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World: No Tobacco Day Focuses On Link Between Tobacco, Poverty

The contribution of tobacco to death and disease is well documented: tobacco use kills 4.9 million people each year, and this toll is expected to double in the next 20 years. Less attention, however, has been paid to another harmful side effect of tobacco -- its contribution to growing poverty around the world. This year's World No Tobacco Day is calling attention to this particular issue.

Prague, 31 May 2004 (RFE/RL) -- In addition to the high public health costs of treating tobacco-related illnesses, the economic costs of tobacco use are devastating at individual, family, and national levels.

Tobacco often kills people at the height of their productivity, depriving families and nations of a healthy workforce. Tobacco users are also less productive while they are alive due to increased sickness.

A 1994 report estimated that tobacco use resulted in an annual global net loss of $200 billion -- a third of it in developing countries.
"[My husband] smokes himself. At the beginning he was against my smoking but now he's gotten used to it. We never count how much we spend for cigarettes. But it seems that we spend a lot. He smokes a pack [of 20 cigarettes] a day."

As the international community today marks World No Tobacco Day, the United Nation's World Health Organization (WHO) is highlighting the link between tobacco and poverty.

This year's No Tobacco Day is being conducted under the slogan: "Tobacco and Poverty: a vicious circle."

Anne-Marie Perucic works for the Tobacco Free Initiative at the WHO in Geneva. She explains how the use of tobacco can exacerbate the problems of low-income families.

"The majority of smokers belong to the most underprivileged classes. And their [tobacco] expenses represent money that is not spent for essential needs such as nutrition, housing [and] education. Tobacco use is also a factor of poverty for individuals and families, as smokers are more susceptible to be sick and die prematurely. This deprives the members of their families from essential revenue and imposes on them supplementary expenses for health care," Perucic said.

Perucic stresses that the problem is particularly acute in low and middle-income countries, which in recent years have recorded sharp increases in tobacco use, especially among men. Close to 60 percent of the cigarettes smoked each year and 75 percent of tobacco users are in developing countries.

According to the WHO, if two-thirds of the money spent on cigarettes in Bangladesh were spent on food instead, it could save more than 10 million people from malnutrition.

Denis Vinnikov, from the Kyrgyzstan-Finland Lung Health Program, says tobacco consumption in the impoverished Central Asian republic is reaching alarming levels.

"According to WHO, 64.1 percent of people between 18 and 65 were smokers in Kyrgyzstan in 2002 -- the latest data available. This rate is higher than in any European country. In Russia it is 63 percent, and 27 percent in Sweden. Since 1998, the percentage of Kyrgyz women smokers has increased from only 15 to 41.4. According to the Kyrgyz Health Ministry, between 12,000 and 15,000 people die every year from smoking," Vinnikov said.

In neighboring Kazakhstan, the Health Ministry says the number of smokers has decreased over the past several years despite an increase in smoking among women. As much as 28 percent of the population is still using tobacco on a regular basis in the oil-rich Central Asian republic.

"[My husband] smokes himself. At the beginning he was against my smoking but now he's gotten used to it. We never count how much we spend for cigarettes. But it seems that we spend a lot. He smokes a pack [of 20 cigarettes] a day. We mainly smoke Kazakh cigarettes [because] others are too expensive," said Zaure, a female smoker in the Kazakh city of Almaty.

Not all tobacco use is in the form of cigarettes. In Tajikistan, some 30 percent of the population are believed to use "nos," a moist tobacco powder placed under the tongue.

Zebo Bahromova is the director of the Tajik National Center for Eastern Medicine. She describes the effect of nos on the human nervous system. "First of all, nos harms people's nervous systems because, besides nicotine, it has a lot of chemical ingredients, like plaster. Of course it's very harmful [and] it's not clean. Nicotine harms the nervous system, especially under the tongue. Therefore it affects the brain system," Bahromova said.

Bahromova says a growing tendency to add poppy to the nos only increases the powder's impact on the nervous system.

Smoking has seen a general decline in many high-income countries in recent decades.

But Perucic of the WHO is calling on developing countries to invest in comprehensive tobacco control programs and to implement strict regulations to help reduce the demand for tobacco.

"A great percentage of developed countries have undertaken strict regulations in the past years, leading to a decrease in consumption. We encourage developing countries to also implement such measures, including the increase of tobacco taxes. This is an efficient measure whose implementation does not cost much to the government, and which has great impact on the most underprivileged strata," Perucic said.

European countries have adopted some legislation against smoking. However none go as far as Norway, which tomorrow imposes a total ban on smoking in public places; or Ireland, where a ban went into force two months ago.

(Amirbek Usmanov from RFE/RL's Kyrgyz Service, Bakoeva Khiromon from the Tajik Service, and Kazakh Service Director Merkhat Sharipzhanov all contributed to this report.)