01 June 2019, Kathmandu
Tobacco use affects the health of men and women and particularly mothers and children. The most economically productive age groups are affected by the consumption of tobacco products. It causes diseases, disability and death, and is the single largest preventable cause of death in the South-East Asia Region and the world.
Tobacco harms the health, the treasury, and the spirit of Nepal. Every year, more than 27100 of its people are killed by tobacco-caused disease. Still, more than 21000 children (10-14 years old) and 3046000 adults (15+ years old) continue to use tobacco each day. Complacency in the face of the tobacco epidemic insulates the tobacco industry in Nepal and ensures that tobacco’s death toll will grow every year. Tobacco control advocates must reach out to other communities and resources to strengthen their efforts and create change.
Different varieties of tobacco products are used in Nepal in both smoking and smokeless forms. The smoking forms are cigarette, bidi, hookah, sulfa and chillum or kankad. The smokeless tobacco products include surti leaves, khaini, gutkha and paan with tobacco ingredients. The major chewing form of tobacco is paan with tobacco and is most popular in the Terai region. Dry tobacco-areca nut preparations such as gutkha and paan masala are popular in Nepal.
Tobacco is one of the most preventable causes of illness and death. In addition to the direct effects on individual’s health, it leads to high health care cost for the individuals as well as the health system.
Nepal became a Party to the WHO Framework Convention on Tobacco Control on February 5, 2007. The Tobacco Product (Control and Regulation) Act, 2010 is the primary law governing tobacco control in Nepal. This act requires products to be licensed and companies selling tobacco to be registered; ban on the sale of smokeless tobacco to under-18 age group, ban on tobacco consumption in all public and work places and prohibits advertising. Pictorial health warnings were implemented in April 2014. The government has issued a directive increasing the size of the pack warnings to 90 percent of the front and back of all tobacco products packaging.
Although tobacco control legislation and policies exist in Nepal, they have been found to be either inadequate or poorly implemented. Reasons for this include a lack of training of law enforcers; unclear roles within government departments; and inadequate resources for enforcement.
Furthermore, illicit trade between India and neighbouring countries, and sale in informal establishments, often in unpackaged forms are other challenges. For smokeless tobacco, in addition to above, there is inadequate data on the production and distribution of smokeless tobacco products, making it difficult for policy makers to develop, implement and enforce effective control measures for these products.
Legislation and rules and policy should be established for the prevention and the control of tobacco use in the communities, particularly in schools, with effective enforcement of the same and school personnel should be trained on the prevention of tobacco use among school students.
Multisectoral efforts are needed for effective implementation of the WHO Framework Convention and in order to monitor the key indicators of the MPOWER policy package through the periodic conduct of different surveys under the GTSS.
