Frontiers In Public Health Editorial: World No Tobacco Day 2023

Sonu Goel^1,2*Garima Bhatt³

• ¹Post Graduate Institute of Medical Education and Research, Chandigarh, India
• ²University of Limerick, Limerick, Ireland
• ³University of York, York, United Kingdom

May 31st marks World No Tobacco Day (WNTD), an annual global campaign led by the World Health Organization (WHO) to spotlight the dangers of tobacco use, expose the deceptive practices of the tobacco industry, and empower people to assert their right to health and protect future generations from tobacco-related harm. [1] For the year 2023, the theme for WNTD was "Grow food, not tobacco" pointing out the ways in which ensuring food security in the face of global change requires sustainable food production. [2] There is well established evidence on tobacco's irreparable harm to health (7 million deaths annually) [3] , environment (600 million trees are chopped down every year and 766,571 metric tons of cigarette butts, 894,700 littered e-cigarettes) [4] and farmers (economic hardships, labour exploitation, environmental degradation, and health problems). [5] Tobacco cultivation is resource intensive and not only damages public health by fuelling tobacco-related diseases but also leads to environmental degradation (e.g., deforestation, pesticide pollution, contaminating water sources, and soil depletion) that harms ecosystems and exacerbates climate change, thereby jeopardizing future food security. [6] In the past decades there has been a global shift of tobacco cultivation from high income countries to low-and middleincome regions. This shift has contributed to environmental harm, including soil degradation and ecosystem disruption, driven by heavy agrochemical use and deforestation for curing of tobacco. These practices have also adversely affected the health of smallholder farmers, exposing them to hazardous chemicals and exacerbating food insecurity. [7] Furthermore, tobacco production emits 80 million tonnes of carbon dioxide equivalent every year. [8] The special collection of nine papers in the current 'Frontiers of Public Health' issue focussed on WNTD 2023 theme "Grow food, not tobacco" explored key public health and policy issues related to tobacco control, including environmental impacts of cigarette filters, second-hand smoke exposure, dual use of cigarettes and e-cigarettes, gender inequity and smoking patterns, public perceptions of e-cigarette regulations, tobacco vendor density law compliance, and industry interference in policymaking.A paper discussing the proposed ban on cellulose acetate cigarette filters in the European Union presents the key reasons for the ban, focusing on both human health and environmental impacts. It also examines the potential outcomes of such a ban and explores public opinion along with the tobacco industry's response. Two articles focus on second hand smoke (SHS) exposure and smoke free policies. One of these article's emphasized on the need to develop targeted interventions to reduce SHS in homes and vehicles, particularly among youth belonging to racial, sexual, and gender minority groups,. The tobacco industry markets smoking as a symbol of freedom and equality for women, especially younger ones, associating it with sophistication and fashion. This messaging makes women more likely to take up smoking or vaping as a form of empowerment or stress relief. [9] While the second one discussed about factors influencing (positively as well as a negatively) the adoption of comprehensive smoke-free policies by the local government. The use of e-cigarettes as a replacement for smoking (displacement) or simply in addition to cigarettes (add-on use) is also explored in this collection highlighting the patterns of dual use, the impact on smoking cessation, and the public health implications. The study suggests that dual use often fails to displace cigarette smoking and may undermine efforts to quit. One of the article also described a two-way link between smoking and reduced quality of life, especially mental health among teachers. Smokers had significantly lower mental well-being scores, and those with poorer mental health were more likely to smoke. Further, gender-specific approaches are essential for effective tobacco prevention in youth. A time -based ecological analysis examined how changes in gender equality influenced smoking rates among 15-25-year-olds over 45 years. As gender equality improved, smoking rates between young men and women became more similar, especially among those with higher education. A study analysed U.S.based Twitter/X public perceptions to the FDA's authorization of Vuse e-cigarettes. It found that most tweets were neutral, while negative posts focused on health risks and criticism of the decision, outnumbered positive ones. Positive tweets, though fewer, often mentioned smoking cessation. Overall, the public discourse reflected more concern than support.Reducing tobacco vendor density is an important measure to prevent tobacco uptake especially among youth and improve compliance to law. A geo-spatial mapping study reported a high concentration of vendors, many violating tobacco control laws through sales to minors, advertising, and proximity to schools. The findings highlight urgent gaps in enforcement and the need for stronger policies. The tobacco industry has been using various tactics to influence health policy and increased v corporate social responsibility (CSR) efforts. One of the paper's assesses India's efforts to reduce tobacco industry interference using the Global Tobacco Industry Interference Index (2019-2023). The findings report that while India initially improved its safeguards under WHO FCTC Article 5.3, progress stalled in 2023. [10] The study calls for stronger regulations, greater transparency, and a unified government response.Overall, these studies align well with theme of research topics i.e., World No Tobacco Day by emphasizing the need to curb tobacco's societal harms and shift toward sustainable, healthcentred alternatives. Given that tobacco cultivation positions a triple threat to health, environment, and food security, a shift toward sustainable agriculture would be an essential step toward climate resiliency and sustainable development in addition to being a public health necessity. This could be supported through phasing out tobacco subsidies, fostering cross sector collaboration (health, agriculture, environment), implementing WHO FCTC Articles 17 and 18 by investing in the transition of farmers from tobacco cultivation to food production [11,12,13] , tackling industry interference and countering the misleading narrative of tobacco farming leads to affluence. [13] This approach critical in achieving Sustainable Development Goals (SDGs), particularly SDG 2 (Zero Hunger) and SDG 3 (Good Health and Well-being). [14]