Submission of the Pakistan Medical Association (NWFP) to the WHO public hearings on the Framework Convention on Tobacco Control

We all know that smoking is injurious to health. It is one of the biggest hazards of today’s life. Cigarette smoking is not only injurious to the health of the smokers but also for those around him/her ie for passive smokers. In the beginning smoking was restricted to the male members of our society but now women and children have also fallen a prey to his evil. Every day more and more people take up smoking and this process is catalyzed by the promotion of different brands of cigarettes, in the form of advertisements on TV and print media, these glamorous and attractive ads shown on TV lure the people into taking up this evil. It is one of the biggest and main causes of death in the world. This fact is of much concern that 40 million people annually die of smoking throughout the world and this figure will reach a 100 million by the year 2030. But how is “smoking” such an evil for the health of masses? The answer is that the three main things present in the smoke of a cigarette (which the smoker inhales) are tar, carbon monoxide, and nicotine. Let us analyse the effects of these injurious factors: • Tar: When inhaled, smoke condenses about 70% of the tar which is deposited in the smoker’s lungs. Condensed tar is a sticky brown substance that causes the staining of smoker’s teeth and fingers. • Nicotine: It is a powerful and fast acting drug, a substance in tobacco, which causes addiction among smokers. When inhaled nicotine is absorbed in the bloodstream. The immediate physiological effects being that of increased rate of heart beat and blood pressure. • Carbon monoxide: An odorless, tasteless and a poisonous gas which gives no warning of its presence – can be fatal in large amounts. It cuts down the efficiency of smoker’s breathing. Other substances in cigarette include acetone, cadmium, arsenic etc, which are equally poisonous. Its effects on health are: • Smoking reduces the rate of lung growth • In adults it causes heart diseases and strokes • Cigarette smokers have a lower level of lung function than those persons who have never smoked • On average someone who smokes a pack or more of cigarettes each day lives seven years less than someone who never smoked • Smoking hurts young people’s physical fitness in terms of both performance and endurance • Smoking is associated with a host of other risky behaviours, such as fighting and engaging in unprotected sex Keeping all this and other factors in mind, it was decided to make efforts to put a stop to the spread of this evil, to remind the people of the world of its harmful effects on their health. It was decided that a “World Anti-Smoking” or “World No-Tobacco Day” should be celebrated each year. A WALK was jointly organized in Peshawar on 31st of May, 2000 by • Pakistan Medical Association (NWFP) • College of Family Medicine, • Pakistan Anti-Smoking Society (PASS) • Pakistan Chest Society • Pakistan Hypertension League (Peshawar Chapter) • Diabetic Association of Pakistan (NWFP) • NWFP TB Association This walk started from Irnum Hospital Peshawar and ended at the Engineering University of Peshawar. This walk was led by NWFP Health Minister Dr Shaheen Sardar Ali and Dr Umar Ayub Khan, President Pakistan Medical Association (NWFP). Students from different Schools and Colleges of Peshawar took part. Prominent among the participants were students of Khyber Medical College, Islamia Collegiate School, Kabir Medical College, Farkhanda Institute of Nursing and others. The walk was followed by a press conference addressed by Dr Umar Ayub Khan, President Pakistan Medical Association (NWFP), Dr Saeed ul Majeed and others. The day after the walk a Symposium was also held at Peshawar on World No Smoking Day, under the Chairmanship of the Federal Minister for Health, Dr Abdul Malik Kansi, who had specially traveled to Peshawar from Islamabad, in view of the importance of this issue. The hall where the Symposium was being held was packed to capacity and was decorated with banners and poster on anti-smoking. The aims and objectives of this walk and Symposium were: • To create public awareness regarding health hazards of tobacco • To counter the advertising campaign of tobacco multinationals • To cooperate and collaborate with other similar societies at local, national and international levels • To undertake the research to assess and treat the local problems • To help prevent people, especially youth from starting tobacco use • To help people quit tobacco addiction Federal Health Minister Dr Abdul Malik Kansi was the chief guest on the occasion. While speaking at the symposium, he announced the establishment of a national task force to look into the growing use of tobacco and its implication. Pakistan Medical Association (NWFP) President Dr Umar Ayub Khan wondered why the Government, which churns out ordinances regularly from Islamabad, cannot issue an ordinance to ban the use of tobacco. He regretted that there was no mention of an anti- smoking campaign in the national and provincial health policies drafted by past Governments. He said that it was high time that an official campaign should be started. Dr Umar Ayub Khan said that there should be a ban on smoking in public places and selling cigarettes to minors, and that measures restricting promotion of tobacco use should also be implemented under the Smoking Control Act 1996. Quoting from government surveys, he pointed out that the number of smokers in the country was growing and the youth in particular was taking up smoking. He also stressed that the Government should discourage smoking on PIA international flights, like many other airlines already have. Also if doctors are found smoking in the offices at public sector hospitals they should be dealt with through a polite letter from the Pakistan Medical Association to fulfill their ethical obligation by setting a good example. Dr Umar Ayub Khan also suggested raising the prices of cigarettes through taxation by the Government. Others who spoke on the occasion included Dr Saeed ul Majeed, Dr Abdul Samad, Dr Mohammed Tufail, Dr Sher Mohammed, and Dr Mukhtar Zaman. The Provincial Health Minister Begum Shaheen Sardar Ali also attended the function. The Pakistan Medical Association congratulates the World Health Organization on this initiative to establish an international treaty to protect human health from the evil of tobacco, and lends its full support to the proposed Convention.