‘Tobacco Smoking in Sri Lanka: Identifying and Understanding the Last Mile Smokers’

• Recommends targetted interventions to reduce smoking prevalence in Sri Lanka

• Advocates continued price increases through taxation as a key policy intervention

• Calls for a ban on sale of single-stick cigarettes to reduce smoking prevalence rate

Tobacco smoking is a dangerous epidemic claiming eight million lives globally1 and is currently the world’s single most significant cause of preventable death. In Sri Lanka, more than 20,000 people are killed every year as a result of tobacco-related diseases. Despite tobacco smoking rates declining over the years, it was still 28.4% among males above 15 years in 2018, indicating that more than one in four males still smoke.

Secondary data analysis shows that smoking prevalence is higher among certain groups. IPS’ latest publication ‘Tobacco Smoking in Sri Lanka: Identifying and Understanding the Last Mile Smokers’ focuses on these groups – referred to as ‘Last Mile Smokers’ (LMS) in the report. The report is based on a study that identifies LMS, examines reasons behind their smoking initiation and continuation, their efforts to quit smoking, and their awareness of the adverse effects of smoking. The challenge for Sri Lanka now is to ‘go the last mile’ and reduce smoking prevalence among LMS.

Findings and recommendations

The study finds that LMS initiated smoking mostly in their youth as they were curious to experiment with new things; were under peer pressure; and were stimulated by smokers in the family, community and celebrities. They continued to smoke because it had become a habit or addiction; perceived smoking as a remedy to overcome job monotony; lacked incentives and support channels to stop smoking; and lacked the self-control to stop smoking.

According to the study, LMS want to quit smoking and require support measures to help them do so. Most of them had made at least one attempt to quit because of health concerns, financial reasons, and commitments towards their families and children. Almost all smokers from different sectors were aware of the adverse health and economic impacts of smoking. However, many were unaware of its adverse impact on the environment, and the effects of second-hand and third-hand smoking

The study also finds that LMS are sensitive to price increases and that price plays a crucial role in shaping smoking patterns, both in relation to initiation and continuation. Further, due to price increases in recent times, many smokers have switched from buying an entire pack to buying single sticks. In fact, 70% of the LMS who participated in the study purchase single sticks.

The IPS report therefore recommends:

• Introducing targetted interventions that reach the LMS as they have specific needs and characteristics which are difficult to address through general interventions.

• Continuing price increases through tobacco taxation as a key policy intervention.

• Implementing the proposed ban on single stick cigarette sales without any further delay.

• Responding to unmet demand for smoking cessation through support programmes.

• Carrying out rigorous awareness campaigns that cover all aspects of adverse implications of tobacco smoking including effects of second-hand and third-hand smoking.

The report is authored by Sunimalee Madurawala, Chathurga Karunanayake and Chamini Thilanka. The study was funded by Cancer Research UK and field work was facilitated by the Alcohol and Drug Information Centre (ADIC).

Access the full report here: https://www.ips.lk/tobacco-smoking-in-sri-lanka-identifying-and-understanding-the-last-mile-smokers/