The Nepali Government's commitment to providing "Health for All" by Year 2000 is a laudable aim. If there is one country that should be concerned about its citizens' health, it is Nepal. Its people are among the lowest per capita calorie consumers in the world; they have the lowest literacy rate and the lowest doctor to population ratio. The situation is even worse for poorer Nepalis, due to the dire imbalance of wealth and available resources. Kathmandu Valley, home to less than five per cent of the population, retains more than half of the country's doctors. Oddly, and most inappropriately, the Government itself is the main producer and pusher of a universally acknowledged health hazard, cigarettes. The Janakpur Cigarette Factory, which until recently had a virtual monopoly over cigarette production and is still, by far, the largest cigarette producer, is nationally owned. Its sizeable profits go directly into the national exchequer.
Alarming Addictions
Nepalis are addicted to tobacco in different ways: young, old, men, women and sometimes children barely out of infancy smoke bidis and hookahs, snort tobacco and chew khaini. But cigarette smoking has overtaken all these other addictions as a threat to Nepali public health, one that needs to be confronted by the Government and the public alike.
In the absence of comparable tobacco and health data for Nepal, the latest statistics from the United States can be used to help put things in perspective. More than 390,000 Americans die every year due to causes attributed to cigarette smoking. Thus, one out of every five deaths is related to smoking. It is responsible for 30 per cent of all cancer deaths, 21 per cent of all coronary heart disease deaths, 18 per cent of deaths due to stroke and 82 per cent of deaths due to chronic obstructive pulmonary diseases.