Make killers pay

Monday 18th January, 2021

Health authorities in some parts of the pandemic-hit US are in a dilemma over the prioritisation of risk groups for vaccination. The New Jersey government is reported to have decided to vaccinate smokers on priority basis as they run a higher risk of having Covid-19 complications than others. It has drawn heavy criticism for its decision, which will result in smokers getting the jab before teachers and public transport workers, we are told.

Covid-19 vaccine saves lives, especially those of people afflicted with chronic non-communicable diseases. The opinion of the New Jersey officials is that smokers should be given the jab as early as possible if their lives are to be saved. But others are convinced otherwise; they ask whether smokers who are fully aware of the health risks they expose themselves to when they puff away at ‘coffin nails’ should get the first dibs on the vaccine. This has led to an ethical dilemma of sorts.

The critics of the New Jersey government decision insist that if smokers are a vulnerable group, they must be asked to remain indoors instead of being inoculated before others who actually deserve priority, given the essential services they render to society during the pandemic, risking their lives. Some people argue that smokers should not be discriminated against in saving lives as their right to life must also be respected. There is yet another school of thought, which opines that only those with respiratory diseases, etc., among smokers should be given priority in the vaccination programme just like those with the same health issues. But the problem is that all smokers are at a higher risk than nonsmokers where the pandemic is concerned.

A false claim is being propagated in some quarters—perhaps at the behest of the powerful tobacco industry—that smokers are underrepresented among the Covid-19 patients needing hospitalisation, and, therefore, smoking, which is associated with morbidity and mortality in many diseases, is protective against the pandemic!

Thankfully, the World Health Organisation (WHO) and the US Food and Drug Administration have given the lie to this claim. The WHO has confirmed that available evidence suggests that smoking is associated with increased severity of disease and death in hospitalised Covid-19 patients. New Jersey Health Commissioner Judith Persichilli has told the media, ‘Smoking puts you at a significant risk for and adverse results from Covid-19.” It has thus been established that smoking is a danger, especially during the pandemic, and the question is why no action has been taken against the tobacco industry, which is making huge profits at the expense of public health, the world over.

The WHO has revealed that tobacco kills more than 8 million people a year in the world; more than 7 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 second-hand smoke. The US Centres for Disease Control and Prevention (CDC) has revealed that cigarette smoking causes more than 480,000 deaths per year in the US. This is about one in five deaths annually, or 1,300 deaths a day, the CDC has said. Covid-19 has killed about two million people globally including about 390,000 Americans during the last 13 months or so. Isn’t the tobacco Mafia more dangerous than coronavirus, and what action has the world taken against it?

Sri Lanka will face the same problem as New Jersey sooner or later when the national vaccination drive gets underway, and risk groups have to be identified. If the current health crisis takes a turn for the worse with the death toll increasing exponentially—absit omen—the high-risk groups including smokers will have to be inoculated before others. The state will have to pay for most of the vaccine doses. It will be a huge financial burden on the cash-strapped government, which will invariably increase its revenue by jacking up indirect taxes. Thus, everyone will have to pay for the vaccine although it is said to be free. It may not be possible to vaccinate everyone, given the huge cost of the vaccine, logistical issues and the sheer number of people to be inoculated although Sri Lanka boasts an efficient healthcare system. How fair will it be to allow smokers to get the shots first at the expense of other citizens while the tobacco industry is earning massive profits without giving anything back for the benefit of its loyal customers?

Let it be suggested that the cost of vaccinating the people who are suffering from smoking-related diseases that predispose them to Covid-19 complications be recovered from the tobacco industry by way of a new tax. Statistics about the number of smokers, etc., are readily available and it is not difficult to determine the cost of vaccinating them. Killers must be made to pay.