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Quitting smoking is as important as wearing a mask

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World ‘No Tobacco Day’ falls tomorrow on the theme ‘Commit to Quit’

by Randima Attygalle

Chemicals found in nail polish, rat poison, battery acid, car exhaust fumes, paints, rubber cement and gasoline are just a handful of what you will find in a single cigarette. A lighted cigarette create more than 7,000 chemicals and nearly 70 of them are known to cause cancer; and many are toxic. While many of these chemicals found in consumer products carry warning package labels (eg. rat poison), there is no such warning about toxins in tobacco smoke, points out the American Lung Association.

While cigarette smoking is the most common form of tobacco use worldwide, all forms of tobacco including water pipe tobacco, smokeless tobacco products, cigars, pipe tobacco, bidis and kreteks (used in Indonesia) are all harmful. ‘The tobacco epidemic’, according to the WHO, is one of the biggest public health threats the world has ever faced, killing more than eight million people a year around the world. More than seven million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to tobacco smoke. ‘Over 80% of the 1.3 billion tobacco users worldwide live in low and middle-income countries, where the burden of tobacco-related illness and death is heaviest. Tobacco use contributes to poverty by diverting household spending from basic needs such as food and shelter to tobacco,’ notes the WHO.

Cigarette smoke reduces the amount of oxygen carried to tissues and even in case of COVID patients, oxygen saturation (percentage of oxygenated hemoglobin returning to the right side of the heart) levels are low. Consultant Respiratory Physician and Senior Lecturer from the Department of Anatomy, Faculty of Medicine, University of Colombo, Dr. Yamuna Rajapakse points out that several studies have now confirmed that oxygen saturation is less in patients who smoke compared to non-smokers. “Smokers function in a low oxygen saturation environment, hence they are at greater risk than non-smokers during COVID lung involvement.”

Smoking causes thrombosis or blood clot formation. This could lead to stroke, heart disease and peripheral vascular disease. COVID too causes thrombotic effects and smoking may increase this risk she explains. Tobacco smoking is a significant risk factor for both viral and bacterial infections of the respiratory system. Smokers are five times as likely to develop influenza and twice as likely to have pneumonia. This, as many reputed medical journals including the British Medical Journal (BMJ) confirms, is an important factor worsening the impact of COVID-19. ‘There is evidence from case series that smoking is associated with more severe disease, a greater risk of intensive care need and excess mortality in people with COVID-19 admitted to hospital,’ notes the BMJ.

Smokers have more phlegm in their system and experience bouts of what is commonly known as the ‘smoker’s cough’. “Tobacco smoke burns the protective mechanism we have in our lungs which acts as a buffer against dust, viral and bacterial particles entering the respiratory system,” says the physician. She adds that smokers are more likely to develop pneumonia and this risk is aggravated in COVID patients who smoke.” Dr. Rajapakse also remarks that while the majority of COVID patients are asymptomatic, smokers show more COVID symptoms as research findings from China and UK also confirm.

New tobacco trends such as shisha smoking (smoking tobacco through a water bowl via a hose or tube) has also become an added problem notes Dr. Rajapakse who also warns that sharing of cigarettes and shisha tubes could increase the transmission of COVID and other respiratory infections.

Lung cancer which is the leading cause of cancer death the world over with smoking long established as a major cause, is now being diagnosed in a younger adult population. “Today we see advanced lung cancers in those in their 30s and 40s. Although genetic predominance is also present in lung cancer, a sizable percentage is attributed to second-hand or passive smoking (involuntary inhalation of other people’s smoke). Victims include women exposed to a smoking spouse.” Pregnancy is the worst time one could be around smoke, says the physician who warns that babies born to mothers exposed to passive smoking have lower lung reserves. Low birth weight is also common among such babies. Third-hand smoke where residual nicotine and other chemicals are left on indoor surfaces, clothing etc. is also bad for people who are exposed to them.

Entailing symptoms similar to asthma with wheezing and coughing, Chronic Obstructive Pulmonary Disease (COPD) is another serious smoke-induced condition. A non-reversible condition, COPD does not respond very well to inhalers, explains Dr. Rajapakse. Smokers with a specific enzyme deficiency can end up with COPD prematurely, she warns. Besides noncommunicable diseases such as high blood pressure, heart disease and stroke, smokers are also at a higher risk of having intermittent claudication and vascular ulcers leading to amputation of limbs, she says.

Despite tobacco smoking being established as a real risk factor for COVID-19, seriously compromising immunity and structural functioning of the respiratory system, there is very little discourse on it, observes the Consultant Psychiatrist from the National Hospital of Sri Lanka and the Director, Centre for Combating Tobacco, Dr. Mahesh Rajasuriya.

“Not smoking is as important as wearing a mask, yet the tobacco industry has been careful in downplaying this,” says the Psychiatrist who adds that apart from developing very serious complications, tobacco smoking also directly violate COVID control measures. “Smokers are compelled to remove their masks to smoke and even if they are smoking outdoors, there is a tendency for them to interact with a few more people in a small enclosure inhaling and exhaling each other’s breath more sharply. Here the risk of contracting COVID is enormous. Secondly our health care system is already exhausted with COVID patients and if a smoker suffers a heart attack, a stroke or gets pneumonia to which they are more susceptible, it will add to the burden.”

While hardly anyone “pledges to smoke to the grave”, most smokers wish to quit at sometime but several factors prevent them from doing so, says Dr. Rajasuriya. “These can be broadly classified into demand and supply factors. While the former makes smokers want to smoke again, the latter keep the environment conducive to smoking such as making cigarettes cheaper and more accessible.” Although the price of a cigarette should be more than what it is now in the Sri Lankan market compared to other consumer goods, it has on the contrary become more affordable, driving those from lower socioeconomic levels and youngsters who are still dependent to become addicted, says Dr Rajasuriya. “The tax increases on cigarettes too has been fraudulent with less money going to government coffers and larger proportions to the tobacco industry.”

The non-availability of a local license system as in the case of many countries including several in the region such India and the Maldives, makes cigarettes freely available, he points out. The absence of a law banning single stick sales adds fuel to fire during the pandemic he says. “Added to the physical touch when selling single sticks, the smoker does not see the pictorial health warnings on cigarette packs.”

A large majority of smokers quit without any psychological help says the psychiatrist who observes that the tobacco industry has created a myth that quitting is an uphill task and only those with extraordinary willpower can do so. “It is imperative to see through this myth first if you want to quit smoking,” he reflects. Certain stereotypes ingrained in the brain such as the need for physical pharmaceutical support for quitting often discourages a smoker wanting to quit the habit. “Another myth which needs to be debunked is that cigarettes need to be replaced with another chemical to help one to quit.”

The benefits of quitting tobacco are almost immediate, confirms the WHO. ‘After just 20 minutes of quitting smoking, your heart rate drops. Within 12 hours, the carbon monoxide level in your blood drops to normal. Within two to 12 weeks, your circulation improves and lung function increases. Within one to nine months coughing and shortness of breath decreases. Within five to 15 years, your stroke risk is reduced to that of a non-smoker. Within 10 years, your lung cancer death rate is about half that of a smoker. Within 15 years, your risk of heart disease is that of a non-smoker.

While some can navigate the transitional phase after quitting, many experience ‘withdrawal symptoms’ such as irritation, anxiety for which medication may be required. Getting rid of not merely cigarettes but all smoking associated paraphernalia including lighters and ashtrays is vital when preparing to quit says Dr. Rajasuriya. The comprehensive course designed by the Centre for Combating Tobacco, Help Quit sponsored by the WHO country office helps those who aspire to quit smoking and other support personnel including doctors, nurses, psychotherapists, counselors etc. to assist others to quit.

“The image about smoking is negative today, although the tobacco industry is trying hard to project otherwise. In this exercise, social media is now heavily used to induce the smoking habit and also to target a locally untapped market of young girls and women. Hence it is important for the public to see the true picture and not be deceived by the tobacco industry’s marketing strategy,” concludes Dr. Rajasuriya.



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The challenge of being positive about SAARC

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The RCSS forum addressed by SAARC Secretary General Ambassador Md. Golam Sarwar in progress. (Pic courtesy RCSS)

It was a few years back that a former President of Sri Lanka took it on himself to pronounce SAARC ‘dead’. Since then there have been other sections of Sri Lankan opinion that have joined the critics of SAARC and taken the solemn stance that SAARC has indeed died what may be called a natural death.

Their fatalism is understandable. SAARC has failed to meet at heads of government or state level for the past several years to take the SAARC process notably forward. Regional cooperation has more or less been only an appealing idea. No substantive concrete projects have taken off to make the idea a hard reality. ‘Inner paralysis’ seems to be SAARC’s lot. Hence the fatalism in these circles.

However, being one of the worst cash-strapped regions of the world and a teemingly populated one with people virtually left to their devices, what choices do the ‘SAARC Eight’ have other than to try their best to band together and continue with their cooperation efforts, however small they may be?

There is no escaping the mounting debt trap for many of these countries and bankrupt Sri Lanka is a glaring example, but ‘throwing in the towel’ and abandoning themselves entirely to the diktats of the strongest economies and their agencies will prove a ‘living death’ for many countries in the SAARC fold.

The gains may be meagre but giving-up on SAARC cooperation in full would prove self-defeating for the organization and South Asia. Right now, the collective intention ought to be to salvage what the region could from the tenuous cooperative efforts. Moreover, such initiatives could go some distance to generate a degree of goodwill among the Eight and help in sustaining a dialogue process.

Given this backdrop it proved ‘a stich in time’ for the Regional Centre for Strategic Studies (RCSS), Colombo, to recently host the SAARC Secretary General Ambassador Md. Golam Sarwar to a round table discussion on the unifying potential of SAARC and its future possibilities, besides other related issue areas.

Held on June 24th and moderated by RCSS Executive Director and former ambassador Ravinatha Aryasinha, the forum brought together a vibrant, wide ranging audience comprising academicians, diplomats, senior public servants, civil society activists and many others. Following the presentation by Ambassador Golam Sarwar titled, ‘Reigniting SAARC: Achievements, Challenges and the Way Ahead’, a lively Q&A followed.

The above forum could be described as an act of lighting the proverbial ‘candle’ rather than ‘cursing the darkness.’ It surely is a ‘darkness’ that could be seen as daunting considering that the region’s pivotal powers, India and Pakistan, are failing to act in a spirit of accord but are engaged in bitter finger-pointing on a number of questions of vital importance to SAARC.

On the other hand, what is the rest of the region doing to bring the above sides together? It is disappointing that to date the rest of SAARC has failed to launch a major diplomatic drive to bring peace between the feuding regional heavyweights. It needs to act without delay and establish its earnestness and this effort would need to prove SAARC’s staying power in the unfolding months and even years.

In assessing SAARC’s seeming failure local opinion in particular has failed to factor in what could be described as weak leadership. Since Sheikh Mujibur Rahman of Bangladesh, the founding father of SAARC, the region has failed to produce a visionary leader who could advance the SAARC cause with charisma and drive.

Among other reasons, weak leadership accounts considerably for the faltering and stuttering status, as it were, of SAARC. Badly needed are leaders who could go the extra mile, think less of narrow national interests and work diligently towards the collective well being of the region but SAARC’s millions of ordinary people have been made to wait in vain for leaders of such stature. Instead, they have been burdened with politicians who seem to be relishing the apparently moribund state of SAARC.

Looking back, it could be said that it was the dynamic leadership factor that led to the launching of the Non-Aligned Movement and for its sustenance for a few decades. True, it could be seen in some quarters that NAM is no more, but as in the case of SAARC, the former too has been unfortunate to be burdened over the years with politicians who lack the vision and drive to unflaggingly advance the fortunes of the South. NAM and SAARC lack the dynamism and vision of leaders of the stature of Jawaharlal Nehru, for example, to give them the required guidance and intellectual depth.

The reasons are complex for there not being among us currently political leaders with the vision and the steadfast commitment to advance the legitimate interests of the South. However, it could be stated with conviction that the majority of Southern leaders have too easily caved in to the demands of the global North and its financial agencies.

These leaders have failed to see, for instance, that the largely market economy oriented Northern governments would not view with favour a centrist economic model that attaches priority to the interests of the dis-empowered publics of the South. This realization ought to have dawned on the current government in Sri Lanka, for instance, some while ago but it has no choice but to abide by IMF dictates since economic survival at present is unthinkable without the latter’s succour.

Accordingly for SAARC this should be the time for some soul-searching. Priority needs to be attached to ending the feuding between India and Pakistan since at present the material fortunes of the region hinge largely on these regional giants giving peaceful relations among them a try. This is no easy challenge to meet but some daring, visionary diplomacy needs to take hold among the rest of SAARC.

There is some sense in SAARC bringing the peoples of the region together through programs that address their best collective interests. A meeting of minds among SAARC nations could enable SAARC and its agencies to build a region-wide people’s movement for progressive political and economic change that could in turn lead to the region’s political leaders sensitizing themselves more to the neglected needs of their publics.

However, the time is ‘now’ for the initiation of these progressive changes and the voice of SAARC well wishers would need to drown out those of their critics.

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OPA seminar examines Sri Lanka’s economic recovery, resilience and growth pathways

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(L to R) Dr Achinthya Koswatte, Anushan Kapilan, Dr Harsha Aturupane, Bhanu Wijeyaratne, Vice President, OPA and moderator of the discussion, and Eng Chamil Edirimuny, General Secretary, OPA, at the head table.

A seminar, “Sri Lanka’s Economic Crossroads: Navigating Recovery, Resilience and Growth” was recently held by the Organisation of Professional Associations of Sri Lanka (OPA) at the OPA Auditorium, bringing together economists, OPA members, and professionals from diverse fields for an insightful discussion on Sri Lanka’s economic recovery and future growth prospects.

The event was held under the patronage of Jayantha Gallehewa, President of the OPA, and was jointly organised by the National Issues Committee (NIC) and the Seminars, Workshops and Programmes Committee of the OPA. The event reaffirmed the organisation’s commitment to advancing professional excellence, fostering insightful intellectual engagement, facilitating interdisciplinary knowledge exchange and creating a constructive platform for informed dialogue on issues of national importance.

The panel of speakers comprised Dr. Harsha Aturupane, Lead Economist and Programme Leader for Human Development at the World Bank for Sri Lanka and the Maldives; Dr. Achinthya Koswatta, Senior Lecturer in Economics at the Open University of Sri Lanka, and Anushan Kapilan, Lead Economist at Verité Research.

In his welcome address, the President of the OPA emphasised that Sri Lanka was at a critical juncture in its economic recovery journey where sustained reforms, effective implementation, and collective national commitment are essential to achieving long-term stability, resilience and inclusive growth. He noted that the country had experienced one of the most severe economic crises in its history with the economy contracting by 7.8 percent in 2022 and a further 11.5 percent in 2023, resulting in significant economic and social challenges.

Delivering his introductory remarks Bhanu Wijeyaratne, Vice President of the OPA and Chairman of the National Issues Committee, underscored the need to move beyond short-term economic stabilisation towards a comprehensive agenda of structural transformation. He observed that the economic crisis had revealed deep-rooted weaknesses within the economy, including persistent fiscal pressures, rising public debt, foreign exchange limitations, and insufficient diversification of the export base. He stressed that addressing these challenges through strategic reforms, institutional strengthening and long-term economic planning would be essential to establishing a more resilient and competitive economy.

While acknowledging recent positive developments, including improved inflation management, tourism recovery and signs of economic stabilisation, Wijeyaratne stressed the need to advance reforms aimed at strengthening fiscal discipline, enhancing productivity, improving competitiveness, developing human capital and reinforcing governance and institutional effectiveness.

He further highlighted the important role of professionals, businesses, academia and other stakeholders in contributing to evidence-based dialogue and supporting Sri Lanka’s journey towards a resilient, inclusive and sustainable economic future.

Delivering the keynote presentation, Dr. Harsha Aturupane provided a comprehensive assessment of Sri Lanka’s economic prospects within the broader context of global economic transformation. He argued that Sri Lanka functioned as a small open economy whose performance is significantly influenced by developments in the global marketplace. External factors could not be controlled, and the country must strengthen its domestic capacity and resilience to respond effectively to international economic shifts, he noted.

Tracing the evolution of global economic systems, Dr. Aturupane highlighted the transition from ideological divisions between state-controlled and market-oriented economies towards increasingly pragmatic approaches focused on growth, competitiveness and development. He noted that Sri Lanka’s own economic journey reflects a similar evolution, with contemporary policy debates now centred on practical solutions for sustainable economic progress.

The presentation also examined the transformative impact of globalisation. Dr. Aturupane observed that global economic integration had enabled several East Asian economies, including South Korea, Singapore, Taiwan and Hong Kong, to achieve remarkable economic advancement through export-led growth strategies. Sri Lanka similarly benefited from this process through the expansion of its apparel industry and increased integration into global value chains.

Turning to Sri Lanka’s recovery programme, Dr. Aturupane emphasised that the ongoing stabilisation process should be viewed as a national programme supported by the International Monetary Fund rather than solely as an IMF initiative. He observed that strong worker remittances, improved tourism earnings, enhanced government revenue mobilisation and prudent import management have contributed significantly to economic stabilisation.

Despite this progress, he cautioned that rebuilding foreign exchange reserves and meeting future debt obligations remain major challenges. He underscored the need to strengthen export performance, attract investment and generate sustainable foreign exchange earnings to ensure long-term economic resilience.

The discussion also focused on monetary stability, inflation management and exchange-rate policy. Dr. Aturupane stressed that maintaining price stability was fundamental to sustainable growth and household welfare, while sound monetary policy remains essential for preserving economic confidence.

Looking beyond stabilisation, he argued that Sri Lanka must transition towards a broader economic transformation agenda. Sustainable growth, he noted, will depend on expanding productive capacity through investment, technological advancement, innovation, skills development and structural reforms.

Among the key constraints identified was the high cost of energy, which continues to affect competitiveness and investment attractiveness. Dr. Aturupane emphasised the importance of improving efficiency and affordability within the energy sector to enhance Sri Lanka’s business environment.

He further highlighted the social dimensions of the crisis, noting the rise in poverty and economic vulnerability among households. Strengthening social protection systems and ensuring inclusive growth, he argued, must remain central components of the national development agenda.

Another critical challenge identified was Sri Lanka’s demographic transition. With an ageing population, outward migration and evolving labour market dynamics, the country is increasingly confronting labour shortages in several sectors. Dr. Aturupane suggested that greater automation, increased labour-force participation and strategic workforce planning would be necessary to address these emerging realities.

Concluding his presentation, he emphasised the need to improve governance, strengthen institutions, enhance competitiveness and create an enabling environment for private sector investment. Sri Lanka’s future success, he noted, will depend on its ability to move decisively beyond crisis management towards a development model founded on resilience, innovation, productivity and inclusive growth.

Dr. Achinthya Koswatta reiterated the importance of policy consistency and predictability in fostering investment and industrial development. She observed that frequent policy changes create uncertainty and discourage long-term investment decisions, whereas stable and coherent policy frameworks build confidence and support sustainable economic transformation.

Meanwhile, Anushan Kapilan highlighted the substantial progress achieved in restoring macroeconomic stability following the recent crisis. He noted significant improvements in fiscal performance, including increased government revenue, reduced reliance on debt financing and a historically low fiscal deficit.

He further observed that public debt levels are declining faster than anticipated, economic growth has exceeded expectations and inflation has been brought under control more rapidly than forecast. Nevertheless, he cautioned that the recovery remains uneven, particularly within the industrial sector and that many households have yet to experience a meaningful improvement in living standards.

The seminar was expertly coordinated by Eng. Chamil Edirimuni, Vice President of the OPA and Chairman of the Seminars, Workshops and Programmes Committee, while the technical moderation and interactive discussion session were facilitated by Bhanu Wijeyaratne, Vice President of the OPA and Chairman of the National Issues Committee.

The event was attended by Tisara De Silva, President-Elect of the OPA, Eng. Ravi Rupasinghe, General Secretary, Past Presidents, members of the Executive Council, representatives of the General Forum and professionals representing a wide range of disciplines.

The seminar concluded with a vibrant exchange of ideas and perspectives, reaffirming the importance of evidence-based policy dialogue, institutional collaboration and collective national commitment in advancing Sri Lanka’s economic recovery, resilience and sustainable growth.

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Her roots run deep in Sri Lanka

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Samantha Kay: Now based in the UK Samantha’s biggest passion is helping people, especially women, build confidence and believe in themselves Today, her focus is on radio, podcasting and coaching women Whenever she visits Sri Lanka, she says she loves spending time on the beautiful south coast, especially Hikkaduwa and Mirissa She released a song with 90s music icon Angie Brown, which reached No. 9 in the UK Club Charts

Yes, for UK-based presenter and artiste Samantha Kay, home is where the heart – and the roots – are. And her roots run deep in Sri Lanka.

In an exclusive interview with The Island, Samantha says “I’m proud to be Sri Lankan. My mum is from Kandy and my dad is from Colombo, so Sri Lanka has always held a very special place in my heart.

“Whenever I visit Sri Lanka, I love spending time on the beautiful south coast, especially Hikkaduwa and Mirissa. It’s somewhere I always feel connected to my roots and completely at peace.”

Now living in Bournemouth, on the south coast of England, where, she says, she is lucky to be close to some of the UK’s most beautiful beaches, including the iconic Sandbanks, Samantha has built a career that refuses to fit into one box.

She is a radio presenter, podcast host, singer-songwriter, personal trainer and life coach.

“I genuinely love the variety because every role allows me to connect with people and, hopefully, make a positive difference in someone’s day.”

Of course, music has taken her far.

One of her proudest achievements, she says, was releasing a song with 90s music icon Angie Brown, which reached No. 9 in the UK Club Charts.

She also reached the final stages of The X Factor and performed at Wembley Stadium in front of thousands.

Beyond music, Samantha competed in bikini bodybuilding across the UK, winning several titles. “It taught me discipline, resilience and self-belief,” she recalls.

Today, her focus is on radio, podcasting and coaching women. Her podcast encourages people to live life on their own terms rather than feeling pressured to follow society’s expectations.

Says Samantha: “Whether someone is single, changing careers, travelling solo or simply trying to find their purpose, I want them to know that it’s never too late to create a life that feels authentic. If you’ve ever felt like you don’t fit into the box, maybe you were never meant to.”

Samantha Kay also spent a year in Dubai, performing at five-star hotels, including FIVE, and coaching at the iconic outdoor gym on Palm Jumeirah.

“I taught strength and conditioning classes, and hosted wellness retreats, combining my passion for music, health and inspiring others.”

However, with family matters calling her back to the UK, she made the choice to return. “Family comes first,” she says.

Looking ahead, Samantha plans to grow her radio and podcast work, release more music, and expand her wellness retreats.

“My biggest passion is helping people, especially women, build confidence and believe in themselves,” she says.

“Wherever my career takes me, I hope to continue inspiring others to live with courage, kindness and authenticity, while never forgetting my Sri Lankan roots.”

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