Amendment of law on tobacco use long overdue

Published : Monday, 04 February 2013

The Daily Financial Express: The World Cancer Day (February 04) occasions soul-searching among all Bangladeshis about the dreaded disease prevailing in the country and its prevention at a time when there is no cure. Cancer is a major cause of deaths in Bangladesh. According to International Agency for Research on Cancer (IARC), 141,100 new cancer cases were found in Bangladesh and among them, 60,000 were males and 81,100 females (the figure was computed for the year 2008). It means, every year about 140 to 150 thousand cancer cases are added in Bangladesh. The cancer death toll is 103,300. Among them, 48,800 are males and 54,400 females. 

Five most common cancers among males are found in lung, lip and oral cavity, oesophagus, pharynx and stomach. Five most common cancers among females are detected in breast, cervix uteri, lip and oral cavity, lung and oesophagus. These top five types of cancers cause 50 per cent of cancer-related deaths. Most of cancers are not identified and about 34 per cent deaths from cancers are not detected. 

World leaders gathered at a special UN high-level meeting in September 2011 and adopted the first-ever political declaration that elevates cancer and other NCDs on the global health and development agenda. It includes key commitments to address these diseases.

The declaration calls for enforcing the Framework Convention on Tobacco Control (FCTC) and increasing access to cancer vaccines and screening. The declaration also commits governments to increase access to affordable, safe, effective, and quality-assured medicines, and to improve access to palliative and rehabilitative services. 

Tobacco uses (chewing tobacco or smoking) are most common causes for cancer. Passive smoking is also a risk-factor for various kinds of cancers particularly lung cancer. Public health experts claimed and also various researches revealed that more than 30 per cent cancers occurred due to smoking and tobacco use. 

Because of grave threat to public health, development and economy, the world has now forged unity to reduce tobacco consumption. That is why a global treaty styled Framework Convention on Tobacco Control (FCTC) has been signed. FCTC holds promise for public health around the world as it is the first global treaty focused on public health and its ultimate goal is to reduce deaths.

Bangladesh was one of the first signatories to the FCTC in 2003 and ratified it in 2004. After the ratification, Bangladesh needed a national law. The country got the law in 2005, named 'Smoking and Tobacco Products Uses (Control) Act 2005'. But the problem arose when the law was put to implementation. Many weaknesses were identified. To overcome those weaknesses, an organisation called Work for a Better Bangladesh (WBB) Trust started its campaign for amendment of the FCTC law highlighting its weaknesses since 2006. WBB Trust organised a national campaign throughout the country in collaboration with Bangladesh Tamak Birodhi Jote (Bangladesh Anti-Tobacco Alliance called BATA in abbreviation) and its associate organisations. WBB and BATA also organised national divisional and national workshops on this issue in 2007 and 2008. From 2009, gradually many other organisations joined this campaign. 

The Ministry of Health and Family Welfare developed a draft amended law through a long process with the involvement of different government and non-governmental agencies. Already the draft has been approved by the cabinet and it is hoped that the law is going to enacted in the parliament. 

The draft amended law prohibits smoking in public places and public transports, but it does not include restaurants, factories/industries (like garments), individually-owned offices, business offices etc. As a result, women and children are exposed to passive smoking in many public places. Besides, there is no responsibility with the authorities in charge of public places or transport owners/managers/caretakers to ensure their places/transports smoke-free. The law prescribes a fine of Tk 50 on a smoker to be charged in prohibited places, but the fine is only collected by mobile courts in presence of executive magistrate. It is thus meaningless to ensure implementation of the penal provision. The law does not include chewing of tobacco (Sada Pata, Jorda, Gul etc) which is most common in rural areas and it is vastly used by the Bangladeshi women. Recently, a global study shows that chewing tobacco consumption is the highest in the world among Bangladeshi women. 

A WBB study says that smoking and tobacco consumption rate is higher among illiterate people, compared to literate persons. So, there is a dire need to launch strong advocacy campaigns in order that mass awareness is created about the evils of smoking. That is why pictorial warning in tobacco packs is needed on both sides, as suggested by FCTC guidelines. 

As the government is about to amend the law, the tobacco companies are running aggressive propaganda and as a result, as alleged by the anti-tobacco campaigners, the amendment of the law is being delayed. This means, we are ignoring public health and encouraging people to die. Hopefully, the parliament will do the needful so far as the amendment is concerned.