Tobacco related harm in South Asia

High mortality but some promising initiatives

To deal with tobacco we must defy a tenet that an influential section of modern society holds dear—that unfettered commerce will deliver us all from want and suffering. South Asia suffers harm from tobacco on a scale that demands a vigorous response. And it provides examples of how to deal creatively with the problem.

Worldwide about 4 million people die annually from tobacco related causes, and by the late 2020s the estimated toll will be about 10 million.1 South Asia, with about a quarter of the world's population, contributes substantially to these figures. Tobacco is used in numerous forms in South Asia.2^–4 The commonest smoked product is the bidi, which has to be puffed harder to keep it alight, making it an enhanced damage delivery device.3 Cigarette consumption is high in some countries, with average annual use of 1440 cigarettes for every inhabitant in the Maldives, 620 in …