Tobacco use a risk factor for health


Md. Sazedul Islam

World No Tobacco Day was observed across the world on May 31 to raise awareness on the dangers of using tobacco, and what people around the world can do to claim their right to health and healthy living.
Evidence released this year shows that smokers were likely to develop severe disease with Covid-19 compared to non-smokers.
Smoking is the leading cause of preventable death across the world. There are 8 million smoking-related deaths annually, killing more people than HIV/AIDS, malaria & tuberculosis combined.
In Bangladesh, about 126,000 people died of tobacco-attributable diseases in 2018, and this constituted 13.5% of all deaths recorded in that year.
According to Bangladesh Country Report (March, 2021) of CSF Global, one of the largest tobacco consuming countries in the world, Bangladesh is home to an estimated 46.3 million adults who use of a variety of combustible and/or smokeless tobacco products. 37.8 million (35.3 percent) adults are consuming a variety of smoked (e.g., cigarettes, bidis) and/or smokeless (e.g., betel quid with tobacco, gul, sadapata, khaini) tobacco products.
The prevalence of tobacco usage in Bangladesh differs by gender. Smoking prevalence is far higher among males (36.2%) than among females (0.8%). The use of smokeless
tobacco (SLT) is much higher among females (24.8%) than males (16.2%). There is also variation in the
prevalence of tobacco products between rural and urban areas, said the report.
Current smoking and gul usage were significantly higher in males (42.2% and 2.2%, respectively) than in females (2.3% and 1.5%, respectively), whereas chewing tobacco was slightly more common in females (21.6%) than males (19.4%).
No significant urban–rural difference was observed in smoking rate after adjusting for socio demographic variables, but chewing tobacco was 1.5 times more likely to be used by rural residents, and gul usage was 3.6 times more likely in urban residents. On average, a smoker consumed 9.3 sticks a day, and males and rural residents smoking more.
Respondents living in slums were significantly more likely to confirm that they smoked cigarettes (53.3%) as compared to those living outside slums (44.6%). A similar pattern was found for bidis (slums, 11.4%; other areas, 3.2%).
Tobacco use was more common among older men, those living in rural areas, men with no education, and
men in the lowest wealth quintile. Regional variations were also notable. Although rural men were more likely 27 to smoke cigarettes than urban men, urban smokers tended to smoke more cigarettes per day than their rural counterparts.
In 2017, the WHO supported the National Institute of Preventive and Social Medicine (NIPSOM) to pilot
tobacco cessation service. Through brief interventions in primary health care settings, NIPSOM set up a training network on tobacco cessation in collaboration with NTCC and DGHS and trained 30 master trainers and 120 primary healthcare physicians on brief interventions. With these master trainers, services can be scaled up.
The WHO Framework Convention on Tobacco Control (WHO FCTC) is an evidence-based treaty that asserts
the importance of both demand and supply reduction strategies. The WHO FCTC is the first global public
health treaty negotiated under the auspices of WHO in response to the globalization of the tobacco pandemic.
Bangladesh ratified the WHO FCTC in 2004, and in 2005, enacted the Smoking and Using of Tobacco Products (Control) Act. The law was amended in 2013 to make it more compliant with the WHO FCTC.
Tobacco use imposes a heavy burden on the societies and families by increasing illness and deaths; worsening economic situation of tobacco users and their dependants; worsening livelihoods of tobacco farmers; harming the environment; and increasing risks of fires.
WHO says, tobacco consumption, in any form, kills more than 161,000 people on average every year, amounting to around 19% of all deaths in Bangladesh.
The government should take steps to control tobacco.
It is important for the government to assess the smokers’ needs and take their opinion on policies which govern their lives and habits. Cessation support, which suits the smokers’ needs, will go a long way in achieving the targets set by Bangladesh government relating to tobacco use and NCDs.

@ The author is a freelance journalist