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Updated: May 30, 2012 21:20 IST

World No Tobacco Day: Command and control

Dr. R. N. Kalra
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An awareness walkathon organised by Bangalore Institute of Oncology in 2005. Photo: V. Sreenivasa Murthy
The Hindu
An awareness walkathon organised by Bangalore Institute of Oncology in 2005. Photo: V. Sreenivasa Murthy

A cigar has “…a fire at one end and a fool at the other.” - Horace Greely

With all the gory statistics related to smoking at our disposal, it would be hard to disagree with the above statement, yet, fools or not, men and women in countless numbers choose to continue consuming tobacco products. Despite the proposals in the World Health Organisation's Framework Convention on Tobacco Control (WHO FCTC), adopted in 2005 by the World Health Assembly, progress made seems so limited that in India alone, within the next two years, around 10 lakh people will die because of smoking, according to one of the most comprehensive studies on the habit in the country. India stands on the threshold of a tobacco-unleashed epidemic.

It is none too soon then, that WHO has chosen ‘Tobacco industry interference' as this year's theme of World No Tobacco Day, which is observed on May 31.

Understanding the tobacco industry's practices is crucial for the success of tobacco control policies. In this context, it's important also to understand that tobacco products are the only legally available products that can kill up to one half of their regular users if consumed as recommended by the manufacturer.

The campaign focuses on the need to expose and counter the tobacco industry's brazen and increasingly aggressive attempts to undermine the WHO FCTC.

diseases like cancer, says a report released by the Framework Convention Alliance (FCA).

WHO FCTC, which was developed in response to the globalisation of the tobacco epidemic, is a pre-eminent global tobacco control instrument. It includes legally binding obligations for its parties, sets the baseline for reducing both demand for and supply of tobacco, and provides a comprehensive direction for tobacco control policy at all levels. WHO FCTC has become one of the most widely embraced treaties, with more than 160 parties, covering more than 86 per cent of the world's population. India has been playing an important role on the tobacco control front since 2003. It had a leading role in negotiations for the Convention too, as Regional Coordinator of South-east Asian countries, and advocated actively for an international treaty on tobacco control.

Use of the guidelines for implementation of Article 5.3 of the Convention will have an overarching impact on countries' tobacco control policies and on implementation of the Convention, because the guidelines recognise that tobacco industry interference, including that of the State-owned tobacco industry, cuts across a number of tobacco control policy areas, as stated in the Preamble of the Convention. The purpose of these guidelines is to ensure that efforts to protect tobacco control from commercial and other vested interests of the tobacco industry are comprehensive and effective. Parties should implement measures in all branches of government that may have an interest in, or the capacity to, affect public health policies with respect to tobacco control.

There should be an effective tobacco surveillance system in the country which should collect information on prevalence of tobacco use, tobacco related morbidity and mortality, and policy and programme interventions of the government. It will definitely enhance the capacity of the government to find out the relation between tobacco and health status of the population; therefore it is expected to assist in setting public health priorities. There is an urgent need to strengthen the research in the country to deal with the problem of tobacco control.

(The author is the Medical Director and CEO of Kalra Hospital and Sri Ram Cardio Thoracic Neurosciences Centre, Kirti Nagar)

Curbing the deadly killer

The following important activities are recommended for addressing the tobacco industry's interference in public health policies.

Raise awareness about the addictive and harmful nature of tobacco products and about tobacco industry's interference with parties' tobacco control policies.

Establish measures to limit interactions with the tobacco industry and ensure the transparency of those interactions that occur.

Reject partnerships and non-binding or non-enforceable agreements with the tobacco industry.

Avoid conflicts of interest for government officials and employees.

Require that information provided by the tobacco industry be transparent and accurate.

Denormalize and, to the extent possible, regulate activities described as “socially responsible” by the tobacco industry, including but not limited to activities described as “corporate social responsibility”.

The smoking stats

Tobacco use is the leading cause of preventable death, estimated to kill more than five million people each year worldwide. Most of these deaths are in low and middle-income countries. The gap between tobacco-caused deaths in these countries and those in high-income countries is expected to widen further over the next several decades. Based on current statistics, the World Health Organisation has estimated that tobacco will cause eight million deaths every year by 2030. And 80 per cent of these premature deaths will take place in low-and middle-income countries. By the end of this century tobacco may kill a billion people or more unless urgent action is taken. .

Cigarette smoke is known as one of the major risk factors leading to heart attack. More than 700 chemical additives are found in cigarettes. Some of them are classified as toxic and not allowed in food. A lighted cigarette releases thousands of chemical compounds and poisons like carbon monoxide and hydrogen cyanide and as many as 43 carcinogens.

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