Tobacco industry accountable for 8 million fatalities in 2019

Globally, the average age when smokers began smoking is 19. However, it is significant to note that worldwide, the number of smokers continues to rise, with smoking causing nearly 8 million deaths in 2019, including one in five male deaths. The scientists at the Institute for Health Metrics and Evaluation (IHME) recently published studies revealing the status of the tobacco epidemic. In 2019, smoking was associated with 1.7 million deaths from ischemic heart disease, 1.6 million deaths from chronic obstructive pulmonary disease, and 1.3 million deaths from tracheal, bronchus, and lung cancer, and nearly 1 million deaths from stroke. At the same time, approximately 87% of deaths attributable to smoking tobacco occurred among current smokers.

Reversing the tobacco epidemic depends on preventing young people from starting to smoke. But the vector of the tobacco epidemic remains a robust tobacco industry worldwide, including in Pakistan. The tobacco industry has many faces to infiltrate in corporate systems of the countries. Like Financial engagement, including foreign investment and trade, was used to enter and sustain in markets. Political activities included lobbying, offering volunteer self-regulatory codes, and escalating corporate social responsibility promotions. Deceptive activities included manipulation of science and use of third-party allies to counter tobacco control policies, impede other tobacco-control strategies, and sustain and solicit backing of legislators, print and electronic media, bureaucracy, and the public for a pro-tobacco industry policy environment.

Universally, resilient evidence corroborates that the tobacco industry uses a comprehensive range of tactics to interfere with tobacco control. These strategies encompass direct and indirect influencing policy/decision makers, political lobbying and campaign contributions, financing of research, attempting to affect regulatory and policy machinery, and engaging in social responsibility initiatives as part of public relations campaigns.

The Tobacco Industry (TI) also gains strength and support in low and middle economic states by gaining access to the political system to protect their interests. They manage to set foot in a supportive environment by promising policies to maximize their profits. The TI has deliberately used fake data and science to compel Governments and resist tobacco taxation reforms to enhance their profits and gains.  

Tobacco use, driven by industry marketing and fueled by social inequities, is killing 08 million people per year, inhibiting socio-economic development at household, national and global levels, exacting economic burdens on national health care systems, infringing human rights, and obstructing progress towards achieving the Sustainable Development Goals (SDGs).

Effective tobacco control is, almost by definition, adversative to the vested commercial interests of the tobacco industry, associated industries, and entities or persons working to further the tobacco industry's agenda. To substantially achieve tobacco industry profits and growth, the tobacco industry needs to put hurdles and halt for policies, which lead to decreased monetary benefits. For getting their interest, they could do anything not to let the policy, decision issued or reversal of the policies and decision. Therefore, precise understanding and effectually counteracting the tobacco industry's efforts and allies against tobacco control are essential.

With growing evidence and considerations on deathtraps & diseases with tobacco usages, the TI has been manipulating science and research worldwide to blur and slow the acceptance of the scientific evidence on the dangers of tobacco use that were pouring legislation and regulation around the world. The TI covertly engaged scientists and public health physicians worldwide and funded research without revealing the funding source to neutralize logical assertions public health community, the world health organization, Framework Convention on Tobacco Control. 

The Tobacco Industry has used direct investment and smuggling to secure a footing in new markets. Countries like Pakistan, where governments usually greeted foreign direct investment and treated the tobacco industry as a source of financial growth. The TI exploited such ventures in joint venture agreements or development agreements with state monopolies or local tobacco companies as market-softening techniques. Once the local tobacco companies were dependent on foreign capital and technology, the TI acquired the local companies. The same was when one multinational company bought a local company in Pakistan a decade ago. 

Usually, the tobacco industry uses a range of strategies to weaken or prevent advances in tobacco control, including establishing inappropriate relationships with relevant government, wielding financial power, leveraging influence through other persons, discrediting government, using surrogates, such as front groups and trade unions, Distorting national and international tobacco control researches, staging media events to distract from tobacco control initiatives and monitoring and surveying tobacco control activities.

The tobacco industry has many business allies and third parties. It works to block the implementation of effective tobacco control legislation and programs. Such groups often appear in the news media and at legislative hearings. They seek to reframe tobacco control policies as economic issues rather than public health initiatives.1 

The tobacco industry has a long history of offering financial support to scientists, other academics, and research consultants.

There is explicit testimony history and enduring TI pressure over tobacco excise policy around the world. Moreover, there has been pragmatic data in many countries, which alludes to numerous claims developed by TI to manipulate misleading excise policy.

Taxation evenhandedly decreases smoking, which is the foremost source of health inequalities in the world. Furthermore, the tobacco industry was found to destabilize the public health benefits recognized from tobacco taxation through its pricing approaches

The TI intends to safeguard that tobacco products continue inexpensive while keeping their profits – at the cost of public health. Tobacco companies target governments and finance ministries with "studies" claiming overstated and inaccurate economic impacts from higher taxes. These companies also use illicit trade as a critical argument against tax increases, despite their participation in illegal trade. While tobacco tax increases are considered gradual because poorer smokers are more price-sensitive. Therefore, high taxes discourage smoking due to related costs. 

The writer is the former Technical Head Tobacco Control Cell, Mo NHSRC, former focal person of Government of Pakistan to FCTC & ITP. He is now Global Public Health and Tobacco Control Consultant.  Ziauddin.islm@gmail.com

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