Tobacco is woven into the fabric of everyday life in Bangladesh. From the city's busy markets to the quiet courtyards of villages, cigarettes, bidi and a wide array of smokeless products such as zarda, gul and khaini remain ever-present. That familiarity has allowed tobacco to persist as one of our country's most stubborn public-health crises - and it is long past time we treated it as such.
The human cost is unmistakable. Tobacco use shortens lives, causes chronic illness and leaves countless families caring for relatives with cancer, heart disease and respiratory disorders. Yet the harm goes beyond those who light a cigarette or hold a quid in their mouth. Secondhand smoke drifts through homes, workplaces, public transport and restaurants, exposing children, spouses and colleagues to dangerous toxins. In many households, women and young children are most affected, breathing the same air where tobacco is considered routine rather than risky.
Patterns of use are shaped by gender, age and culture. Smoking remains concentrated among men, while smokeless tobacco enjoys wide prevalence among women and older adults. Products like zarda are tied to social customs - often consumed with betel leaf and areca nut - and because smokeless forms do not produce visible smoke, their dangers are easily underestimated. That misconception makes these products especially insidious: they are perceived as less harmful, socially acceptable, and thus harder to discourage.
A fresh worry is the growing presence of e-cigarettes, particularly among teenagers and young adults. Sleek devices, flavored liquids and aggressive marketing make vaping appear modern and harmless to a generation that did not grow up with tobacco restrictions. But nicotine addiction is nicotine addiction - and the long-term health consequences of these devices remain uncertain. Left unchecked, vaping risks replacing one epidemic with another.
We have laws and policies on paper. Bangladesh has taken steps to restrict smoking in public places and to set a policy framework for tobacco control. Yet enforcement is patchy. Bans are ignored, point-of-sale advertising and visible product placement persist, and promotional tactics continue to normalize tobacco for the young. When regulation is uneven, the poorest and least educated populations - those already with limited access to health services - bear the greatest burden.
Quitting is possible, but most users struggle. Many try repeatedly without professional support. Effective cessation requires accessible services: counselling, affordable nicotine replacement therapy and community-based programs that address local habits and cultural norms. Without such support, awareness alone will not produce sustained declines.
What, then, should be done? First, firm enforcement of existing smoke-free laws should be a national priority, with clear penalties and routine inspections that reach beyond metropolitan centres. Second, marketing and point-of-sale visibility must be curtailed - especially near schools and youth centres. Plain packaging, graphic health warnings that reflect the realities of smokeless products, and bans on promotions should be implemented fully. Third, smokeless tobacco needs parity in policy and public messaging; it must lose the false reputation of being a "safer" alternative. Fourth, we should regulate e-cigarettes strictly, restrict flavored products that appeal to youth, and fund research on long-term harms.
A national quitline, integration of cessation services into primary care, and mass campaigns that resonate with diverse communities can help users make real change. Community leaders, religious institutions and schools should be engaged to shift social norms that currently sustain tobacco use.
The writer is from the Department of Law, State University of Bangladesh
