Last Updated on 23 May 2023, 12:50 PM IST | According to the World Health Organization, the Covid-19 (CoronaVirus) pandemic has made millions of tobacco users want to quit smoking. With nearly 60% of tobacco users around the world wanting to quit smoking but only 30% of the global population having access to quality tobacco cessation services, WHO (World Health Organization) launched a global campaign under the slogan “Commit to Quit” to celebrate the World No Tobacco Day 2023. Aiming to help 100 million people quit tobacco use through various initiatives and digital tools, WHO (World Health Organization) campaign can help create healthier conditions that promote tobacco cessation.
WORLD NO TOBACCO DAY DATE
Celebrated around the world every year on May 31, World No Tobacco Day was created by the Member States of WHO in 1987 to draw global attention to the tobacco epidemic and the preventable death and disease it causes.
WORLD NO TOBACCO DAY HISTORY AND IMPORTANCE
In 1987, the WHA (World Health Assembly) passed Resolution 40.38, calling for April 7, 1988, to be “a world no-smoking day.” In 1988, Resolution WHA (World Health Assembly) 42.19 was passed, calling for the celebration of World No Tobacco Day, every year on May 31.
HOW TOBACCO GROWING ALL OUR THE WORLD?
All tobacco products start with a simple leaf. The cultivation of tobacco leaf, indigenous to the Americas, dates back at least eight millennia, and tobacco smoking for at least two. In the 15th century, Columbus helped shape the future of the tobacco industry as the first “importer” of tobacco into Europe. Within decades, tobacco had spread globally, including cultivation for commercial purposes.
Mechanization of cigarette manufacturing in the 1880s helped grow the market for cigarettes dramatically, increasing demand for tobacco leaf. While widespread cultivation of tobacco leaf has generated many challenges including health hazards for farmers, environmental degradation and child labor issues the most pressing systemic public health challenge is how the industry often uses tobacco farming to undermine tobacco control, arguing that tobacco control destroys the livelihoods of smallholder tobacco farmers. This specious argument often perpetuated by governments’ economic and/ or agri-business sectors has resonated widely, undermining tobacco control efforts around the globe. Not coincidentally, tobacco farming has also shifted to some of the world’s lowest-HDI countries, where governments are typically more economically and politically vulnerable. Recent research across major tobacco-growing countries demonstrates that farming tobacco is not prosperous for most smallholder farmers.
- Many farmers including many with contracts with oligopolistic leaf-buying companies pay too much for inputs (e.g., fertilizer, pesticides, etc.), receive very low prices for their leaf, and dedicate hundreds of hours to a mostly unprofitable economic pursuit.
- The opportunity costs of farming tobacco are high, with farmers missing out on human capital development and more lucrative economic opportunities. So why do tobacco farmers grow tobacco? Many farmers report an assured market, even if prices are consistently low. Others report difficulty obtaining credit for other economic activities. For some, it is a way to generate cash in low-cash economies to pay for necessities like education and health care. Yet, the research demonstrates consistently that many tobacco farmers underestimate their costs and overestimate their returns.
- Article 17 of the WHO FCTC compels Parties to promote viable alternative livelihoods for tobacco farmers. Few governments have made such efforts. There is no panacea for this transition; some countries have tried small programs to introduce new crops e.g., bamboo in Kenya (with mixed results). Some farmers switch to and from tobacco, based on hopes for high leaf prices.
- The most successful larger-scale examples of change rely more on existing skills and experience. In Indonesia, former tobacco farmers are growing non-tobacco crops that they have always grown, and are making more money doing so.
MANUFACTURING OF TOBACCO ALL OVER THE WORLD
Once raw tobacco leaf has been grown by a farmer and sold to a manufacturer, it must be processed into a desirable consumer product. To maximize profits, tobacco manufacturers want to make products that are as attractive and addictive as possible. The product standards governing this process of transformation aim to control tobacco products’ characteristics and which kinds of tobacco products can be sold to consumers. When these standards are written with public health in mind, tobacco products can be mandated to be less attractive and less addictive to users. Such strategies include bans on characterizing flavors, limits on nicotine content, and prohibitions against additives that quicken nicotine’s absorption into the body.
Additional policies include freezing the tobacco market by preventing the introduction of new brands, restricting a brand to a single presentation to prevent implicit suggestions of reduced harm in variants, and requiring the disclosure of ingredients to regulatory agencies and consumers. Banning the addition of menthol, the most widely used flavor in tobacco products, has considerable potential to curb smoking. Research suggests that menthol in cigarettes may facilitate initiation and hinder quitting. Fortunately, laws banning the sale of menthol in tobacco products have passed in Brazil, Turkey, Ethiopia, the European Union, and five Canadian provinces.
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While manufacturing standards that limit the appeal and addictiveness of products hold the promise of shrinking the tobacco market in the long run, there can be unintended consequences if such regulations do not carefully consider the broader tobacco product marketplace. For example, the market position of existing varieties of cigarettes became solidified when they were exempted from pre-market scrutiny under the United States’ law extending the Food and Drug Administration’s jurisdiction to cover tobacco products. Cigarette manufacturers were permitted to keep selling a deadly consumer product with only some restrictions, while barriers to the introduction of new potentially less harmful products were codified. Meanwhile, the global tobacco industry has recently consolidated through privatization, acquisitions and mergers now only 5 firms control 80% of the global cigarette market. These firms have automated and consolidated their own factories, steadily driving down the number of employees. Hence, now more than ever, when tobacco companies say that tobacco control policies threaten manufacturing jobs, we must remember that they are only in the business of maximizing their profits for shareholders, not protecting the well-being of their workers.
MARKETING STRATEGY OF TOBACCO ALL OVER THE WORLD
- Once a product rolls off the manufacturing line, it needs help to get to consumers. Tobacco companies must build the demand for products, particularly from new consumers. Marketing creates consumer demand, essentially inventing the reasons why a person would want to smoke a cigarette or use other tobacco products. Controlling the ability of the tobacco industry to spread favorable ideas about tobacco use is the essence of tobacco control efforts to regulate marketing. Closing off marketing channels to everyone has the primary benefit of shielding children from persuasive efforts that influence them to start smoking. While the tobacco industry always claims that their advertisements are not intended to appeal to children, they walk a fine line by aiming their marketing efforts to young adults, a group who children see as their closest peers and role models. Sometimes, such as by marketing tobacco like candy, tobacco companies cross this line.
- The tobacco industry has found creative ways to market its products, including through attractive packaging and so-called “corporate social responsibility” campaigns wherein they seek to present themselves as positive contributors to society. Regulating these myriad marketing strategies is a central tobacco control strategy. Essentially, wherever the tobacco industry tries to change the message about what their products represent away from disease and death, tobacco control attempts to change the conversation firmly back to the essential facts of tobacco use: disease and death.
- Tobacco companies typically respond to marketing restrictions by reallocating resources to the remaining open channels. For example, when the government prohibits magazine and billboard advertising, the industry simply moves to other strategies, such as direct mail, internet, point of sale, package branding and discounting. When regulation successfully eliminates all channels, the tobacco market will freeze up and dwindle over time. But we know that until every single channel for marketing is closed off, tobacco companies will try to spend their way around the problem because there is money to be made doing so. Thus, tobacco control must work relentlessly toward closing off every avenue available to tobacco companies to promote their destructive products. Such innovative anti-marketing efforts include requiring plain, standardized packaging of their products, and eventually plain, standardized products.
PERCENTAGE OF ADULTS MALES AND FEMALES WHO SMOKE DAILY ALL OVER THE WORLD?
Globally, 942 million men and 175 million women ages 15 or older are current smokers. Nearly three quarters of male daily smokers live in countries with a medium or high human development index (HDI), whereas half of female daily smokers live in very high-HDI countries. Male smoking prevalence in most medium to very high-HDI countries substantially increased in the past century, though this generally happened earlier in very high-HDI countries (the first half vs. second half of the 20th century). Almost all very high-HDI countries saw a significant decrease in male smoking after the 1950s. Many medium- or high-HDI countries have also seen a decline in prevalence, but mostly a relatively moderate one from the beginning of this century.
Smoking prevalence has been historically modest in most low-HDI countries, though this still translates into tens of millions of smokers. Female smoking prevalence in very high-HDI countries peaked a few decades later than the peak in male smoking, but it has remained relatively low or had a moderate increase thus far in other countries. However, the earlier decreasing trend in smoking prevalence in most very high-HDI countries has stalled in recent years, and smoking prevalence has continued to rise or remained at high levels in many medium- or high-HDI countries. Further, some low-HDI countries (e.g., in sub-Saharan Africa) have seen a recent increase in prevalence.
This trend is likely to occur in many other low-HDI countries in the future because of income growth and increasing cigarette affordability, as well as the tobacco industry’s strategy of aggressive marketing in those countries, unless governments implement stronger tobacco control policies, including raising taxes to increase prices of tobacco products. Another major concern is a recent increase in smoking prevalence among youth, particularly among females, in several low- to high-HDI countries, in some of which smoking among adolescent girls is now more common than among adult women or even adolescent boys.
Nearly two thirds of countries, including 98% of low-HDI countries and 93% of countries in sub-Saharan Africa, have not implemented tobacco use monitoring at best-practice level . Effective monitoring at the national level must be a priority for governments, as this is essential for estimating the tobacco-related burden and evaluating the success of tobacco control policies. Although tobacco use remains a major health issue worldwide, the declines in prevalence in countries with active tobacco control efforts demonstrate that we can reduce smoking with effective strategies.
HEALTH EFFECTS OF TOBACCAO
Tobacco use is one of the most important preventable causes of premature death in the world. More than 6 million people per year die from tobacco use across the globe. There is no question that limiting tobacco use is one of the most effective ways to save lives and improve overall well-being. Smoking tobacco causes exposure to a lethal mixture of more than 7000 toxic chemicals, including at least 70 known carcinogens that can damage nearly every organ system in the human body. Harms from tobacco begin before birth, as pregnant women who smoke give birth to infants at higher risk of congenital disorders, cancer, lung diseases, and sudden death. Newly identified risks from smoking include renal failure, intestinal ischemia, and hypertensive heart disease. The risk of death and disease from tobacco rises with the number of cigarettes smoked, but damage begins with use of a very small number of cigarettes.
A regular life-long smoker loses at least 10–11 years of life to tobacco on average. In addition, exposure to secondhand or environmental tobacco smoke is associated with increased risk of cancer and heart disease, among other deleterious health effects. Lung cancer is now the leading cause of cancer death in the world. It has long been the leading cause of cancer death among men, and in many countries is now also the leading cause of cancer death among women, outpacing breast cancer.
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the world, and mortality from this condition is increasing in most countries; globally, 45% of all deaths from COPD are attributed to tobacco use. Similarly, death from heart disease and stroke, the two leading causes of death in the world, are heavily tied to tobacco use. Combustible tobacco use is extremely hazardous to human health and is responsible for more than 90% of tobacco-attributable death and disease, despite efforts by the tobacco industry to market safer-sounding alternatives such as low-tar cigarettes and water pipes. Therefore, a top priority is to avoid combustible tobacco products, and the only way for an individual to completely eliminate tobacco.
TOBACCO HEALTH EFFECTS IN OUR HUMAN BODY
1. EYES – Cataracts, blindness (macular degeneration) – Stinging, excessive tearing and blinking
2. BRAIN AND PSYCHE – Stroke (cerebrovascular accident) – Addiction/withdrawal – Altered brain chemistry – Anxiety about tobacco’s health effects
3. HAIR – Odor and discoloration
4. NOSE – Cancer of nasal cavities and paranasal sinuses – Chronic rhinosinusitis – Impaired sense of smell
5. TEETH – Periodontal disease (gum disease, gingivitis, periodontitis) – Loose teeth, tooth loss – Root-surface caries, plaque – Discoloration and staining
6. MOUTH AND THROAT – Cancers of lips, mouth, throat, larynx and pharynx – Sore throat – Impaired sense of taste – Bad breath
7. EARS – Hearing loss – Ear infection
8. LUNGS – Lung, bronchus and tracheal cancer – Chronic obstructive pulmonary disease (COPD) and emphysema – Chronic bronchitis – Respiratory infection (influenza, pneumonia, tuberculosis) – Shortness of breath, asthma – Chronic cough, excessive sputum production
9. HEART – Coronary thrombosis (heart attack) – Atherosclerosis (damage and occlusion of coronary vasculature)
10. CHEST & ABDOMEN – Esophageal cancer – Gastric, colon and pancreatic cancer – Abdominal aortic aneurysm – Peptic ulcer (esophagus, stomach, upper portion of small intestine) – Possible increased risk of breast cancer
11. LIVER – Liver cancer
12. MALE REPRODUCTION – Infertility (sperm deformity, loss of motility, reduced number) – Impotence – Prostate cancer deat
13. FEMALE REPRODUCTION – Cervical and ovarian cancer – Premature ovarian failure, early menopause – Reduced fertility – Painful menstruation
14. URINARY SYSTEM – Bladder, kidney, and ureter cancer
15. HANDS – Peripheral vascular disease, poor circulation (cold fingers)
16. SKIN – Psoriasis – Loss of skin tone, wrinkling, premature aging
17. SKELETAL SYSTEM – Osteoporosis – Hip fracture – Susceptibility to back problems – Bone marrow cancer – Rheumatoid arthritis
18. WOUNDS AND SURGERY – Impaired wound healing – Poor post-surgical recovery – Burns from cigarettes and from fires caused by cigarettes
19. LEGS AND FEET – Peripheral vascular disease, cold feet, leg pain and gangrene – Deep vein thrombosis
20. CIRCULATORY SYSTEM – Buerger’s disease (inflammation of arteries, veins and nerves in the legs) – Acute myeloid leukemia
DEATHS RATES OF ALL OVER THE WORLD
Tobacco use increases the risk of death from many diseases, including ischemic heart disease, cancer, stroke, and respiratory diseases. In 2016 alone, tobacco use caused over 7.1 million deaths worldwide (5.1 million in men, 2.0 million in women). Most of these deaths (6.3 million) were attributable to cigarette smoking, followed by secondhand smoke (884,000 deaths). There is a several-decade lag between changes in smoking prevalence and changes in smoking-related death rates in the population.
In general, countries with a very high human development index (HDI) have seen a decline in smoking prevalence at least since the 1960s, followed by a decrease in smoking-related death rates since the 1980s–90s. Nevertheless, the burden of smoking-related diseases, notably lung cancer, is still substantial in those countries. Smoking-related death rates are expected to increase for the decades to come in many countries with a lower HDI, as they saw an increase in smoking prevalence more recently (the 1980s–90s or even later); in some, the prevalence is still increasing. In about 55 countries, at least one-fifth of all deaths in males are attributable to smoking.
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These countries generally are high- or very high-HDI countries, mostly located in Europe (33 countries) or the Western Pacific region (11 countries), although there are two or more such countries in the other World Health Organization regions, except the African region. The lower tobacco-related burden in Sub-Saharan Africa reflects its historical lower smoking prevalence. However, with an increase in affordability of tobacco products and the tobacco industry’s aggressive marketing in Africa, smoking prevalence has already started to rise, or is likely to substantially increase in the future. With its rapidly-growing populations and rising life expectancy, an increase in the number of smokers along with population aging is likely to make Africa suffer the most from future smoking-related burden.
Consistent with lower female smoking prevalence in many countries, the tobacco-related burden in women is lower than in men globally. However, with recent increases in smoking prevalence among female adolescents in some countries, this pattern may not continue. In addition to very high-HDI countries, with current trends, most other countries are or will soon be facing substantial smoking-related burden, while many already have limited health resources. Even in very high-HDI countries, smoking prevalence and the related burden are now far higher among lower-income groups, which are more likely to have limited access to care. This dynamic further underscores the need for effective tobacco control to improve health and reduce disparities at the population level in all countries.
SOCIETAL HARMS OF TOBACCO ALL OVER THE WORLD
- Tobacco-related harms reach far beyond the death and disease caused by tobacco consumption. Put simply, tobacco harms the world’s sustainable development. The economic cost of smoking globally amounts to nearly 2 trillion dollars (in 2016 purchasing power parity) each year, equivalent to almost 2% of the world’s total economic output. The majority of the total economic cost of smoking is the lost productivity of those sickened or killed by tobacco.
- Another 30% of these costs are the healthcare-related expenses of treating smoking-attributable diseases. Notably, this price tag does not include other substantial costs, such as the costs caused by second-hand smoke, non-combustible tobacco products, the environmental and health damages from tobacco farming, smoking-related fire hazards, cigarette butt littering, and, foremost, the immeasurable pain and suffering of tobacco victims and their families. The cost of tobacco use is rising rapidly, following the increase in the number of tobacco users in low-, medium-, and high-HDI countries. Given the limited resources in most countries, these costs represent a lost opportunity to instead spend these resources on advancing the economy through education, healthcare, technology, and manufacturing.
- Because most health effects of smoking lag smoking initiation by more than a decade, the societal harm of smoking will still inevitably increase in countries where tobacco consumption has risen, and even in those where it has only recently started to fall . Most tobacco users become addicted as youth without knowing the health consequences that tobacco use will eventually inflict upon them in the future, causing a level of economic hardship that they would undoubtedly not have chosen for their families or themselves.
- Regardless of a country’s stage of economic development, the burden of tobacco falls disproportionately on the poor, and is a source of both health and economic disparities. The poor spend a larger share of their income on tobacco products, crowding out spending on necessities such as food, education, health and shelter. Additionally, tobacco-related illnesses contribute to catastrophic health expenditures that compete with basic needs in poor households. When a family breadwinner gets sick or dies prematurely due to tobacco use, the entire family is devastated and further impoverished.
- This cycle of tobacco use and poverty is vicious and will perpetuate through generations without intensified tobacco control efforts; thus, there is a particular need for efforts directed toward the poor. The following chapters of the Atlas will focus on proven tobacco control strategies. The development and implementation of these strategies are fundamental investments in human capital that promotes human development.
IS SMOKE-FREE WORLD?
Creating smoke-free environments is a vital tobacco control intervention and serves important purposes. First and foremost, these laws protect non-smokers from the harmful effects of secondhand and even third hand smoke . Secondhand smoke has been associated with most of the same harmful health effects as direct smoking. Conversely, one study of bartenders documented prompt improvements in lung function after indoor smoking bans were enacted. Second, limiting smoking in public places helps to create the sense that smoking is socially unacceptable behavior, and reinforces the idea of non-smoking as a societal norm.
Smokers who cannot smoke in public are also more likely to try to quit. At present, despite some progress, most of the world’s population is currently left unprotected by strong smoke-free laws and regulations. National-level bans exist in some countries, such as Turkey, which passed a ban in 2008 prohibiting tobacco use in all indoor spaces including bars, cafés and restaurants, sports stadia, and the gardens of mosques and hospitals. Sometimes, laws that are in place have been enacted locally. In New York City, for example, smoking is not allowed in bars, restaurants, clubs, public parks, city beaches, or even apartments in public housing projects.
Although approximately 1.5 billion people around the world are now protected to some extent by smoking bans in public places, more than 80% of the world’s population is still vulnerable to secondhand smoke. In many countries and cities, smoking in many public places (e.g., airports) is only allowed in specially designated smoking rooms. Such partial bans are often ineffective. Ventilation for such smoking rooms does not remove all the smoke, so leakage occurs around doors and windows. Additionally, smoking is still preserved as a social norm, removing a major motivating factor for smokers to quit. Governments must be comprehensive and forceful in their smoke-free policies. For example, some jurisdictions have begun to include water pipes in their ban, or have at least implemented partial bans (e.g., the United Arab Emirates). E-cigarette public bans (including New York City) not without controversy have also become more common around the globe.
WORLD NO TOBACCO DAY 2023 QUOTES
- “Smoking is eating our body from inside; don’t be used to of it.”
- “Smoking eats our body slowly which we don’t feel for long time!”
- “Don’t smoke! There are many activities you can enjoy in life”.
- “Keep the key of life in your hands, don’t give it to tobacco”.
- “Your life is in your hands, but smoker’s life in tobacco hand”.
- “Tobacco is killing us, don’t let it kill you!”
- “Eliminate tobacco from your life before it kills you!”
- “We need to burn calories daily, not tobacco!”
- “We are burning cigarettes; it is what we are doing!”
- “Smoking makes our life shorter and diseased.”
- “Stop smoking! If you really want to live a long and healthy life.”
- “Burn calories not your body through smoking.”
- “Eliminate smoking from your life, not yourself from life.”
- “Smoking is a definite killer, why you don’t understand!”
- “Don’t regret yourself, regret your bad habits and eliminate smoking.”
- “Replace your cigarettes with a glass of juice daily.”
- “Eliminate smoking to bring smile to many faces in your life.”
- “Eliminate smoking and be a real hero for your family.”
- “Quit smoking today to get happiness tomorrow!”
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