A world free of tobacco by 2030?

On May 31, World No Tobacco Day is being observed worldwide. It encourages tobacco users to abstain for at least 24 hours, and draws attention to the harm tobacco does to human health. Millions smoke despite knowing the harmful effects it has on them and those around them. At the macro level, the consequences of smoking draw heavily on public health expenditure that could otherwise be used to save many more lives.

Tobacco use is linked to a number of non-communicable diseases (NCDs) including lung cancer, cardiovascular diseases, metabolic diseases, coronary heart disease, cerebrovascular disease, stroke, diabetes mellitus, pneumonia, influenza, tuberculosis, perinatal conditions, prenatal conditions and sudden infant death syndrome.

More than 6 million people die every year from direct tobacco use, and almost 900,000 die from second-hand smoke, according to the World Health Organization (WHO). There were nearly 100 million smoking-related deaths last century, and if current trends continue, this century may see 1 billion fatalities.

Eighty percent of smokers live in the developing world. According to the WHO, if current trends continue, smoking-related deaths in the developing world will exceed 6 million by 2030. In most Western countries, national health systems, insurance and other mechanisms reduce the discomfort for patients and the financial burden on their families. But this is not the case for most smokers in the developing world.

Tobacco use spread rapidly during the 20th century, primarily due to widespread advertising and aggressive marketing by cigarette manufacturers. Becoming a fashionable habit, smoking spread throughout the developing world even faster.

Some countries are implementing policies to tackle the problem, from banning tobacco advertising to increasing taxes. New Zealand aspires to become tobacco-free by 2020; Sweden has similar plans by 2025. But some countries have done nothing.

Given the evidence of harm caused by tobacco use, it is important to completely ban it via national legislation. Some governments may be reluctant to do so because of intense lobbying by cigarette manufacturers, and fear of losing tax revenue. But the collective socioeconomic harm of tobacco use likely outweighs revenue from taxing tobacco products.

Banning tobacco is also very important from a development viewpoint. Besides treatment of tobacco-related diseases depleting developing countries’ limited health budgets, people’s income spent on tobacco products could be better spent on children’s education, for example.

One of the UN’s Sustainable Development Goals is to “strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in all countries, as appropriate.” The WHO FCTC was adopted by the World Health Assembly on May 21, 2003, and entered into force on Feb. 27, 2005. It has since become one of the most rapidly and widely embraced treaties in UN history.

The WHO FCTC was developed in response to the globalization of the tobacco epidemic. The evidence-based treaty reaffirms the right of all people to the highest standard of health. It represents a milestone for the promotion of public health, and provides new legal dimensions for international health cooperation. To implement the WHO FCTC, countries must develop legislation to ban all forms of tobacco manufacturing and use.

A gradual transition toward a tobacco-free world can be achieved by increasing taxes on tobacco cultivation and processing; curbing illicit trade in tobacco products; banning advertisement and marketing of tobacco products; outlawing smoking in public places (open areas as well as buildings) and the purchase of cigarettes by under-18s; reducing health subsidies and social benefits for people proven to smoke beyond certain limits; providing psychological support and mentoring to quitters; and launching a massive public awareness campaign about the ills of smoking.

These measures should be tailored to suit local contexts and consider national cultures and power structures, as well as the likely consequences of disrupting the tobacco market. Governments, while implementing the WHO FCTC, should provide alternative employment opportunities for people currently employed in the tobacco industry, and offer alternative business opportunities to tobacco traders and manufacturers.

The fight against tobacco has to be won by getting tobacco-related businesses to this side of the table. Also, governments, public health professionals and officials, civil society organizations, NGOs and donor communities must work together to develop strategies that work on the ground. We can achieve a tobacco-free world by 2030.

• Shamas-ur-Rehman Toor is senior program management specialist at the Islamic Solidarity Fund for Development, Islamic Development Bank Group. He is based in Jeddah.