World tobacco outlook and Sri Lankan experience

BY Ferni Wickramasinghe

Last week, the World Health Organisation (WHO) made a good report card on the global campaign against tobacco pointing out that many countries have achieved considerable progress in this endeavour. It reports that following the adoption of the Framework Convention on Tobacco Control (FCTC), the smoking rates in 126 countries have dropped from 24.7 percent in 2005 to 22.2 percent in 2015. 

The report estimates that close to 4.7 billion people around the world – 63 percent of the total population – is covered by at least one tobacco control measure due to government intervention and the FCTC, which is laudable. 

The FCTC contains provisions on demand reduction, price and tax measures, protection from exposure, product packaging, restrictions on tobacco advertising, sponsorship and reducing dependence. Sri Lanka was one of the first signatories to the FCTC. A protocol has also been discussed to combat smuggling to eliminate illicit trade in tobacco, which is anticipated to come into effect next year. 

As per the WHO report, over the last two years, 34 countries have adopted large graphic pack warnings, including Bangladesh and India, plus, 23 countries in the European Union (EU) that adopted the warning label directive. Seven mainly low-and-middle-income countries (Afghanistan, Kuwait, Nigeria, Qatar, Republic of Moldova, Senegal and Uganda) introduced a comprehensive ban on all tobacco advertising, promotion and sponsorship including at the point-of-sale.

It adds that Sri Lanka has a high compliance of smoke-free policies and record adult daily smoking prevalence at 10 percent parallel to India, whilst Indonesia recorded 34 percent. Smoking prevalence was amongst 20 percent of males in Sri Lanka and 0.2 percent of females.

Sri Lanka must stand proud of its achievements in the arena of tobacco control. The country was one of the first to ratify the FCTC and made early progress with a ban on public place smoking, graphic health warnings, ban on sales to persons under 21 and a ban on sponsorship, supported by a voluntary industry effort prior. A 43 percent increase in price of cigarette sticks in October last year rendered Sri Lankan fags the second most expensive in the Asian Pacific region. 

There is much that we have done and much we have achieved, however, there is a need to strengthen and extend these initiatives to achieve tangible results on the ground. This was demonstrated during our ongoing economic and social research on the impacts of women and their livelihoods islandwide as the incidence of beedi have grown twofold in many districts.

 
For instance, in the Kegalle District in a village of 347 families, 200 were engaged in producing beedi with close to 1,000 sticks a day. That’s the equivalent of 4,400,000 million sticks in a normal work week, with each family earning Rs.650 per 1,000 sticks made. This was the update from Kegalle, whilst similar incidents were also reported from the Gampaha, Anuradhapura, Kandy and Badulla Districts. 

Heroin is far easier to source in areas like Hikkaduwa than a standard cigarette

A close look at the Customs and government revenue data would indicate that these production figures and consumption goes unaccounted. In our conservative estimates, that is over 300 million sticks that contribute no revenue to the government and pose serious challenges to the health and safety of consumers and support criminal elements that promote its trade. These activities continue without any deter. 

This is a familiar situation that the governments in developing countries and development agencies must better consider and counter. This is not a situation exclusive to tobacco control, reporting measurement, this is a situation which is commonplace for many projects and programmes in developing countries especially the Indian subcontinent, where we tend to tap the tip of the iceberg, ignoring the broader issues that lie beneath, which are far more difficult to tackle. 

This is the sad state with respect to tobacco, alcohol, microfinancing, women’s health, development aid and many more – clouded by politics, bureaucracy, inefficient state and development machinery and lack of reporting. 

The latest WHO report lays emphasis on monitoring tobacco use and control policies and recognizes tobacco as the number one for preventable death in the world claiming seven million lives annually and stresses the need to act more quickly and forcefully to win this fight. 

But, I believe it is essential for the WHO and governments all over the world to ensure that actions and impacts are real and reach those segments that matter, as opposed to making mere good reading, reports and self-applaud. The tobacco industry may not be the biggest obstacle to greater progress; it could be the government and agencies themselves due to inaction. 

Tobacco regulation will continue to become more global and expand its reach. However, we need to be careful in ensuring that legislature is reflective and relevant to individual markets and regions. One size does not fit all. Sri Lanka was reportedly considering further extensions to its existing ban on public space smoking to private hotels and establishments, sales bans in proximity to areas patronized by minors – but what real purpose do these serve?

These measures become further ironic when heroin is far easier to source in areas like Hikkaduwa than a standard cigarette. Hundreds of youth are languishing at homes in the Colombo and Gampaha Districts – including schoolchildren – victims of addiction to ganja and narcotics. What action are we talking there? The long-term impacts of narcotics on health, society and law and order are second only to terrorism. We must also take the fight to the real enemy. 

(Ferni Wickramasinghe is a researcher and analyst engaged in ethnographical research into social and economic behaviour in Sri Lanka and South Asia. She can be reached at 
[email protected])