KATHMANDU, Dec 14: Nepal is facing a worsening public health crisis as tobacco use rises and deaths linked to tobacco related diseases double within five years, exposing deep policy failures and strong industry influence inside the state system.
Despite more than two decades of campaigns and regulations aimed at controlling tobacco use, the situation has moved in the opposite direction. Consumption has grown at an alarming pace, and the number of deaths caused by tobacco related illnesses has surged sharply.
This grim picture was laid out at a special interaction with journalists in Kathmandu, organized by Action Nepal, where public health experts, activists and policy watchers voiced serious concern over the state’s weak response and the steady grip of the tobacco industry on policy making bodies.
Experts argued that Nepal’s tobacco control laws rank among the strongest in South Asia on paper, yet poor enforcement and insider influence have rendered them ineffective. They pointed to the presence of industry linked figures, often described as agents, within key ministries as a major reason for rising harm.
Deaths nearly double in five years
Presenting a detailed working paper, Dr Tara Singh Bam, Director at Tobacco Control Asia Pacific, cited official data from the Tobacco Control and Regulatory Information Center. His comparison of figures from 2019 and 2023 revealed a disturbing trend.
In 2019, around 24,800 people in Nepal died from diseases caused by tobacco use. By 2023, the number had jumped to 39,200. The figures confirm that tobacco related deaths have almost doubled in just five years.
Dr Bam stressed that this is not only a human tragedy but also a heavy economic burden. He said Nepal spends about Rs 12.2 billion every year on treatment of tobacco related illnesses such as cancer, heart disease and respiratory problems. This cost is borne jointly by the state and citizens.
Losses that prevention can stop
Alongside the bleak assessment, Dr Bam outlined what could still be saved through firm action. He said that with effective laws, clear policies and honest enforcement over the next 15 years, Nepal could avoid massive loss of life and money.
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According to his projection, decisive steps taken now could save 1.144 million lives over the next 15 years. The country could also directly save around Rs 24 billion in treatment costs. On top of that, Nepal could prevent productivity losses worth Rs 24.9 billion caused by illness and premature deaths among the working population.
Current estimates show that tobacco related harm is draining 1.2 percent of Nepal’s gross domestic product. Each year, the country also loses productivity worth Rs 12.7 billion due to poor health linked to tobacco use.
Industry influence inside ministries
While Nepal’s tobacco control laws are widely praised, enforcement remains weak. Dr Bam said the main reason lies within the state itself.
He alleged that individuals influenced by the tobacco industry hold sway in ministries responsible for health, industry, commerce and supply, as well as in bodies tasked with drafting laws and enforcing regulations.
“The real question today is who is responsible for the failure of a long running campaign,” Dr Bam said, pointing to internal interference. He claimed that such actors leak advance information about new laws, regulations or court cases to tobacco companies, delay decisions, or reshape policies to suit industry interests.
As a result, ministries hesitate to take firm steps in favor of public health.
Conflict of interest claims against a minister
At the event, Action Nepal raised serious questions about Industry, Commerce and Supply Minister Anil Kumar Sinha, accusing him of siding with the tobacco industry and operating under a clear conflict of interest.
The organization said Minister Sinha, who also holds responsibility in other portfolios, has acted in ways that go against the spirit of tobacco control. Existing rules and the Tobacco Regulation Directive 2014 bar public officials from supporting or engaging in tobacco industry activities.
Action Nepal claimed that Sinha’s background and current links suggest close ties with tobacco companies. Before becoming a Supreme Court justice, Sinha worked as a corporate lawyer with strong links to the tobacco sector. His private firm, Sinha Verma Law Concern in Babarmahal, Kathmandu, is now run by his daughter, advocate Anjalika Sinha.
The group said Anjalika Sinha currently represents tobacco companies in court, raising serious ethical questions.
A recent example involves the government’s directive issued on February 2 this year, requiring health warnings and images to cover 100 percent of tobacco packaging from mid-August. Surya Tobacco challenged the rule in court. The legal fight on behalf of the company was handled by Sinha Verma Law Concern, with Anjalika Sinha arguing the case alongside senior lawyers.
The Supreme Court later issued an interim order in favor of the tobacco company, dealing a blow to the government’s plan to enforce full coverage warnings.
Action Nepal also recalled earlier cases. In 2016, before becoming a judge, Sinha represented Surya Nepal in a case opposing the rule requiring 75 percent warning coverage on tobacco packets. Later, as a judge, he sat on the bench hearing cases that delayed the implementation of a 90 percent warning rule for nearly eight years, with hearings repeatedly deferred.
Wider concern over policy capture
Other speakers at the event echoed concerns about the tobacco industry’s unseen hand in policy making. They linked the failure to raise tobacco taxes, weak enforcement of warning labels, and poor compliance with smoking bans in public places to industry pressure.
They also pointed to stalled proposals, such as rules requiring plain packaging without company branding, as further signs of interference by vested interests.
Participants agreed that the urgent task is to identify and remove such agents from ministries and regulatory bodies, or bring them under strict accountability.
Consumer rights advocate Jyoti Baniya highlighted contradictions between law and practice. He noted that electronic cigarettes are banned under existing law, yet the Department of Commerce has granted customs tax exemptions on their import.
Baniya stressed that tobacco control also falls under local public health laws and called for coordinated action by federal, provincial and local governments.
Health Information and Communication Center Director Radhika Thapaliya said the state is planning school level interventions to protect children and adolescents, the main targets of tobacco marketing. She said harmful effects of tobacco will be added to school curricula, and a No Tobacco Use Campaign will soon be launched among students.
Senior public health official Upendra Dhungana acknowledged Nepal’s commitments at national and international forums but admitted that implementation still lags far behind.
The discussion concluded that state indifference, conflicts of interest and industry pressure have allowed tobacco harm to spiral, putting public health at serious risk.
