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Tobacco addiction remains a serious public health issue in Bangladesh, with studies showing extensive usage across key demographics across the country. Though the country has tried to achieve progress in implementing tobacco control, the approach remains fragmented. Various government ministries and agencies operate with conflicting interests, undermining the core essence of integrated policy execution. To effectively address this issue, Bangladesh must adopt a unified governance approach that integrates all relevant sectors under a coherent, regulation-centric framework.
Despite being one of the first signatories of the Framework Convention on Tobacco Control (FCTC) in 2003, Bangladesh continues to struggle with uncoordinated policymaking in tobacco control. The situation has been further complicated by a recent amendment to the Import Policy Order of 2021-2024, enacted by the interim administration, which prohibits the importation of safer alternatives to conventional tobacco products. The significance of this restriction is particularly concerning given that a 2022 WHO study found that 13.1% of Bangladesh’s adult population over the age of 15 is addicted to cigarettes, with many actively seeking safer alternatives as they consider quitting.
Islam, M. M. (2023). identified a second major issue in Effective tobacco control measures in Bangladesh require a whole-of-government approach. The issue is the lack of coordination among different regulatory bodies. For instance, enforcement officers are always in a state of confusion regarding their responsibilities, leading to ineffective monitoring of tobacco sales and prohibition of smoking in public places. While the Ministry of Health advocates for strong measures against smoking, there are other ministries that prefer to prioritize economic interests for the country. The Ministry of Finance for example, considers the tobacco industry a significant earner, and the Ministry of Industries encourages foreign investment in tobacco production. This conflict prevents the government from formulating concrete and practical policies.
As the mentioned research by Islam M. M. emphasizes, a unified government strategy requires coordinated action by all the involved ministries. To do so, instead of limiting tobacco control to the Ministry of Health, the government must integrate tobacco policies into economic, agricultural, and labor strategies. The National Tobacco Control Cell (NTCC) must be restructured into a fully autonomous and authoritative body, free from excessive external influence from external agencies such as the Bloomberg Philanthropies backed Campaign for Tobacco Free Kids and Vital Strategies. While international collaboration is valuable, independent decision-making is crucial for aligning policies with national priorities. The NTCC should be expanded to include representatives from key ministries such as Agriculture, Finance, Labor, Industries, and Local Government, ensuring a multi-sectoral approach. Placing it under the Prime Minister’s Office or the Cabinet Secretary would grant it greater authority to implement policies effectively. Additionally, it must develop a clear action plan with defined milestones and accountability mechanisms, enabling it to enforce tobacco control measures decisively rather than serving as a passive advisory body.
Also authoritative leadership from political authorities at the highest level is required. Top-down commitment towards tobacco control is required, which can harmonize all agencies into the country's public health agenda. Bangladesh has the potential to lead global tobacco control efforts, but to do so, it must eliminate policy fragmentation, resolve internal conflicts, and develop a nationally driven approach that prioritizes public health. Through the adoption of a unified government strategy as its top priority and resisting excessive outside pressures, the country can make its dream of being tobacco-free a reality without compromising economic stability and public health.
Messenger/JRTarek
