Kathmandu-Nepal received the prestigious ‘Bloomberg Global Tobacco Control Award’ in 2015. The reason for receiving the award was that “Nepal has brought the best law in the international arena for tobacco control to promote public health.” The sections and sub-sections of the Tobacco Products (Regulation and Control) Act passed by the Parliament in 2068 (2011 November) are so good that many countries of the world are following Nepal’s example and creating laws accordingly. Some have already implemented. For example, Thailand, Myanmar, Indonesia, India and Sri Lanka, which have prepared laws much later than Nepal, are making laws and implementing them.
But, looking at the state of law enforcement, it seems that the law made by Nepal was brought only to get that award. “The government, which is expected to implement more dynamically after receiving the award, is resting in happiness,” Action Nepal president Anand Bahadur Chand, who has been working on the tobacco control campaign for a long time, quipped, “We have made the law very well. If we look at the implementation side, there is no point in boasting just because we got an award.
Tara Singh Bam, the Regional Director of Asia Pacific of The Union that works at the international level on tobacco control says that the image of Nepal at the international level was high because of the good work done by receiving the award, but it is declining owing to its poor implementation of the laws. “There is no such country in the world, where the law is not implemented even after 12 years of the formulation,” says Bam, “Nepal is the only such country in the my region, where such a good and simple law remains unimplemented.”
Officials of the Ministry of Health and Population, who are the main stakeholders in the implementation of the law, escape by blaming political instability. “Because of the lack of permanent leadership in the ministry, the implementation has been slow,” says Reshraj Sharma, Member Secretary of the Tax Fund Secretariat of the Ministry of Health, “With the arrival of new leadership in the ministry; preparations are being made to move forward in a new way for tobacco control. In a few months, the effect will be seen.”
Law and implementation status
By and large, tobacco control, law making and implementation are more concerned with public health than with international awards. The use of tobacco products has been viewed as one of the main causes of non-communicable diseases that have been increasing in recent times. Smoking is indeed the main cause of non-communicable diseases, such as heart attack, cancer, diabetes, severe asthma, stroke, sexual weakness, infertility, etc. Its influence is increasing more in developing countries than in developed ones. Diseases such as HIV, malaria, and measles, which once challenged the world as epidemics, are decreasing, while the diseases caused by tobacco consumption are increasing. Even if the effects of all three communicable diseases are added, the effects of using tobacco products are more visible, according to the data of the World Health Organization. Currently, 600,000 people die from measles in the world, while 100,000 die from malaria. Similarly, it is mentioned in the data of the health organization that 3 million people die from HIV infection. It has been found that more people have died due to consumption of tobacco products than these three causes.
Census of Nepal, 078 (2021) showed that 196 thousand people die every year. 62% of the deaths are due to non-communicable diseases, according to data released by the World Health Organization in 2022. A survey in 1996 showed that 51 percent of deaths in Nepal are due to communicable diseases, 44 percent due to non-communicable diseases and the remaining 5 percent due to other accidents. However, as the 27th year of the survey is approaching, the situation has been reversed, says Dr. Pradip Gyawali, Member-Secretary of Nepal Health Research Council. He believes that tobacco use is the main reason for the increase in non-communicable diseases. “In 27 years, the nature of communicable and non-communicable diseases in Nepal has not only been reversed, the proportion of non-communicable diseases has been increasing geometrically,” says Gyawali, “Non-communicable diseases have become an epidemic due to environmental pollution, lifestyle changes and tobacco consumption.” Although there is no exact data on how many people die due to tobacco products in Nepal, surveys based on various hospitals records have revealed that 27 to 37 thousand people die every year.
Cancer specialist, Prof. Dr. Rajendra Baral says that people who consume tobacco products are 30% more likely to develop all types of cancer than the general population. “Those who consume tobacco products are more at risk of any type of cancer,” says Dr. Baral, “Lung cancer is number one in Nepal, the main source of which is tobacco.” In addition to cancer, people who consume tobacco are more likely to have heart disease, cerebral palsy, and kidney disease. According to cardiologist Dr. Om Murthy Anil, the risk of heart attack is three times higher for people who smoke than for the normal.
Talking about the law, it not only prohibits children under the age of 18 from consuming tobacco, but also prohibits them from buying and carrying tobacco in shops. However, in Nepal, 13 to 19-year-olds start smoking. Deputy Director General, Bam says that people fall into its trap at a young age because there is not enough public awareness about tobacco. He suggested that the easiest way to prevent it would be to effectively implement the message picture printed on the shell of tobacco products. “In Nepal, the number of teenagers who fall into tobacco addiction is high, if only the laws are strictly enforced, the public health sector will be rejuvenated,” says Bam, “If only the rules against printing pictorial message and not selling loose sticks of cigarettes are strictly enforced, there will be a lot of improvement.”
Among the sections and sub-sections of the tobacco control law, only the subject of pictorial messages is in the stage of partial implementation. However, other clauses still remain unimplemented.
Impishness of Surya Nepal for 9 years
In Section 9 of the Tobacco Products (Regulation and Control) Act, 2068, it is mentioned that at least 75 percent warning pictures and messages must be printed on the wrappers and wrappers of tobacco products. After the government gave a circular to the tobacco industries to print such pictures after the enactment of the Act, the industries went to the Supreme Court. Initially, the industries that got the interim order took it for granted and violated the law. After 27 months (14th December 2007), the joint bench of Supreme Court Justices Kalyan Shrestha, Tarka Raj Bhatt and Gyanendra Bahadur Karki ruled in favor of the government, and the tobacco industry was forced to print 75% warning pictures. After 75% of the picture was printed, a study conducted by the Health Research Council and Action Nepal found that people who smoked 11 cigarettes per day reduced it to 5 cigarettes, while 25% stopped smoking itself. Based on the same section of the Act, the government issued a directive one year later on 13 Oct 2015, giving 6 months’ time to change the image of the warning message and increase the area to 90%. According to the guidelines, the changed standards have been partially implemented. Surya Nepal, which occupies 80 percent of the Nepalese cigarette market, is still printing pictures with only 75 percent of the message violating the law. Even though Surya Nepal has failed to comply with the legal standard, the government is waiting as a mute spectator in inaction.
What happened and when?
2011 –Tobacco (Regulating Control) act passed
2013 –The regulations were prepared and published in the gazette
2013-Supreme Court ruling in favor of the government, it is mandatory to print 75% warning messages and pictures on tobacco packets.
2015 –Release of instructions
2015-after 6 month The rule to increase from 75 percent to 90 percent pictures
