How Southeast Asia can kick the killer habit

The impacts of tobacco go far beyond health. Premature death and disease plus the massive expenditure on healthcare damage productivity, affect quality of life and take an economic toll on our societies. 

There is also a close association between poverty and tobacco, whose use is more prevalent among socio-economically vulnerable groups. 

One in 10 students in the region has been offered free tobacco, according to a recent Global Youth Tobacco Survey. There has been no decline in tobacco use among 13- to 15-year-olds since 2003, with some countries recording an increased use in this age group. The situation is grim and getting worse. 

A decade has gone by since the WHO Framework Convention on Tobacco Control (FCTC) was forged. All 11 countries in Southeast Asia signed the FCTC and are implementing measures against tobacco use. Clearly, what we are doing is not enough. We need to redouble our efforts to outpace the tobacco epidemic. 

The use of the drug is a major risk factor for non-communicable diseases (NCD), which account for 62 per cent of the deaths in the region. NCDs are also on the rise. A large proportion of these diseases and deaths and their socio-economic consequences are preventable with effective tobacco control and prevention measures. 

To accelerate efforts, countries adopted the Dili Declaration on Tobacco control at the Regional WHO Southeast Asia meeting in Timor-Leste on September 7. All 11 member countries pledged a full-on war against tobacco.  

This renewed commitment needs to be reinforced with stronger measures to prevent and control tobacco use. The most cost-effective and appropriate of these includes increasing taxes on all tobacco products. Making all these products less affordable would discourage people from switching from an expensive tobacco product to a less expensive one. Taxing all smokeless tobacco products, which are highly toxic and addictive, is equally important. 

Countries need to develop, implement and strengthen legal frameworks, regulatory mechanisms, policies and sale of tobacco products. We now need policies and regulations for e-cigarettes – to restrict or ban their sale, promotion, advertising and sponsorship.

Robust public campaigns against tobacco and large graphic warnings on cigarette packs and other tobacco products need to be implemented at the earliest. Countries need to ensure smoke-free workplaces and public spaces.

Health systems need to be strengthened to address tobacco control and prevention, while cessation services should be provided at all healthcare levels. 

Governments also need to start focusing attention on creating alternative livelihoods for tobacco growers and workers.

Implementing stronger measures needs firm and continuous political commitment. National, regional and inter-country cooperation mechanisms are necessary for the regular sharing of best practices on tobacco control. Most importantly, countries need to support cross-border control of tobacco-related trade and marketing.

Countries in the region have unanimously committed to achieving a 30-per-cent reduction in tobacco use by 2025. To get there we need to act now, firmly.

 

Poonam Khetrapal Singh is World Health Organisation regional director for Southeast Asia.