smoke tobacco products include cigarette, bidi, leaf bidi, hookah, cigar etc. Smokeless tobacco included zarda, gul, saadapata, khaini etc. Smokeless tobacco products are widely accepted and widely used among the people of our society. Among South Asian countries India, Pakistan, Sri Lanka, and Myanmar also Bangladesh the use of smokeless tobacco products is not less than the female number of men besides.  Generally, in our house or village grandparents, and uncle as well as aunty are seen to have zarda and saadapata with betel leaf. More importantly, the use of betel leaf at our wedding reception is very popular and is very much appreciated for guests. But we do not know, we take the poison in our own social system.

According to WHO Global adult tobacco survey (GATS)-2017, we found 35.3per cent overall (37.8 million adults), 46per cent of men and 25.2per cent women currently used tobacco.

This study shows that 20.6 per cent (22.0 million) adult population is using smokeless tobacco products (16.2 per cent adult males and 24.8 per cent adult women). Intake of betel quid with smokeless tobacco (Zarda and Saadapata) is 18.7 per cent (20.0 million adults) (14.3 per cent adult males and 23.0 per cent adult women) of the total adult population. In the use of Gul, 3.6 per cent of the total adult population (3.9 million) (3.1 per cent adult male and 4.1 per cent adult women) are using Gul (WHO). In the year 2010, the age of information is more than 7.1 times higher than the average age of the person in the age of 15 years, according to the study of the primary and theoretical factors.

A significant portion of the study is that women are using smokeless tobacco products more often. The rate of use of smokeless tobacco products in the year 2009 was 26.4 per cent among adult males, 27.9 per cent for adult women and the year 2017 is 16.2 per cent in adult men and 24.8 per cent in adult males. So, according to the results of two studies, the use of smokeless tobacco products among women is still very high. The use of smokeless tobacco mainly increases heart disease, stroke, and neck as well as mouth cervical cancer. Use of smokeless tobacco products among adult men is getting high blood pressure, cardiovascular disease. In the last 15 years, mouth and neck cancer has increased due to the use of smokeless tobacco products. In our country, among all cancers have 32-35 per cent of mouth and neck cancer. The number of patients will be doubled in 10 years. People are suffering from cancer due to having smokeless tobacco. Because of neck, tongue, vocal chord cancer there is no survey in the South Asian region or Bangladesh.

But according to the World Health Organization, 5, 50,000 people in the world are suffering from head and neck cancer, in which about 380,000 people die every year. The use of tobacco products in different types of cancer also plays an important role, and pregnant mother can take tobacco products, as a result, the congenital problem of birth, cancer, lung problems and even sudden death.

There is a significant increase in non-communicable diseases due to the use of tobacco products as social norms in the South Asia region as well as Bangladesh at female teenagers and women. Smokeless tobacco and public health in Bangladesh [Indian Journal of Public Health 61(Supplement)] in the study, found that the cheaper variety of Zarda is sold for ˂0.60 Taka per gram, and the higher price variety sells for 0.60–1.00 Taka per gram, the price of Gul is relatively skewed centering on 0.10 Taka per gram. There is no information available about Saadapata.

In our family income and expenditure statistics, smokeless tobacco consumption in different types of tobacco is more than other tobacco products. These expenses are usually more in lower income family. For the reason, low price is generating affordability of purchase for lower-income people.

Framework Convention on Tobacco Control (FCTC) agreement was approved in 2003 to reduce tobacco control and tobacco use in a global way. Bangladesh is the first signatory country of this agreement and in its continuation; Bangladesh formulated the Smoking and Tobacco Products (control) Act in 2005 and subsequently amended the law in 2013. Although there is no restriction on the use of smokeless tobacco in the law, various initiatives may be taken to reduce the use of smokeless tobacco products. The potential initiatives are as below:

1.    “Saadapata” production companies should be registered, marketing is undertaken by packaging tax structure.

2.    Take appropriate measures to control the use of tobacco products by government and related authorised organisations.

3.    Smokeless tobacco packaging should be manufactured by Graphical Health Warning (GHW) by the law, and it will be monitored.

4.    Instead of the complex structure of the tax, to make specific supplementary duty or excise duty, and to increase the tax excise tax of 50 per cent, in order to reduce the ability to purchase tobacco products, and increase the government revenue.

5.    Increase the health development surcharge from 1 per cent to 2 per cent.

6.    According to the law, tobacco products should not be sold to anyone under 18 years of age.

    There are FCTC basic prerequisite for achieving sustainable development goals in developing countries like Bangladesh. And by 2040 for tobacco-free country, we need to change the tax structure and take the necessary steps to make effective pictorial health warning.

 

The writer is a tobacco control researcher

Tobacco to kill eight million people by 2030

Oral cancer is one of the most devastating forms of cancer and is the greatest concern associated with smokeless tobacco use. Those who survive often experience a significant impact on their quality of life

One of the main and preventable causes of premature death and disease is the use of tobacco. About 54 lakh people die every year due to tobacco-related diseases. By 2030, the annual death will rise to 8 million. More than three-fourths of these deaths will occur in lower and middle-income countries. So the picture of tobacco-related death and damage in Bangladesh is horrific. According to Tobacco Atlas-2018, in Bangladesh every year one lakh sixty thousand two hundred people died from tobacco-related diseases. In our country, tobacco use is two types - smoking and smokeless. Smoke tobacco products include cigarette, bidi, leaf bidi, hookah, cigar etc. Smokeless tobacco included zarda, gul, saadapata, khaini etc. Smokeless tobacco products are widely accepted and widely used among the people of our society. Among South Asian countries India, Pakistan, Sri Lanka, and Myanmar also Bangladesh the use of smokeless tobacco products is not less than the female number of men besides. Generally, in our house or village grandparents, and uncle as well as aunty are seen to have zarda and saadapata with betel leaf. More importantly, the use of betel leaf at our wedding reception is very popular and is very much appreciated for guests. But we do not know, we take the poison in our own social system. According to WHO Global adult tobacco survey (GATS)-2017, we found 35.3per cent overall (37.8 million adults), 46per cent of men and 25.2per cent women currently used tobacco. This study shows that 20.6 per cent (22.0 million) adult population is using smokeless tobacco products (16.2 per cent adult males and 24.8 per cent adult women). Intake of betel quid with smokeless tobacco (Zarda and Saadapata) is 18.7 per cent (20.0 million adults) (14.3 per cent adult males and 23.0 per cent adult women) of the total adult population. In the use of Gul, 3.6 per cent of the total adult population (3.9 million) (3.1 per cent adult male and 4.1 per cent adult women) are using Gul (WHO). In the year 2010, the age of information is more than 7.1 times higher than the average age of the person in the age of 15 years, according to the study of the primary and theoretical factors. A significant portion of the study is that women are using smokeless tobacco products more often. The rate of use of smokeless tobacco products in the year 2009 was 26.4 per cent among adult males, 27.9 per cent for adult women and the year 2017 is 16.2 per cent in adult men and 24.8 per cent in adult males. So, according to the results of two studies, the use of smokeless tobacco products among women is still very high. The use of smokeless tobacco mainly increases heart disease, stroke, and neck as well as mouth cervical cancer. Use of smokeless tobacco products among adult men is getting high blood pressure, cardiovascular disease. In the last 15 years, mouth and neck cancer has increased due to the use of smokeless tobacco products. In our country, among all cancers have 32-35 per cent of mouth and neck cancer. The number of patients will be doubled in 10 years. People are suffering from cancer due to having smokeless tobacco. Because of neck, tongue, vocal chord cancer there is no survey in the South Asian region or Bangladesh. But according to the World Health Organization, 5, 50,000 people in the world are suffering from head and neck cancer, in which about 380,000 people die every year. The use of tobacco products in different types of cancer also plays an important role, and pregnant mother can take tobacco products, as a result, the congenital problem of birth, cancer, lung problems and even sudden death. There is a significant increase in non-communicable diseases due to the use of tobacco products as social norms in the South Asia region as well as Bangladesh at female teenagers and women. Smokeless tobacco and public health in Bangladesh [Indian Journal of Public Health 61(Supplement)] in the study, found that the cheaper variety of Zarda is sold for ˂0.60 Taka per gram, and the higher price variety sells for 0.601.00 Taka per gram, the price of Gul is relatively skewed centering on 0.10 Taka per gram. There is no information available about Saadapata. In our family income and expenditure statistics, smokeless tobacco consumption in different types of tobacco is more than other tobacco products. These expenses are usually more in lower income family. For the reason, low price is generating affordability of purchase for lower-income people. Framework Convention on Tobacco Control (FCTC) agreement was approved in 2003 to reduce tobacco control and tobacco use in a global way. Bangladesh is the first signatory country of this agreement and in its continuation; Bangladesh formulated the Smoking and Tobacco Products (control) Act in 2005 and subsequently amended the law in 2013. Although there is no restriction on the use of smokeless tobacco in the law, various initiatives may be taken to reduce the use of smokeless tobacco products. The potential initiatives are as below: 1. Saadapata production companies should be registered, marketing is undertaken by packaging tax structure. 2. Take appropriate measures to control the use of tobacco products by government and related authorised organisations. 3. Smokeless tobacco packaging should be manufactured by Graphical Health Warning (GHW) by the law, and it will be monitored. 4. Instead of the complex structure of the tax, to make specific supplementary duty or excise duty, and to increase the tax excise tax of 50 per cent, in order to reduce the ability to purchase tobacco products, and increase the government revenue. 5. Increase the health development surcharge from 1 per cent to 2 per cent. 6. According to the law, tobacco products should not be sold to anyone under 18 years of age. There are FCTC basic prerequisite for achieving sustainable development goals in developing countries like Bangladesh. And by 2040 for tobacco-free country, we need to change the tax structure and take the necessary steps to make effective pictorial health warning. The writer is a tobacco control researcher