Undernutrition and tobacco use are major determinants of TB globally. In 2021, of the 10.6 million people who fell ill with TB, 2.2 million were attributable to undernutrition and nearly 0.7 million to tobacco smoking. People who smoke tobacco have double the risk of TB disease, slower recovery, and a higher risk of unfavourable TB treatment outcomes, including recurrence of TB, death, and post-TB pulmonary and cardiovascular disease. Smoking cessation during TB treatment can improve treatment outcomes and has been shown to reduce the risk of TB infection and TB disease among household contacts as well. Improving food security and reducing tobacco smoking globally will therefore contribute significantly to the fight to end TB.
The theme of this year’s World No Tobacco Day campaign “Grow food, not tobacco” provides an opportunity to highlight the critical role of these interlinked determinants of health, including TB, and the need for collective multisectoral action to address them. It encourages governments to end subsidies for tobacco growing and use these savings to transform farming practices to contribute to improved food security and nutrition.
“As we mark World No Tobacco Day, we urge countries to strengthen collaboration between TB programmes and tobacco control programmes, and with all relevant sectors in planning and implementation of holistic people-centred services to reduce deaths and suffering due to TB and tobacco smoking”, said Dr Tereza Kasaeva, Director of WHO’s Global Tuberculosis Programme.
WHO’s End TB Strategy emphasises the need for action on TB and comorbidities, including tobacco smoking. At the 2018 UN High Level Meeting on TB, Member States committed to assuring health services that address tobacco use as part of a comprehensive package of TB services. This requires close partnership between TB programmes and tobacco control programmes, and the engagement of all key stakeholders to scale up implementation of WHO recommendations on TB and on tobacco cessation to meet this commitment. The WHO Framework for collaborative action on TB and comorbidities provides guidance on strengthening people-centred services for TB and comorbidities, including tobacco smoking.
The upcoming second UN High-Level Meeting on TB provides an opportunity to reaffirm and strengthen these commitments and accelerate progress to end TB. In the context of increasing global food insecurity due to climate change and international conflict, a shift from tobacco farming towards growing sustainable food crops can significantly impact the health and wellbeing of populations. This requires linkages beyond the health sector, something which is emphasised in WHO’s Multisectoral Accountability Framework for TB, currently being rolled out in several countries. Sustained efforts to reduce tobacco smoking and improve global food security can contribute to ending TB and achieving Health for All, and to progress towards the Sustainable Development Goals.
World No Tobacco Day is commemorated on 31 May to draw global attention to the tobacco epidemic and the preventable suffering, disease, and deaths it causes.
Source: World Health Organization