By: Khalil Dogar
Smoking is the practice of combustion, inhalation of tobacco and other recreational drugs. Its history can be traced back to 5000 BC. It is one of the major public health challenges in today’s world and single most important cause of preventable deaths worldwide. It is a major risk factor for non-communicable diseases like Acute Coronary Syndrome, Cerbrovascular accidents, debilitating chronic diseases like atherosclerosis, hypertension and Chronic Obstructive Pulmonary Disease (COPD). Tobacco and tobacco smoke have about 4,000 chemicals, 200 of these are poisonous and 60 of these chemicals are known to cause cancer (carcinogens).
According to the World Health Organization (WHO) figures there are about 1.3 billion smokers in the world and 20 billion cigarettes are sold every day. Smoking is declining in US and many other western countries. In USA smoking rate have decreased to almost half over the last three decades but it is on the rise in developing countries like Pakistan, India, Philippine, Thailand and Cambodia . In some developed countries in far East like Japan and China more than 60 % of male population smokes. One third of the world population smokes, 12 % of them are women and every day 100,000 kids are added to this number. Every year 5.6 million people die of tobacco/smoking related diseases. Every 6 second a current or former smoker dies and 70 % of smokers die younger than normal population. Smokers die 15 year younger than non-smokers. In 21st century, 1.3 billion people will die of smoking
In Pakistan, 15.6 Million people use tobacco. Tobacco cause some 108,800 deaths every year, i.e. 298 per day. Some 1,500 youngsters start smoking in Pakistan every day. Among youth of age group13 to 15 years, around 34% report being exposed to second-hand smoke in public places and 27% report exposure at home
Tobacco control is not new to Pakistan as there have been policies and laws regarding heavy restrictions on advertisement of tobacco products, no sales to minors, restriction of sales and distribution of tobacco products near educational institutions and strict penalties adopted since the early 1950s. Significant policy development started in 2002 when Pakistan adopted it first comprehensive national tobacco control law, 2002. Continuing its commitment to tobacco control, Pakistan signed and ratified the World Health Organization’s Framework Convention on Tobacco Control (FCTC), in 2004. Given the health structure available and the resources allocated for tobacco control in the context of health budgets, implementation and enforcement of the laws has remained a challenge. In order to fulfill the obligations under WHO-FCTC and to coordinate all matters relating to tobacco control, a Federal Tobacco Control Cell (TCC) was formed under Ministry of Health. Despite the formation of the TCC and the devolution of powers to the provinces under a constitutional amendment (8 April, 2010), the anecdotal evidence reveals weak enforcement of laws at national level. Unfortunately there is no national data available to assess the enforcement status
The tobacco Industry in Pakistan remains a strong player in tobacco control for its economic argument and putting pressure on the government through its front groups. The recent debates and legal cases for larger pictorial health warning on cigarette packs is one example of the influence generated by the tobacco industry. There have also been cases of violations by the tobacco industry of the provisions of the laws governing advertising and promotion of tobacco products
A summary of imposing a ‘sin tax’ on cigarettes and beverages has been sent to the Economic Coordination Committee (ECC).The summary proposes Rs10 tax on a cigarette pack and Re1 tax on a beverage bottle. Prime Minister Imran Khan has approved sending of the summary to the ECC. It is expected that the summary will be presented in the next meeting of the ECC. According to Health Ministry’s summary, the money obtained from ‘sin tax’ will be utilized for health insurance scheme. The tax money will also be utilized for treatment patients affected by serious diseases.
Despite recent attempts, the sale of cigarettes to minors and near educational institutions remains a worrying constant in the country. The advertisements and youth-focused marketing were one of the main tools used by the tobacco industry to reach a younger consumer base
Pakistan’s health authorities should be reactive to efforts towards monitoring and curbing tobacco to reverse the country’s tobacco epidemic. Collaborative activities like anti-smoking education, smoke-free policies, increase the price of cigarettes, display pictures of complications of smoking, tobacco control legislation, raise tobacco taxes, ban on tobacco advertising, promotion and sponsorship ,create awareness among citizens regarding negative effects of smoking, implementation of tobacco control laws, development of a national coordinating mechanism, establishment of a tobacco control cell, establishment of a federal enforcement committee, establishment of a technical advisory group, National Action plan for Enforcement, Provincial Tobacco Control Cells should be set up and with support for implementation of the Bloomberg Initiative Grants Program.
The writer is Manager Research & Communication, SPARC Islamabad.
