Smoking, health, and survival: prospects in Bangladesh.

Smoking is an increasingly prevalent habit in Bangladesh, particularly among men. In the past 10-15 years cigarette consumption has more than doubled. Over 100000 acres (405 Km2) of land that could produce food are planted with tobacco, and cereal imports making up for these production losses generally do not reach the below-subsistence cultivator and landless. Cancer of the lung is already the third commonest cancer among males, and annual deaths from this cause can be expected to increase by 12000 within 15 years. At present respiratory disease is the best-recognised direct health consequence of smoking. However, a more important health risk may be the reduction in nutritional status of young children which results from expenditure on smoking in households whose income for food purchase is already marginal. Smoking of only 5 cigarettes a day in poor household in Bangladesh might lead to a monthly dietary deficit of 8000 calories (33.5 MJ). The existence of young children in Bangladesh is already precarious owing to poor nutrition. If, as seems likely, expenditure on smoking means that they get even less food, then the survival of a large number of children is being seriously endangered.