Tomorrow is the global annual observance of World No Tobacco Day, created by the World Health Organisation (WHO) in 1987 to draw attention to the tobacco epidemic and its contribution to the spread of chronic non-communicable diseases and death. The yearly observance is seen as an opportunity to further promote awareness of the dangers of tobacco use, including second-hand smoke and to deter non-users from even thinking of trying it. It has not worked as well as it should have.

This year’s theme or focus, according to the WHO’s Tobacco Free Initiative, is on tobacco and lung health; it has already addressed most if not all the dangers of tobacco use over the past 31 years of marking the day. Tobacco is dangerous in any form: chewing, sniffing or smoking, though the majority of users smoke it. Nicotine, which is addictive, occurs naturally in tobacco plants, but it has been made even more potent by additives which producers of tobacco products have been using since the 1970s to enhance their attractiveness, taste and colour, in the name of profits. Many of these additives are either toxic by themselves or become that way when added to the tobacco products or when lit and burned in the form of cigarettes and cigars. Others are also carcinogenic (cancer causing). The American Cancer Society lists some of the chemicals found in tobacco smoke as hydrogen cyanide, formaldehyde, lead, arsenic, ammonia, benzene and carbon monoxide. This list is by no means exhaustive.

None of this is new information, nor is any of it a secret and yet people continue to use tobacco products. This is because the global tobacco producers like British American Tobacco (BAT) and Phillip Morris International (PMI) – said to be the two largest in the world – have had a jumpstart of decades during which they marketed their products well, including targeting women and young people when they felt the men market was saturated.

There have since been several moves made to reduce the hold ‘big tobacco’ has on the world, including laws preventing children from purchasing tobacco products; successfully advocating for the removal of cigarette smoking in films and TV shows; removing tobacco advertisements from movie theatres, television, magazines and newspapers and asking sports organisations to refuse sponsorship.

So far, the WHO and its global partners, including governments with the political will to resist the big bucks flashed at them by big tobacco, have been fighting an uphill battle. The tobacco companies might no longer be able to advertise as they like, but they would have to be blind not to recognise that every person who picks up a cigarette or cigar in public is a walking advertisement. Perhaps health organisations and governments would have been able to make more headway if people fell ill immediately or keeled over and died after using tobacco products. Unfortunately, they do not work that quickly, instead they slowly poison and kill users. It happens so gradually that people do not even recognise what is causing them to be diagnosed with infertility, respiratory diseases like emphysema, heart disease, oral, lung, stomach, bladder, esophageal and other cancers until a health-care provider points it out. They also fail to see that their children, as a result of inhaling second-hand smoke, suffer with asthma and other respiratory diseases and develop cancers as well.

Meanwhile, despite adverse publicity, including numerous lawsuits some of which the tobacco companies have lost and others that are still ongoing, they are yet to move towards halting their production. The reason is simple, money. Last year, PMI, an American company which has its headquarters in New York drew in revenue of US$79.8 billion, while BAT, a British multinational company with headquarters in London, UK garnered £24.4 billion in revenue; tobacco is still big business in spite of all the harm it does.

But these companies are also not sitting on their hands hoping to weather the storm. While in theory they have admitted that tobacco is harmful, they have taken the line that the harm is due to the toxicants produced by smoking – lighting and burning a cigarette or cigar. Big tobacco has therefore now moved towards what they term as “sustainability” and are producing “less harmful alternatives to cigarettes” and “potentially reduced-risk products”. And guess what? They are already taking these to the bank.

For example, BAT is now marketing tobacco heating, vapour and modern and traditional oral products including moist snuff and snus, as well as tobacco-free nicotine pouches. PMI is offering flavourful nicotine vapour products as well as two tobacco heating systems called IQOS and TEEPS that heat the tobacco without burning it. Vapour products also called e-cigarettes and hookahs (water pipes) are already very popular, particularly among young people. They are just as dangerous as tobacco products in terms of causing diseases and addiction and while that message struggles to be heard above all of the noise, big tobacco is raking in the bucks. Hopefully consumers will stop and listen before it’s too late.

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