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KOHIMA— According to a World Health Organisation (WHO) report, the tobacco epidemic is one of the biggest public health threats the world has ever faced, killing over eight million people each year while tobacco control remains a global health priority.
In light of this, the recently published WHO report on the global tobacco epidemic (2023) stated that in 2022, at least one MPOWER measure at the highest level of achievement covered more than 5.6 billion people, or more than 70% of the world's population.
Death, illness and impoverishment
Out of the over 8 million deaths, more than seven million are the result of direct tobacco use, while around 1.3 million are the result of non-smokers being exposed to second-hand smoke.
The report pointed out that all forms of tobacco use are harmful, there is no safe level of exposure to tobacco, and cigarette smoking is the most common form of tobacco use worldwide. Other tobacco products include waterpipe tobacco, cigars, cigarillos, heated tobacco, roll-your-own tobacco, pipe tobacco, bidis, kreteks, and smokeless tobacco products.
Another WHO global report on trends in the prevalence of tobacco use 2000–2025 (fourth edition) showed that around 80% of the 1.3 billion tobacco users worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest.
It added that tobacco use contributes to poverty by diverting household spending from basic needs such as food and shelter to tobacco. This spending behaviour is difficult to curb because tobacco is so addictive.
The economic costs of tobacco use are substantial and include significant health care costs for treating the diseases caused by tobacco use as well as the lost human capital that results from tobacco-attributable morbidity and mortality.
Measures
Accordingly, the WHO recommended key measures to reduce the demands, including surveillance and good monitoring of tobacco use to strengthen policies.
Pointing out that there is no safe level of exposure to second-hand smoke, which kills over one million people every year and causes heart disease, cancer, and many other diseases, it added that even brief exposure can cause serious damage. It also cited Article 8 of the WHO FCTC to create completely smoke-free indoor public places.
[bsa_pro_ad_space id=1]Asserting that tobacco users need help to quit, the report stated that counselling and medication can more than double a tobacco user’s chance of successfully quitting.
Another measure includes hard-hitting anti-tobacco mass media campaigns and pictorial health warnings that prevent children and other vulnerable groups from taking up tobacco use and increase the number of tobacco users who quit. Besides bans on tobacco advertising, it also recommended increasing taxes on tobacco products, and stopping the illicit trade of tobacco products.
Addictive ENDS, not without harm
The report also noted that heated tobacco products (HTPs) that produce aerosols containing nicotine and toxic chemicals upon heating of the tobacco or activation of a device containing the tobacco with the highly addictive substance nicotine and non-tobacco additives are often flavoured.
It stated that despite claims of ‘risk reduction’, there is no evidence to demonstrate that HTPs are less harmful than conventional tobacco products.
While many toxicants found in tobacco smoke are at significantly lower levels in HTP aerosol, HTP aerosol contains other toxicants found sometimes at higher levels than in tobacco smoke, such as glycidol, pyridine, dimethyl trisulfide, acetoin, and methylglyoxal.
It added that some toxicants found in HTP aerosols are not found in conventional cigarette smoke and may have associated health effects. Also, these products are highly variable, and some of the toxicants found in the emissions of these products are carcinogens.
E-cigarettes are the most prevalent form of electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery systems (ENNDS), but there are others, including e-cigars and e-pipes, which contain varying amounts of nicotine and emit harmful emissions.
Recent research indicates that the use of ENDS may increase the risk of heart disease and lung disorders. Exposure to nicotine during pregnancy can have negative health effects on the foetus, and nicotine, a highly addictive substance, is detrimental to brain development.
MPOWER way out
There is a fundamental and irreconcilable conflict between the interests of the tobacco industry and those of public health policy because the former produces and promotes a product that has been scientifically proven to be addictive, to cause disease and death, and to cause a variety of social ills, including increased poverty.
WHO claimed that the FCTC is a milestone in the promotion of public health as it is an evidence-based treaty that reaffirms the right of people to the highest standard of health, provides legal dimensions for international health cooperation, and sets high standards for compliance.
Since its entry into force in 2005, the FCTC has had 182 parties covering more than 90% of the world’s population, and in 2007, WHO introduced a practical, cost-effective initiative to scale up the implementation of the demand reduction provisions called MPOWER.
MPOWER is the WHO Framework Convention on Tobacco Control (WHO FCTC) and has been in place for 15 years. It stands for Monitor tobacco use and prevention policies, Protect people from tobacco smoke, Offer help to quit tobacco use, Warn about the dangers of tobacco, Enforce bans on tobacco advertising, promotion, and sponsorship, and Raise taxes on tobacco.