Problem of Smoking in Karachi

INTRODUCTION

In Karachi there are an estimated eight million smokers at present. If each smoker spends just Rs. 20 per day Rs. 16 million are wasted in smoking cigarettes. In addition people on the treatment of smoking related diseases every year spend several billion rupees. Thus, the economics loss to the city of Karachi as a result of tobacco use is huge.

Experience from the western world has shown that controlling tobacco consumption in a country actually saves money. The city government of Karachi, unlike other governments in the country has so far not taken any concrete step toward the control of this epidemic. The government probably fears that by controlling tobacco they will lose the revenue generated from taxation on cigarettes and the marketing of the cigarette brands through the hoardings. According to the experts of WHO and World Bank, controlling tobacco use will bring unprecedented health benefits without harming the economy of the country.

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Electronic Cigarette Inhalation

There are over 7,000 scientific studies published in various international journals, which prove the serious harm caused to human health from tobacco use. Up to 90 percent of lung cancer and 80 percent of deaths from chronic obstructive lung disease in Karachi are caused by tobacco use.

Tobacco use is also the most important risk factor for heart attack. Smoking is also a risk factor for cancer of the kidney, buccal cavity, food pipe, larynx, bladder, pancreases and breast. Smokers have a poor quality of life compared to that of non-smokers.

The harmful effects of tobacco use are not just confined to the smokers alone; those who live or work close to smokers are also at an increased risk of various diseases including lung cancer, heart attack, child hood respiratory disease, effusion in children, asthma, eye, nose and throat irritation and cot death.

Following are the main reasons and causes for smoking

1.Advertising

2.Price

3.Media role and lack of Health Education Programme

4.Few smoking cessation clinics

5.Anti Tobacco Law

ADVERTISING

Each year the tobacco industry in Karachi spends billion of rupees in advertising, marketing and promoting tobacco. Scientific studies have proven without any doubt that cigarette advertisements have a strong influence on people particular teenagers.

PRICE

Unfortunately the price of cigarettes in Karachi is the cheapest in the world. In just two rupees one can get four to six loose cigarettes. The price increase on cigarettes is highly effective in reducing demand.

MEDIA ROLE AND LACK OF HEALTH EDUCATION PROGRAMMES

Most smokers begin this habit at an early age. At present, education on the harmful effects of tobacco is not being imparted in our school and colleges. Karachi TV shows hundreds of colourful and attractive tobacco advertisements everyday. There is hardly any message for the general public on the harmful effects of tobacco. Patients suffering from serious diseases caused by tobacco should be shown to the general public in order to discourage those who are smoking. This will also act as a deterrent to youngsters who are thinking of taking up this addiction.

SMOKING CESSATION CLINICS

It is indeed sad that a high percentage of medical students and doctors in Karachi smoke; studies on smoking prevalence among doctors in Karachi has shown the smoking rate to as high as 40 percent in males and 8 percent females. Many smokers can be motivated to change through brief advice given by a health professional. Others need the extra support, which can be provided by special smoking cessation clinics. Unfortunately, most doctors in the country are not trained in smoking cessation counseling. There is a need to train health professionals so that those who wish to quit smoking can get the help they need.

ANTI TOBACCO LAWS

In the last 50 years not much has been done to control tobacco use in this city. At present there is no law that can help control the ever-increasing use of tobacco in this city. The present city government under the supervision of Mr. Niamat Ullah Khan has taken few bold steps for controlling effects of smoking tobacco.

SUGGESTIONS TO CITY GOVERNMENT FOR REDUCING USE OF CIGARETTE

1.Ban on Advertising

2.Increasing the price of the cigarette

3.Media Role & health education programme

4.Smoking Cessation Clinics

5.Controlling the smuggling of cigarettes

6.Anti Tobacco Law

7.Warning on cigarette packs

8.Litigation against tobacco industry

BAN ON ADVERTISING

In countries where tobacco advertisements were completely banned on TV, radio and print media there followed a significant decline in the per capita consumption of cigarettes. The ban on tobacco advertisement has to be comprehensive, as partial bans are not successful. All forms of sponsorship of sporting events as well as musical concerts should be included in the ban.

Increasing the price of the cigarette

It has been found out that by, on average 10 percent increase in price of a cigarette pack would reduce the demand by 8 percent. Excess money generated by increased taxation can be spent on health education. (John, 2004)

MEDIA ROLE & HEALTH EDUCATION PROGRAMME

There is a tremendous need for starting regular health education programmes for school and college students. Through these children one can also try to change the smoking habit of their parents. All forms of tobacco use should be strictly prohibited in and around schools and colleges. Schoolteachers should act as good health models for their students by being non-smokers.

SMOKING CESSATION CLINICS

A reduction in tobacco use is one of the single most important public policy actions that countries can undertake for health gain. Preventing people from starting smoking is very important if we are to gain health in the next 40 years. Smoking cessation in adults brings much quicker health gains. Countrywide campaign should be started by government to train the doctors in 'smoking cessation counseling'. There is a need to train health professionals so that those who wish to quit smoking can get the help they need.

CONTROLLING THE SMUGGLING OF CIGARETTES

Cigarette smuggling is a serious problem in Karachi. Many foreign brand cigarettes are smuggled into Karachi. There is also a lot of demand of cigarettes in Karachi, the Middle East and other neighboring countries. Cigarettes are very cheap in Karachi and smugglers make huge profits by selling cigarettes in other countries. The government has taken important steps in controlling the export of heroin and opium; the authorities should also take action against the smuggling of cigarette both in and out of country.

Anti Tobacco Law

The city government of Karachi must work towards bringing a strong anti tobacco law. The law must contain:

1. RESTRICTION OF SALE OF TOBACCO TO MINORS

Those under the age of 18 with strict penalties imposed on those shopkeepers who violate the law.

2. SMOKING AT PUBLIC PLACES MUST BE BANNED

In particular, there should be a complete ban on smoking at enclosed public places such as banks, offices, airports, trains, public transport etc.

3. WARNING ON CIGARETTE PACKS

The present warning, smoking is injurious to health', is too weak. There should be a law under which cigarette companies should be asked to put the warning in the bold letters and it should cover at least 50 percent of the cigarette pack. Warnings should be more explicit e.g. smoking is addictive, etc. The law should also include warnings on billboards is either not present or is written in such small font that it is illegible.

4. LITIGATION AGAINST TOBACCO INDUSTRY

Litigation against tobacco companies wrong doing has several potential benefits. First of all, it brings the issues of the effect of tobacco on health in front of the media and general public. Secondly, it offers prospects for large monetary awards, which can help cover smoking, related medical cost. The money generated could also be used for the anti-smoking/health education campaigns in the country. The lawyer in Karachi should come forward and help the victims of the tobacco industry. When people in the western world can get compensation from tobacco companies, why can't our patients, who have developed tobacco-induced diseases?

SOME FACTS AND FIGURES ABOUT SMOKING

Tobacco Smoke contains over 4000 chemicals in the form of particles and gases. It includes over forty carcinogen (Cancer causing substances)

Tobacco causes more deaths each year than road accidents, suicides, homicides, fire, AIDS, heroin, cocaine and alcohol combined.

Tobacco not only causes harms to the individual who smokes bur it also affects the health of the person who lives works or travels with the smoker (Passive or second hand smoking).

22 REASONS FOR BANNING SMOKING

PERSONAL HEALTH

1.Increases the risk of all forms of cancer

2.Increases the risk of stroke

3.Increases the risk of pneumonia

4.Increases the risk of respiratory disease

5.Affects breathing quality

6.Affects the operation of the immune system

7.Increases the chance of infertility

8.Reduces the capacity of the blood to take in oxygen (Sepe, 2000)

HEALTH OF OTHERS

9.Increases the chance of miscarriage or damage to the foetus

10.Lower birth weight of children

11.Lower mental capacity (IQ) of children

12.Increased chance of SID (cot death) when the parents smoke

13.Increased chance of other causes of infant death

14.Affects the health of others in the environment

QUALITY OF LIFE

15.Physical addiction

16.Psychological addiction

17.Social addiction

18.Loss of sense of smell

19.Loss of sense of taste

PERSONAL HYGIENE

20.Body odours

21.Breathe odours

22.Premature ageing of skin leading to an older appearance

CONCLUSION

Tobacco is killing people at an unprecedented scale yet there is a complete silence on this important public health issue in Karachi. It is the moral responsibility of all of us in general and city government of Karachi to control this rising epidemic in our city. Our children and grandchildren will question us if we do not act against this biggest killer. There is a need to spread the message in the society that 'SMOKING KILLS'.

BIBLIOGRAPHY

John Fahs. Cigarette Confidential: The Unfiltered Truth about the Ultimate American Addiction. New York: Berkeley, 2004.

Lee A. Fritschler. Smoking and Politics: Policy Making and the Federal Bureaucracy. Upper Saddle River, NJ: Prentice Hall, 2004.

Sepe, Ed. "Tobacco Promotions in the Alternative Press: A Content Analysis of Tobacco Marketing." University of California Berkeley, 2000.