Vital Strategies works in more than 40 countries to support the adoption of proven policies to reduce tobacco use, and participated in the recent World Lung Conference at Hyderabad.Sandra Mullin, senior vice-president, spoke about the TB-tobacco relationship, the ban on e-cigarettes and the End-TB campaign.
What are your thoughts on the recent ban on e-cigarettes in India and compare that with the U.S. where the authorities are now calling it a ‘teen epidemic’?
In the U.S., policymakers have tragically allowed e-cigarette companies to foster a new generation of nicotine users who are now hooked to their products. The unregulated introduction of e-cigarettes into the U.S. market has led to an epidemic of youth vaping, with a jump of 73% over a single year, undermining the decades-long trend of reduction in tobacco use, particularly among youth.
We commend the Government of India for taking decisive action to protect youth from e-cigarettes. We hope the comprehensive ban on the sale, manufacture, import and advertising of e-cigarettes will help prevent its rising use among youth, as we’ve seen in the U.S. and other countries.
More and more countries around the world are increasing their support for regulating and banning these products, and we hope that the momentum is continued.
Is there a relationship between tuberculosis and tobacco use?
Smokers are twice as likely to develop active TB and die from it than non-smokers, and smoking also makes TB treatment less effective. In 2018, 900,000 TB cases were attributable to smoking, according to the latest Global Tuberculosis Report. Worldwide TB rates could drop by as much as 20% if we eliminated smoking, according to the most recent Tobacco Atlas .
And it’s not just smokers who suffer. We know that secondhand smoke has been linked to TB relapse and also impacts the outcome of TB treatment.
Sandra Mullin. File
The message is clear — tobacco control is tuberculosis control.
Implementing strong tobacco control policies is among the best ways that countries can prevent TB, especially in a high-burden country like India.
There is a lot of focus on TB globally and in India with the End TB campaign. Are there synergies between tobacco control and tuberculosis treatment?
Due to better evidence around the links between tobacco use and TB outcomes over the last few years, there’s been more global attention paid to coordination between national TB and tobacco control programmes.
We applaud countries who have taken steps in this direction. India’s National Strategic Plan for TB elimination provides a road map for coordination between the Tuberculosis Control and Tobacco Control Programmes. We can see opportunities for coordinating care, for instance, providing TB patients who identify as tobacco users support to help them quit. India’s framework also provides smoke-free health facilities to patients and links tobacco users to nearby cessation clinics.
Urging the public to take action and highlighting the twin dangers of tobacco use and TB is also critical. In March 2018, the Indian Health Ministry relaunched the successful ‘TB Cough’ mass media campaign during the END-TB summit in New Delhi.
The campaign viscerally depicts the association between TB and tobacco use, and encourages smokers to visit their doctor to confirm whether a persistent cough is a sign of TB.
The campaign was remarkably effective, and we will be presenting the evaluation and lessons learned at this conference.
This year, what were your expectations from the World Lung Conference?
Each year, the Union World Conference on Lung Health brings together doctors, policymakers, researchers and health advocates working to end the suffering caused by lung disease.
A key focus was TB, the world’s leading infectious killer, and issues like air pollution and tobacco use that need bold, coordinated, multi-sectoral action .
Earlier this year, Vital Strategies and its collaborators published results from the landmark STREAM clinical trial in The New England Journal of Medicine demonstrating that a new treatment regimen for multi-drug resistant TB could reduce treatment times from two years to just nine months.
