By Dr Sudhanshu Patwardhan
On May 31st this year, the World Health Organization (WHO) marks ‘World No Tobacco Day’ with a very topical theme: “Tobacco- threat to our environment”. We are indeed at a crossroads in public as well as environmental health. For the first time ever, two UN bodies- the WHO and the UN Environment Programme (UNEP), have published a list of the environmental harms from tobacco-related farming, manufacturing, supply chain and consumption.
The health harms from risky forms of smoked and smokeless tobacco products such as cigarettes, cigars, bidis, hookah, gutkha, khaini, misri, zarda etc are already well known. That knowledge has not made these products or their use obsolete- even today over a billion people around the world consume these risky products and more than half of them die prematurely as a result.
Nicotine is addictive but is not the cause of tobacco related cancers, cardiovascular disease and lung disease. The invention of nicotine replacement therapy (NRT) products three decades ago, in the form of nicotine gums, skin patches, lozenges and mouth sprays, was crucial in realising nicotine’s role as a medicine in helping quit tobacco. NRT enables smokers and smokeless tobacco users to better manage their cravings and withdrawal symptoms. Still, quitting tobacco and preventing relapse remains a big challenge globally for a variety of interlinked reasons: (i) Pharmaceutical investment and innovation in improved tobacco cessation tools and products has been lacking in recent years, (ii) Universal access to affordable and appealing nicotine replacement products remains poor, and (iii) Healthcare professionals around the world are not adequately trained on how to advise their patients to use nicotine replacement products. In fact, many of the doctors themselves harbour misperceptions about nicotine, wrongly believing that nicotine in the tobacco products causes cancer. This limits doctors’ ability to confidently support their patients’ tobacco de-addiction journey using nicotine replacement principles.
Pharmaceutical-grade nicotine used in gums and patches is currently sourced from tobacco waste. Thanks to agricultural expertise in growing high-nicotine tobacco plants for nicotine extraction, India is a leading exporter of such nicotine for supplying the world’s increasing demand in nicotine replacement products. However, the environmental footprint of such nicotine is intricately linked and correlated to that of growing and processing tobacco. That needs to be understood and urgently addressed.
Tobacco related harms to the environment start from the seed and go well beyond the cigarette and bidi smoke. The WHO notes that globally an additional 200,000 hectares of land is cleared annually for growing tobacco and curing tobacco leaves that are used in making smoked and smokeless tobacco products. Rich and diverse natural habitats, including pristine rainforests, are being lost to meet the global tobacco demand. It is estimated that 3.7 litres of water are used to make 1 cigarette. Trillions of cigarettes are sold and burned annually, to deliver nicotine to a billion smokers worldwide. The environmental pollution is not limited to the emitted smoke and the ash, but also to the cigarette butt litter that refuses to decompose for years. In countries such as India, spitting smokeless tobacco imposes an additional burden on health and leaves unsightly marks in buildings and roads.
Economic harms from tobacco are pernicious. Despite the well-documented healthcare and societal costs from tobacco, cash-strapped governments remain addicted to the revenues from ever-hiking sin taxes levied on tobacco products, while many economies and livelihoods around the world remain slavishly dependent on growing tobacco. India faces the additional dilemma of balancing tobacco control with providing alternative livelihood to millions of women who currently earn less than 75 dollars a month hand rolling bidis at their homes.
This year’s World No Tobacco Day theme provides the much-needed impetus to seek solutions outside the box. As a starter, we can sustainably change the source of nicotine, harnessing India’s prowess in pharmaceutical manufacturing. Is it possible to completely bypass the environmentally costly tobacco growing, processing and nicotine extraction process, and instead innovate into synthesizing nicotine using green chemistry? Yes. Over the past three decades, many advances in chemistry and chemical engineering have resulted in new processes and patents issued for synthesising nicotine from non-tobacco related raw materials. If the correct isomer of nicotine – the s-isomer- can be manufactured at scale using these processes, that can be revolutionary and indeed, game changing. In parallel, farmers growing tobacco can be incentivised and weaned away to grow other cash crops, enhancing India’s own food security and net global food production.
The availability of high-quality, low-cost, synthetic nicotine, without any tobacco related contaminants, can enable a new discourse that clearly separates tobacco’s harms from nicotine’s dependence-causing potential. The former is simply unacceptable in the 21st century, the latter has to be contextualised in terms of relative risks and the harm reduction principle. Nicotine replacement products that are innovative, suitably regulated and where necessary medically licensed, can be introduced globally for tobacco cessation at low cost and in product formats appealing to current adult smokers and smokeless tobacco users.
Both planet earth and her inhabitants will benefit from such a green chemistry revolution.
(The author is a Medical Doctor and Nicotine Expert. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)