A RECENT article reported that the US state of California may raise the legal age for buy cigarettes from 18 to 21. As I read this, I wondered if we should feel happy or satisfied that teenagers will not be able to buy tobacco products in California now. Should I commend the courage of the state legislators who have approved the restriction on the sale of cigarettes to teenagers or rather lament over their falling short of asking for a complete ban on smoking? Talking about the restriction, I believe, at the most, it might delay smoking by youngsters for some years; yet, it will not eliminate or reduce smoking. One can give a sigh of relief, but, believe me, it is purely an ephemeral and temporary measure, since what matters now is not age-based restrictions or selected conditions for buying cigarettes, but an absolute ban on tobacco production for non-medical use. Thankfully, we eliminated different economic, social and health scourges from the world in the last two centuries and we can take legitimate pride in having done so as well as commend the leaders who were behind such movements. Many economic and social maladies including slavery, racial discrimination and inequality have been eradicated to a large extent from different societies. Similarly, different countries have restricted the production, manufacturing and sale of many products found to be injurious to health and causing death. However, it is really very sad that we have not paid enough attention to the serious risks which tobacco poses to the health of those who consume it in different manners and forms. This may sound a bit harsh, yet, I find no sanity in the argument that an absolute ban on producing or selling tobacco products or disallowing its use by the common man would infringe upon the rights and freedom of people. Accepting that contention should directly lead us to permit the sale of drugs including heroin, hashish, marijuana, etc. to one and all because it might be said that people have the right to eat, drink or consume whatever they wish. Can we do that or allow that to happen? Has this ever been plausible anywhere in the world? Certainly not. Even the most liberal societies cannot afford to make the sale of drugs legal on any grounds or pretext. Another argument against a ban on smoking is that it would promote illicit trade and consumption, but this is similar to the former argument. Should we be concerned about such threats or risks? In the beginning, there will be such issues, but they will gradually disappear. Even if they exist marginally, we will be successful if we have emancipated a large portion of the population from the menace of smoking. Present statistics indicate that cigarette smoking will consume over one billion lives in the 21st century, ten times more than the number of deaths attributed to smoking in the 20th century. The statistics state that cigarette smoking is causing over six million deaths every year and that the number will reach eight million a year by 2030. If one adds the number of deaths caused by other tobacco products such as the direct consumption of tobacco, a common practice in the Asian subcontinent and many African countries, the number of fatalities will swell further. Moreover, these figures do not include the deaths of passive smokers. Several studies have proved emphatically that cigarettes have killed half of those who have used them for a long period of time. Now do we need more research or data to impose a complete ban? With the above stark figures in our clear sight which cannot be disputed, why and how can we allow cigarette smoking to continue in our society? A change in the nicotine content of cigarettes from 2 percent to 0.1 percent could drastically reduce the number of deaths and diseases, yet, it will not eliminate deaths from cigarette smoking and, therefore, we should not allow ourselves to be hoodwinked by cigarette companies. Secondly, the progress achieved in making tobacco more inhalable has made the lungs more vulnerable to the toxicity of tobacco as smokers do not have any difficulty in inhaling the nicotine deep into the lungs. Besides having a direct impact on smokers, the harmful effects that emanate from the production of cigarettes and other tobacco products cause damage to economies and societies at large. The massive amounts of pesticides which are used to protect tobacco plantations and the huge deforestation due to the use of wood for making charcoal for flue curing, a process to make tobacco inhalable, pose serious environmental issues. A great impediment to imposing a ban is the strong tobacco lobby around the world and especially in the US where the tobacco industry is concentrated. The tobacco lobby works hard to influence legislators and regulators and employs discreet and tacit means to keep them happy so that they will not raise their voices against the production or sale of tobacco products. Governments the world over are concerned about the adverse economic impact from the imposition of a ban on the production and sale of tobacco products, especially the decrease in revenue which they extract in the form of different taxes and duties on tobacco producers and cigarette companies and the potential risks of unemployment if the industry is shut down. However, this is offset by the huge expense being incurred by public health systems in treating the diseases directly attributed to smoking and the losses due to the death of smokers who contribute to their societies and economies. As a rough estimate, cigarette smoking costs over $300 billion to the US economy every year in treating smoking-related diseases and the direct economic impact from the loss of people of working age. Most countries have done very little to publicize the risks of cigarette smoking. They have been content to oblige tobacco companies to display warning signs on cigarette packs or to ban the advertisement of tobacco products. A lot needs to be done to educate the general public about the danger of using tobacco products. Hundreds of suits including some class actions have been raised in courts of law against tobacco producers and cigarette companies for causing deaths and incurable diseases. Although, in a few individual cases, the courts have awarded decent compensation, yet, no court has yet decreed compensation in the amount which would force the closure of businesses and become a precedent for other jurisdictions to follow or act as a deterrent for tobacco companies. A quick glance at tobacco-related litigation indicates that in most cases, tobacco companies were successful on the pretext that smokers knew about the risks posed by smoking but still continued to smoke. In the US, even state governments have failed to prove their case before the courts. Ridiculously, in one instance, the attorneys general of 46 US states agreed to settle the matter by having tobacco companies pay them annual sums to compensate them for health care costs. This sounds as if the states were only concerned about the expenses being incurred by their health care systems and had no regard for the loss of lives due to smoking. The highest compensation ever awarded anywhere in the world was probably $ 23 billion awarded by a jury in Florida, which, was unfortunately overturned by the Appeals Court, which shrank the sum to just $17 million. Tobacco companies defend themselves by stating that they are producing cigarettes as per permissible laws and regulations, and as such they cannot be held liable for smoking-related diseases and deaths. Therefore, only governments can rescue people from disease and death related to smoking by legislating laws and implementing them with full force. Obviously, it is not possible to impose an immediate and thorough ban on tobacco products since smokers will need time to quit smoking. However, there should be a plan which includes a clear timeline for a sure and certain ban on the production of tobacco for non-medical use and a complete halt on the making of cigarettes and cigars. In this interim period, smokers are encouraged to gradually stop smoking and should be provided with different means to enable them to do so. Wherever feasible and practical, they should be provided with incentives in cash or kind to stop smoking. As an interim measure, governments should order the lowering of nicotine levels in cigarettes. The media and Non-Governmental Organizations (NGOs) will have to create awareness and bring pressure on governments to act for the greater good of society. Safi H. Jannaty,
