Making a difference: Tobacco control in Bangladesh (2024)

15 January 2017

Feature story

“We have made tremendous progress in terms of improving on general hygiene and being aware of tobacco related illness after declaring the hospital tobacco free,” said Dr Syed Md Amirul Haque, the resident medical officer of the hospital. Dr Haque gives the credit to the ‘tobacco free hospital’ campaign which prevented people from spitting chewed betel leaf .(often taken with Zarda – a form of smoke-less tobacco) or throwing cigarette butts in the hospital compound. “Even the doctors quit smoking following this initiative,” he said. The hospital received the Health Minister’s Award for Best Performing Government Hospital for two consecutive years.

Tobacco use in Bangladesh

Bangladesh has historically experienced high production and consumption of tobacco products, resulting in a heavy burden of tobacco-related illnesses. The Government of Bangladesh (GoB) enacted the Smoking and Using of Tobacco Products (Control) Act in 2005. Smoking is now prohibited in selected public places and on public transports. A ban on advertisem*nt of tobacco products was also imposed, together with health warnings on product packaging.

Despite the enactment of the Act, gaps and loopholes have prevented it from becoming fully effective. Following suggestions from WHO, tobacco control activists, civil society and WHO, the GoB amended the law in 2013 to make it more FCTC-compliant. The rules have also been updated in 2015.

The tobacco control initiatives have already started to show results. According to the WHO Report on the Global Tobacco Epidemic 2015, the prevalence of adult smoking (15 years and over) in Bangladesh fell from 34.6% to 20% between 2000 and 2013.

Tobacco Control Efforts in Bangladesh: Did You Know?

-Bangladesh was the first country to sign the WHO Framework Convention on Tobacco Control (FCTC) in 2003 which is the world’s first health treaty against the global tobacco epidemic and was among the first countries to ratify the treaty, in May 2004. Bangladesh was also among the first countries to ratify it in 2004.

-Through amending the tobacco control law in 2013, smokeless tobacco is brought under purview of law; penalty for violation of various sections of the law has been increased; ban on advertisem*nt of tobacco products made comprehensive; sale of tobacco to and by minors has been banned and printing of Graphic Health Warning on packs of tobacco products made mandatory.

-WHO supported the publication of Graphic Health Warning (GHW)-based anti-tobacco advertisem*nts in national daily newspapers in late 2015 and mid 2016.

-The Government of Bangladesh (GoB) is committed to a “tobacco-free Bangladesh” by 2040

Bangladesh is currently implementing several measures to reduce the use of tobacco. WHO contributes to this implementation by: providing technical assistance for developing tobacco control legislation in compliance with the FCTC; providing technical and logistical support to the National Tobacco Control Cell (NTCC), National Board of Revenue (NBR); and various professional bodies and nongovernmental organizations in their tobacco control programmes. WHO also works closely with the country to strengthen enforcement of tobacco control law, impose higher taxes on all types of tobacco products and to create public awareness.

A major factor contributing to tobacco use is its affordability. Another WHO priority in Bangladesh has been to collaborate with the National Board of Revenue (NBR) to build capacity on tobacco taxation. Since the beginning of the collaboration in 2010, the NBR has set up a Tobacco Tax Cell (TTC) which has drafted a “Tobacco Tax Policy and 5-Year Roadmap” based on international best practices – the first of its kind in Bangladesh. Also with WHO support, the TTC has drafted a situation report on tobacco taxation based on data collected by the central database.

See Also

Identifying A Bat Problem

WHO Contributions to Tobacco Control in Bangladesh

-Develop policies, guidelines, standards, enforcement tools and updated legislations in compliance with FCTC.

-Generate evidence through studies, such as Global Adult Tobacco Survey, Global Youth Tobacco Survey, CD STEPS survey; Impact of tobacco-related illnesses in Bangladesh.

-Provide technical and logistic support to NTCC, taskforce committees, NBR, and various professional bodies and non-government organizations on their tobacco control programmes.

-Build capacity on tobacco control through training, especially on enforcement of tobacco control law

-Develop models of tobacco cessation in community and hospitals

- Create awareness on detrimental health effects of tobacco use and tobacco control law.

- Tax tobacco products efficiently aiming at reduction of consumption keeping revenue earning unharmed.

-Establish a model upazila on Tobacco Advertisem*nt, Promotion and Sponsorship (TAPS) ban applying local level planning and implementation.

Although Bangladesh taxes tobacco, the tax structure is complex and base price is still very low, with more than a quarter of adults using smokeless tobacco (SLT), which contributes to a high prevalence of oral cancer. SLTs are available in various forms including Zarda, Gul, Khaini and Sada Pata and their low price make it affordable to everyone. To discourage purchase and use, Bangladesh has implemented Graphic Health Warning on packs of tobacco products. Strong guidelines for FCTC Article 11, adopted in 2008, state that graphic warnings that cover at least 50% of the principal display areas of the package should be included. These warnings about the dangers of tobacco use, together with large graphic health warnings, national mass-media campaigns, and increasing tobacco taxes are currently being implemented toward tobacco use abatement.

WHO Country Office for Bangladesh is continuing to work with the government to ensure full compliance with the FCTC and to support the NTCC in drafting a Tobacco Control Policy for Bangladesh. WHO also works with Bloomberg Initiative Partners, NGOs, and governmental and nongovernmental stakeholders to organize workshops on countering tobacco industry interference, on tobacco advertising, promotion and sponsorship bans, on tobacco cessation and tobacco taxation, as well as on smoke-free implementation and enforcement. National, district, and sub-district taskforce committees have been formed to oversee field enforcement of the law.

The future

The use of tobacco in Bangladesh remains relatively high but the GoB has made tremendous efforts to combat this, with the support of WHO and other stakeholders. Following WHO global advocacy this year, the GoB has also pledged to ensure plain packaging of tobacco products. “We are working towards making Bangladesh tobacco free by 2040 as per the recent directives of the Honourable Prime Minister of Bangladesh,” said Ms Roxana Quader, Additional Secretary of the Ministry of Health & Family Welfare. Ms Quader added that the National Tobacco Control Cell is working relentlessly to enforce tobacco control laws in Bangladesh to achieve that goal. Bangladesh still faces several implementation challenges, including: a shortage of resources to carry on a sustainable tobacco control programme; perceived economic benefit that the national economy enjoys from tobacco sales; and strong lobbying influence of tobacco industry.

“We want to create mass awareness of the health hazards associated with tobacco use among the general public,” says Dr N Paranietharan, WHO Country Representative to Bangladesh. Using a multi-pronged approach, WHO is now working with various arms of the government to restrict or prohibit the use of logos, colours, brand images or promotional information on packaging. This approach aims to reduce the attractiveness of tobacco products, limit misleading information on packaging and increase the effectiveness of health warnings.

“We believe that plain packaging, combined with strong enforcement of existing laws, will contribute further to the eventual decline in tobacco use in Bangladesh,” Dr Paranie concludes.

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