Second hand smoking causes about 890,000 premature deaths a year worldwide

By Ifham Nizam

The National Authority on Tobacco and Alcohol (NATA), Sri Lanka, in partnership with the World Health Organisation, has initiated a project to set up 362 Smoke Free Zones (SFZs) in Sri Lanka to protect the general public from tobacco smoke, said Supun Lahiru Prakash, Researcher on Smoke Free Zones, and introduced a 10-step process for establishing Smoke Free Zones in Sri Lankan context. NATA Chairman Dr. Samadhi Rajapaksa said exposure to secondhand tobacco smoke (SHS) was a serious threat to the health of the public and it caused death and disease in non-smoking adults and children. “It is a harmful mixture of two forms of smoke, produced from burning tobacco products, such as cigarettes, cigars, or pipes, and smoke that has been exhaled by smokers.

“There is no safe level of exposure identified to SHS. In adults, SHS causes serious cardiovascular and respiratory diseases, such as coronary heart disease, lung cancer, and stroke,” he added In addition, SHS causes low birth weight in pregnant women and sudden death in infants. At least half of children regularly breathe the air polluted from tobacco smoke in public settings. Ear infections, more frequent and severe asthma attacks, respiratory symptoms (coughing, sneezing, and shortness of breath) and respiratory infections (bronchitis and pneumonia) are some of the health issues caused by SHS to children. SHS causes about 890,000 premature deaths per annum. Children accounted for 28% of the deaths attributable to SHS in 2004. Therefore, eliminating smoking at all homes, worksites, and public places is essential in order to fully protect non-smokers from SHS. There are different strategies employed in combating tobacco-related health issues all over the world. The World Health Organization Framework Convention for Tobacco Control (WHO-FCTC) promotes smoke-free cities as an effective tobacco control strategy.

Sri Lanka is the fifth country in the South-east Asian Region to sign the Framework Convention for Tobacco Control and the first country in the region to ratify it.According to the guidance of WHO-FCTC, the National Authority on Tobacco and Alcohol Act, No. 27 of 2006 was enacted in Sri Lanka supporting preventive measures regarding alcohol and tobacco use. Sri Lanka, while the overall smoking prevalence has shown a downward trend, SHS exposure at home remains a significant problem, despite the recent laws enacted to prohibit smoking in public places.

Women and children are highly vulnerable; it is they who inevitably breathe in SHS due to the high prevalence of male household members who use tobacco. The National Authority on Tobacco and Alcohol of Sri Lanka has taken the initiative in carrying out a National programme for establishing ‘Smoke Free Zones’ for combating SHS with the help of Public Health Inspectors (PHIs) who are the main coordinators at the grass root level in 2015. During 2015 – November 2019, there were 253 SFZs established in 102 Medical Officer of Health divisions in 20 districts of nine provinces.The highest number of SFZs was established in 2018 (95) followed by 2019 (63), 2016 (55), and 2017 (35). Ninety-six percent (96%) of SFZs were sustained up to the end of 2019; however, the attention was given by PHI lesson due to the Covid-19 pandemic. However, the attempt to establish SFZs in the island again by the NATA should be very much appreciated.