Need for crackdown on smoking

As Barbados continues to be tardy in honouring all its obligations under the Framework Convention On Tobacco (FCTC), the country is being warned of dire consequences to its public health.

But in addition to highlighting the problem, public health specialist Dr Nastassia Rambaran has also suggested several initiatives to turn the situation around, including Government provision of a quit line to help addicts kick the habit and provide nicotine replacement therapy at subsidized costs for low-income individuals.

She said while this might be costly now, it would save Government much more in the long-run.

“What should be encouraged . . . is the development of a national toll-free quit line with a ‘live’ person available 24 hours to offer support and advice –– an intervention of proven efficacy. This can be coupled with integration of cessation services into the public health system –– accomplished by training existing staff and developing some dedicated cessation specialists,” Rambaran argued in the latest Barbados Association of Medical Practitioners’ (BAMP) bulletin.

Rambaran said that should be boosted by cost subsidisation of nicotine replacement therapy (NRT) and medication, provided at affordable prices, to low-income earners.

“This coordinated effort will incur some cost, but will be offset by the decreased health expenditure on smokers unable to quit,” she said.

Rambaran cautioned that without constant vigilance and the support of regulations, the island could easily slip on tobacco control.

She reminded health authorities that ever since ratifying the convention in 2005, only two pieces of legislation had been passed which addressed the protection of minors from tobacco products and the prohibition of tobacco smoking in public places.

“Together, these have had some success in improving tobacco control, but implementation has been far from perfect,” the medical practitioner suggested.

“In addition, the country lags behind in fulfilling several FCTC obligations, including labelling of tobacco products, offering cessation services and banning tobacco advertisements, promotions and sponsorships. To ensure all the success so far is not lost, the battle needs to continue on, and these areas be addressed as priorities in the scaling up of the public health response to tobacco use in the country.”

Rambaran also drew Government’s attention to the recommendations of the FCTC, which she insisted must be treated as priority.

“These priority policy recommendations, along with enhanced policing of current policies, are needed to push back the tobacco industry in Barbados.

“With increased trade liberalization and loss of markets in the developed countries, transnational companies, such as BAT [British American Tobacco], have their eyes set on expanding into vulnerable developing countries,” she cautioned.

She insisted that in order to decrease the large health care costs and continued smoke exposure generated by smokers who were unable to quit, Government must address Article 14 of the convention which speaks to “demand reduction measures concerning tobacco dependence and cessation”.

Rambaran said while comprehensive cessation services were unlikely at this time, given that money was scarce   and expenditure on health needed to be prioritized, the quit line and other initiatives should be the focus.


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