Agrees Dr Gan Quan: "In Indonesia, one in three TB cases- over 300,000 people - get TB due to tobacco use. According to a few studies, up to 96% of male TB patients in the country smoke tobacco. It is a powerful reminder of how closely these two epidemics are intertwined. If we are serious about ending TB then we have to end tobacco use - that means, higher tobacco taxes, ending all forms of tobacco marketing, standardised health warnings on all tobacco packaging, making indoor spaces smoke- free, and offering support to tobacco users to quit."
In addition, tobacco industry is the biggest threat to implementation of evidence-based tobacco control measures, as well as to the global tobacco treaty (formally called the WHO Framework Convention on Tobacco Control or WHO FCTC), that calls upon governments to stop tobacco industry interference in public policy (Article 5.3) and hold tobacco industry legally and financially liable for the harms they have knowingly caused to human race and our planet (Article 19).
Antimicrobial Resistance and tobacco use
Dr Vineet Bhatia shared that in 2024 he was part of WHO Indonesia Drug-Resistant TB Mission along with Dr Conradie Francesca of WHO HQ. They found that there were a significant number of patients who were started on individualised drug-resistant TB treatment regimens (but not on the WHO recommended shorter DR-TB treatment regimens) because of extensive lung lesions. The biggest probable causes for this were: late diagnosis, smoking (as a lot of these patients were smokers), undernutrition and other co-morbidities associated with TB.
#EndTB and #EndTobacco as enablers of progress towards SDGs
Strong science-based evidence shows how we can screen everyone (regardless of TB symptoms) in high burden settings and offer them upfront molecular testing to find ALL TB, link them to same-day-test-and-treat with best of TB regimens (after doing drug susceptibility testing), and implement the full cascade of TB prevention (like TB preventive therapy, ending malnutrition, ending tobacco and alcohol use, diabetes prevention and control, ensuring every person living with HIV has made undetectable equals untransmittable a reality, and addressing other TB risk factors).
But reality on how we find TB, treat TB or prevent TB is far away from this science-based approach. Let us bridge this gap.
Likewise, it is high time that governments fully implement science-based tobacco control measures (such as MPOWER measures recommended by WHO and WHO FCTC) and end tobacco use.
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