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Report on the Socio-Economic and Health Impacts of Tobacco Use in Relation to Sustainable Development Goals

Impact on SDG 3: Good Health and Well-being

The provided account highlights severe challenges to achieving Sustainable Development Goal 3, which aims to ensure healthy lives and promote well-being for all. The powerful addictive nature of tobacco is a primary barrier to this goal, as evidenced by several cases.

• A 64-year-old homeless man, who has suffered amputations due to frostbite, prioritizes purchasing cigarettes over essential protective items like gloves. This demonstrates how addiction compromises basic health and safety decisions.
• A terminally ill patient continued smoking until the end of her life, even while on high-powered pain medication. This case underscores the failure to manage non-communicable diseases (NCDs) and their contributing factors, a key target of SDG 3.
• A historical case is cited of a WWII veteran dying from smoking-induced emphysema, illustrating the long-term, fatal consequences of tobacco use that public health initiatives under SDG 3 seek to prevent.

Intersection with SDG 1 (No Poverty) and SDG 10 (Reduced Inequalities)

The narrative illustrates the interconnectedness of public health with poverty and inequality, directly relating to SDG 1 and SDG 10.

• The case of the homeless man demonstrates how addiction perpetuates the cycle of poverty. Financial resources that could be allocated to essential needs for survival and well-being, such as clothing and shelter, are diverted to sustain a tobacco addiction.
• Tobacco use disproportionately affects vulnerable and marginalized populations, including those experiencing homelessness and severe illness. This exacerbates both health and economic inequalities, undermining the objective of SDG 10 to reduce inequality within and among countries.

Implications for SDG 16: Peace, Justice and Strong Institutions

The account raises critical questions regarding institutional integrity and governance, which are central to SDG 16. The influence of corporate interests on public policy can undermine efforts to protect public health.

• The report questions the acceptance of political donations from the tobacco industry (“Big Tobacco”) by public officials.
• This practice suggests a potential conflict of interest that could weaken strong institutions and compromise their ability to implement effective public health policies aimed at tobacco control.
• Achieving SDG 16 requires accountable and transparent institutions that prioritize citizen well-being over the interests of industries detrimental to public health.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being

   • The article’s central theme is the devastating health impact of tobacco addiction. It provides explicit examples of smoking-related suffering and death, such as the author’s father who “succumbed to his painful and torturous emphysema death that was created by his smoking addiction,” and a terminally ill woman who “still smoked” despite her high intake of pain medication. These narratives directly connect to the goal of ensuring healthy lives and promoting well-being.

2. SDG 1: No Poverty

   • The article begins with the story of a “64-year-old wheelchair bound homeless man.” This directly introduces the issue of poverty and extreme vulnerability. His decision to “buy cigarettes before gloves” despite having lost his toes to frostbite illustrates how addiction can exacerbate the hardships faced by those living in poverty, trapping them in a cycle of poor health and financial distress.

3. SDG 16: Peace, Justice and Strong Institutions

   • The article questions the integrity of political institutions by highlighting that President Trump could “accept Big Tobacco donations for his $300 million White House Ball Room.” This raises concerns about the influence of corporate interests on public policy, which can undermine public health efforts and weaken the effectiveness and accountability of institutions responsible for protecting citizens’ health.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.4: Reduce premature mortality from non-communicable diseases

   • This target aims to reduce by one-third premature mortality from non-communicable diseases (NCDs) through prevention and treatment. The article directly relates to this by citing emphysema, a chronic respiratory disease, as the cause of death for the author’s father. The stories of addiction leading to severe health consequences in all three individuals mentioned are examples of the burden of NCDs that this target seeks to address.

2. Target 3.a: Strengthen the implementation of the WHO Framework Convention on Tobacco Control

   • This target focuses on strengthening tobacco control measures. The article’s criticism of “Big Tobacco donations” to a political figure implicitly points to a major barrier to implementing effective tobacco control. Such financial influence can weaken political will to enact strong policies like tax increases, advertising bans, and public smoking restrictions, which are central to the Framework Convention.

3. Target 1.2: Reduce at least by half the proportion of people living in poverty

   • The mention of the “homeless man” directly connects to this target. Homelessness is an extreme form of poverty. The article illustrates how the challenges of poverty are compounded by addiction, making it harder for individuals to escape their circumstances and improve their well-being.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Prevalence of tobacco use

   • The article provides anecdotal evidence of persistent tobacco use across different vulnerable populations: a homeless man, a terminally ill woman, and a WWII veteran. These stories collectively imply a continued high prevalence of smoking. This directly relates to Indicator 3.a.1 (Age-standardized prevalence of current tobacco use among persons aged 15 years and older).

2. Mortality rate from non-communicable diseases

   • The explicit mention of a “torturous emphysema death” serves as a qualitative indicator of mortality from a chronic respiratory disease. This aligns with Indicator 3.4.1 (Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease). The article underscores the fatal consequences of the NCDs targeted by SDG 3.

3. Incidence of homelessness

   • The description of the “wheelchair bound homeless man” serves as a direct, albeit anecdotal, indicator of extreme poverty. The existence of individuals in such conditions points to a failure to address the goals of poverty reduction. This can be seen as a proxy for indicators measuring the proportion of the population living below the poverty line (Indicator 1.2.1).

4. SDGs, Targets, and Indicators Table

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