Will alcohol and tobacco use jeopardize the response to COVID-19?


Amidst the COVID-19 crisis initially the government was trying to enforce compliance of social (physical) distancing norms very strictly. However, rush of migrant workers to home, which was unpreventable, and big queues infront of liquor shops, which were entirely preventable, have thrown all safeguards regarding distancing to wind. In Lucknow at two community kitchens being run for the needy some people consumed liquor on 4 May and created ruckus such that the kitchens had to be shut down. The ultimate losers were women and children. Unable to resist the temptation to generate revenue, which seems to be as strong as temptation for liquor itself, the government has ensured that the money which would otherwise have been spent on food or medicines for the family of poor would now be squandered.

As per the World Health Organization (WHO), tobacco and alcohol both increase the risk to coronavirus disease (COVID-19). Tobacco and alcohol industries coax children and young people with their lies and deception tactics to lure them into addictions that cause diseases, misery and untimely deaths. Even the often-cited argument that governments earn revenue from tobacco and alcohol is not fully true, because governments lose much more money if we look at the cost of diseases, disabilities and untimely deaths caused by these addictions. 

The WHO’s writing on the wall is clear: there is “no safe limit” to tobacco and alcohol consumption. Tobacco and alcohol corporations have knowingly marketed a product that kills, using deception and lies. The industry lobby has pushed its markets even in the times when the world is hit strongly by the public health emergency of COVID-19. For example, the alcohol industry lobby said last month “According to the Food Safety and Standards Authority of India, food and alcohol are essential commodities...” One blessing in disguise of COVID-19 is that everyone on the planet probably knows by now that food is among the most essential needs of humankind. But alcohol and tobacco are not only non-essential but they will actually defeat us in our efforts to contain COVID-19.

alcohol increases the risk of severe COVID-19 outcomes

According to the WHO, “Alcohol is known to be harmful to health in general, and is well understood to increase the risk of injury and violence, including intimate partner violence, and can cause alcohol poisoning. At times of lockdown during the COVID-19 pandemic, alcohol consumption can exacerbate health vulnerability, risk-taking behaviours, mental health issues and violence.”

The WHO adds: “Alcohol consumption is associated with a range of communicable and noncommunicable diseases (NCDs) and mental health disorders, which can make a person more vulnerable to COVID-19. In particular, alcohol compromises the body’s immune system and increases the risk of adverse health outcomes. Therefore, people should minimize their alcohol consumption at any time, and particularly during the COVID-19 pandemic.”

Alcohol is responsible for 3 million deaths a year worldwide. Tobacco kills over 8 million people every year. Each of these untimely deaths due to alcohol and tobacco could have been averted. This is entirely a human-made pandemic, propelled by its industry knowingly.

The WHO also warned that “Alcohol has effects, both short-term and long-term, on almost every single organ of your body. Overall, the evidence suggests that there is no “safe limit” – in fact, the risk of damage to your health increases with each drink of alcohol consumed. Alcohol use, especially heavy use, weakens the immune system and thus reduces the ability to cope with infectious diseases. Alcohol, even in very small quantities, is known to cause certain types of cancer. Alcohol alters your thoughts, judgement, decision-making and behaviour. Heavy use of alcohol increases the risk of acute respiratory distress syndrome (ARDS), one of the most severe complications of COVID-19. Alcohol has a deleterious effect on your immune system and will not stimulate immunity and virus resistance.”

link between alcohol and violence

Increase in violence against women has emerged as a serious concern during Covid-19 lockdown. Stress, disruption of social and protective networks, decreased access to services due to the lockdown have exacerbated the risk of violence for women (as well as their children), especially those who are in abusive relationships.

WHO has stated categorically that “Alcohol is closely associated with violence. It increases the risk, frequency and severity of perpetration of interpersonal violence such as intimate partner violence, sexual violence, youth violence, elder abuse, and violence against children. Men perpetrate most of the violence against women, which is worsened by their alcohol consumption”.

deadly partners: tobacco and COVID-19

Scientific evidence from COVID-19 hard-hit countries globally has shown that elderly people and also those with conditions such as non-communicable diseases are at a much higher risk of severe outcomes of COVID-19, including death. Tobacco use is the biggest common risk factor of major NCDs such as heart diseases and stroke, cancers, diabetes, chronic respiratory diseases among others. Both tobacco smoking and vaping adversely affect the respiratory system and have the potential to damage the lungs as well as weaken the immune system. Tobacco has a deadly connection with the world’s biggest killer infectious disease tuberculosis (TB), which heightens the risk of serious outcomes of COVID-19.

The recent release of a report by the National Institute of Health in Italy stated that more than 99% of those who have died from COVID-19 had pre-existing medical conditions, including high blood pressure, heart disease, Chronic Obstructive Pulmonary Disease, and diabetes. Tobacco (along with alcohol) is a major common risk factor for all these listed conditions.

According to Ministry of Health and Family Welfare, Government of India, 86% of deaths due to COVID-19 have exhibited comorbidity related to diabetes, chronic kidney issues, hypertension and heart related problems. Tobacco is again a common and major risk factor here (along with alcohol).

Tobacco spitting in public places could enhance the spread of the COVID-19. According to Indian Council of Medical Research (ICMR), “Chewing/ smokeless tobacco products (Gutkha, ‘Paan masala’ with tobacco, ‘Paan’ and other chewing tobacco products) and areca nut (supari) increase the production of saliva followed by a very strong urge to spit. ICMR has urged to refrain from consuming smokeless tobacco products and spitting in public places. State Government of Uttar Pradesh in India had banned the sale of ‘paan masala’, in view of the alarming COVID-19 pandemic in March 2020.

tobacco and alcohol revenue is less than economic loss because of it

With the looming danger of economic recession due to COVID-19, it becomes even more vital to avert the huge financial cost of tobacco use to the global economy. According to the World Bank, “Tobacco-related deaths are not only preventable tragedies but have an important economic cost. Worldwide, the total economic damage of smoking (including medical costs and productivity losses from death and disability) has been estimated at more than US$ 1.4 trillion per year, equivalent to 1.8 percent of the world’s annual Gross Domestic Product (GDP).”

The economic evaluation report prepared by the World Economic Forum and the Harvard School of Public Health states that 5 NCDs (cardiovascular disease, chronic respiratory disease, cancer, diabetes, and mental illness) “could contribute a cumulative output loss of US$ 47 trillion in the two decades from 2011, representing a loss of 75% of global GDP in 2010 (US$ 63 trillion).”

Even if we believe the lie of industry that ‘tobacco and alcohol revenue is needed for development’ (which is not true of course if we see the economic loss these addictions incur), then how come states like Gujarat where there is a ban on alcohol or rich nations like USA where there is a sharp decline in tobacco use, are cited for their development?

There is only one economic truth in tobacco and alcohol: the profits made by their sale is the lifeline of its industry. And this industry has scant regard for the people or the planet.

who is to blame?

Tobacco and alcohol are scientifically proven strong addictions and the companies have used its tricks of deception and lies to hook people, especially when they are young, to its deadly products. It is difficult to quit these life-threatening addictions, so ‘hook them young’ is the old mantra of such companies.

Is it the responsibility of our children and youth to stay away from tobacco and alcohol, or, is it the responsibility of the government to ensure that children and youth and all others, are not exposed to the misleading deceptive advertising of the tobacco and alcohol industry? Whose responsibility is it to hold to account corporations whose products cause epidemic-proportion of preventable diseases and deaths?

Tobacco and alcohol use are entirely avoidable risk factors when the world is trying to contain a ravaging COVID-19 pandemic. COVID-19 has not only severely constrained health systems but has also caused humanitarian crises in the lives of so many of our population.

The government of India (and all other state governments) needs to review the merits of the decision of opening tobacco and alcohol shops. Among the most important and corrective political decisions would be the one to ban tobacco and alcohol altogether. Citizens need to be reassured that people's interests matter most.

 (Dr Sandeep Pandey, is a Ramon Magsaysay Awardee and national Vice President of Socialist Party (India). Shobha Shukla is the founding head of CNS. Bobby Ramakant is part of CNS, Asha Parivar and Socialist Party (India). Follow them on Twitter: @Sandeep4Justice, @Shobha1Shukla, @bobbyramakant)
The Kashmir Times (editorial page), India (13 May 2020)
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