Smokeless tobacco products causing public health menace
A standardized packaging needs to be introduced for reducing use
The Covid-19 pandemic has pushed us to adapt to a new normal, retrospect on underlying behaviours towards health and stop old harmful habits that are detrimental to one's health and that of others. One such habit is smoking or using smokeless forms of tobacco. In the Asia-Pacific Journal of Public Health, Volume-27, Issue-2 it has been written "Despite scientific evidence about the harmful effects of smokeless tobacco (SLT), it is widely used in Bangladesh". About 51.5% of the SLT users in Bangladesh said that they use these SLT products as a part of their addiction (ibid).
When addiction is there in the picture you have to go pay its price as well. Now, we know that Prime Minister Sheikh Hasina spoke on South Asian Speakers'Summit in 2016 and made a public commitment to make Bangladesh a tobacco-free country by 2040. In the section of 10 (ii) of Act 16 of Bangladesh Tobacco Control Law 2013 it has been clearly written that the warnings have to be printed in the body of cover, box, cartoons of smokeless tobacco products. In order to restrict the usage of smokeless tobacco standardized packaging needs to be ensured.
However, the SLT businesses are using different ill-tactics to sell loose tobacco products for which law amendment has become necessary in order to restrict the number of SLT usage in the country. It is now time to restrict the sale of loose smokeless tobacco products in the market by making some correction in the Tobacco Control Law for the greater interest of the society.
A recent review of studies by public health experts convened by WHO in April 2020 found that smokers are more likely to develop severe disease with Covid-19, compared to non-smokers. There is evidence that impaired lung function due to smoking and susceptibility to non-communicable diseases (NCD)?like cardiovascular disease, cancer, and diabetes due to continued use of tobacco products, are putting people at higher risk of developing severe Covid-related health complications. Some studies show that the risk is 14 times higher in smokers to get coronavirus attack according to WHO.
Now, we look into this matter whether SLT products can be harmful for the environment. In the Asia Pacific Journal of Public Health, Volume-27, Issue-2 it has been found in a survey that 42 participants (2.3%) Bangladeshi 40-75 years residents of Dhaka City were found to believe that SLT products can be harmful for the environment when spitted. During the time of the covid-19 pandemic the virus can be transmitted through spitting in case the person who is spitting after consuming betel leaves is being affected by coronavirus which he/she might not even know in case of asymptomatic cases.
Evidence of this can be found in the BMC Medicine journal, Volume-13, Issue-194 where it has been written that Kamran Siddiqi, Professor of Department of Health Sciences and Hull York Medical School, University of York has discussed that there is severe concern as the corona infected person's spitting of chewing tobacco products can cause the virus to be transmitted to others. So this is another way of getting coronavirus attack from SLT users.
On the other hand, the tobacco companies apply different kinds of ill-tactics to increase the sales of SLT products. A recent study shows that despite 53% of SLT products collected from the markets had a written health warning, 44% among them had low visibility due to very small font, 22% had warning in English only, 11% had these tactfully hidden in the packaging, and 11% had misleading information.
Nearly 11.8% of products had a label saying "not suitable for children," whereas 41.2% of products printed ingredients on their labels, of which only 57% mentioned "tobacco" as an ingredient. These ill-tactics of the SLT businesses have to be continually addressed in the media so that general people become aware and the law have to be amended at the same time so that the tobacco companies cannot succeed in taking advantage of the loophole in the law. At the same time actions should be taken against tobacco industries for misleading common people.
It is perceived that SLT use was associated with heart disease, cancer, tuberculosis, lung disease, and hypertension. From my experience of working as a dental specialist I believe that SLT usage is very harmful for general people especially during the covid-19 pandemic. Henceforth, I strongly agree with the researchers--who are part of an international group called Addressing Smokeless Tobacco and building Research Capacity in South Asia as they have raised their voice for the governments and public health bodies to regulate the production and sale of smokeless tobacco in the world including Bangladesh.
The government has to ensure public health during the pandemic by amending the law to restrict the usage of smokeless tobacco products through a standardized packaging system and also ensure awareness of mass people in the rural areas regarding the harms from SLT usage in Bangladesh by ensuring regular participation of different kinds of media publicity in this important issue. Moreover, the government has to increase the scope of education for mass people in Bangladesh as well as ensure mass awareness, since it has been proven that over half of the SLT users do not have any formal education--while SLT use is culturally accepted in the rural areas in Bangladesh
Dr Arup Ratan Choudhury, Honorary Senior Consultant and Professor, Department of Dentistry, BIRDEM General Hospital, Founder President of Association For the Prevention of Drug Abuse (MANAS) and Member-National Drug Control Advisory Board & National Tobacco Control Task Force Bangladesh.