Reducing Tobacco-Related Deaths

By Ozioma Ubabukoh

African nations seem poised to undergo the highest increase in the rate of tobacco use among developing countries, and nearly 90 per cent of people on the continent, perhaps, remain without meaningful protection from second-hand smoke, according to a new report released at a regional conference recently.
The report, ”Global Voices: Rebutting the Tobacco Industry, Winning Smoke-free Air”, however, tend to point to signs of hope. Several African countries are fighting against the tobacco industry‘s aggressive campaigns to stop public health interventions by putting smoke-free laws into place, probably protecting more than 100 million more people since 2007. This report was published by the Global Smoke-free Partnership.
Recent data suggest that, with current trends, more than half of the region of Africa may double its tobacco consumption within 12 years. And to check this, ”Smoke-free public places are one example of a low-cost and extremely effective intervention that must be implemented now to protect health”, said Dr. Otis W. Brawley, chief medical officer of the American Cancer Society.
In about less than two years, Kenya and Niger Republic have enacted national smoke-free policies, and South Africa, which has been smoke-free since 2007, according to reports by environment reporters, has been termed to play an important role in the region, demonstrating that smoke-free laws could work in Africa. In what seemed as a first for the region, Mauritius recently passed a law that is close to meeting the Framework Convention on Tobacco Control standards, ranking among the most robust anti-smoking measures in the world.
According to the American Cancer Society monitoring team report, implementation remains a challenge in many places, including the Democratic Republic of Congo, Ghana and Uganda. Even with the ban placed on smoking in public places in Abuja, the nation‘s federal capital, in 2008, by its former minister, Alhaji Aliyu Umar Modibbo, the city is seen as most vulnerable to the campaign of ensuring a smoke-free society.
”In Abuja, Nigeria, for example, 55 per cent of school students are not aware that second-hand smoke is harmful to health, and only 1 per cent of Nigeria‘s population is protected by strong smoke-free laws”, the report said.
It also exposes the tobacco industry‘s tactics to hold back legislation and convince African governments that tobacco is important to economic activity; that raising taxes on cigarettes and implementing smoke-free laws will result in revenue and job losses. In Kenya, for instance, it was reported that the tobacco industry issued a legal challenge to a smoke-free law passed by the Parliament. In Zambia equally, the British American Tobacco company has been accused of aiming to dilute proposals for a smoke-free law.
Some people have alleged that the campaign against tobacco smoking, especially in Nigeria, seems to be hindered by some journalists who would rather comment on any other health issue, no matter how agonising, than report or write on the dangers of smoking cigarettes.
According to them, some journalists are of the belief that the best writers are those who smoke and drink. And they have passed this notion to the younger ones planning to take up a career in journalism.
The National Coordinator, Nigeria Tobacco Control Alliance, Mr. Akinbode Oluwafemi, said this might be responsible for deaths of more journalists from tobacco-related ailments.
Oluwafemi, who is also the Programme Manager, Environmental Rights Action and Friends of the Earth, Nigeria, said, ”For how long are we going to be silent? Several Nigerian journalists and activists are aware that they are dying from cancer of the lungs and tobacco-related ailments, yet they have kept the stick burning. On most occasions, they lead the campaign against smoking, and immediately after that you find them lighting the stick. We have lost the likes of Steve the sleek Kadiri, Momoh Kubanji, Yinka Craig and Beko Ransome Kuti to tobacco smoking.
”Cancer control programme should be linked to tobacco control. Journalists should lead on awareness creation. It is time to be open about our friends, brothers and sisters dieing of tobacco- related cancers. Let‘s support the passage of the national tobacco control Bill.”
It is estimated that in 2010 smoking will claim the lives of six million people worldwide, 72 per cent of whom reside in low and middle-income countries, Nigeria inclusive. If current trends continue, tobacco will kill seven million people annually by 2020 and more than 8 million people annually by 2030.

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Reducing Cancer begins with supporting Tobacco Control Bill

When news that former First Lady, Mrs. Maryam Babangida had died from ovarian cancer in far away United States (US) filtered through the airwaves on December 27, 2009, many Nigerians realised that if the latest cancer victim was wife the former military President, Ibrahim Babangida, it is indeed time to check the killer disease. One way to fight cancer, a non communicable disease involving abnormal growth of cells, is keeping away from tobacco smoking.

According to data issued by the World Health Organisation (WHO), cancer affects people of all ages with the risk for most types increasing with age. With the increase of cancers recorded globally since 2008, the link between cigarette smoking and cancer has been brought to the fore.

Researchers have clarified that tobacco use is associated with many forms of cancer and that cancer caused about 13 per cent of all human deaths in 2007. Also, research has shown that cancer causes 90 per cent of lung cancer. These are some of the issues raised at a training on Cancer Reporting for Health Reporters organised by Journalists Advocacy on Tobacco & Health (JATH) in Lagos recently. Among resource persons at the workshop were Mrs. Ebun Anozie, Chief Executive Officer, Care Organisation Public Enlightenment, also known as C.O.P.E., Akinbode Oluwafemi, Programme Officer, Environmental Rights Action/Friends of the Earth Nigeria (ERA/FoEN), Tosin Orogun of JATH, among others.

Tobacco’s role in increasing the chance of lung cancer is one of the most widely known of tobacco’s harmful effects on human health. Decades of research has demonstrated the link between tobacco use and cancer in many sites in the body in addition to the lungs. Other parts of the body that cancer can affect are the head and neck, (coveringof the esophagus, larynx, tongue, salivary glands, lip, mouth, and pharynx), urinary bladder and kidneys, uterine cervix, breast, pancreas, and colon.

According to the Programme Officer, Environmental Rights Action/Friends of the Earth Nigeria (ERA/FoEN), Akinbode Oluwafemi, there are about 599 approved additives in a stick of cigarette. He said, “Cigarette smoke is proven to contain over 4,000 toxic and cancer causing chemicals. The list is long: carbon monoxide, nitrogen oxides, hydrogen cyanide and ammonia to name a few.”

He noted that smoking is a major risk factor for different cancers and apart from the high cost of cancer treatment and the infrastructural challenges, smoking related cancers account for 30 per cent of cancer related deaths.

Therefore, taking prompt action to check cancer related deaths becomes more compelling now considering the large number of smokers in the nation. Data issued by the WHO states that 17 per cent of Nigerian adults smoke, resulting in 17 million Nigerians. “And because research has shown that half of smokers are going to die of tobacco-related illnesses, that means 6.5 million Nigerians are going to die as a result of that smoking habit,” he said.

Consequently, Akinbode said that is why it is very urgent for government to begin to take actions in order to reduce tobacco use in Nigeria.

While he noted that tobacco related deaths are preventable, Programme Officer of ERA/FoEN urged the government to put in place policies that will discourage people from putting up the habit of tobacco smoking and for people who are already smoking to quit.

A speedy passage of the National Tobacco Control Bill 2009, sponsored by Senator, Olorunnimbe Mamora will help, Akinbode said.

The bill, which has passed through the First Reading at the National Assembly seeks to domesticate the Framework Convention on Tobacco Control that was negotiated under the WHO. Nigeria became a party to that convention in 2005.

Since Nigeria is now a part of that Convention, he said, “We should domesticate all the provisions of that international treaty.”

The provisions talks about Tobacco Demand Reduction, the mechanisms of which include ban on advert, sponsorship and promotion of tobacco products, raising taxes on them, creating smoke-free environment for the citizens and making the public places smoke-free.

Similarly, it includes awareness creation and obligations on cessation of tobacco smoking.The other side of it that has to do with manufacturing talks about packaging and labeling of tobacco products.

How do manufacturers package tobacco products? Programme Officer of ERA/FoEN said they have to put in place appropriate warnings on cigarette parks.

“For instance, Akinbode said the Framework Convention on Tobacco Control recommends 50 per cent pictorial warnings, meaning that manufacturers have to put on the cigarette park pictorials on what is cancer, that cigarettes cause impotence, that cigarettes smoke is dangerous for unborn babies and pregnant women, among others.”

According to him, these pictorial warnings are already being put on cigarette packages in some African countries. He said, “For instance, Mauritius has even moved a step further to say that those warnings will occupy 75 per cent of the display area on the cigarette park Besides, it is the same companies that are here that are manufacturing cigarettes in Mauritius. So, they don’t have any excuse for not complying with those laws in Nigeria.”

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WHO On Passive Smoking

EDITORIAL

The warning by the World Health Organisation (WHO) that passive smoking constitutes a global threat, is revealing and must be checked.
The UN agency had in its second major report on the "tobacco epidemic" released last week, said second-hand or passive smoking killed nearly 600,000 people each year. WHO, which also warned that tobacco is still the leading preventable cause of death, killing five million people every year, said more and more people were likely to suffer from the harmful effects of passive smoking.
According to the agency, only 5 per cent of people in the world are protected from second-hand smoke in public areas. Insisting that unless more stringent measures were taken to minimize smoking's impact, WHO said that of the world's 100 most populous cities, just over a fifth, or 22 are smoke free.
Last year, WHO unveiled six strategies that countries could implement to protect their people from the harm of cigarettes. These include smoking bans, higher tobacco taxes and bans on tobacco advertising. The 2005 WHO Framework on Convention on Tobacco Control (WHO FCTC) made it clear that banning of smoking in public places is essential to not only protect nonsmokers, but to make it easier for those who want to quit to stay smoke-free.
WHO, which lamented that just a mere 17 nations had passed comprehensive smoke- free laws, raised the alarm that the annual death toll from tobacco related diseases could rise to eight million by 2030.
It is sad that despite the well documented effects of smoking on humans, countries have more or less, continued to pay lip-service to fighting what from all indications, constitutes one of the major health challenges of the 21st century. No less a body than the International Labour Organisation (ILO) has said that 200,000 workers die every year due to exposure to second-hand tobacco smoke at work. WHO estimates that around 700 million children, or almost half of the world's children, breathe air polluted by tobacco smoke which is generally carcigenous.
Given the insalubrious effects of tobacco smoking, governments the world over must rise to the challenge of not only protecting passive smokers, but ensuring that smokers alike are regularly reminded of the risks they face. There is no safe level of exposure to second-hand smoke. Action is, therefore, needed by governments to protect their people from the dangers posed by this type of smoking.
Besides, the fact that more than 94 per cent of people remain unprotected by smoke-free laws three years after international tobacco control measures introduced the requirement, shows that much work needs to be done. Governments must implement the 2005 WHO Framework which 170 nations have signed. As it is said, passive smoking kills people and being passive about it will also kill.
For Nigeria, which is a signatory to the WHO FCTC, the challenge posed by passive smoking is by no means less daunting. Although there are no available data on passive smoking, a report by an Expert Committee on Non-communicable diseases in 1988 certified that 4.5 million Nigerians were smokers. The committee set up by the federal health authorities, also said Nigerians smoked close to seven million sticks of cigarettes daily, which according to then Health Minister, Prof. Olikoye Ransome-Kuti, added up to 49 million sticks a week, or 196 million sticks a month.
It is pertinent to add that it was during Olikoye's tenure as Health Minister under the Ibrahim Babangida regime, that a law against smoking in public places was enacted. Unfortunately, the law all but exists in name as a report by the News Agency of Nigeria (NAN) had it that over 60 per cent of Nigerian undergraduates smoked. Given the very lax nature of the law on smoking and the general lack of awareness about passive smoking in the country and its consequences, it is not unlikely that the general population are at risk.
While it must be stated that Nigerians are also exposed to other equally deleterious forms of fumes such as acid rain and fumes from automobiles, no effort should be spared to save lives that are exposed to this danger. Indeed, every single life is important and as much as possible, life should be safeguarded.
There is no gainsaying that smoking places a huge burden on health care provisions all around the world. Governments should, therefore, embark on aggressive public enlightenment campaigns to sensitise Nigerians on the effects of passive smoking, and indeed, smoking in general. No effort should be spared to ensure that Nigerians stay healthy.

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State government takes tobacco companies to court

-Odunayo Abiodun

A joint suit filed by the Lagos State Government and the Environmental Rights Action/ Friends of the Earth Nigeria (ERA/FOEN) against five tobacco companies was brought before a Lagos High Court on Monday.
The claimants jointly instituted the action against the tobacco companies - British American Tobacco (Nigeria) Limited, International Tobacco Limited, British American Tobacco Plc and British American Tobacco Investment Limited - on the ground that tobacco smoking has severe health implications including but not limited to cancer, cardiovascular and pulmonary complications, noting that the defendants have recently admitted these facts.
At the resumed hearing of the suit before Bukola Adebiyi, the counsel to the claimants, O. Akinosun moved his application asking for extension of time to file his reply to the request for stay of proceeding in the matter by the defendants.
The defendants did not oppose the application; but they noted that the reason given for the delay was not contained in the affidavit attached to the application.
Mr. Adebiyi, however granted that application and she further adjourned the hearing in the matter until February 9, 2010.

Allegations
The claimants had alleged that, in spite of the obvious knowledge of the adverse effect of their product, the defendants have fraudulently targeted young and underage people in their advertising and marketing.
They claimed that, through the use of market surveys and sophisticated advertising, the tobacco companies have utilised such means as music, cinema and fashion, to attract young and underage persons to smoking.
They submitted further that the mandatory health warnings inscribed on their packs are ineffective as the defendants promote a retail strategy of sale by the stick whereas the individual sticks that most consumers purchase have no such warning.
The claimants' causes of action are based on negligence, public nuisance, restitution, strict liability, and conspiracy to commit actionable wrongs, among others. It was contended that the overall effect of the defendants' course of conduct is that the state government is called upon to expend its resources in treating tobacco related ailments caused by the use of defendants' products, maintaining that the state government spends at least N316, 000 per month on each of these ailments.

Claims
Consequently, the claimants wants an order of mandatory injunction compelling the defendants, their successors-in-title, privies and or agents to cease the marketing, promotion, distribution and sale of tobacco-related products to minors or under aged persons.
An order of mandatory injunction restraining the defendants from representing or portraying to minors or persons under the age of eighteen, any alluring and or misleading image regarding tobacco related products whether by direct depictions, pictorials, advertorials, images, words, messages, sponsorships, branding and or through overt or covert and or subliminal means.
Furthermore, the claimants asked for an order of mandatory injunction restraining the defendants from marketing, distributing, selling, or putting into the stream of commerce either by themselves or through their distributors, agents, resellers, trade partners, marketers, and or any other person, any tobacco related products of whatever make or brand within a one thousand (1000) metre radius of any schools, hospitals, cinemas, playhouses or locations, children's shopping areas, childcare facilities or such other public places in Lagos State, which are predominantly a location for minors and young persons under eighteen (18) years old to "hang out", play, assemble, congregate for any purpose whatsoever including but not limited to educational, recreational, social, religious, sports or any other purposes.
In addition, they urged the court to grant an order of mandatory injunction compelling the tobacco companies to fund a tobacco control programme to be administered and controlled by an independent third party who is to be appointed by the Lagos State government, targeted at minors and young persons under eighteen (18) years old.
They also want a declaration of the court that the tobacco related products as manufactured, marketed, promoted, distributed and sold by the defendants are addictive and a declaration of the court that the tobacco related products as manufactured, marketed, promoted, distributed and sold by the defendants are hazardous and injurious to the public health.

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Childhood passive smoking increases miscarriage risk later in life

If you’re a woman who was exposed to second-hand smoke during your childhood you are more at risk of fertility problems or miscarriage, according to new research.
Toxins breathed in from passive smoking when young could have caused permanent damage that will harm your chances of falling pregnant or miscarrying the baby during pregnancy.
A team from the University of Rochester in New York studied nearly 5,000 women who gave details about their attempts to fall pregnant, miscarriages and history of being exposed to second-hand smoke.
A third of the women questioned lost one or more babies while 11% had difficulty falling pregnant. In total, 40% of women reported problems with prenatal pregnancy such as miscarriages and struggling to become pregnant.
Four out of five women reported being exposed to passive smoke during their life and 50% grew up in a home where a parent smoked. Of those who during their childhood had parents who smoked, 26% were found to be more likely to have difficulty conceiving and 39% were more likely to have suffered a miscarriage.
An estimated 17% of mothers smoke during their pregnancy despite the many warnings about how it affects their health and that of their unborn baby. Passive smoking is also likely to interfere with hormones which will affect fertility.

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Anti-smoking law: Only 1% of Nigerians are protected by smoke-free laws —Report

By Waheed Bakare

Only one per cent of Nigeria’s over 140 million people are protected by strong smoke-free laws, a new report released last Wednesday by Global Smokefree Partnership and the American Cancer Society has revealed.

Besides, the report also stated that in Abuja, Nigeria’s Federal Capital Territory, 55 per cent of school pupils were not aware that secondhand smoke is harmful to health.

Medical experts had repeatedly said there was scientific evidence that secondhand smoke was a proven cause of serious diseases and premature death.

According to the report, “Global Voices: Rebutting the Tobacco Industry, Winning Smokefree Air,” nearly 90 per cent of people on the African continent are without meaningful protection from secondhand smoke.

The report noted that it was worrisome that Africa, which accounted for 14 per cent of the world’s population, had just four per cent of the world’s smokers today. Despite the infinitesimal percentage of the world’s smokers on the continent, the report noted that African nations would soon undergo the highest increase in the rate of tobacco use among developing countries, “with more than half the continent expected to double its tobacco use within 12 years if current trends continue.”

“If we don’t act now on tobacco control in Africa, millions of lives will be lost because tobacco is now becoming an issue in Africa,” Tom Glynn of the Global Smokefree Partnership told the Agence France Presse.

Despite the gloomy picture, the report noted that many African countries were resisting tobacco industry’s aggressive efforts to stop governments from putting in place smoke-free laws.

“For the first time in history, we have the tools in hand to prevent a pandemic. Recent data suggests that, with current trends, more than half of the region of Africa will double its tobacco consumption within 12 years. Smoke-free public places are one example of a low-cost and extremely effective intervention that must be implemented now to protect health.” said Dr. Otis W. Brawley, chief medical officer of the American Cancer Society.

To back up its claim, the report observed that Kenya and Niger had enacted national smoke-free policies within the last year, and South Africa, which had been smoke-free since March 2007, still played a major role on the continent.

The South Africa’s inspiring role, the report added, was an indication that smoke-free laws could work on the continent.

“In a first for the region, Mauritius recently passed a law that is close to meeting the Framework Convention on Tobacco Control standards, ranking among the strongest anti-smoking measures in the world,” the report stated.

But it said implementation remained a challenge in many places such as Democratic Republic of Congo, Ghana and Uganda, adding that “barriers include identifying resources for implementation, and tobacco industry opposition to smoke-free laws.”

For instance, a Lagos-based lawyer, Mr. Fred Agbaj, regretted that since anti-smoking law was passed in 1990, Nigerian law enforcement agencies were yet to arrest and prosecute any violator.

He said, “I am aware that in this country, the regime of Gen. Ibrahim Babangida passed the anti-smoking law in 1990. By this law, smoking was banned in public places. I am aware that the law is still in force but no arrest has been made. Police have access to public places where people smoke but how many have they arrested?”

Agbaje, who spoke on the phone with our correspondent, advised the government to have the will, resources and determination to enforce this law in the interest of the majority who were not smokers.

However, the Programme Manager, Enviromental Rights Action/Friends of the Earth Nigeria, Mr. Bode Oluwafemi, faulted the report and disagreed with Agbaje.

He said the report was a “fallacy”, adding that ban of smoking in public places was still in force in Nigeria. He said the law specified that smoking should not be carried out indoors.

Oluwafemi described anti-smoking law as “citizen law meant to teach attitude.” He said if people for instance, smoke within a court premises, they had not violated the law as such places were not indoors.

“There is a lot of misconception about this law. The law says you cannot smoke indoors. If you go to government buildings, schools, restaurants, hospitals, do people smoke there? The answer is no. Enforcing the law does not mean people should be jailed. The law is self-enforcing and it is meant to teach attitudes,” he said.

In spite of this sharp division, the report exposed tobacco industry’s tactics aimed at holding back legislation and convincing African governments that tobacco was important to economic activity, that raising taxes on cigarettes and implementing smoke-free laws would result in revenue and job losses.

The report estimated that in 2010, smoking would kill six million people worldwide, 72 per cent of them would come from low and middle-income countries.

It added that if the current trends were not abated, tobacco would claim the lives of seven million people a year by 2020 and more than eight million people annually by 2030.

The report, which was launched at a media summit hosted by the American Cancer Society on November 12, 2009, in Dar es Salaam, Tanzania, observed that some one billion people in 45 countries were now protected from health hazards of secondhand tobacco smoke at work and in public places.

“Despite this progress, more than 85 per cent of the world’s people are without such protection,” it warned.

Countries that have enacted strong, nationwide smoke-free laws include: Bermuda, Bhutan, Colombia, Djibouti, Iceland, Ireland, Lithuania, New Zealand, Norway, Panama, Turkey, the United Kingdom, and Uruguay. Most Canadian provinces/territories and Australian states/territories have also enacted such laws.

The National Secretary-General, Nigerian Medical Association Dr. Ken Okoro, said secondhand smoking is better known as perceive smoking. He said percesive smoking was when non a smoker inhale the smoke puffed out by a smoker.

Okoro in a telephone interview confirmed that perceive smoker could be at higher risk compare to a smoker because perceive smoker had no control over the quantity of smoke he or she inhales.

He said, “Sometimes a perceive smoker is sometimes more expose to danger than actual smoker. A smoker inhales the smoke and puff out some. So, he can determine the level of smoke he inhales. Whereas, a perceive smoker innocently inhales as much smoke quantity as possible and cannot puff out any smoke.

“This presupposes that a secondhand smoker can have lung cancer, small blood vessel or cardiovascular disease.”

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Femi Kuti - Why I Quit Smoking

You just mentioned that you neither drink nor smoke. Where do you get your kicks?

It is my work. Hard work.

But it may be difficult for people to believe you.

That is their business. I have smoked before and I don‘t deny it. But I have stopped. I stopped smoking for fifteen years. I did it again for two years and finally stopped. I started smoking after my mother died because I was very depressed. I have not done it for a couple of years now. Because of this same argument, I stopped. I don‘t need to smoke to become a great man. Even some people say that I don‘t smoke like my dad because I am not as strong as he was. I will not smoke.

Why the decision?

It is bad for my health. It gives me chest pains, but the main reason is on moral ground. It is because I address a serious and important subject that concerns justice and values and I don‘t want anybody to rubbish me by saying that I am a smoker or that I smoke Indian hemp. If I am fighting social ills and I continue to smoke, people will not take me seriously and I don‘t want that. Even if most members of my band smoke, I have to restrain myself just to combat issues. There are so many social ills that I am fighting against in my music and I cannot afford to allow myself to be embarrassed and dismissed as a hemp smoker.

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