Tobacco use in all forms is a major cause of disease, disability and death across the world. Every year tobacco kills an estimated 8 million people globally, including at least 1.2 million exposed to second-hand smoke. Tobacco use is a major risk factor for several of the most common noncommunicable diseases (NCDs), from cancer and diabetes to cardiovascular and chronic respiratory diseases. Tobacco use also increases the risk of COVID-19 and infectious respiratory diseases such as TB. The health impact of tobacco use is particularly severe in low- and middle-income countries, negatively affecting economic growth and sustainable development. And yet the tobacco industry continues to aggressively promote the use of traditional tobacco products and newer heated tobacco products, especially among young people, and is working to popularize emerging nicotine products such as electronic nicotine delivery systems (ENDS), also known as e-cigarettes.
The WHO South-East Asia Region has in recent years taken important steps to curb tobacco use. In pursuit of Sustainable Development Goal (SDG) 3.a, Member States in the Region have accelerated implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC), for which they are leveraging the WHO MPOWER package and NCD “best buys”. In 2018 Thailand became the first country in Asia to adopt plain packaging, building on the Region’s leadership in applying some of the world’s largest graphic warnings to the packaging of tobacco products. All Member States are committed to reducing the prevalence of tobacco use among persons aged 15 years and above by 30% by 2025, in line with WHO’s global NCD action plan. The Region’s Flagship Priorities, WHO’s Thirteenth General Programme of Work and the SDGs continue to facilitate anti-tobacco interventions that are driving real impact at the country and community level.
To help create a generation of young people free of tobacco and its harmful effects, which is among the goals highlighted by this year’s World No Tobacco Day, WHO and its Member States in the Region must sustain and accelerate progress, especially as we aggressively respond to the COVID-19 pandemic. Quite apart from the negative impact tobacco has on the immune system, the act of smoking increases the frequency with which a person touches their mouth, as does the act of chewing or lodging tobacco, which also causes users to spit. Both behaviours significantly increase the chance of COVID-19 being transmitted. As WHO continues to respond to the pandemic, and as we mark World No Tobacco Day, WHO remains committed to supporting Member States in the Region to resist tobacco industry influence so that together we can advance towards a healthier, more sustainable future.
As an immediate priority, leaders across sectors can fully implement and rigorously enforce FCTC provisions on the advertising of tobacco products. The Region has in recent years made remarkable progress against direct tobacco advertising, resulting in an increase in indirect advertising – for example, the display of tobacco products at points of sale or the practice of “brand stretching”, which is when a tobacco company applies a distinctive part of their branding to a non-tobacco product. Where existing legislation is being ignored, enforcement measures should be applied. Where legislation is insufficient, and is being circumvented, it should be updated to cover all forms of tobacco advertising, providing zero room for workarounds.
Given that ENDS have the potential to induce young people to start using tobacco, and to re-normalize smoking, such products should be effectively regulated. Already, six Member States in the Region have passed legislation to ban the use of ENDS. One other regulates ENDS the same as it regulates traditional tobacco products. To complement such measures, all countries in the Region should increase access to proven cessation interventions, from national toll-free quitlines and mobile messaging services to nicotine replacement therapies and non-nicotine pharmacotherapies. Evidence must continue to chart the path ahead.
Schools can raise awareness of the dangers of initiating nicotine and tobacco use by providing information resources and making their campuses tobacco and ENDS free. Youth groups can organize local events to engage and educate young people on the many harms of tobacco use, including its impact on personal finances. Film, television and drama production companies can pledge to no longer depict tobacco or e-cigarette use. Celebrities and social influencers can reject offers of “brand ambassadorship” and refuse sponsorship by nicotine and tobacco industries.
On World No Tobacco Day, WHO reiterates its commitment to supporting Member States in the Region to implement and enforce legislation that protects the health and well-being of all young people. Together we must empower the next generation to be tobacco free, and create a future that is healthier, and which facilitates sustainable economic growth and development. For this generation, and every generation to come, an environment free of tobacco is possible. The future is ours to make.