‘Tobacco control at crossroads in Bangladesh’

Bangladesh, among the top five countries in tobacco consumption, stands at a “critical juncture” in controlling it, president of the US-based Campaign for Tobacco-Free Kids (CTFK) has said.

Matthew Myers told bdnews24.com in an exclusive interview that tobacco industries were eyeing Bangladesh market like the other developing countries for their future profit making after rich countries imposed stiff tobacco controls.

“So vigorous implementation of the new (tobacco control) law is truly a matter of life and death for Bangladesh,” he said on Friday.

The CTFK, being a key recipient of the Bloomberg Philanthropies funds, works actively in Bangladesh for tobacco control.

Myers said tobacco industry lobbies were “very powerful” in Bangladesh, but the parliament showed it could stand up against them by passing the law last year in April.

But he lamented that it was more than a year that regulations for its implementing the law could not be enacted.

He said the Ministry of Health has proposed strong regulations while the Ministry of Law has proposed to somewhat dilute it.

“If the law ministry has its way, millions in Bangladesh will be exposed to passive smoking,” he said.

The new law kept the provision of pictorial health warnings covering 50 percent of the package, banned advertisements in any form and restrict indoor smoking which harms others.

But the industries were lobbying hard to delay regulations, without which a key provision of graphical warning cannot be implemented.

Media reports suggested that industries wrote to government arguing that they would need at least two years time to start using the pictorial warnings in the package.

The CTFK President said in every country tobacco industries come up with similar arguments. “It’s just delaying tactics”.

Myers helped found the CTFK in 1996 and became its President in 2000.

Initially, he served as its Executive Vice President and Legal Counsel and oversaw its legal and advocacy efforts.

In his more than 30 years of anti-tobacco activism, he has won many awards including the highest award of the Harvard School of Public Health and that of the American Cancer Society.

He said Bangladesh was their top priority in tobacco control because it had 41 million smokers, which is nearly one-fourth of the country's population.

World Health Organisation estimates that tobacco kills 57,000 people in Bangladesh every year and affects more than 350,000 people.

“If many people continue smoking 15 years from now, it will become evident that the government has taken care of the tobacco industry and neglected the health concerns of the people,” he said.

“I think that won't happen,” said Myers.

He appreciated the new law and said it was for the first time Bangladesh has a law that brings it “much closer” to compliance with the WHO FCTC.

But he was quick to add -- “if and only when it is fully implemented”.

Bangladesh was one the first countries who signed the FCTC that guides countries on how to control the tobacco menace.

“None can afford the fallout on public health if a country had 41 million smokers,” Myers said.

But he said the new law, if fully implemented, has the potential “to save literally millions of people from dying prematurely of tobacco use”.

The CTFK has advocated strongly in Bangladesh using all stakeholders to pass the law.

Myers said good implementation would depend on “political will as much as it was needed for passing the law”.

“If you can do that, the potential to bring down tobacco use is enormous”.

He said enforcing the law was the only way through which the government can save lives “more quickly and more cheaply”.

He said he knew tobacco industries were “very powerful” in Bangladesh and that “they did everything they could to prevent the law from being passed”.

“But Bangladesh Parliament demonstrated it is capable of standing up to tobacco industry if it wants to,” he said.

That makes Myers optimistic that the law would be implemented properly.

“The government has a very concrete choice … is it going to protect the health of the citizens or that of the tobacco industry in Bangladesh,” he said.

Myers said they had seen how the tobacco lobby opposed higher taxes especially on bidis.

“And the government has taxed the industry far too little to bring down tobacco use,” he said.

“Failure of the government in particular to increase tax on bidis, virtually invites people to consume them.”

Myers said this explains 'behind the scene' lobbying by the tobacco industry.

He said rich countries across the world have made great deal of progress in reducing tobacco use by regulating the industry.

“So, tobacco industries now see countries like Bangladesh as their future profit making zone.

“The critical question is whether or not the government of Bangladesh will act boldly and strongly to make sure that does not happen,” he said.

“The law is a very good first step."

He, however, warned that tobacco industries have become tricky now in marketing their products.

A US report in January showed that today’s smokers have more than twice the risk of getting cancer than 50 years ago because tobacco industries were using more addictives in their products.

He said ‘e-cigarette’ is also coming as a challenge for countries like Bangladesh who have “limited capacity to regulate those tricky advertisements”.

He said e-cigarettes contain various levels of nicotine in high quantity. The nicotine delivering device does not contain tobacco that creates a debate whether it is as harmful as cigarettes.

Myers, however, said it would be “a real threat”.

“It’s another tool to addict millions of new nicotine users,” he said.

“It poses unknown health risk in the absence of strict regulations.”

He said marketing of e-cigarette has been devised in a way targeting young people, specially the non-smokers among them.

“If non-smokers start using e-cigarette, their risks of diseases dramatically increase,” he said.

He also urged medical professionals to lead the tobacco control efforts against the backdrop of a recent high court order issued to a number of big public hospitals in Dhaka.

The court instructed them to take measures for establishing smoke-free environments in hospitals as a group of anti-tobacco organisations showed that big hospitals are not smoke-free.

Myers said hospitals and healthcare facilities “have to be the first place to ban tobacco”.

“It is inconceivable that in the 21st century any hospital anywhere in the world will continue to allow smoking."

“There is no excuse for the medical profession not to be in the lead and banning smoking in all healthcare facilities,” he said.