PROGGA and The Daily Star recently organised a roundtable on "Tobacco Control Law & Smoke-free Environment". Here we publish a summary of the discussions
Reaz Ahmad, Assignment Editor, The Daily Star
Bangladesh government passed the Tobacco Control Law in 2005. It came into force in 2006. With increasing awareness about the harmful effects of tobacco use and campaign by various organisations the government felt the need to update the Law and it did so in 2013. Finally, on March 12 this year the government has finalized necessary rules of the Law. It clearly delineates effective ways of controlling tobacco use in Bangladesh. Now, we need to enforce the Law to save people from the harmful effects of tobacco.
Tobacco control is a multifaceted issue ranging from production to marketing. But I will request our speakers to focus on various aspects of enforcement of the new rules which impose greater restrictions on tobacco consumption to create a smoking-free environment at public places.
Professor M Mostafa Zaman, NCD Coordinator, WHO, Bangladesh
One of the two most neglected epidemics of public health is tobacco use. It needs not to say more about the harmful effects of tobacco. I will rather focus on the imperatives to implement the Tobacco Control Law effectively.
According to the Law, all medical institutions should be smoke free. Health Ministry has already sent a directive to these institutions in this regard. But we do not see any real impact on the ground. Major reason behind this is the unawareness of the doctors. We need to sensitise our doctors. They can play a key role in controlling tobacco use and making people aware.
According to cigarette affordability index, Bangladesh is among the top countries where the price of cigarettes is the lowest. Though we are in a relatively better position in terms of taxing tobacco, the base price is still very low. For example, imposing 60% tax on Tk.1:00 cigarette will make the price only Tk. 1.60 which is still very much affordable for its consumers. So the price base should be made higher to such an extent that the young people cannot afford tobacco use with their limited financial resources.
One needs license to sell alcohol but not for cigarettes. But the gravity of danger caused by cigarettes is thousand times more than that of alcohol. Obviously, there should be licensing provision for selling cigarettes. It will impose control on easy access to cigarettes.
Bangladesh government has taken a laudable initiative by introducing 1 percent health development tax. This fund should be used to control tobacco usage and reduce related health hazards.
I also need to add that even though cigarette use has decreased in the last year, the use of smokeless tobacco has increased. We need to also focus on reducing the overall use of tobacco in the country.
Professor Dr. Arup Ratan Choudhury, President, Association for the Prevention of Drug Abuse (MANAS)
Tobacco companies are still doing advertisements of their products at various sales points. Under the nose of the Law, they have been promoting cigarette sales. This is a clear violation of the Tobacco Control Law. The government should take immediate action against these tobacco companies.
In TV serials and movies we often see scenes of smoking which is prohibited by the Law. Directors of film and TV serials should be made aware about this gross violation of Tobacco Law.
In public places we see signboards with the message ' no smoking zone' which is not right. It should be written as 'smoking in public places is a punishable offence'. The amount of penalty should also be mentioned in the sign board.
The tobacco control legislation clearly prohibits sales of tobacco products to anyone below 18 years. Employing anyone below 18 years in tobacco sales is also a punishable offence. But the salesmen are not aware about these legal provisions. They also do not have the means to verify a consumer's age. So we can make a provision of showing ID card to buy any tobacco products. Tobacco control task forces should look into the issue more seriously.
To help people quitting tobacco use there should be helpline and counseling programmes in hospitals. We have started such a counseling programme in BIRDEM. Doctors should come forward in introducing this type of counseling. History of tobacco use should be included in a patient's medical history and he or she should be prescribed to quit this bad habit.
Golam Sarwar Chowdhury, Professor at the Department of English, ULAB
Universities should be smoking free zone. Teachers should discourage students about tobacco use. In every department there are student counselors. They should make students aware about the harmful effects of smoking. Smoking habit often turns into drug addiction. Young people often become victims of drugs. So this awareness about smoking should be taken as seriously as anti-drugs campaign. University Grants Commission should issue a directive banning use of tobacco in university campuses.
Dr Md. Habibe Millat, Honourable Member of Parliament, Sirajganj-2
Personally I have always stayed far away from smoking and always tried to become a part of any anti-smoking movement. Even though we have the law we don't see much incidents of actually fining anyone for smoking. If we take the parliament buildings for example, it is clearly mentioned even in the lobby of our parliament that smoking is prohibited in any indoor space with roof or other overhead covering of any kind and walls or side coverings. But still people tend to smoke there which hampers non-smokers like me. I requested our respected speaker to make sure the law is enforced within the parliament first. Another thing is we can't stop smokers smoke overnight. We need to give them a designated smoking zone. In the developed countries it is seen that public places like bus stand also has a smoking zone in the corner. We need to start something similar to that. Being a doctor myself, I can tell you how hard it is to sit or sleep in a government or private hospital in our country because of the smell of cigarettes and also for the ash and cigarette butts lying everywhere. As an MP I believe that it is our responsibility to run anti-smoking movement in our respective areas even if we don't belong to the standing committee of that particular ministry. If each of us could send a letter to the hospitals of our areas stating the law and the punishment I believe it would help decreasing the rate. Last year on World Health Day, in a live talk show I proposed to open a help line for the people who want to quit smoking and provide a separate smoking zone for the smokers in public places. I am reiterating again, and I believe if I along with 40 or 50 other MPs go to health minister with such proposal this might get implemented.
Also we need to impose higher tax on tobacco products in the upcoming budget. One more thing that people like us who get the platform to give speech can do is giving speeches on anti-smoking movement. I have been maintaining contact with WHO in the Geneva head quarter regarding anti-smoking movements and I hope to get technical support from the local offices as well to advance this movement further.
Taifur Rahman, Country Director, Campaign for Tobacco Free Kids (CTFK)
The Bangladesh government was the first signatory of WHO Framework Convention on Tobacco Control and they had later ratified it. According to the convention, it is our responsibility to ensure a smoking-free public place. According to Article 7 of the law, there should be a designated place for smokers. This is being followed by countries all over the world. The Framework Convention on Tobacco Control (FCTC), which we signed, says that there should not be a separate designated place for smoking, because if there is a separate place for smokers amidst non-smokers than the effects of passive smoking cannot be avoided. Secondly, if a concentrated place is allocated for smokers then their health will be further affected.
A designated area for smokers is allocated in Bangladesh, however, if we look carefully at the rules, we'll find that it stipulates that there are certain places where smoking is completely prohibited. Ten places, such as hospitals and educational institutes, have been mentioned as areas where smoking is entirely forbidden. In these places, designated spaces can be reserved only if non-smokers are in no way affected by the smoke. The National Tobacco Control Cell under the health ministry needs to ensure the implementation of the rules and for that we need adequate manpower, funding and resources.
If we talk about funding in Bangladesh, one percent of the national budget is allocated to the health development sector. At least Tk 200 crore is supposed to be coming from there. If we can allocate a portion of that amount for tobacco control by the health ministry, it can help to implement the law.
Fahim H Chowdhury, Artist
I would like to request the members of parliament present here to allow for a small, half-minute long documentary before the airing of the news on television channels. This would be very helpful. We can't ensure a tobacco-free environment through seminars. Most of the people in Bangladesh watch TV and we don't ever miss the news. The law also needs to be strengthened and implemented.
Kazi Rafiqul Alam, President, Dhaka Ahsania Mission
Ahsania Mission has been working against addiction and drug use since 1990. And over the years from experiences in our treatment centres, we've seen that smoking often leads to addiction. Thus, it's imperative to stay away from it.
As cigarettes are affordable, it leads to increased smoking. Taxes on cigarettes could be increased to discourage people from buying them. Tobacco control could also be improved if licenses were issued to tobacco traders.
Rahatul Ashekin, Global Youth Advocate, United Nations
One-third of our population is young people. The habit of smoking usually begins during the teenage years. Thus, we need to create awareness amongst the youth to inform them of the negative consequences of smoking.
We also need to investigate why youngsters smoke. The slogan of last year's International Youth Day was 'mental health matters'. A young individual might try to relieve their psychological tensions by smoking.
A huge network of the young people works in 64 districts under the Department of Youth Development and Department of Social Services. Thus, I believe that these organisations can create a strong groundwork to raise awareness regarding the after effects of tobacco use. We need to also have role models, such as famous personalities, to make youngsters aware of the consequences of smoking.
Md. Shariful Alam, Consultant, Campaign for Tobacco Free Kids (CTFK)
Under the law, there is a provision to penalise owners and authorities of public spaces where smoking is prohibited. Moreover, it's compulsory to display the no-smoking notice on a platform that is visible to all so that employees and patrons are aware that smoking is prohibited in that area under law.
While there's no question about making the public aware about the impacts of smoking on their health, it's important to inform them that there is a law against tobacco use in public spaces. And they, along with the authorities of that space, will be punished accordingly if they are caught smoking in such areas.
I also believe that we shouldn't shift focus from demanding a tobacco-free environment to ensuring designated spaces for smokers. This will detract us from our primary objective.
Nafizur Rahman, Architect
I believe that it's an architect's responsibility to decide the smoker's area in every building or house that they design. We need to grow an awareness regarding this amidst people in the profession of architecture. There is no point in blaming the owners of building spaces as architects are the ones guiding them regarding the design of their building.
Even though I am not a smoker, I believe that there should be separate smoking zones as I wouldn't want someone to smoke beside me. Also, it's important to install proper signage in those areas to warn smokers of the ill-effects of smoking. Audio-visual systems could also be installed in the smoking zones of public spaces to create awareness.
Chitta Francis Rebeiro, Journalist
We could request the religious leaders of our country, be it imams, reverends or priests, to include the ill-effects of smoking in their sermons. Thus, a wider segment of the population could be made aware about how destructive smoking is through their respective religious institutions.
Shahed Imran, Doctor, Rashmi – An Association for Cancer Prevention and Awareness
I believe that we need to ensure that such significant discussions reach the concerned authorities in the government who can implement these suggestions.
It would be extremely difficult to persuade a 50-year old chain smoker to quit smoking. However, we could ensure that school children are convinced of the dangers of smoking. Teachers and parents play a major role in this regard. I believe that everys parent needs to be aware of whether their children are smoking or not.
Md. Nobi Newaz, Honourable Member of Parliament, Jhenaidah-3
We need to identify the vulnerable age where people actually pick up the habit of smoking. We could request the Education Ministry to ask schools to announce the adverse effects of smoking in classrooms so that the youth is discouraged from smoking cigarettes. If a documentary or picture showing explicitly the dangerous impacts of smoking then they could be discouraged. I believe that if we need to be developed, we need to educate our youngsters against such evils.
If we can request mobile companies to raise awareness by issuing advertisements against the use of tobacco, it could reach a wider range of people. Like others, I too believe that an increased tax on cigarettes can also influence people to give up smoking. As members of parliament, every one of us present here will raise this issue in the parliament and use every possible measure to ensure a tobacco-free environment.
Abul Kalam Md. Ahasanul Hoque Chowdhury, Honourable Member of Parliament, Rangpur-2
We could seek the help of owners of commercial buildings such as restaurants and hotels by giving them the authority to fine persons who smoke in non-smoking zones. They could issue a revenue stamp of Tk. 300, for example, with a receipt to those breaking the anti-smoking law in public spaces. However, it would not be easy to seek the help of law enforcement agencies to implement this fine on smokers. Instead, the law will be exploited.
Many people, particularly those living in villages are not even aware about a specific law whereby smokers who smoke in non-smoking zones can be fine. It is imperative that they are made aware of this law.
I also believe that the designated space for smoking in every building should be one that is unkempt and unattractive so smokers would be discouraged to spend long time there. We should be able to instill a sense of shame and embarrassment in smokers so as to dissuade them from smoking in public spaces.
We should also focus on marijuana which does not need to be cultivated. It is used extensively by people living in rural villages and thus we also need to raise awareness regarding its use.
Fazilatun Nasa Bappy, MP, Reserved seat for woman in Parliament, Seat No-30
Rural women generally use various smokeless tobacco products like sada pata, khoini, gul that cause serious health hazards, particularly on their reproductive health. Women are also exposed to indirect smoking which is equally harmful as direct smoking.
Tobacco is cultivated in a large area of Bangladesh. Tobacco cultivation seriously affects the quality of the soil. It also requires huge amount of TSP and Urea fertilizers. Besides controlling tobacco cultivation we also need to restrict use of these fertilizers. During the rainy season, rain water washes out these harmful chemicals into nearby water sources and cause serious damage to the biodiversity. We need to address this issue by strictly applying the Tobacco Control Law.
Another important issue is controlling tobacco use in public places. It is strictly prohibited by the Tobacco Control Law. In the Law, there is a clear definition of what constitutes a public place and a public transport. Restaurants and indoor workplaces have also been included among these public places. Now we need to enforce the Law to keep our public places smoke-free. We urgently need a help line so that people can seek help to control tobacco use in unauthorized places.
Parliament members can play a big role in controlling tobacco. They often attend various public meetings. In these public gatherings if they talk about harmful effects of tobacco use people will be aware about it. We, parliamentarians, can start from our own working place and make a promise to keep the canteen of National Parliament tobacco free.
MPs can also work for arranging adequate fund for Tobacco Control Cell. In the upcoming budget we should highlight this funding issue. In every district there is a task force to control tobacco use. MPs can monitor whether these task forces are working properly or not.
We need to resist the aggression of tobacco companies. They get involved in various social programmes under the disguise of corporate social responsibility and advertise their products. We also need a campaign to make our MPs aware so that they do not favour tobacco companies.