Tobacco control and salt reduction initiatives are needed

To make more far-reaching inroads in the battle against chronic non-communicable diseases (CNCDs), The Bahamas should adopt smoking bans and salt reduction initiatives as undertaken in countries around the world.

“The state of our collective health is in peril,” declared Health Minister Dr. Duane Sands during Monday’s Supplementary Budget debate in Parliament as he highlighted statistics from the Ministry of Health’s recently completed STEPS 2019 survey.

Among those statistics was a 145 percent increase in the use of tobacco products over their usage 15 years ago.

What was not referenced was the role of exposure to secondhand smoke in the country’s incidences of CNCDs, particularly among the thousands of Bahamians employed in the country’s hospitality sector.

Concerns over the years had been expressed by some that smoking bans would have a negative impact on the tourism sector, but these fears are not consistent with the findings of leading bodies of research on smoking bans and tourism.

Such fears also elevate protecting the revenue of an industry over protecting the health of Bahamians who make the industry possible and viable.

According to the U.S. Centers for Disease Control (CDC), there is no risk-free exposure to secondhand smoke.

The CDC advises that secondhand smoke contains 70 cancer-causing chemicals and its exposure caused the deaths of 2.5 million non-smoking adults in the U.S. since 1964.

Secondhand smoke causes conditions in adults including coronary heart disease, stroke and lung cancer, according to the CDC, and is found in research to increase the risk of breast cancer, according to the U.S. National Cancer Institute.

In a report released by the World Health Organization (WHO), 482 Bahamians died from cancer in 2018 with 933 new cancer cases recorded that same year.

Among the new cases were 200 cases of prostate cancer, 60 cases of colorectal cancer, and 25 cases of lung cancer in men, and 166 cases of breast cancer, 55 cases of colorectal cancer, and 39 cases of corpus uteri among women.

In its April 2018 NCD report, the Healthy Caribbean Coalition — a regional civil society grouping of over 40 Caribbean-based health NGOs — indicated that five countries in the region had implemented tobacco control legislation/regulations consistent with the WHO’s Framework Convention on Tobacco Control (FCTC): Trinidad & Tobago, Barbados, Jamaica, Suriname and Guyana.

The Bahamas ratified this framework treaty back in 2009, with the last legislative discussion on the matter having occurred back in 2015 when then Health Minister Dr. Perry Gomez advised Parliament that the ministry was involved in a multi-agency drafting of a tobacco control bill.

All Bahamians ought to be able to work and live in safe environments, and our visitors ought to be provided the same level of safety which cannot be provided if the public is not protected from exposure to secondhand smoke.

Also in his budget debate speech, Sands highlighted that Bahamians consume “double the amount of recommended salt”.

The WHO, which recommends that adults limit their salt intake to just under a teaspoon in total per day, says approximately 2.5 million deaths could be prevented each year if global salt consumption was reduced to the organization’s recommended level.

High salt intake increases one’s risk of hypertension, heart disease and stroke — all primary killers in The Bahamas.

Results of a 2015 study published by the US National Center for Biotechnology Information (NCBI) entitled, “Salt Reduction Initiatives around the World – A Systematic Review of Progress Towards the Global Target” indicated that 75 countries had adopted national salt reduction strategies which mostly included industry engagement to reformulate products, establishing sodium targets for foods, consumer education and taxes on high-salt foods.

Salt reduction legislation establishing mandatory targets, food procurement policies and taxation had been implemented in 33 countries, with 12 countries reporting reductions in population salt intake, according to the study.

In the Eastern Mediterranean, countries such as Kuwait gradually reduced the salt content of bread through its public bread supplier which provides the majority of the bread in the market, according to a 2018 WHO report.

The WHO, meantime, has created for member states a SHAKE Technical Package to aid in the development, implementation and monitoring of salt reduction strategies to enable reductions in population salt intake.

Similar strategies should be evaluated and introduced here at home as the battle against CNCDs rages on.


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