Nepal lags far behind in its anti-tobacco policy

Failure to enforce smoking bans, low taxation of tobacco products, and the absence of a ban on advertising for these products are among Nepal's major shortcomings in tobacco control. Efforts remain to be made to reduce smoking prevalence and its health consequences.

Although it has ratified the WHO Framework Convention on Tobacco Control (CCLAT) in 2006 and adopted a Tobacco Product (Control and Regulatory) Act in 2011, Nepal is making only slow progress in its fight against smoking. Two areas in particular require improvement: enforcement of smoking bans in enclosed spaces and increasing taxes on tobacco products. Nepal is also lagging behind in banning tobacco advertising, an area where it was required to adopt significantly more restrictive provisions within three years of ratifying the FCTC.

Smoking bans poorly enforced in Nepal

Enforcing smoking bans in enclosed spaces appears to be a challenge in Nepal: although the 2011 legislation prohibits smoking in all workplaces and public places, it appears to be very poorly observed. This ban was the subject of a 2020 call to order public authorities with decentralized services, which remained without effect.

The Kathmandu metropolitan area itself reaffirmed this ban locally on September 17, 2022, with a penalty of 100 rupees (0.70 cents) for violations, but this was hardly followed any more than those already issued in 2016 and 2019. Public health actors are calling for more firmness to be shown in order to better enforce this smoking ban.

This issue of law enforcement is not specific to Nepal and is found in many countries. It refers to the fundamental issue of controls, which are not ensured, to verify the effective application of these laws and to sanction any breaches in a dissuasive manner.

Taxation still insufficient

The other weak point identified by health professionals is the modest taxation of tobacco products, the rate of which is only around 41 %. "Taking into account the estimated inflation rate for the coming fiscal year, the overall tax percentage will even drop from 41 % to 39 %, far from the 75 % recommended by the World Health Organization (WHO) to successfully regulate tobacco consumption.", said Anjana Lamichhane, an associate researcher at the Nepal Development Research Institute[1]. "If we are concerned about the health of the population, the government must set a minimum rate of 65 % to reduce consumption.", she continued. Sharp tax increases on tobacco products have indeed been shown to be the most effective measure to reduce smoking prevalence[2].

A country that still consumes a lot of various tobacco products

With an overall smoking prevalence of 28.9% (48.3% for men and 11.6% for women), Nepal remains a high tobacco consumer country.[3]These are divided between smoked products (cigarettes, shisha and bidis)[4] : 17 %, including 13.3 % daily smokers) and non-smoked products (guthka[5], khaini[6], betel nuts and leaves, snuff: 18.3 %, including 15.3 % of daily users), 6.5 % of adults consuming these two categories of products. The use of electronic cigarettes is observed mainly among young people and, as in other countries, has experienced strong growth in recent years; these products are not covered by the law on tobacco products.

While Nepal stands out as the country with the largest graphic health warnings, covering 90% of the surface area of cigarette packs, it remains far behind in terms of tobacco advertising, which is still permitted on radio and television. Significant efforts therefore still need to be made to reduce mortality and the many diseases caused by various forms of smoking.

Keywords: Nepal, smoking ban, taxation, oral products.

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[1] Dhakal S, Nepal's failed approach to controlling tobacco use, The Annapurna Express, published June 28, 2023, accessed the same day.

[2] Chaloupka FJ, Straif K, Leon ME; Working Group, International Agency for Research on Cancer. Effectiveness of tax and price policies in tobacco control. Tob Control. 2011 May;20(3):235-8.

[3] Dhimal M, Bista B, Bhattarai S, et al. Report on Noncommunicable Disease Risk Factors: STEPS Survey Nepal 2019, Nepal Health Research Council, 2020, 394 p.

[4] Stick made from a rolled tobacco leaf.

[5] Chewing mixture, composed of tobacco, sweet flavors and areca nuts.

[6] Chewing blend, composed of flavored tobacco, spices and linden.