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ISLAMABAD: As the Covid-19 pandemic spreads, STOP (Stopping Tobacco Organizations and Products), a global tobacco industry watchdog, has strongly urged governments and civil society to hold tobacco companies accountable for the burden they have placed on the people and the health systems.

According to the World Health Organization (WHO), tobacco kills more than eight million people globally every year, more than seven million of them from direct tobacco use and around 1.2 million non-smokers are exposed to second-hand smoke.

Based on the WHO's 2013 estimates, as many as 19.1 percent of Pakistan's adult population currently use tobacco in some form or other.

The Pakistan Pediatrics Association has estimated that 1,000 to 1,200 children aged six to 16 years take up smoking every day in the country.

The COVID-19 is an infectious disease that primarily attacks the lungs.

Smoking impairs the pulmonary immune function, making it harder to fight off coronavirus and other respiratory diseases. Studies by public health experts, recently commissioned by the WHO, found that smokers are at higher risk of developing severe Covid-19 complications and death. Smokers may also be physically more vulnerable to contracting the Covid-19, as the act of smoking involves contact of fingers with the lips, which increases the possibility of transmission.

Contaminated cigarettes may also be a factor; it was reported in the news that a manufacturing unit of a multinational tobacco company in Pakistan was shut down after 44 of its workers tested Covid-19 positive. Even before the Covid-19 pandemic, tobacco placed a massive burden on healthcare systems globally.

A 2018 WHO study estimated that smoking resulted in $422 billion in health costs in a single year.

With no end to the pandemic in sight, and Pakistan being one of the worst affected, the country's under-par and over-worked health system is struggling to keep up with the sudden increase in demand for resources and manpower.

Much of the previous global focus on prevention and cessation focused around non-infective respiratory, cardiovascular, and cancer related deaths.

However, during pandemics such as Covid-19, the risk of infectious complications becomes the predominant focus and concern.

Some countries have banned the sale of tobacco products during lockdown periods. Unfortunately, Pakistan did not. Now, as healthcare systems rush to increase capacity for the surging number of patients, inadequate public health infrastructure will need even more funding. The scenario is far worse for poorer countries.

The Economist reported that per capita health spending in Pakistan is a mere 0.5 percent the level of that in the United States. The economic cost of smoking in Pakistan is estimated to be Rs143.208 billion annually.

Tobacco manufacturers should be held accountable, if smoking results in disease and death. Nicotine is a highly addictive substance and quitting a struggle for most smokers. It has been proven beyond doubt that the tobacco industry is well aware of the adverse effects of smoking. In fact, it deliberately manipulates the amount of nicotine in cigarettes to maintain addiction, and has attempted to conceal these issues. Governments like Pakistan that have ratified the Framework Convention on Tobacco Control, a global treaty, have the power to hold tobacco companies financially and legally accountable for their abuses.

Our government should use that power to regulate the industry and discourage smoking. The most effective way is a steep increase in taxes, resulting in a significant decrease in demand.

These can also yield much-needed revenue that can be allocated to support healthcare systems. Research has shown that when tobacco prices increase, fewer people begin using tobacco, more people quit, and users reduce their consumption.

This is especially true for youths and other price-sensitive consumers. Governments can also levy fees on tobacco manufacturers to fund quit-smoking programmes.

The WHO suggests such fees may include licensing, registration, manufacturing and retail fees, and carry penalties for non-compliance. Tobacco manufacturers have been engaging in reprehensible PR gimmicks during the COVID-19 pandemic. They have supplied ventilators, masks and the PPE to health facilities and made donations to charities.

These token gestures come nowhere close to compensating for the vast damage caused, and the rich profits reaped at the expense of individuals and governments.

The Covid-19 pandemic has brought into sharp focus the immense human and financial costs of healthcare, economic recovery and investments in better public health.

Governments have the power to make tobacco manufacturers pay for the damage they have caused before and during the pandemic, and to use the revenue generated to fund critically needed healthcare system enhancement. Let us not delay any further.