Give up smoking, save your heart

Tobacco is deadly. The global tobacco epidemic kills more than seven million people each year, of which close to 900,000 are non-smokers dying from breathing second-hand smoke. There are more than 4,000 chemicals in tobacco smoke, of which at least 250 are known to be harmful and more than 50 known to cause cancer. Tobacco use is addictive, alters the neurochemistry of the brain, causes long-term adverse health consequences and often leads to illness and death.

The focus of World No Tobacco Day 2018, which falls today (May 31) is “Tobacco and Heart Disease” under the slogan “Tobacco Breaks Hearts”. Tobacco use is a known risk factor for the development of coronary heart disease, stroke, and peripheral vascular disease. The campaign is spearheaded by the World Health Organisation (WHO).

Although the fact that tobacco causes lung cancer is very well known, knowledge among the public that tobacco is one of the leading causes of Cardiovascular Diseases (CVD) is low. Cardiovascular diseases kill more people than any other cause of death worldwide, and tobacco use and second-hand smoke exposure contribute to approximately 12 percent of all heart disease deaths worldwide. In fact, tobacco use is the second leading cause of CVD, after high blood pressure.

The health cost of tobacco consumption is immense and negates any revenue gained through taxes on tobacco on tobacco products as many countries including Sri Lanka treats diseases caused by tobacco free of charge under their free healthcare systems.

Governments have been urged to reduce tobacco use and protect people by taking several measures. Sri Lanka has complied with most of these measures which include: tobacco use and prevention policies; Protecting people from exposure to tobacco smoke by creating completely smoke-free indoor public places, workplaces and public transport; Offering help to quit tobacco; Warning about the dangers of tobacco by implementing plain/standardized packaging, and/or large graphic health warnings on all tobacco packages, and implementing effective anti-tobacco mass media campaigns that inform the public about the harms tobacco use and second-hand smoke exposure; Enforcing comprehensive bans on tobacco advertising, promotion and sponsorship and raising taxes on tobacco products and make them less affordable.

Hard-hitting anti-tobacco advertisements and graphic pack warnings have been proven to reduce the number of youth who begin smoking and increase the number of smokers who quit. Seventy eight countries (including Sri Lanka), representing 47% of the world’s population, meet the best practice for pictorial warnings, which includes the warnings in the local language and cover an average of at least half of the front and back of cigarette packs.

Studies have shown that tobacco taxes are the most cost-effective way to reduce tobacco use, especially among young and poor people. Indeed, after the Sri Lankan Government sharply raised taxes on cigarettes, sales have dropped by a staggering one billion sticks. Sri Lanka has implemented many progressive measures aimed at discouraging tobacco consumption such as prohibiting tobacco sales to those under 21, severely restricting all forms of advertising including Point of Sale advertising and limiting smoking in most public places. Plans to ban the sale of “loose” cigarettes must be implemented without delay. The availability of loose cigarettes encourages consumption because most people can afford to buy 2-3 cigarettes. However, not many can spend nearly Rs.1,200 to buy a complete pack. The credit for most of these measures should go to President Maithripala Sirisena and Health Minister Dr. Rajitha Senaratne.

Another aspect of tobacco control that gets little attention is the danger posed by illicit tobacco. It is estimated that 1 in every 10 cigarettes and tobacco products consumed globally is illicit. Each year, more than 400 billion cigarettes are illegally sold globally, making it the most widely smuggled product in the world. The illicit market is supported by various players, ranging from street peddlers to organised criminal networks involved in arms and human trafficking. These illegal manufacturers do not employ the quality control measures usually adopted by the legal manufacturers, making them even more harmful to smokers and others. Governments also lose revenue as illicit tobacco is often smuggled in, denying revenue at the point of entry and point of sale. All ports and airports must be thoroughly secured and smuggling avenues closed – the same measures used to contain narcotics such as heroin must be pursued in the case of illicit tobacco.

With many adults giving up smoking, the tobacco industry is increasingly turning towards the youth, including young women, as a target market. The youth are easily swayed by glamourous depictions of smoking by role models - the cinema and teledrama industry must take care not to show scenes that may glamourise smoking. If such scenes are shown, a warning must be displayed. The media should play a bigger role in vilifying tobacco and alerting the public to the dangers posed by tobacco through deadly diseases. The youth must be saved from this scourge to ensure a brighter, smoke-free and disease-free future. Every day should be a No Tobacco Day to make the world a better place to live in.