Why do people not quit tobacco smoking?

Globally, the tobacco epidemic is considered to be the most prominent preventable cause of death, responsible for taking lives of an estimated figure of 6 million people a year; 600,000 of the victims are second-hand smokers or non-smokers (WHO, 2015). Most of the smokers hail from low and middle income countries where the burden of tobacco-related illness and death is paramount. Tobacco smoking is a key risk factor for lung cancer, respiratory disease and heart disease that cause most deaths globally, as well as nationally. Tobacco smokers are also more susceptible to be addicted to narcotics.

Recently, The Health Minister of Bangladesh stated in a press conference that one lakh people die per year nationally from tobacco-related diseases and illness, making the death rate per hour stand at 11. Why are middle and lower income countries like Bangladesh more vulnerable to smoking?

All member states of the United Nations including Bangladesh observed (31 May) World No Tobacco Day which was proclaimed by associated countries of World Health Organization (WHO) in 1987. In 2016, the theme was 'to get ready for plain packaging':  a measure to restrict or prohibit the use of logos, colours, brand images or promotional information on packaging other than brand names and product names displayed in a standard colour and font style.

In accordance with WHO, Bangladesh has already taken various measures such as mass media campaigns, bans on tobacco promotions, increasing taxes on tobacco products, hard-hitting anti-tobacco advertisements, and graphic pack warnings. Despite that, 2.5 crore people consume tobacco everyday in Bangladesh. The figures make us confront the question as to what stimulates an individual to smoke in the first place and why can't they quit. Then why does antismoking campaign fail to influence people in quitting smoke as well as why not state ban tobacco completely?  

 Peer pressure, media influence, and experimentation are major factors which influence people to become smokers particularly adults. Young people perceive that it looks cool and smart when they are smoking. Movie stars smoke in blockbuster movies which creates the cool and macho image of smoking. Adults want to experiment with smoking to obtain the 'cool' and 'macho' experience, and to get a feel of smoking. In addition, tobacco smoking is a means of relaxation, recreation, gossip, passing leisure as well as part of culture.  Albert Bandura dubbed this as 'Social Learning' process.

The vast majority of the people are aware of the negative consequence of smoking, even at the point of purchase from the cigarette pack. Besides, every year, Government increases the tax on tobacco and it raises the price of tobacco products. The government has also banned the promotional advertisements on tobacco products.

If so, why after all these intervention and policies do people not quit smoking? Why the enduring prevalence rate? There are twofold reasons regarding this question. One, due to shocking health information and the high price of tobacco products, people think about quitting smoking but it does not motivate enough smoking cessation. Because use of fear tactics to portray negative health effects of smoking do not trigger off any effect as people feel that they are far-fetched, bearing no resemblance to reality. People also do not believe that particular behavioral change will reduce the susceptibility of those diseases. An individual also often feels that he/she is capable of quitting smoking. This is the lack of self-efficacy among individuals. Hence, anti-tobacco campaigns should target people in an emotional way, more emotional towards the people who care about them such as their mother, future wife, kids, and friends.

Secondly, the large-scale structural failure is also responsible for this epidemic. Government launches anti-tobacco campaigns, however, they are also similiarly ineffective. Media creates 'cool' image of smoking and also at the sametime advises to restrain from smoking which questions anti-tobacco campaign. At the same time, there are different laws and regulations for tobacco control which are not enforced at all. These question the intention of the state and anti-tobacco campaigns because the anti-tobacco campaign is itself a business nexus that generates money. Therefore, these campaigns are becoming a mere display of responsibility towards people rather than controlling tobacco. Sometimes, social customs allow smoking which should also be stopped. In conclusion, if state and anti-tobacco campaigns are absolutely keen to control tobacco: why not they are targeting those people who are producing and marketing this tobacco? Why not ban tobacco completely? 

The author is a university lecturer and freelance writer.