The COVID-19 pandemic has severely impacted Bangladesh, exposing significant public health vulnerabilities. According to Directorate General of Health Services, total confirmed cases of COVID-19 were 2,051,152 and death were 29,499 (1.44 %) in Bangladesh. One critical issue that has emerged is the strong association between tobacco use and severe COVID-19 outcomes; pertaining to death. Recent research underscores the urgent need to strengthen tobacco control laws and raise tobacco prices to prevent Non-communicable disease and protecting public health.
A comprehensive study undertaken by the Shastho Shurokkha Foundation, utilizing data from the COVID-19 Telehealth services of ‘Shastho Batayon 16263’ uncovered alarming statistics. Among 127,071 COVID-19 patients, individuals who smoked, used to smoke, or consumed smokeless tobacco (SLT) displayed notably higher case fatality rates. Smokers exhibited a 6.6% case fatality rate, SLT consumers 4.4%, in contrast to 2.1% among non-smokers. Smokers were discovered to have a 73% greater probability of COVID-19-related death compared to non-smokers, while former smokers and smokeless tobacco consumers also encountered elevated risks.
These findings highlight an urgent need for strengthening tobacco control measures. The government should take significant action to protect public health by enacting strong policies that prevent tobacco use, safeguard the vulnerable, and reduce the burden on our healthcare system.
One of the most effective measures to reduce tobacco consumption is through stronger tobacco control laws and engagement of population for knowing harmful effects of tobacco. The Government of Bangladesh should amend existing laws to ban the display of tobacco products at points of sale and prohibit smoking in all public places, workplaces, and public transport. Creating a 100% smoke-free environment is crucial to protect non-smokers from the dangers of secondhand smoke, which increases the probability of COVID-19-related death by 40%.
The enforcement of these laws must be strict. Public places, including restaurants, offices, and transportation hubs, should be free from the harmful effects of tobacco smoke. This can be achieved through regular monitoring, imposing significant penalties for violations, and running public awareness campaigns to educate citizens about the dangers of tobacco use and secondhand smoke.
Economic measures also play a critical role in reducing tobacco consumption. Increasing tobacco taxes and prices can significantly deter smoking, especially among the youth and low-income groups. Higher prices make tobacco products less affordable and reduce consumption rates. Studies have shown that a 10% increase in tobacco prices can lead to a 4% decrease in tobacco use in high-income countries and up to an 8% decrease in low- and middle-income countries like Bangladesh.
The additional revenue generated from increased tobacco taxes can be reinvested in healthcare, particularly in programs aimed at combating non-communicable diseases (NCDs) and enhancing the country’s capacity to deal with future pandemics. This dual benefit of reduced tobacco consumption and increased healthcare funding presents a compelling case for policymakers.
To effectively address tobacco-related health issues, we must enhance the capacity of healthcare providers. Training programs for healthcare practitioners should focus on recognizing and treating tobacco dependence, providing cessation counseling, and understanding the links between tobacco use and diseases like COVID-19.
Organizations working in tobacco control should intensify their awareness campaigns about the risks associated with smoking, secondhand smoke, and smokeless tobacco use. Public service announcements, community outreach programs, and school-based education initiatives can play a vital role in changing public attitudes towards tobacco.
COVID-19 has shown that individuals with comorbidities, such as diabetes, hypertension, and cardiovascular diseases, are particularly vulnerable to severe outcomes. Smokers and smokeless tobacco users often fall into this high-risk category. Therefore, targeted interventions are essential. Physicians should prioritize these groups for COVID-19 vaccinations and offer tailored cessation support to reduce their risk of severe disease.
The COVID-19 pandemic has provided a stark reminder of the need for robust public health policies. By strengthening tobacco control laws and raising tobacco prices, Bangladesh can make significant strides towards reducing the prevalence of tobacco use and its associated health risks. These measures will not only save lives in the short term but also contribute to the long-term health and prosperity of our nation.
The government, healthcare providers, civil societies and the young generation must work together to implement these changes. By doing so, we can protect future generations from the harms of tobacco, ensure a healthier population, and build a resilient healthcare system capable of withstanding future pandemics. Now is the time to act decisively and safeguard the health of our nation.
As research show strong association between COVID-19 death and tobacco use, we find it very alarming that the death of tobacco user are three times higher in COVID-19 than the non-user of tobacco. It’s an urgent appeal to policymakers to strengthen the tobacco control laws for saving the lives of future generation.
Principal Investigator and Author: Dr. Nizam Uddin Ahmed
Executive Director: Shastho Shurokkha Foundation and Chairman of Gavi CSO Steering Committee and Senior Public Health Exper
