World No Tobacco Day 2022: Quit tobacco for a healthier planet

This year, the theme for World No Tobacco Day is Tobacco: Threat to Our Environment which aims to raise awareness about harmful effects of tobacco for individuals and communities across the planet. Tobacco pollutes our environment in a number of ways, and as a result, it threatens the health of all people, regardless of their location. The Union for International Cancer Control reports that 6 trillion cigarettes are manufactured each year - for every 300 cigarettes, one tree is cut down. Tobacco cultivation also produces around 84 megatons of carbon dioxide emissions. This should give tobacco-users an additional motivation to quit for the sake of their own health, for the wellbeing of those around them, and in order to conserve the environment.

The Union for International Cancer Control (UICC) advocates for tobacco control in low- and middle-income countries where 80% of the world’s smokers live, and where tobacco production is concentrated. These countries also bear the highest environmental burden of tobacco-use. In Pakistan, around 24 million people use tobacco in some form, the World Health Organization reports. The Government of Pakistan ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2004, but concerted efforts from all stakeholders are still required to effectively implement this. For example, even though Pakistan has banned smoking in public places and sale of cigarettes to minors is prohibited, the implementation of these rules and regulations has been ineffective as indicated by the Global Youth Tobacco Survey. The need to raise awareness on the far-reaching negative impact of tobacco on people and the environment must be mainstreamed, and the media can play a vital role in raising awareness around this public health challenge.

We should remember that tobacco remains the largest preventable risk factor for four major non-communicable diseases. These are various types of cancers, cardiovascular diseases, respiratory diseases and diabetes. Tobacco in all its forms is dangerous and addictive, including smoking cigarettes, cigars, hookah (water-pipe), sheesha, paan, gutka, etc. Tobacco and tobacco smoke contain about 7,000 chemicals, of which 250 are poisonous and 60 have been known to cause cancer (carcinogens). The Shaukat Khanum Cancer Registry, over the past two decades, shows that cancers linked with tobacco use remained in the list of top ten most common cancers across our facilities.

Healthcare professionals can also play an important role in tobacco control. For countries with limited resources, integrating brief advice into existing health care systems is recommended as the first step towards implementing cessation services. This includes firm advice by doctors during routine consultation at primary and specialised care levels. Moreover, a support system for tobacco use cessation can more than double the chance of people quitting tobacco successfully and thus preserve valuable lives.

Our national strategy to curb this menace must also take into account the economic impact on the healthcare system, and consider measures to levy appropriate taxes on tobacco products in line with international practices. A nationwide campaign through the media and school curricula to promote healthy lifestyles, enforcement of the public space smoking ban, and support for those quitting smoking or other tobacco use must be prioritised as a matter of national health.

World No Tobacco Day 2022 should be a reminder that if you quit smoking, you will be protecting your health and the health of everyone on this planet. (The writer is consultant pulmonologist at Shaukhat Khanum Memorial Cancer Hospital)