Dr. Himanshu A. Gupte, Vice President Health, Narotam Sekhsaria Foundation
Tobacco use is one of the leading causes of death globally. There were about a hundred million tobacco related deaths in the last century and at current estimates there may be about one billion deaths this century.
India alone reports an estimated 1.3 million tobacco-related deaths annually and the Global Adult Tobacco Survey (2016-17) estimated about 267 million adult tobacco users in India.
With this huge burden of tobacco use and the resultant morbidity and mortality linked to tobacco use, tobacco is considered one of the major obstacles for development.
As part of the 2030 Agenda for Sustainable Development, the United Nations General Assembly adopted the Sustainable Development Goals (SDGs) in 2015in a resolution entitled “Transforming our world: the 2030 Agenda for
They include 17 goals and 169 targets to be achieved with the aim to “end poverty, protect the planet, and ensure prosperity for all as part of a new sustainable development agenda”.
Tobacco use is associated with many of these goals and targets and thus hampers their achievement. The most relevant SDG affected by tobacco is Goal 3 – Ensure healthy lives and promote well-being for all at all ages.
With the multitude of adverse health effects caused by tobacco, the health and well-being of not just the individuals using tobacco products but also theirfamilies and friends is affected.
Tobacco affects the cardiovascular, respiratory, reproductive, excretory, nervous, and other systems of the body and is associated with various health conditions including non-communicable diseases like hypertension, diabetes, and sixteen types of cancers. The health
effects of second-hand smoking on passive smokers are well established.
The WHO Framework Convention on Tobacco Control (WHO FCTC) has set a target of a 30% relative reduction in the prevalence of current tobacco use by 2025.
The FCTC recommends tobacco taxation and appropriate financing and bans on tobacco advertising and promotion. India has implemented the Cigarette and Other Tobacco Products Act (COTPA, 2003) towards this end.
While Goal 3 is the most obviously applicable to tobacco, other goals which are also relevant are
Goal 1: End poverty in all its forms everywhere.
Goal 5: Achieve gender equality and empower all women and girls.
Goal 10: Reduce inequality within and among countries.
Goal 12: Ensure sustainable production and consumption patterns.
Goal 17: Strengthen the means of implementation and revitalize the global
partnership for sustainable development.
Though tobacco visibly affects the health of its consumers, its impact on society at large due to its social and economic effects is often ignored.
Tobacco has contributed to increasing poverty and increasing health disparities, particularly in low- and middle-income countries. Tobacco control reduces the disproportionate burden that tobacco use imposes on the poor.
It is important to note that tobacco use harms these populations disproportionately. While the tobacco use rates are disproportionately higher among males globally, rising trends among women and targeted marketing of tobacco products for women is an area of concern. Women and their unborn children are at a great risk.
These issues hamper the achievement of Goals 1, 5 and 10. Tobacco is the only consumer product known to kill at least 50% of its consumers when used as intended. There are no circumstances under which tobacco production and promotion can be seen as responsible.
Thus, tobacco farming and production, which again is practised mainly in developing countries hinders Goal 12 of the SDGs.
Overall, tobacco control has to be achieved by various means for addressing the above issues.
This needs intensive global engagement in support of implementation of all the Goals and targets, bringing together Governments,
the private sector, civil society, the United Nations system and other actors and mobilizing all available resources. This is precisely the Goal 17 that encourages partnerships at all levels.