India and other countries need to scale up the cost-effective, proven and WHO-recommended strategies to reduce the number of deaths attributed to tobacco use. The World Health Statistics Report (2008) of WHO released 10 days before this year’s World No Tobacco Day (May 31) ups the urgency to scale up quality interventions to control tobacco use.
About half of all countries in the world implement none of the recommended tobacco control policies despite the fact that tobacco control measures are cost-effective and proven. Moreover, not more than five percent of the world’s population is fully covered by any one of these measures.
The World Health Statistics Report (2008) had confirmed that heart disease, obesity and tobacco use were among the leading causes of deaths worldwide. The number of deaths from non-communicable chronic conditions, the risk to which is exacerbated by tobacco use, is alarmingly rising far more than the number of deaths from communicable diseases like HIV, TB or malaria.
The single most preventable cause of death worldwide, the report stated, is tobacco use. Tobacco use has been found to kill one-third to one-half of its users, according to this report.
Earlier in February 2008, WHO had released the World Tobacco Epidemic Report which not only underlined the evidence-based fact that tobacco epidemic was worsening but also recommended a comprehensive package of six effective tobacco control policies – clubbed as ‘MPOWER’. These have demonstrated results in helping countries stop the diseases, deaths and economic damages caused by tobacco use.
The MPOWER package includes:
M: stands for ‘monitor’ tobacco use and prevention policies. Assessment of tobacco use and its impact must be strengthened.
P: stands for ‘protect’ people from tobacco smoke. All people have a fundamental right to breathe clean air. Smoke-free places are essential to protect non-smokers and also to encourage smokers to quit.
O: stands for ‘offer’ help to quit tobacco use. Services to treat tobacco dependence are fully available in only nine countries with five percent of the world’s population. Countries must establish programmes providing low-cost, effective interventions for tobacco users who want to quit.
W: stands for ‘warn’ about the dangers of tobacco use. Despite conclusive evidence, relatively few tobacco users understand the full extent of their health risk. Graphic warnings on tobacco packaging deter tobacco use, yet only 15 countries, representing six percent of the world’s population, mandate pictorial warnings (covering at least 30 percent of the principal surface area) and just five countries with a little over four percent of the world’s people, meet the highest standards for pack warnings. More than 40 percent of the world’s population live in countries that do not prevent use of misleading and deceptive terms such as ‘light’ and ‘low tar’.
E: stands for ‘enforce’ bans on tobacco advertising, promotion and sponsorship. Partial bans on tobacco advertising, promotion and sponsorship do not work because the industry merely redirects its resources to other non-regulated marketing channels. Only a total ban can reduce tobacco consumption and protect people, particularly youth, from industry marketing tactics. Only five percent of the world’s population currently lives in countries with comprehensive bans on tobacco advertising, promotion and sponsorship.
R: stands for ‘raised’ taxes on tobacco. Raising taxes and therefore prices is the most effective way to reduce tobacco use and especially to discourage young people from using tobacco. Only four countries, representing two percent of the world’s population, have tax rates greater than 75 percent of retail price.
“Reversing this entirely preventable epidemic must now rank as a top priority for public health and for political leaders in every country of the world,” said Margaret Chan, director general of WHO, in the summary.
However, the global tobacco epidemic stands starkly apart from other conventional disease control programmes because of an aggressive tobacco industry that is hell-bent on protecting and expanding its markets globally, particularly in the developing countries of Asia and Africa. Tobacco corporations across the world have not only been aggressively protecting and promoting their tobacco markets, particularly in developing countries but also trying their best to either abort or weaken the public health policies that begin to take shape in countries around the world.
(Bobby Ramakant is a regional correspondent and a member of Network for Accountability of Tobacco Transnationals (NATT). He can be contacted at: email@example.com)