Policy priorities for strengthening smokeless tobacco control in Bangladesh: A mixed-methods analysis
Introduction Smokeless tobacco (ST) remains poorly regulated in Bangladesh. This study describes the prevalence and trends of ST use in Bangladesh, presents ST-related disease burden, identifies relevant policy gaps, and highlights key implications for future policy and practice for effective ST con...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Publishing
2021-10-01
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| Series: | Tobacco Induced Diseases |
| Subjects: | |
| Online Access: | http://www.tobaccoinduceddiseases.org/Policy-priorities-for-strengthening-smokeless-tobacco-control-in-Bangladesh-A-mixed,140826,0,2.html |
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| author | Rumana Huque Zunayed Al Azdi Aziz Sheikh Jasjit S. Ahluwalia Masuma P. Mishu Ravi Mehrotra Nasiruddin Ahmed Linda Bauld Syed Mahfuzul Huq Syed Mahbubul Alam Faraz Siddiqui Sohel R. Choudhury Kamran Siddiqi |
| author_facet | Rumana Huque Zunayed Al Azdi Aziz Sheikh Jasjit S. Ahluwalia Masuma P. Mishu Ravi Mehrotra Nasiruddin Ahmed Linda Bauld Syed Mahfuzul Huq Syed Mahbubul Alam Faraz Siddiqui Sohel R. Choudhury Kamran Siddiqi |
| author_sort | Rumana Huque |
| collection | DOAJ |
| description | Introduction
Smokeless tobacco (ST) remains poorly regulated in Bangladesh.
This study describes the prevalence and trends of ST use in Bangladesh,
presents ST-related disease burden, identifies relevant policy gaps, and
highlights key implications for future policy and practice for effective ST
control in Bangladesh.
Methods
We analyzed secondary data from the two rounds (2009 and 2017)
of The Global Adult Tobacco Survey, estimated ST-related disease burden,
and conducted a review to assess differences in combustible tobacco and ST
policies. In addition, we gathered views in a workshop with key stakeholders
in the country on gaps in existing tobacco control policies for ST control in
Bangladesh and identified policy priorities using an online survey.
Results
Smokeless tobacco use, constituting more than half of all tobacco
use in Bangladesh, declined from 27.2% (25.9 million) in 2009 to 20.6%
(22 million) in 2017. However, in 2017, at least 16947 lives and 403460
Disability-Adjusted Life Years (DALYs) were lost across Bangladesh due to
ST use compared to 12511 deaths and 324020 DALYs lost in 2010. Policy
priorities identified for ST control have included: introducing specific
taxes and increasing the present ad valorem tax level, increasing the health
development surcharge, designing and implementing a tax tracking and
tracing system, standardizing ST packaging, integrating ST cessation within
existing health systems, comprehensive media campaigns, and licensing of
ST manufactures.
Conclusions
Our analysis shows that compared to combustible tobacco, there
remain gaps in implementing and compliance with ST control policies in
Bangladesh. Thus, contrary to the decline in ST use and the usual time lag
between tobacco exposure and the development of cancers, the ST-related
disease burden is still on the rise in Bangladesh. Strengthening ST control
at this stage can accelerate this decline and reduce ST related morbidity and
mortality. |
| first_indexed | 2024-04-12T22:45:06Z |
| format | Article |
| id | doaj.art-baf7c751f44c4980a77d341db15202f1 |
| institution | Directory Open Access Journal |
| issn | 1617-9625 |
| language | English |
| last_indexed | 2024-04-12T22:45:06Z |
| publishDate | 2021-10-01 |
| publisher | European Publishing |
| record_format | Article |
| series | Tobacco Induced Diseases |
| spelling | doaj.art-baf7c751f44c4980a77d341db15202f12022-12-22T03:13:33ZengEuropean PublishingTobacco Induced Diseases1617-96252021-10-0119October11010.18332/tid/140826140826Policy priorities for strengthening smokeless tobacco control in Bangladesh: A mixed-methods analysisRumana Huque0Zunayed Al Azdi1Aziz Sheikh2Jasjit S. Ahluwalia3Masuma P. Mishu4Ravi Mehrotra5Nasiruddin Ahmed6Linda Bauld7Syed Mahfuzul Huq8Syed Mahbubul Alam9Faraz Siddiqui10Sohel R. Choudhury11Kamran Siddiqi12Department of Economics, University of Dhaka, Dhaka, BangladeshARK Foundation, Dhaka, BangladeshUsher Institute, The University of Edinburgh, Edinburgh, United KingdomDepartment of Behavioral and Social Sciences, Alpert Medical School, Brown University School of Public Health, Providence, United StatesDepartment of Health Sciences, Faculty of Sciences, University of York, Heslington, United KingdomCentre for Health Economics, University of York, York, United KingdomInstitute of Governance and Development, BRAC University, Dhaka, BangladeshUsher Institute, The University of Edinburgh, Edinburgh, United KingdomCountry Office of World Health Organization, Dhaka, BangladeshThe Union, Dhaka, BangladeshDepartment of Health Sciences, Faculty of Sciences, University of York, Heslington, United KingdomDepartment of Epidemiology and Research, National Heart Foundation Hospital and Research Institute, Dhaka, BangladeshDepartment of Health Sciences, Faculty of Sciences, University of York, Heslington, United KingdomIntroduction Smokeless tobacco (ST) remains poorly regulated in Bangladesh. This study describes the prevalence and trends of ST use in Bangladesh, presents ST-related disease burden, identifies relevant policy gaps, and highlights key implications for future policy and practice for effective ST control in Bangladesh. Methods We analyzed secondary data from the two rounds (2009 and 2017) of The Global Adult Tobacco Survey, estimated ST-related disease burden, and conducted a review to assess differences in combustible tobacco and ST policies. In addition, we gathered views in a workshop with key stakeholders in the country on gaps in existing tobacco control policies for ST control in Bangladesh and identified policy priorities using an online survey. Results Smokeless tobacco use, constituting more than half of all tobacco use in Bangladesh, declined from 27.2% (25.9 million) in 2009 to 20.6% (22 million) in 2017. However, in 2017, at least 16947 lives and 403460 Disability-Adjusted Life Years (DALYs) were lost across Bangladesh due to ST use compared to 12511 deaths and 324020 DALYs lost in 2010. Policy priorities identified for ST control have included: introducing specific taxes and increasing the present ad valorem tax level, increasing the health development surcharge, designing and implementing a tax tracking and tracing system, standardizing ST packaging, integrating ST cessation within existing health systems, comprehensive media campaigns, and licensing of ST manufactures. Conclusions Our analysis shows that compared to combustible tobacco, there remain gaps in implementing and compliance with ST control policies in Bangladesh. Thus, contrary to the decline in ST use and the usual time lag between tobacco exposure and the development of cancers, the ST-related disease burden is still on the rise in Bangladesh. Strengthening ST control at this stage can accelerate this decline and reduce ST related morbidity and mortality.http://www.tobaccoinduceddiseases.org/Policy-priorities-for-strengthening-smokeless-tobacco-control-in-Bangladesh-A-mixed,140826,0,2.htmlsmokeless tobaccotobacco controlregulationtobacco taxtobacco policy |
| spellingShingle | Rumana Huque Zunayed Al Azdi Aziz Sheikh Jasjit S. Ahluwalia Masuma P. Mishu Ravi Mehrotra Nasiruddin Ahmed Linda Bauld Syed Mahfuzul Huq Syed Mahbubul Alam Faraz Siddiqui Sohel R. Choudhury Kamran Siddiqi Policy priorities for strengthening smokeless tobacco control in Bangladesh: A mixed-methods analysis Tobacco Induced Diseases smokeless tobacco tobacco control regulation tobacco tax tobacco policy |
| title | Policy priorities for strengthening smokeless tobacco control in Bangladesh: A mixed-methods analysis |
| title_full | Policy priorities for strengthening smokeless tobacco control in Bangladesh: A mixed-methods analysis |
| title_fullStr | Policy priorities for strengthening smokeless tobacco control in Bangladesh: A mixed-methods analysis |
| title_full_unstemmed | Policy priorities for strengthening smokeless tobacco control in Bangladesh: A mixed-methods analysis |
| title_short | Policy priorities for strengthening smokeless tobacco control in Bangladesh: A mixed-methods analysis |
| title_sort | policy priorities for strengthening smokeless tobacco control in bangladesh a mixed methods analysis |
| topic | smokeless tobacco tobacco control regulation tobacco tax tobacco policy |
| url | http://www.tobaccoinduceddiseases.org/Policy-priorities-for-strengthening-smokeless-tobacco-control-in-Bangladesh-A-mixed,140826,0,2.html |
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