The Present Status of Tobacco Control in Bangladesh

Abstract

Opinion Tobacco is one of the leading causes of disability and death worldwide. Bangladesh has double burden of tobacco production and consumption. It is the common risk factor of different diseases like cancer, lung disease and cardiovascular diseases. Tobacco, especially smoking is a major cardiovascular risk factor and death. Recent evidence has suggests a positive association between smoking and diabetes mellitus (DM) in both male and female. A study of Bangladesh shows, among the diabetic smoker (39.6%) had higher level of nicotine dependence and diabetic smokeless tobacco user (82.5%) had higher level of nicotine dependence measured by fagerstrom scale [1]. In a cohort study at USA shows positive association between cigarette smoking and DM. Cigarette smoking may be an independent, modifiable risk factor for insulin dependent diabetes mellitus. In another study it was found that, smoking is independently associated with increased risk of DM among both middle aged and elderly men and women [2]. Tobacco kills one in ten persons globally, accounting for approximately 5 million deaths per year, out of which 1.2 million deaths occur in the South-East Asia Region (SEAR) [3]. Tobacco consumption is an important public health problem in Bangladesh. According to a WHO study in 2004; 30.9 million people aged 15 years and above consumed tobacco in some form or other. About 57,000 people died and 3, 82,000 became disabled due to eight tobacco related illness. Bangladesh suffered a net loss of 442 million US$ (Taka 26.1 billion) [4]. Bangladesh is one of the high tobacco consumption countries of the world. According to Global Adult Tobacco Survey (GATS) Bangladesh 2009, a nationally representative household survey of men and women aged 15 years or above, 43.3% people currently use both smoke and smokeless tobacco. 23.0% currently smoke tobacco and 27.2% currently use smokeless tobacco. About 45% of males and 1.5% of female smoke, and 26% of male and 28% of females use smokeless tobacco. It is estimated that about 41.3 million adults use tobacco in Bangladesh. The GATS study shows, the average number of cigarettes and bidis smoked per day were five sticks and seven sticks, respectively. The average number of times smokeless tobacco was used per day was eight. 7 out of 10 want to quit tobacco. Overall, 97.4% of the adults believe that smoking causes serious illnesses and 92.7% of the adults believe that smokeless tobacco use causes serious illnesses [5].