According to the STEPS Survey of Nepal 2019, around 27,000 deaths occur annually from tobacco use, which comprises about 14.9 percent of all deaths. Despite this huge loss of life, tobacco related law and taxation policy remain dismal. The government is reluctant to increase tobacco tax due to the pressure from big tobacco companies. This year too, Finance Minister Prakash Sharan Mahat did not heed the experts’ suggestion to increase the tobacco tax by 40 percent. Today, tobacco products are readily available to anyone including the minors, and they are being openly consumed in public places. The Tobacco Control and Regulation Act 2011 law bars tobacco use in public places, but the law is hardly followed or enforced.

The law also prohibits sales and distribution of tobacco products within a 100-meter radius of health and educational institutions. Again, there is no one to implement the rule. Shops and tea stalls outside hospitals, schools and colleges openly sell tobacco products.

Health journalist Kalpana Acharya says it is common to see shops and street vendors selling cigarettes and other tobacco products outside major hospitals such as Kanti Children’s Hospital, TU Teaching Hospital, Bir Hospital, and Patan Hospital, among others. Public health experts say there is no designated agency to implement the anti-tobacco laws and regulations. Ideally, the Ministry of Health and Population should be coordinating with the Ministry of Home Affairs and its subordinating bodies to implement the laws on tobacco use. But this has not been happening. There is also a lack of awareness among the public about the laws that are in place, because the government has not taken any initiative to let people know. Journalist Acharya says running campaigns on the health risks of tobacco use alone will not help. She says many shopkeepers and street vendors she talked with didn't know that there was an anti-tobacco law in the country, and that it was illegal to sell cigarettes and other tobacco products near hospitals and educational institutions. It shows that the government simply is not bothered to discourage the use of tobacco products, because it runs against the interest of tobacco companies. This is also why tobacco tax in Nepal is among the lowest in the whole of South Asia. Global experiences show that increasing tobacco excise taxes and prices is the most effective, cost-effective, and result-oriented measure for reducing tobacco use. But the government is not ready to take the path. Health experts and stakeholders that ApEx talked to as part of the Annapurna Media Network’s ‘No Tobacco Drive’ also agree that substantially increasing the tobacco tax is the sure-fire way to discourage tobacco use and save lives. They say doing so would also help generate more revenue in the form of tobacco tax. But government officials fear that raising the tax on tobacco will only promote illicit trade. However, studies have shown that tobacco blackmarket will not be that big of a problem if the tobacco tax is raised significantly. Nepal is also obliged to raise its tobacco tax as per the WHO Framework Convention on Tobacco Control, of which it is a party. The framework talks about raising tobacco excise taxes so that they account for at least 70 percent of retail prices.  So by setting low tax on tobacco, the Nepal government is flouting the rules set by the WHO. The UN health agency has also suggested the MPOWER policy package for country-level implementation of effective interventions to reduce the demand for tobacco. The six evidence-based components of MPOWER are: monitoring tobacco use and prevention policies; protect people from tobacco smoke; offer help to quit tobacco use, warn about the dangers of tobacco; enforce ban on tobacco advertising, promotion and sponsorship; and raise taxes on tobacco. Nepal has failed to comply with most of these intervention measures. Experts say for the effective implementation of the anti-tobacco law, there should be a proper interaction between government agencies and the tobacco industry, which is not happening now. To improve the situation, there is also a need for sensitization among the political parties. Our lawmakers rarely speak about those matters in the Parliament to press the government to increase taxes and implement the law. They are more focused on securing development projects in their core constituency and less on the issues related to public health. It takes commitment and cooperation from all sides if we are to create a tobacco-free, healthy society. HIghlights

• Monitoring tobacco use and prevention policies
•  Protect people from tobacco smoke
•  Offer help to quit tobacco use,
•  Warn about the dangers of tobacco;
• Enforce ban on tobacco advertising, promotion and sponsorship
• Raise taxes on tobacco.