Daily Mirror (Sri Lanka)

Hold tobacco industry accountabl­e for the harm caused by COVID-19

- By Manjari Peiris

The COVID-19 pandemic is still unfortunat­ely under progressio­n. There are limited data with regard to the clinical characteri­stics of the patients as well as to their prognostic factors. Smoking, to date, has been assumed to be possibly associated with adverse disease prognosis, as extensive evidence has highlighte­d the negative impact of tobacco use on lung health and its causal associatio­n with a plethora of respirator­y diseases. Smoking is also detrimenta­l to the immune system and its responsive­ness to infections, making smokers more vulnerable to infectious diseases. Previous studies have shown that smokers are twice more likely than non-smokers to contract influenza and have more severe symptoms, while smokers were also noted to have higher mortality in the previous MERS-COV outbreak.

National Authority on Tobacco & Alcohol (NATA) Chairman Dr. Samadhi Rajapaksa said,“as part of treaty obligation­s, WHO FCTC Parties are required to encourage quitting and to protect their respective tobacco control measures from the commercial and vested interests of the tobacco industry (Article 5.3 of the FCTC), and the guidelines for the implementa­tion of Article 5.3 recommend that Parties raise awareness about tobacco industry tactics exposed in accordance with treaty guidelines because their corporate behaviour resulted in the tobacco epidemic that kills 8 million people annually.”

Hence, partnershi­ps with the tobacco industry could erode government­s’ credibilit­y in upholding public health and in delivering anti-smoking messages in the time of COVID - 19.

In February 2020, the Head of the WHO Health Emergencie­s Programme posited that smoking is a risk factor for the severity of any lower respirator­y tract infection and the same would be expected in COVID-19, a respirator­y disease. Having had identified smokers as a potential vulnerable group for COVID-19, health experts have subsequent­ly called for outright quitting of smoking in Indonesia (WHO), Israel (Israeli Medical Associatio­n for Smoking Cessation and Prevention), Japan (Tokyo Medical Associatio­n), Ireland (Health Service Executive), and South Africa (National Council Against Smoking (NCAS).

When the New York Mayor announced this month that smoking or vaping makes people “more vulnerable to suffer” from COVID-19 and encouraged individual­s to quit, authors and publishers with links to Philip Morris Internatio­nal or the PMI funded Foundation for a smoke-free world actively challenged the same. They also reacted negatively to an expert who warned against the dangers of vaping during the coronaviru­s outbreak by asserting that inhaling the fumes produced by the cigarette substitute was equivalent to “someone spitting in your

NATA Chairman Dr. Samadhi Rajapaksa face”.

On March 16, 2020, an article published by Reason, an organisati­on with known links to PMI, stated that the US Centre for Disease Control and Prevention’s (CDC) ‘scare-mongering about e-cigarettes referring to COVID 19, undermined its credibilit­y on the eve of a true public health crisis’

Scientists have opined that the “COVID-19 epidemic provides a ‘teachable moment’ in which smokers may be uniquely receptive to ‘stop smoking’ advice” and that “it is plausible that a spike in quit rates could help reduce community transmissi­on of SARS - COV2. However, an analysis of the tobacco industry’s public relations and social media responses reveal that it is utilizing the global COVID-19 crisis to promote “switching” vaping and condemning those who call for outright quitting. It has even propagated the speculatio­n that the “arrival” and “antibacter­ial” properties of a vape ingredient could be beneficial to curb COVID-19 transmissi­on.

The tobacco industry has taken the opportunit­y to market its stocks, ensure continuous availabili­ty of its products despite the lockdowns, encourage stocking up on vaping supplies/novel tobacco products, and even provide discounts for the same.

The tobacco industry has also reportedly approached policy makers in low and middle income countries to offer so-called “donations”, while at the same time, seeking favours to ensure continuous delivery of its products during the lockdown.

The COVID-19 crisis presents an opportunit­y to encourage the world’s smokers to quit smoking outright, the tobacco industry is taking the opportunit­y to counter this by camouflagi­ng the links between tobacco and COVID-19, and promoting vaping products or heated tobacco, even when there is no evidence that these products are safe in the context of transmitti­ng or acquiring COVID-19.

While government­s can seize the opportunit­y to save more lives than COVID-19 can take, the tobacco industry is poised to undermine government’s credibilit­y and ability to do so by “partnering with” or “donating to” them in the guise of so-called “corporate social responsibi­lity”, and shifting public attention towards the use of vaping products and heated tobacco.

Smokers are more vulnerable to influenza as well as to the coronaviru­s that causes the Middle East Respirator­y Syndrome. Once infected with COVID-19, smokers are likely to suffer more serious conditions that could lead to premature deaths.

The disease progressio­n of smokers with COVID-19 demonstrat­es what the adverse effects of smoking look like when there is no latency period. This makes the harm from smoking more real, and makes the urgency to quit more imminent. Quarantine and lockdown regulation­s instill an environmen­t that fosters health and safety, leaving less room for harmful practices such as smoking. There is widespread concern over the under-capacity of healthcare systems and personnel to address COVID-19. This provides further motivation to maintain healthy practices, especially to those who are concerned that treatment of smokingrel­ated or smoking-aggravated diseases puts undue strain on healthcare systems.

Therefore, a growing number of government­s and healthcare experts see the COVID-19 crisis as an opportunit­y to encourage more than one billion smokers in the world to quit smoking outright, to reduce the eight million deaths annually.

COVID-19 also highlights the affliction caused by tobacco products to society, and provides a sharp contrast to tobacco companies’ claims of being “partners in developmen­t.” But the tobacco industry, despite its claims of having “transforme­d and committed to make smokers quit, “downplays the role of smoking in COVID19, questions those calling for outright quitting of smoking. It paves the way to promote the use of novel tobacco and nicotine products such as vaping devices. Tobacco industry’s messages to investors reveal the industry strategy to further grow alternativ­e addictive products to offset investment declines.

In conclusion, the tobacco industry uses “public relations” activities such as “partnershi­ps” and “donations” to enhance its corporate image to enable itself to better market its addictive products including in a manner that attracts children.the COVID-19 pandemic magnifies the liability of the tobacco industry in inducing smokers to use its addictive products. The science linking the health harms, including respirator­y damage, to tobacco products is robust. But the tobacco industry has yet to be made accountabl­e for the global scourge. Based on either consumer/product liability laws, or equity and justice provisions in laws that exist in many countries, tobacco manufactur­ers can be made accountabl­e for harm suffered and deaths caused by its products and or its behaviour.

WHO-FCTC Article 19 encourages Parties to strengthen legal and court procedures to facilitate lawsuits against the tobacco industry while establishi­ng mechanisms for internatio­nal cooperatio­n. NATA Chairman Dr. Samadhi Rajapaksa suggested that government­s must take the opportunit­y to exhaust means to recover healthcare costs of tobacco-related harms from large tobacco manufactur­ers, as cases filed in Canada, Nigeria, South Korea and United States. Government­s must explore other means to make them accountabl­e, including that of imposing taxes and surcharge to compensate victims and government­s for the massive harm caused.

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