World No Tobacco Day 2020: The ongoing COVID-19 crisis has raised public awareness about pandemics. The global response to this emergency has been extensive and prompt, without which the extent of the disease would likely be much more significant. Yet, there are other far worse afflictions about which we are complacent. A habit which spreads like a disease among young people affects almost all organs, condemns victims to substandard quality of life and finally kills two-thirds of users – tobacco is a pandemic by any definition. Besides, tobacco consumption is a considerable burden on the economy due to increased healthcare costs and losses from decreased productivity and premature deaths. In India alone, these costs are estimated to be over ₹1 lakh crore per annum, which is more than the total government healthcare budget.
Reduce Tobacco Consumption
Maneesh Kasera is a Member, CHRA (council for harm reduced alternatives), IT professional and a tobacco harm reduction advocate states that the need to reduce tobacco consumption in general and to smoke in particular has been recognized for over 50 years now. However, the growing revenues and profits of tobacco companies worldwide indicate that the idealistic abstinence-only methods adopted by governments, NGOs, pharmaceutical companies and public health bodies have been unable to meaningfully control the problem.
- Humans have a disposition to stimulant use, which cannot be checked by prohibition alone. Restrictive policies encourage a black market and abuse of the products.
- Bans increase the appeal for a large number of people, especially the young. Further, punishing or ostracizing victims is both inhumane and ineffective, while on the other hand, simple verbal encouragement to quit is not enough.
- Tobacco is a highly profitable business. Companies have grown vast and prosperous to the point where they can get laws and policies framed in their favour.
- Also dependent on the tobacco business are the farmers and factory workers, who number more than four crores in India. Their welfare takes precedence whenever there is an attempt to reduce tobacco consumption seriously.
Tobacco & Taxation
"Additionally, tobacco products, especially cigarettes, are so heavily taxed in every country that the government budgets would be severely affected if this revenue was to reduce significantly. In many countries, including India, governments also own stakes in the tobacco companies. This causes a conflict of interest and dissuades effective legislation. All these factors have caused a complicated situation where the road to hell is paved with good intentions. The agencies which should be working for the greater public good are instead merely paying lip service to the cause. There is no desire to find real solutions, as this would cause monetary loss to everyone involved. All is, however, not lost" says Maneesh Kasera.
The United Kingdom
In the United Kingdom, the National Health Service (NHS) and Public Health England (PHE) have been able to reduce smoking levels to historically low numbers, and they continue to fall. Active promotion of various reduced-risk products, mainly e-cigarettes, had played a significant role. Sweden has been successful in reducing smoking rates to astonishingly low levels, currently the lowest in Europe, followed by the UK. Their key to success has been snus, another reduced-risk product.
Measures To Reduce Tobacco Consumption
Maneesh Kasera says that, if we are to make a significant reduction in tobacco consumption in India, various measures must be taken simultaneously. Foremost among these is government disinvestment from all tobacco-related businesses. This is not only pragmatic but also mandated by the Framework Convention on Tobacco Control (FCTC), a binding international treaty signed by India. The government must also make budgetary adjustments to decrease dependence on tobacco tax, which totals to a significant ₹43,000 crore. A sure shot and effective way of doing this is by ensuring that the tax collected from tobacco is spent on tobacco control, research and healthcare, providing funds to set up de-addiction centres with dedicated medical facilities and personnel.
- There should be re-training programs for farmers to transition from tobacco farming to other crops. Workers in the bidi and other industries can be re-skilled to work at the manufacturing facilities of reduced-risk products.
- Tobacco is consumed in India in various ways, including smokeless tobacco (SLT) and bidi. In addition to the available reduced-risk alternatives like e-cigarettes and snus, there is a need to encourage the development of new products to ease the transition for users of various forms of tobacco.
Most tobacco products, apart from cigarettes, attract meagre taxes. High taxes on cigarettes are meant to be a deterrent to consumption. A similar ideology can be applied to all tobacco products. Further, tobacco products should be sold only to adults from licensed shops to discourage youth uptake of harmful habits. This approach has worked well for alcohol. A tobacco-free society is ideal, but insisting on it is impractical. Given the human propensity to use stimulants, tobacco or nicotine use is here to stay. Our best approach is to be realistic and reduce the harmful effects to such levels that it does not matter anymore. With the right measures, tobacco can be made as harmless as coffee.
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