Control use of tobacco for building healthy nation
Bangladesh has been successfully dealing with COVID-19 pandemic. Where many developed countries are lobbying for COVID-19 vaccine, Bangladesh has already started mass vaccination. It's an immense success. The death rate by COVID-19 is lower than many other developed countries. People who died by COVID-19 in Bangladesh, most of them were suffering from other complicated diseases. After achieving 'Millennium Development Goal (MDGs)' Bangladesh's focus is now on 'Sustainable Development Goal (SDGs)'. Health is an important issue of SDGs. In this regard Prime Minister Sheikh Hasina has announced Tobacco Free Bangladesh by 2040 at the South Asian Speakers Summit titled as, 'Achieving Sustainable Development Goals' held in Dhaka in 2016.
During the COVID-19 crisis, tobacco related issues have come forward with utter seriousness. According to the World Health Organization (WHO), smokers suffer 14 per cent more complications in post-COVID period. We believe there is no other option but controlling the production, import and use of tobacco to ensure good health for all citizens of Bangladesh. Therefore, amending Tobacco Control Law is one of the most effective ways to ensure good health of the citizens.
Following the signing of the World Health Organization's (WHO) Framework Convention on Tobacco Control (FCTC) in 2003, Bangladesh government amended the tobacco control law in 2013 and passed the rules of law in 2015. Not only that, FCTC has already been included in the seventh, 'Five Year Plan' to meet the SDGs. As a result, tobacco control activities have been integrated with mainstream development activities. The success is tremendous. Tobacco users have decreased remarkably--18.5 per cent in 2017 comparing to the year 2009. But new challenges came up over the time. So, it's necessary to amend the law.
According to the Global Adult Tobacco Survey 2017, more than 3.75 million of people use tobacco in Bangladesh. More than 4o millions of people are victims of second hand smoke at home. 8.1 million people are victims of second hand smoke at the workplace and 25 million of people on public transport. Smokeless tobacco (Jorda, Gul) are one of other concerns here, where women are most affected. More than 8.6 per cent of women than men use smokeless tobacco in our country.
67 per cent of all non-communicable diseases are caused by Tobacco. Joint Research by Bangladesh Cancer Society and Dhaka University titled, 'The Economic Cost of Tobacco Use in Bangladesh: A Health Cost Approach' reported, nearly 126,000 deaths, accounting for 13.5 per cent of deaths from single cause, in Bangladesh in 2018. Approximately 1.5 million adults were suffering from diseases caused tobacco use and nearly 61,000 children were suffering from diseases due to exposure to second hand smoking.
The estimate of the direct healthcare costs attributable to tobacco use amounted to BDT 83.9 billion annually, . 76 per cent of this cost is paid by tobacco users' and 24 per cent is financed through the public health sector budget--which represents nearly 9 per cent of total government health expenditure in the fiscal year 2018-19.
The question is what do we want in the amendment of law on tobacco control? We want the amended law to be finalized according to WHO's FCTC guidelines. There are six proposals: (1) Remove the exemptions in the smoking ban for restaurants and public transport; (2) ban the display of tobacco products at point of sale; (3) ban tobacco company 'Corporate Social Responsibility' activities; (4) ban the sale of single sticks and unpackaged smokeless tobacco; (5) ban the sale and import of E-Cigarettes and heated tobacco products; (6) allow for stricter rules on packaging, including increases to the size of health warnings.
In this regard the Members of Parliament have many more things to do. As the elected representative of people, the MPs must have the urge to properly implement WHO's FCTC. Initiatives should be taken to make tobacco free environment. Everyone's participation must be ensured. Parliamentarians need to speak for amending the Tobacco Control Law in the Jatiya Sangsad Session. According to the WHO's guideline, laws have to be amended after every five years.
We need to coordinate with experts to take initiatives on which policies and strategies should be followed. The national budget has to be against tobacco. A proposed amendment of law can be drafted. Separate programs may be adopted for groups that are at risk of using tobacco and tobacco products. Lastly, the ministries of Health, Industry and Finance must work together to protect the harmful effects of tobacco and its socio-economic implications.
Hopefully, we are already working to amend the Tobacco Control Law. An informal committee has been formed titled as 'Bangladesh Parliamentary Forum for Health and Wellbeing' at the Jatiya Sangsad. The Forum is to facilitate knowledge exchange among parliamentarians on health-related issues; where tobacco control is one the priorities. The forum is going to hand over a letter signed by 153 MP's demanding amendment of the Tobacco Control Law to the minister of health soon. We are very hopeful we will win the anti-tobacco fight.
Dr Habibe Millat, MP, Founder Chairman, Shastho Shurokkha Foundation