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The tobacco epidemic stands as one of the most significant public health challenges the world is confronting. Annually, tobacco claims the lives of over 8m individuals, with approximately 1.2m of these fatalities attributed to second-hand smoke exposure.

In the haze of discussions surrounding the health risks of tobacco use, the environmental toll of this pervasive habit often goes unnoticed. As the global population grapples with the consequences of tobacco consumption, a shadow looms over the very Earth we inhabit. This article seeks to unveil the intricate web of environmental challenges woven by the tobacco industry and its implications for our planet.

The tobacco production cycle exhibits a notably destructive impact. From cultivation and manufacturing to consumption, tobacco inflicts widespread environmental degradation and health hazards. 

Deforestation and agriculture

One of the least acknowledged impacts of tobacco use lies in the vast swathes of land cleared for cultivation. Each year, around 600m trees are felled to produce 6trn cigarettes. Approximately five percent of the annual global deforestation is attributed to tobacco farming. This deforestation significantly amplifies carbon dioxide emissions in the environment, contributing to adverse climate change impacts. Deforestation to make way for tobacco crops eradicates biodiversity and disrupts delicate ecosystems. The use of chemical fertilizers and pesticides further compounds the environmental toll, leaving a lasting mark on the lands where tobacco takes root. The cultivation of tobacco plants necessitates substantial quantities of chemicals, many of which prove detrimental to the environment and farmers' health. This exposure to harmful substances can lead to various illnesses, such as respiratory problems, skin disorders and neurological issues among those involved in tobacco farming.

Water scarcity and pollution

The cultivation of tobacco places an extraordinary burden on water resources, intensifying water scarcity in regions where it thrives. Annually, approximately 22bn tonnes of water is utilized in global tobacco production. Notably, tobacco production demands up to eight times more water than cultivating tomatoes or potatoes. The runoff of pesticides from these tobacco fields presents a substantial risk to nearby water sources, endangering aquatic ecosystems and the well-being of both the environment and local communities.

Cigarette butts, the most visible remnants of tobacco use, are a significant source of environmental pollution. Slow to decompose and laden with toxic chemicals, they pose a threat to soil and water, leaving a long-lasting imprint on the environment. Cigarette butts contain hazardous substances such as arsenic, lead, nicotine and ethyl phenol. When these butts are discarded, these substances leach into aquatic environments and soil. While the precise environmental impact of this waste remains unquantified, the substantial volume of discarded butts raises concerns about potential leachates affecting the quality of drinking water.

A cloud of environmental cost

The journey from farm to cigarette involves energy-intensive processes and the consumption of vast resources. The paper production for cigarette packaging, often derived from deforested areas, contributes to environmental degradation. The weight of non-biodegradable packaging waste adds to the already substantial burden on the planet. They contribute to an annual production of 767,000 kg of toxic waste, while 4.5trn cigarettes scatter across our cities, parks, beaches and waterways, contaminating both land and water.

Stubbing out the planet’s health

Beyond the ecological toll of deforestation and manufacturing, the plastic pollution from tobacco wrappers exacerbates urban environmental challenges. Discarded wrappers clog drains, pile up on th streets and contribute to the global plastic crisis. Cities face blockages and increased municipal waste management challenges, further emphasizing the need for sustainable alternatives. Moreover, discarded cigarette butts stand out as the most prevalent type of plastic waste globally.

Smokeless tobacco products are usually wrapped in a plastic packet, which poses an environmental impact. In Nepal, usually during the rainy days, major cities face a similar kind of drainage blockage resulting in flooding and disrupting daily activities. 

Air pollution 

During the intricate process of curing tobacco leaves, a cascade of harmful chemicals is released into the air, becoming a significant contributor to air pollution in regions dominated by tobacco cultivation. This airborne pollution transcends the boundaries of the tobacco fields, casting a shadow over communities and posing a direct threat to the health and overall well-being of the people residing in these areas.

Tobacco cultivation contributes to air pollution. Additionally, the act of smoking cigarettes itself significantly impacts air quality. Combusting cigarettes releases over 7,000 chemicals, with at least 69 known to be carcinogenic and many possessing poisonous properties.

A study conducted in Italy revealed that cigarettes emit particulate matter into the air at a rate 10 times higher than that of a diesel engine. The combined emissions from cigarette smoke and tobacco cultivation directly contribute to climate change.

The hazards of secondhand smoke are widely recognized, emphasizing the importance of considering it not only as a public health concern but also as an environmental issue.

Global impact and social responsibility

The link between the tobacco industry and environmental degradation cannot be ignored. As consumers, it is imperative that we consider the environmental consequences of our choices. Advocacy for corporate responsibility and sustainable practices within the tobacco industry is crucial for mitigating its global impact.

Tobacco is cultivated in 125 countries, involving around 33m farmers, often receiving direct support from tobacco companies. This labor-intensive, low-yield crop demands substantial pesticide use. According to UNICEF, if the land were utilized for food production instead, it could potentially benefit 20m hungry people.

Beyond the smoke rings

In the quest for a healthier world, we must not only address the health risks associated with tobacco use but also confront the environmental consequences. It is time to unmask the hidden toll of tobacco on our planet and collectively work towards a more sustainable and responsible future. The most impactful strategy is to cease smoking altogether and, concurrently, to launch awareness campaigns discouraging the initiation of smoking.

Unveiling the concealed toll that the tobacco industry exacts on our planet, it is incumbent upon us to collaboratively forge a more sustainable and responsible future. Governments, through measures such as environmental taxes on cigarettes, can play a pivotal role, as evidenced by the positive step of enacting an environmental tax as  taken by nations like Benin, Chad and Gambia. Such proactive measures not only serve to discourage the consumption of environmentally harmful products like cigarettes but also contribute to revenue generation for the government. The imposition of environmental taxes aligns with broader global efforts to address public health concerns and mitigate the impact of climate change. By adopting such policies, governments demonstrate their commitment to creating a sustainable and healthier future for their citizens.

The recent initiatives taken by local authorities in Nepal, particularly by the Kathmandu Metropolitan City, to ban plastic-wrapped tobacco products are commendable beginnings. Nevertheless, the Supreme Court has issued a verdict to halt its implementation until the court takes a final decision. The government has the opportunity to take further steps by introducing environmental taxes on tobacco products, prohibiting the use of plastic wrappers and facilitating the transition of tobacco farms to cultivate alternative crops.

At an individual level, supporting policies banning single-use plastics, encompassing cigarette filters, smokeless tobacco pouches and disposable electronic cigarettes takes us toward a cleaner, healthier planet. In dismantling the smoke rings that shroud the environmental impact of tobacco, we embark on a collective journey toward a sustainable and responsible future. 

Safe water, sanitation and hygiene (WASH) is critical in public health. There is growing evidence that millions of people globally lack adequate WASH services and consequently suffer from or are exposed to a multitude of preventable illnesses. Lack of safe WASH services not only have adverse socio-economic and cultural impacts on people’s lives, but also weaken health systems and threaten health security at large.

While there are significant efforts from governments and civil society to strengthen, scale up and sustain inclusive and resilient WASH services, it is yet to explore how people’s health, their social-wellbeing and future resilience benefits in different socio-cultural, economic and political contexts. More attention is needed to improve access to WASH services in healthcare facilities, schools, families and public places and harness the community engagement toward Universal Health Coverage (UHC).

Provision of safely managed and sustained WASH services can greatly contribute to better health, nutrition and education in the families and communities. Shifting the locus of WASH services from infrastructure delivery, it is high time to establish inclusive, sustainable and resilient WASH systems where people’s voiced experiences, needs and choices are socio-culturally addressed in local policies, strategies and interventions.  

More significantly, WASH-related diseases and risks are wide-ranging, and these are exacerbated by a range of factors such as climate change, population growth, migration and urbanization. The infectious diseases and risks, among others, include diarroheal disease, neglected tropical diseases, maternal and neonatal sepsis and infections from unsafe healthcare waste management.

Undoubtedly, the health risks will have profound impacts on people’s social well-being and their quality of life. At the individual level, it undermines dignity and personal safety with the prevailing fear, anxiety and stress.  In the healthcare facilities, healthcare seeking behavior, safety and morale of the service providers are largely affected due to the poor provision of WASH services.   

According to WHO, 42 percent of healthcare facilities lack hand hygiene facilities at the point of care and 40 percent do not have systems to segregate waste around the world. Good hand hygiene is one of the most effective ways to reduce healthcare-associated infections and can reduce the risk of diarrhoeal diseases. Compared to hospitals, smaller facilities like clinics, health centers and health have limited access to water and sanitation services.

Therefore, integrating WASH into health systems can increase synergies and impacts on health programs such as maternal, neonatal and child health, nutrition, neglected tropical diseases, infection prevention and control, and many others. Therefore, such an integration is more likely to reduce the burden of multiple diseases and help break the vicious cycle of disease and poverty. Understandably, infectious diseases are most common among poor and marginalized populations having limited access to safely-managed WASH services.

Among WASH in health initiatives, integrating hygiene behavior change into routine immunization is a historic progress in Nepal. With the technical support from WaterAid Nepal and other implementing partners, hygiene promotion through routine immunization initiative is a nationwide scaled-up model of integrating hygiene behavior change in health systems that aims to empower mothers of children under 15 months of age in adapting key hygiene behaviors. With this intervention, evidence suggests that there is significant reduction in diarrhea and other WASH-related diseases.

Additionally, poor management of menstrual health and hygiene has a negative impact on adolescent girls and women. Still, many girls have to miss school due to menstrual cramps, heavy bleeding and fear of leakage. Therefore, a comprehensive package of WASH services is necessary for better health and education outcomes.

We continue to face healthcare waste that exposes health care workers, waste handlers, patients and their families and the community to preventable infections, toxic effects and injuries. There are critical needs of ensuring safe waste management practices in hospitals and healthcare facilities by promoting WASH in healthcare facilities in partnership with other technical agencies and relevant experts. 

Considering the critical needs of WASH in urban areas, city-wide inclusive sanitation (CWIS) is gaining priority in recent years. Recently convened ‘National Citywide Inclusive Sanitation Conclave 2023’ offered a good platform for stakeholders to share their experiences and learning in the area of WASH, and advocate for local governments to invest more in addressing WASH-related issues and challenges.

As we see, there is a growing emphasis on the sustainability of WASH services, including the need to promote community-led approaches to WASH service delivery. Despite some remarkable progress, there is an urgent need to significantly increase political commitment and ownership to deliver reliable, resilient and inclusive WASH services at scale. More concerted efforts are needed to strengthen multi-sector engagement and partnerships to increase investments in the area of WASH systems strengthening for better health outcomes at all levels.

The author is a health policy analyst

Nepal, with its abundant water resources and favorable landscape, is actively pursuing hydropower development to meet the surging energy demands and catalyze economic growth. However, concerns have arisen regarding the potential negative impacts on other sectors, prompting comparisons to the infamous “Dutch disease.” Is hydropower evolving into the “Dutch disease” of the country’s economy?

The Dutch disease

The term “Dutch disease” originated in the Netherlands in the 1970s when the country discovered and profited from natural gas resources. Several characteristics define the “Dutch disease” and its potential impact on an economy. One primary characteristic is economic imbalance, where the emphasis on the resource sector leads to the negligence of other sectors and industries, resulting in an economic imbalance. Another aspect is the decline in non-resource sectors resulting in reduced investment, job losses and a diminished capacity for economic diversification. Income inequality is a major concern as the benefits of the resource boom may not be distributed evenly across the population, leading to a risk that the wealth is concentrated in the hands of a few. Another concern is susceptibility to economic volatility as the economy becomes heavily dependent on the performance of the resource sector. Currency appreciation is another problem, which may seem beneficial, but it can have adverse effects on non-resource sectors making them less competitive.

Pros and cons of hydro development

Nepal’s ‘colossal’ hydropower potential has attracted substantial private sector involvement, acting as a catalyst for economic development and a solution to the nation's persistent energy shortages. Hydropower projects create jobs, stimulate economic activity, attract foreign investment, and foster international partnerships and technology transfer.

However, the surge in private investments in the hydropower sector has raised concerns as well. Many investments appear haphazard, ineffective, and, at times, unethical. Unsystematic and dubious investments are causing a lack of transparency and efficiency, fostering unfair practices without considering potential negative effects. Unethical practices, including financial manipulation, speculation, and corruption, are additional issues that contribute to the undermining of the sector’s integrity, eroding public trust and foreign investment. Furthermore, inadequate due diligence by investors has resulted in poorly functioning projects with technical, financial, or operational challenges and failures. Some investors prioritize short-term financial gains over long-term sustainability of projects. A growing concern is the concentration of hydropower projects in the hands of a few major players, creating an oligopoly.

‘Dutch disease’ in Nepal

The looming ‘Dutch disease’ in Nepal’s economy signifies the potential risks associated with the intense focus of investors on the hydropower sector. This heightened emphasis might inadvertently divert attention and resources away from the growth and advancement of other vital sectors. The consequences of such a single focus could be profound, primarily due to the over-reliance on energy exports, a factor that poses a considerable threat to the diversification and independence of the country's economy.

Despite the fact that energy exports can be a crucial component of Nepal’s economic development, the significant risk associated with an overemphasis on exports is the vulnerability it creates in the country's economy, especially given its reliance on importing nations. When a country heavily depends on energy exports as a primary revenue source, it becomes intricately tied to the demands of its importing partners. This level of dependence can be a precarious situation for several reasons. Firstly, the country becomes highly susceptible to fluctuations in energy markets. Changes in demand, geopolitical events or shifts in the energy policies of importing nations can result in sudden and unpredictable changes in exports and associated revenue. Secondly, the overemphasis on energy exports can lead to a lack of economic diversification. A diversified economy is more resilient in the face of external shocks because it isn’t solely reliant on a single sector. Additionally, a heavy reliance on importing nations for energy exports means that the country’s economic fate is interconnected with the policies and economic health of those nations. Economic downturns or policy changes in importing countries may result in reduced demand or changes in trading conditions, potentially leading to adverse consequences.

Furthermore, an imbalanced focus on the hydropower sector may divert attention and resources away from the development of other vital sectors like manufacturing, agriculture, tourism and other services, hindering the overall resilience of the economy. Even though large-scale hydropower projects undoubtedly contribute to energy exports and revenue generation, they may fall short in providing substantial job opportunities compared to sectors that are more labor-intensive, such as manufacturing, agriculture, tourism and other services, which offer broader employment prospects. Moreover, the concentration of hydropower projects in specific regions further compounds this issue, potentially leading to economic disparities among different regions of the country, inadvertently leaving them neglected or underserved.

A holistic approach

To mitigate potential “Dutch disease” effects, the country should adopt a comprehensive approach encompassing strategies for diversified economic growth and meticulous impact management.

Promoting diversification and multipurpose project development: Actively encouraging multipurpose projects and investing in non-hydropower sectors like agriculture, tourism, manufacturing, services and technology are crucial steps to fortify economic resilience. Investing in the development of multipurpose projects can support various sectors and regions, fostering inclusive growth and mitigating regional disparities.

Policy interventions, integrated planning and sustainable practices: Developing policies that incentivize and promote domestic consumption of hydropower is essential by fostering a competitive energy market and ensuring a stable supply for households, industries and other consumption needs. Integrated national development plans should consider the interconnectivity of various sectors, ensuring hydropower development aligns with broader economic and social objectives to reduce vulnerability to economic shocks. Emphasizing efficient and sustainable development practices involves thoroughly addressing social and environmental concerns.

Education, research and skills development: Prioritizing education and skills development is crucial to cultivating a resourceful and skilled workforce. Investing in research and innovations is crucial for the development of new technologies and sustainable practices. This initiative enhances the potential for job creation, reduces brain-drain, and may motivate the return of the workforce from foreign countries to contribute to the nation’s development.

Monitoring and evaluation: Establishing a robust monitoring and evaluation system is necessary. This system should persistently assess the economic, social, and environmental impacts of hydropower development, allowing for timely adjustments in policies. Conducting a comprehensive evaluation of the performance of existing hydropower projects in contrast to their intended targets and benefits, along with assessing their impacts, is crucial for future endeavors.

In conclusion, Nepal faces a critical juncture in balancing its hydropower surge with potential risks of the “Dutch disease.” Safeguarding against adverse effects demands a comprehensive approach, emphasizing diversification, integrated planning and sustainable practices. This ensures that the benefits of the country’s resources extend across various sectors and reach ordinary citizens, paving the way for a resilient, inclusive and sustainable economic development.

The author is a specialist in river basin and water infrastructure, currently employed at the international organization Royal HaskoningDHV, headquartered in the Netherlands. With over 27 years of professional experience, he actively contributes to dam and reservoir projects globally. He can be reached via [email protected]

There was a time when agriculture was the booming sector on which the livelihood of rural people depended. Returns were promising and increasing back then. 

In recent years, however, returns from this sector have been diminishing alarmingly despite encroachment upon forests,  pastures and marginal parcels for cultivation. Unable to make a living by relying solely on the farms, rural people have begun looking for alternatives. 

With youths leaving the villages in droves for abroad, farmlands have fallen fallow, mainly in hilly areas. Instead of agriculture, remittance is fast becoming the source of  livelihood for rural people.

Food imports have gone up in recent years, thanks to an increase in uncultivated land and increased flow of remittance resulting from a growing exodus of village youths. 

This article seeks to examine the factors turning agriculture into an unattractive sector and triggering youth exodus, and prescribes ways to revive the sector. 

The farmer needs a number of things to maximize returns from agriculture in this day and age. A large parcel of land, access to bank credit, irrigation facilities, a reliable supply of fertilizers as well as electricity and an easy access to the market are some of the prerequisites. 

But these things are hard to get in our country. Farmlands are shrinking, thanks to ownership transfer from one heir to another. Even these parcels are located in remote parts where it is quite difficult to apply modern methods of cultivation for improving both production and productivity.

With the aim of helping small farmers improve farm production and productivity, the government as well as banks have launched various microfinance schemes/programs. 

But even this intervention has failed to make meaningful changes in the farmers’ lives. First and foremost, these programs/schemes have failed to bring back the farmer into farming. What’s more, most of the beneficiaries have not been able to pay interest, leave alone the principal. Contrary to Nepal’s experience, Bangladesh has been implementing a similar program/scheme with great success. 

The way out

The need of the hour is to turn farmlands lying fallow into cultivable land and make Nepal a food-sufficient country by thinking albeit differently. 

The government in particular needs to take a number of steps, to begin with. 

First of all, it needs to go for community farming. 

How to bring parcels of land lying fallow under community farming? What should be the basis for cost and benefit sharing? 

Leasing could be one of the options. A group of persons, including entrepreneurs, can lease parcels belonging to a large number of land-holders by paying them a certain amount annually. Such groups can maximize both production and productivity in those swathes by employing modern methods of farming. This will enable food-insecure communities living close by to buy locally-grown foodstuffs at reasonable rates apart from giving sustainable agricultural practices a great boost. Large farms also mean jobs for members of local communities. All in all, such farms can bring great dividends to rural Nepal. 

However, the government has to have political will to opt for community farming. First and foremost, it needs a huge budget to lease parcels of land before leasing it out to large-scale growers. Also, the government needs to invest in the development of necessary infrastructure and provide legal, technical and financial support to the growers. 

At a time when farmlands are shrinking, the government needs to move ahead with a sense of urgency if it is serious about averting a grave food crisis.