Life as a teenager is not a walk in the park. It can be physically, mentally and emotionally exhausting at this age to figure out what to do in life. The temptation to step into the world of addiction through peer pressure and the urge to fit in due to the constant influence of social media may seem alluring. However, smoking certainly doesn’t make things any easier. Although it might appear amusing and entertaining from the outside, it will gradually cause significant damage in the long run.

Smoking is one of the most common causes of non-communicable diseases, which can take young lives or lead to significant morbidity at a young age.

So, the rising trend of vaping and smoking in restaurants and cafeterias, particularly among school and college students in Nepal, is alarming.

Beginning to smoke at a young age is associated with numerous immediate health risks and paves the way for severe, long-lasting illnesses that may arise later in life. Whether through traditional cigarettes, e-cigarettes, or vaping devices, the adverse effects are highly detrimental. All types of tobacco consumption are damaging, and no level of exposure can be considered safe. Nicotine, present in all these products, is the primary agent of harm. Adolescent exposure to nicotine can lead to cognitive, functional and developmental problems. Not only is nicotine highly addictive, but it also poses a threat to brain health, particularly in young individuals whose brains are still developing.

Health issues

Research indicates that young people who smoke or are frequently exposed to smoke face a significantly heightened risk of developing health issues, including cardiovascular diseases, various cancers and respiratory ailments like asthma and dental problems. This underscores the necessity for extensive education and intervention efforts aimed at preventing youth from smoking or vaping to safeguard their health from irreversible harm.

The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing over 8 million people a year. More than 7 million of those deaths are the result of direct tobacco use, while around 1.3 million are the result of non-smokers being exposed to second-hand smoke.

Looking at this data, the global burden of tobacco-related illness is expected to rise, particularly in low and middle-income countries where its control measures can be less stringent. With the growing population and rapid urbanisation, second-hand smoke exposure could become a concern in densely populated areas. Additionally, the emergence of new tobacco products, such as e-cigarettes and heated tobacco devices, results in long-term side effects and new addictive patterns. If current tobacco use patterns persist, an estimated 5.6 million youth under age 18 will eventually die prematurely from a smoking-related disease, according to a report.

Nepal only began taking precautions and control of tobacco consumption in the early 1990s. This was heightened by the taxation of international brands in 1992 and the banning of advertisements on audiovisual media in 1998. Later, in 2003, the WHO Framework Convention on Tobacco Control (WHO FCTC), the first global strategy on tobacco control, was initiated. The government used this as a guide to formulate, implement and evaluate extensive multi-sectoral national tobacco control plans and strategies.

Further, SDG targets aim to reduce the prevalence of tobacco consumption from 30.8 percent to 15 percent by 2030. Nepal’s Ministry of Health follows WHO, FCTC and the MPOWER approach for tobacco control and prevention. The country also has provision for one of the world's largest pictorial health warnings (PHW) (images on tobacco products) after it increased the size from 75 percent to 90 percent in any form of package.

Despite some promising interventions in the implementation of PHW in Nepal, the smoking trend seems to be increasing at an alarming rate. Although policies regarding a smoke-free environment in public places with penalty provisions are in place, there is poor compliance due to weak institutionalisation. Ineffective warnings, monitoring and cessation programmes are the behavioural challenges associated with it.

Policy intervention

To combat the tobacco epidemic effectively, robust policy compliance mechanisms should be implemented and strictly enforced. Key measures include prohibiting sales and consumption in public places to minimise secondhand smoke. Additionally, verifying the legal age and non-pregnancy status for purchases can protect vulnerable populations.

It is imperative to outlaw single-unit sales and mini-pack marketing of tobacco as these tactics frequently increase tobacco’s accessibility and attractiveness, especially among young people and low-income purchasers. Authorities should closely monitor the industry and penalise deliberate violators of tobacco control legislation, such as misleading marketing strategies and attempts to circumvent rules. Tobacco use can be significantly reduced through strict control, multi-sectoral coordination, community involvement and public awareness initiatives.

As there is an increasing trend of smoking among adolescents, cessation interventions should be targeted at schools and colleges. Designing targeted interventions such as peer education groups to initiate discussions at schools, colleges and youth clubs is paramount to achieving this. As many youths use social media, its use in awareness campaigns might be effective. Street dramas and quit-line support campaigns can also be influential in this approach.

Quitting smoking has multiple health benefits that can be seen within hours or minutes. It can lower a person’s heart rate and blood pressure, and blood carbon monoxide levels can be expected to return to normal. Coughing and shortness of breath usually go away within one to nine months and circulation and lung function return to normal within 3 months. Within 10 years of stopping smoking, the chances of dying from lung cancer is decreased by 30-50 percent. According to recent data, the risk of dying from ischemic heart disease is halved within five years of quitting, and the risk of stroke returns to that of a newer smoker within five to 15 years. Stop smoking habits today to live a healthy life!