WHO FCTC Global Knowledge Hub on Smokeless Tobacco Calls for Strengthening Tobacco Control and Prohibiting Spitting in Public Places

The COVID-19 pandemic has shaken us to better understand the importance of public health for human development and prevent the spread of diseases. Countries worldwide marshaled their resources towards addressing this global crisis in a coordinated manner. Despite the existing barriers in public health services, governments have responded diligently to the unprecedented challenges that the pandemic brought in. The South East Asia region shoulders the highest burden of tobacco consumption, with 81% of the global smokeless tobacco (SLT) users residing across 11 countries in this region. Full implementation of the tobacco control measures under WHO FCTC must continue even in the midst of the pandemic, to not only safeguard the hard-earned health gains but also to contain the ongoing COVID-19 pandemic. 

Under the Global Non-Communicable Diseases Action plan, countries across the world have resolved to reduce tobacco use by 30% among individuals aged 15 years or older by the year 2025. In many countries, especially in the SEAR nations, SLT use holds social sanction and its consumption is widespread. The act of chewing tobacco products also induces salivation and promotes the urge and the necessity to spit. Public spitting, especially in the context of the ongoing pandemic, has become a major public health hazard for the spread of infectious diseases including COVID-19. Moreover, there is also a risk of hand-to-mouth transmission of the SARS CoV-2 virus, as users mix SLT products in their hands and use their fingers for placing the products inside their mouth. All this makes it necessary for all the nations to bring about tobacco control measures in all its forms including the SLT to curtail the spread of the pandemic. This will prevent not only the tobacco related non-communicable diseases but also the aerosol and hand to mouth transmission of illnesses caused by SLT consumption including COVID-19. 

Unlike smoking, adverse outcomes of SLT use and its potential in the spread of COVID-19 pandemic have received little or no attention of policy makers and researchers. This is an appropriate time to reduce the demand and supply of SLT products, which are otherwise easily available, by phasing out the entire spectrum of logistics i.e., manufacturing, transport, storage, sale, use and sharing of SLT products and spitting in public places. Apart from prohibiting SLT use and spitting in public places, there is also a need to enhance public awareness about the health hazards of SLT use and the benefits of quitting it. These benefits are not restricted to cancer prevention only, but also include prevention of considerable morbidity and mortality due to cardiovascular and other tobacco related diseases. There is a need to further enhance tobacco control awareness programmes and cessation support services, including through the use of digital health platforms. In addition, it is critical to monitor the tobacco industries’ circumventing tactics and strategy to interfere in implementing tobacco control policies. These include, but are not restricted to, financial aid and donations by surrogate fronts of tobacco industry during humanitarian crises and for philanthropic causes. Increasing tobacco taxation and mandatory use of prominent pictorial and textual health warning messages on all tobacco product packages will go a long way in reducing the demand for tobacco products. 

Strict implementation of ban on all forms of tobacco advertisement and sponsorships should be strengthened further with penal provisions. All stakeholders and countries should implement these policies in a coordinated manner. During the present ongoing global health crisis, there is an opportunity to intensify and sustain tobacco control efforts with multi-sectoral collaboration. The need of the hour is to win this war against the global tobacco epidemic by bringing tobacco control measures into sharp focus along with COVID-19 containment measures, as opposed to the COVID-19 pandemic relegating tobacco control measures into background. This approach of combining control of SLT use and public spitting along with measures for COVID-19 containment in an integrated manner has the potential to increase the efficacy of both the programmes in an exponential manner. 

WHO FCTC Global Knowledge Hub on Smokeless Tobacco 
ICMR – NATIONAL INSTITUTE OF CANCER PREVENTION AND RESEARCH 
Ministry of Health & Family Welfare, Government of India I – 7, Sector – 39, NOIDA, Uttar Pradesh – 201301, INDIA 

http://www.nicpr.res.in, | https://untobaccocontrol.org/kh/smokeless-tobacco/ 
Email : director.nicpr@icmr.gov.in 

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