Yesterday, the World Health Organization (WHO) observed the International Day of No Tobacco Day. It is time for our policymakers, legislature, and health professionals to reflect on the existing situation of tobacco and alcohol use especially among young people if we want to address the substance abuse issues in the country.
The WHO highlighted the urgent need to protect children and adolescents from the deceptive tactics of the tobacco industry. Tobacco use causes over 8 million deaths annually, accounting for 13% of global deaths. Further, tobacco production consumes 22 billion tons of water and contributes to 5% of global deforestation. The economic burden of tobacco-related healthcare exceeds US$ 1 trillion yearly. Our National Health Survey 2023 revealed that 29.9% of adults use tobacco, with 17.65% and 52.35% exposed to second-hand smoke.
Similarly, Alcohol regulation is virtually non-existent, with lifted dry-days and no restriction on the sale of alcohol in the country. Today, every grocery store, hotel, and restaurant are filled with numerous types of alcoholic products. This creates easy and affordable access to children to purchase tobacco and alcohol products when violations are hardly even warned, let alone punished. Regulations on tobacco and alcohol are far more relaxed than meat and vegetables, which are allowed to be sold only in designated places.
The Prime Minister correctly said that “there are problems with drugs in the country and everyone should accept this truth and support each other to solve it. The students opt for drugs due to personal issues or peer pressure, and there is a risk of many students getting involved in such unhealthy acts”. But the government seems to think that parents are failing, and children get into drugs. The primary failure is the government and parents and peers are complicit in creating this conducive environment for children to get into habit. The state has created an environment that enables and encourages such behaviour through flawed policy of making these gateway drugs easily accessible and affordable and laxed enforcement.
Studies have shown that the lack of enforcement and abundance of access to these gateway drugs normalize and promote their consumption from a young age. Comprehensive reforms to restrict sale and display of tobacco and alcohol are necessary to control underage access to harder drugs.
The Tobacco Control Act mandates the state to design and implement effective cessation programs, to prevent and treat tobacco dependence, including providing pharmaceutical aids. However, these programs are either non-existent or limited to a few locations. Simultaneously, smoking is increasingly becoming a status symbol and a source of pride at public events and venues. No-smoking signs in public places are fading or being removed, and smokers congregate in hotels, party halls, and public restrooms. With lax enforcement allowing underage access to tobacco, alcohol, and nightclubs, schools and parents can only do so much to combat the issue.
If gateway drugs like tobacco and alcohol remain readily accessible and affordable, fighting substance abuse will remain an uphill battle. The government first needs to take comprehensive measures to curb easy access to gateway substances by enforcing existing regulations and implementing new policies to restrict their availability and appeal, especially to the youth.
Sonam Tshering
Lawyer, Thimphu
Disclaimer: The views expressed in this article are author’s own.