Sri Lanka's Battle Against Tobacco: Progress, Setbacks, and the Road Ahead

Tobacco remains one of Sri Lanka’s deadliest public health challenges, claiming an estimated 20,000 lives every year. Despite decades of progress and the nation’s pioneering role in global tobacco control, experts warn that momentum has slowed and urgent action is needed to protect future generations. With the WHO Framework Convention on Tobacco Control (FCTC), Sri Lanka stands at a crossroads: will it renew its leadership in the global fight against tobacco, or allow industry interference and policy inertia to erode hard-won gains? This area should be of utmost importance to the Health Minister of the current Sri Lankan government as a policymaker.

- By Dr DHANUSHKA DISSANAYAKA

A National Picture of Tobacco Use

According to the 2020 Global Adult Tobacco Survey (GATS), tobacco use remains alarmingly high in Sri Lanka. Over one-third of men (36.2%) and nearly five percent of women use tobacco in some form. While cigarette smoking is the most visible form of use, smokeless tobacco remains a stubborn problem, particularly among rural and lowincome communities.

The numbers translate into devastating human and economic costs. Each year, tobacco-related diseases such as cancer, heart disease, stroke, lung disease, and diabetes take the lives of tens of thousands of Sri Lankans. Treatment of tobacco-related cancers alone costs the public health system an estimated Rs. 5.6 billion annually.

The indirect costs are equally staggering. Families bear the brunt of lost income when breadwinners fall ill or die prematurely. Household expenditure on tobacco often displaces spending on food, education, and healthcare, deepening cycles of poverty.

Secondhand Smoke: A Hidden Threat

Beyond active smokers, millions of Sri Lankans remain exposed to secondhand smoke. GATS data revealed that 16.7% of adults working indoors are regularly exposed to smoke at their workplaces, while 8.4% are exposed inside their homes. Alarmingly, 25.2% reported exposure when visiting restaurants.

Exposure to secondhand smoke causes serious illness. More than 94% of Sri Lankan adults recognize this danger, yet enforcement of smoke-free laws remains patchy. Smoking is banned in many indoor public places and workplaces, but loopholes allow designated smoking areas in hotels, restaurants, and airports. Beaches, parks, and roads are not covered by the ban, leaving large segments of the population vulnerable.

The Economics of Addiction