Conference raises concern over fate of Tobacco Control Bill

• Many participants at the World Conference on Tobacco or Health (WCOTH), which ended in Singapore at the weekend, are worried that several months after the National Tobacco Control Bill was passed, President Goodluck Jonathan is yet to sign it into law, reports OLUKOREDE YISHAU

Two days ago, the global community ended a conference where it was agreed that health should take precedence over financial gains from the tobacco industry. The World Conference on Tobacco or Health (WCOTH), which ended in Singapore at the weekend, showed that the tobacco epidemic must be curtailed before it increases the number of people it kills above its current benchmark of 6 million annually.

Two reports released at the conference, the Fourth Edition of the Tobacco Atlas and the Tobacco Watch, paint the gory picture of the state of things. The reports show that Nigeria is at risk, if the National Tobacco Control Bill is not passed into law by President Goodluck Jonathan. 

The Tobacco Atlas puts the cost of tobacco smoking to the Nigerian economy in terms of losses to treatment and low productivity at $591m annually. It said 17 billion cigarettes are produced in the country annually and showed that more people are getting into tobacco use. 

Many participants at the conference kept asking the Nigerian contingent while the Bill passed by the National Assembly remains unsigned. They are of the view that with no law regulating the industry, initiatives to fight the epidemic in the Third World, such as the $200 million worth initiative announced by New York Mayor Michael Bloomberg, will achieve little result.

President of the Washington DC-based Campaign for Tobacco Free Kids (CTFK) Matt Myers urged Jonathan to sign the Bill. Myers said: “If I meet President Goodluck Jonathan, I will tell him that one thing he needs to do quickly that will save the lives of many Nigerians is to sign the Tobacco Control Bill and guarantee that the country will implement it right away. If the Tobacco Bill is signed and implemented, it will save literally over the course of time millions of Nigerians from death. Most importantly, it will protect Nigerian young people from lifetime tobacco addiction and premature deaths.”

Environmental Rights Action’s (ERA) Director, Corporate Accountability, Mr. Akinbode Oluwafemi,  said the Bill is a domestication of the Framework Convention on Tobacco Control (FCTC), the first global health treaty developed by the World Health Organisation (WHO), which Nigeria has ratified. 

Oluwafemi said: “The FCTC is one of the most successful international conventions. It includes other specific steps for governments addressing tobacco use, including to:  adopt tax and price measures to reduce tobacco consumption; create smoke-free work and public spaces; put prominent health warnings on tobacco packages; and combat illicit trade in tobacco products. 

“The big tobacco are doing their best to ensure regulations are not enforced in line with the FCTC by using tactics hidden under Corporate Social Responsibility (CSR) to hoodwink people in government into toeing their way at the risk of the people’s health. These tactics include: partnership agreements between government and industry; industry-run programmes claiming to prevent youth smoking; and training for farmers.”

Communications Manager, Africa Tobacco Control Regional Initiative (ATCRI), Mr. Adeola Akinremi,  urged Jonathan to sign the Bill into law.

Speaking at the WCTOH, Akinremi  said: “President Jonathan should assent the bill, which is capable of saving lives of many Nigerians in the long run.” 

Akinremi noted that the signing of the bill will help the cause for which the New York mayor has been committing his personal funds. 

For Akinsola Owoeye of the Nigeria Tobacco Control Alliance, there are several reasons why the Bill must be signed. Owoeye  said:  “Despite the promises made by the government and tobacco industry, death toll began to rise in Nigeria after BAT came in. A survey in Lagos State showed an increase in smoking prevalence from 8.9 per cent to 10 per cent, and prevalence of heavy smoking which rose to 16.3 per cent. It also shows that two persons die in the state daily from tobacco related diseases. Using the conservative estimates of Lagos State, it means each state in Nigeria has spent at least N2,847,000,000 ($ 18,058,992) to treat smokers in hospitals. Multiply that amount by the 37 states in Nigeria, it also means that Nigeria lost N105,339,000,000 ($668,182,708) in one year. If this figure is justifiable, it clearly make nonsense of the 10 billion naira ($6,343,165) per year, tax paid by BATN.” 

Olukorede Yishau

War against tobacco thickens in Nigeria

- SEUN AKIOYE

Tobacco control activists in Nigeria are calling for the passage of Nigeria Tobacco Control Bill sponsored by Senator Olorunnibe Mamora even as the British American Tobacco Nigeria (BATN) battles opposition from several fronts.Up till this time things have worked perfectly for  members of the tobacco control community in  Nigeria. Led by the Environmental Rights Action/Friends of the Earth Nigeria, the members have fought a relentless battle against the unregulated tobacco market in Nigeria. Sometimes too they have challenged the Nigerian government over its decision to invite the British American Tobacco (BAT) in 2001 into the country in an investment worth $150 million tobacco manufacturing plant in Oyo State.

Victory comes in trickles for the NTCA and its members. The Nigerian regulators soon banned smoking advertisements in the media, which was soon to be followed by some other forms of marketing restrictions in 2004. But the biggest stories of the tobacco control battle in Nigeria would come later.

In February 2009, Deputy Minority leader of the Nigerian Senate, Senator Olorunnibe Mamora, was on the floor of the Senate to present a bill entitled “A Bill for an Act to Repeal the Tobacco (Control) Act 1990 Cap T16 Laws of the Federation and to Enact the National Tobacco Control Bill.” It provided for the regulation or control of production, manufacture, sale, advertising, promotion, sponsorship of tobacco or tobacco products in Nigeria. The bill as proposed by the senator also seeks to domesticate the World Health Organizations Framework Convention for Tobacco Control (FCTC), a global treaty signed and ratified by Nigeria in October 2005.

Mamora, a two term senator from Lagos and a major player in the Senate knew his bill would face stiff opposition from the tobacco manufacturers and lobbyists, but he would be banking on his popularity and goodwill amongst his colleagues in the Nigerian upper legislative house. Mamora began by establishing the dangers in smoking, the inadequacy of Nigeria's health sector to cope with a tobacco epidemic. He progressed by reeling out statistics on the dangers associated with the use of tobacco products and how Nigeria is still unprepared to manage a tobacco epidemic. He also listed  Nigeria's obligation to domesticate the Framework Convention on Tobacco Control (FCTC), a World Health Organization (WHO) instrument to curb the global tobacco epidemic. Nigeria is a party to the convention having ratified the treaty in New York in October 2005. Mamora  then appealed to his colleagues, he touched a soft spot in the Senate: the constitutional duty of the Senate.

"A sober consideration for us as lawmakers is that it is not just a question of pro-activity when we pass this law; it is a constitutional duty and responsibility. Our constitution mandates us under its Chapter 11, The Fundamental Objectives and Directive Principles of State Policy, to enact laws to protect all vulnerable groups, our community, the society and the environment."

The senators listened to Mamora and while referring the bill to the Senate Committee on Health, Senate President David Mark, warned the members against the manipulations and lobbying of the tobacco industry who may try to derail the passage of the bill.

Outside the National Assembly, tobacco control groups are strategizing. A prominent member of the group is Akinbode Oluwafemi, programme manager of Environmental Rights Action/Friends of the Earth Nigeria (ERA/FoEN).  For most of his career, Akinbode has been fighting the tobacco industry and has been campaigning for tobacco control. He is instrumental to almost all tobacco control policies in Nigeria.  Akinbode was there at the beginning when the tobacco industry went unchallenged in Nigeria and the country became a dumping ground of sorts for the tobacco industry. But the story has changed and this is how it happened.

The tobacco industry in Nigeria On September 24, 2001, former Nigerian president, Olusegun Obasanjo in his quest for Foreign Direct Investment signed a Memorandum of Understanding (MoU) with the British American Tobacco (BAT) at the Park Lane Hotel London. The deal was worth $150 million and it involves the establishment of a cigarette manufacturing factory in Nigeria. The tobacco merchants promised thousands of jobs to Nigerians and were given generous concessions and a free hand to manufacture, sell, market and distribute tobacco products in the country.  The deal was signed, sealed and delivered but to the disbelief and anger of public health advocates in Nigeria. One of the protesting voices belongs to Oluwafemi.

"That was the first mistake of the Nigerian government, inviting the tobacco industry to Nigeria when it has become  a discredited industry and the truth is that government legislation  and control of its activities have made it difficult to do business in the Western countries, unfortunately the industry has turned to the developing world for survival," Akinbode told News Star.

The formal entrance of BAT into the Nigerian market was shrouded in mystery.  Internal documents of the company which were made available to News Star show that the company had been involved in cigarette smuggling into the country long before 2001. 

Internal documents also reveal that BAT had conducted a survey with the intention of determining the smoking pattern of Nigerian youths. A result of the survey shows that young people began to smoke around the age of nine. "New smokers enter the "market" at a very early age in many cases, as young as 8 or 9 years seems to be quite common." Continuing, it was admitted that most of the respondents of the survey had started smoking before they left junior school." 

Between 2001 and 2004, BAT's operation took an interesting dimension. The company employed several marketing, advertising tactics to market its products. The company organized series of musical events, fashion shows, street carnivals and even used Hollywood movies to promote Rothmans in the Experience IT campaign. At these events, underage persons were allegedly encouraged to smoke cigarettes before they gain entrance into the venues while inside free supply of cigarettes was ensured.  Tobacco control activists accused the company of employing "severely damaging tactics" that were no longer acceptable in the United States  and other developed countries to market aggressively to young people in Nigeria.  

The result of this, according to a statement from ERA/FoEN, is an alarming increase in the number of young people who are addicted to smoking. Investigations reveal that the company still engages in direct advertising to young people through a series of secret night parties organized in several parts of Nigeria.  Cigarettes are also still being sold in sticks which, according to the civil society, makes it accessible to young people.  The groups also want an increase in taxes on all tobacco products to discourage young people from starting out. 

BAT denies all the allegation which has also formed a part of the litigation in Nigeria.

A global epidemic

According to the World Health Organisation (WHO), tobacco currently kills 5.4 million people every year globally and if left unchecked this number will increase to 8 million with devastating results for developing countries which will contribute about 80 per cent of that casualty. If in the 20th century the tobacco epidemic killed 100 million people WHO says in the 21st century, it could kill one billion people.

Tobacco has also been said to be the only consumer product that is guaranteed to kill half of its regular users if used according to the manufacturers instructions. According to Olufunmi Shaba of the African Tobacco Control  Regional Initiative (ATCRI), a tobacco research institute based in Nigeria, "Tobacco use is a risk factor in six of the eight cancers in the world. A single stick contains more than four thousand carcinogens which are extremely dangerous to the human body."

In Nigeria, the situation looked pathetic.  A survey obtained from the 2006 census put the conservative number of Nigerians who smoke daily at 13 million. Also the Ministry of Health has warned that more young people are taking to smoking daily in Nigeria.

Also according to a survey by the National Expert Committee on Non-Communicable Disease in 2002 to determine smoking prevalent amongst secondary school students shows that 26.4 per cent of students interviewed have ever smoked cigarettes or used some form of tobacco products while 17.1per cent currently smokes. Another corroborative survey: The Global Youth Tobacco Survey conducted for Cross River State a year before reveals that 18.8 per cent of students have ever smoked cigarettes while 20.4 per cent said they would likely start smoking the following year.

Tobacco industry battles for survival

It is most unlikely that BAT bargained for the opposition it faced and so soon after it began operations in Nigeria and because the opposition did not come from competitors challenging its over 80 per cent dominance of the Nigerian markets, it made fighting back more difficult.

BAT has reiterated that it was interested in regulations that would help young people to stop smoking, the only snag being that it did not say that there are chemicals fused into the cigarettes to keep smokers addicted to it. The company also claimed to be assisting the regulatory bodies in regulating its activities. It has collaborated with the Nigerian Customs to curb smuggling by donating patrol vans; it voluntarily accepted a 30 per cent increase in warning signs on packs. But anti-tobacco groups are not impressed at all. According to Tosin Orogun, Communications Manager of ATCRI, what BAT wants is self regulation which is against the spirit and letter of Article 5.3 of the FCTC which warns against tobacco company interference in public health policy.  "You don't call the mosquito to the table when discussing a possible cure for malaria," he said.

BAT brought its case to the public arena during the public hearing on Mamora's bill on July 20-21, 2009. It argued that the bill would close down the industry if passed in its current form and open the floodgate to smugglers who may introduce contaminated   cigarettes thereby endangering the lives of Nigerians. But Mamora in an interview told News Star that the motivation for his bill is humanity. " The basic thing to say is humanity. When I say humanity, it is all encompassing. When you look in our Constitution under section 14 sub section 2, says "Security and welfare of the people shall be the primary purpose of government", that is under fundamental objectives and derivative principles of state policy, security and welfare; these are the fundamentals. And of course part of that welfare is safeguarding the health of the people and when you now take that further, particularly from my own background as a medical practitioner, it's no longer news, the hazards which tobacco cause to human health".

For now, the tobacco industry and the anti-tobacco advocates are locked in a battle for the souls of young people awaiting further actions from the Senate. 

But Phillip Jakpor, media officer to the ERA/FoEN said, "We call on the Senate and the leadership of the National Assembly to pass the National Tobacco Control Bill now. It has been a year after the public hearing organized by the Senate Committee on Health led by Senator Iyabo Obasanjo-Bello; the civil society is asking that the committee should return the bill to the plenary for prompt passage in order to save the lives of our young people."

Jakpor and his organization have another reason to be happy. In October 2009, Osun State House of Assembly passed the Prohibition of Smoking in Public Places Bill 2009, making it illegal to smoke tobacco products in all public places in the state. The state imposed a fine of between N10,000 and N250,000 for violators. Only last week, Rivers State passed a similar bill banning smoking in all public places in the state.

Akinbode said he is optimistic the National Tobacco Control Bill will scale through but he can only hope.  His optimism might have been due to a lifeline given to him by Senate President David Mark while declaring open the public hearing ""We stand between health and economy that is the truth of the matter. People who are against it are worried about the impact on the health of Nigerians and people  who are for it are saying well, the nation stands to benefit from it. The simple question is, 'when do you begin to worry about economy? Is it when you are dead or when you are alive?"

SOURCE

Tobacco bill not dead, ERA replies Adedibu

IMAOBONG UDOH

THE Environmental Right Action (ERA) has faulted a statement credited to Senator Kamarudeen Adedibu that the National Tobacco Bill is dead.
The ERA Programme Manager, Mr Akinbode Oluwafemi, said at a press briefing in Lagos that bill which had passed the public hearing was not dead.
He said: “The tobacco bill is to regulate the manufacture, distribution, sponsorship and marketing of tobacco products in Nigeria. The bill scaled through the second reading in the Senate in February 2009 and at that reading, all the senators present spoke at the plenary expressed strong support for the bill.
“Senator David Mark, while referring the bill to the Committee on Health, enjoined the members to expedite action because of the intense lobbying of the tobacco industry which will seek to derail the enactment of laws that protect lives of Nigerians and also curtail criminal activities.”
Oluwafemi said over 40 Non-Governmental Organisations (NGOs) presented memoranda supporting the bill and asking for its special passage. Besides, there were words of commendations and support for the bill from five international NGOs - Campaign for Tobacco Free Kids (CTFK), Framework convention Alliance (FCA), Corporate Accountability International (CAI), African Tobacco Control Alliance (ATCA), and the Africa Tobacco Regional Initiative (ATCRI).
The ERA programme manager said: “Senator Mark, while speaking at the public hearing made some profound statements which underscore the importance of the bill 'We stand between health and economy that is the truth of the matter. People who are against it are simply worried about the impact on the health of Nigerians and people who for it are saying well, the nation stands to benefit from it. But the simple question is, when do we begin to worry about the economy? Is it when we are dead or when we are alive?'
“Mark added that the Senate will not employ the usual method of voice voting but that individuals will vote their support for or against the bill when it comes back to plenary. The bill has not return to the Senate plenary, so how then did the bill die?
“Let me state again that the bill is not about personal gains or recognition for anybody. The bill seeks to domesticate the Framework Convention on Tobacco Control which is a World Health Organisation (WHO) initiative to combat the global practice of the tobacco industry. Nigeria has signed and ratified that treaty and we owe it as an obligation under international protocol to fully domesticate the provisions of the treaty. It is about the health of our people as reconsigned by all leading health institutions.”

SOURCE

'Anti-tobacco bill is still alive'

By Michael Orie and Wole Oyebade

ANTI-TOBACCO activists, under the aegis of Environmental Rights Action / Friends of the Earth Nigeria (ERA/FoEN), have debunked the purported 'death' of the National Tobacco Control Bill (NTCB) at the National Assembly, insisting that the bill was still under consideration before the Senate Committee on Health.
Their reaction came in the wake of Senator Kamaldeen Adedibu's insinuation to the effect that the bill, which has passed the public hearing stage, "is dead."
At a media briefing in Lagos yesterday, Programme Manager, ERA, Oluwafemi Akinbode, said: "Contrary to the lies and deception of the statements credited to the senator, the NTCB bill is not dead. The bill scaled through the second reading in the Senate in February 2009 and at that reading, all the senators present and who spoke at the plenary expressed strong support for the bill.
"Indeed, Senate President David Mark, while referring the bill to the Committee on Health, enjoined the members to expedite action on it because of the intense lobbying power of the tobacco industry, which seeks to derail the enactment of law that would protect the lives of Nigerians and also curtail the industry's criminal activities."
ERA described Adedibu's comments as "inflammatory, albeit deceitful, reckless, misleading and totally false."
The National Tobacco Control Bill 2009, sponsored by Senator Olorunnimbe Mamora (Lagos East), seeks to provide the regulation or control of production, manufacture, sale, advertising, promotion and sponsorship of tobacco or tobacco products in Nigeria and other related matters.
The bill also seeks to prohibit sale of cigarette to persons under 18; sale of tobacco products through vending machines; and sale of cigarette in single sticks;
It also seeks to prohibit all forms of tobacco advertisement, sponsorship and promotion, endorsements or testimonials, sale promotions; and smoking in public places, among others.
Akinbode also disclosed that a two-day public hearing was organised by the Senate Committee on Health headed by Senator Iyabo Obasanjo-Bello on July 20 to 21, 2009, with the Federal Ministry of Health leading government agencies to lend support for the bill.
His words: "In all, over 40 Non-Government Organizations (NGO) presented memoranda supporting the bill and asking for its speedy passage. Besides, there were words of commendation and support for the bill from five International NGOs; Campaign for Tobacco Free kids (CTFK), Framework Convention Alliance (FCA), Corporate Accountability International (CAI), African Tobacco Control Alliance (ATCA) and the African Tobacco Control Regional Initiative (ATCRI).
"Besides the tobacco Industry, only Senator Adedibu, who represents the Oyo South Federal Constituency, expressed his opposition, hinging his reason on loss of jobs and vowing to oppose the bill even if that would be the only thing he would do in the Senate.
"The committee has not presented the bill to the plenary and we know for a fact that there was supposed to be a retreat on the result of the public hearing but for the recent political developments in the country. Therefore the bill has not been voted on by the Senate plenary, how then did it die?"
African regional coordinator, Framework Convention Alliance, Adeola Akinremi, disclosed that the World Health Organisation (WHO) estimated that tobacco kills 5.4 million people every year and if current trend continues, it would kill more than eight million people.
In 2006, from a survey carried out in 11 Lagos State government-owned hospitals, it was discovered that at least two persons die each day from a tobacco-related disease. Also in one single year, about 10 000 cases of tobacco-disease was recorded in Lagos.
Akinremi said: "All we need to do is extrapolate that figure all over the country and we will have an idea of the epidemic we are dealing with.
"ERA/FoEN wishes to condemn in its totality the activities of Senator Adedibu. We demand that he immediately cease from making such statements and ask the Senate leadership to investigate his allegations.
"However, while we still have trust in the Senator Iyabo Obasanjo-Bello-led committee, we are constrained to be apprehensive about the long delay in presenting the bill at plenary. This is the time to complete work on this public health bill. This is the only way to show the world that the committee has not been compromised by the tobacco industry as Senator Adedibu has insinuated.
"Nigerians are dying by the seconds due to tobacco addition while tobacco manufacturers smile to the banks. Every delay is more deaths, more ill-health."

SOURCE

Cancer: Cost and causes of a killer ailment

By NIYI ODEBODE

Until 2007 when she was admitted to the Lagos University Teaching Hospital, Idi-Araba, Comfort Adio was hale and hearty. Before December that year, the 46-year-old woman had never been hospitalised. But what she thought was an ordinary sore on her right breast later became fatal. She was forced to consult a doctor, when the sore did not heal after two months of self-medication.
Her husband, Martin, said, ”We did not suspect that it was a serious illness. We thought that it was a sore that we could treat with an antibiotic.”
The woman was diagnosed with breast cancer at LUTH. According to her husband, the cancerous cells had spread to other organs. In September 2007, she decided to go to India for treatment. The 46-year-old teacher required N4m for surgery and other treatments in India. She died early 2008, while her husband and other relations were making efforts to raise the fund.
While Comfort lost the battle of her life to breast cancer, another patient, Adeola, has been bed-ridden by the ailment. She was diagnosed with it in 2008. Adeola initially took a lump in her left breast for granted because it was painless. When the lump persisted, she strolled to a hospital, where she was diagnosed with the cancer. She has been living in pain since 2009, when she began cancer treatment.
The women‘s cases typify the problems associated with cancer in Nigeria. Besides the two, the ailment, which was hitherto thought to be foreign, had claimed lives of prominent Nigerians. Such people included a Lagos-based lawyer, Chief Gani Fawehinmi; a broadcaster, Mr. Yinka Craig; a popular musician, Mr. Sunny Okosuns and recently, the wife of a former military president, Mrs. Mariam Babangida, who died of ovarian cancer in a United States hospital.
These eminent Nigerians died abroad after unsuccessful treatments. Some of them, particularly, Fawehinmi, were forced to seek foreign treatments, when their conditions were misdiagnosed in the country.
Cancer patients are a pitiful sight to watch when they are in agony. A consultant oncologist at LUTH, Dr. Remi Ajekigbe, said, ”There is no pain as worse as cancer pain. It is the worst pain anybody can have.”
The World Health Organisation estimated that 7.6 million people died of cancer in 2005 globally. It stated that there were 100,000 new cases annually. The world body predicted that the figure would increase to 500,000 as from 2015.
Currently, Nigeria does not have a national cancer registry. There are no reliable data on the prevalent rate of the ailment. What the country relies on are hospital-based statistics. There are, however, indications that hospitals are seeing more cases of different types of cancer.
Ajekigbe, who confirmed this, said, ”There are increasing cases of cancer all over the world. As Nigeria is also part of the world, there is increase in the country. Here in LUTH, if we compare what we are seeing now to what we used to see in 1980s, there has been a 25 per cent increase.”
Also, studies in Ibadan showed that there had been an annual incidence of 10,000 cervical cancer cases in the South-Western part of the country.
What are the reasons for the increasing cases of cancer? One of the reasons is the increase in the level of awareness. More Nigerians, particularly, the educated, now go to hospitals for treatment rather than dying at home.
Medical experts, including Ajekigbe, said that there had been an increase in the level of awareness. Ajekigbe also said, ”We are getting more westernised. We are doing everything the Western way. We are changing our diet and importing virtually everything, including foreign diseases.”
In spite of the increase, cases in hospital may be a tip of the iceberg as cancer screening centres are not in many parts of the country.
While the Federal Government in 2009 directed its tertiary hospitals to set up screening services for breast, cervix and prostate cancers, these are not available in many secondary and primary health facilities. Where facilities are available, only a few Nigeria go for check-ups.
The Coordinator of the National Cervical Control Prevention Programme, Dr. Kin Egwunomwu, at the inauguration of the organisation in Lagos, said that some groups that were offered opportunities of screening rejected them.
Narrating his experience, he said that a church did not allow its members to undergo free cervical cancer screening, when his organisation went there. ”What we often hear from such organisations is ‘God forbid. It is not our portion,” said Egwunonwu, who is also a reverend.
Corroborating the cleric, Ajekigbe said that most cases of cancer in Nigeria were presented late. He said, ”Cancer of the inner parts of the body may not be detected early because it affects parts that are not seen. But the cancer of the outer part can be detected early. Our people report late. They say they are bewitched. They go to native doctors and pastors. They come to hospitals as a last resort.”
Also, the Coordinator of Cancer Control Programme of the Federal Ministry, Dr. Patience Osinubi, stated, ”30 per cent of cancer cases are preventable and 40 per cent are easily detectable in the pre -malignant stages.”
She, however, noted, ”Many cases of cancer are presented to hospitals at advanced stages when effective intervention is not possible. This has been one of the major reasons for the high mortality rate.”
Even when cases are diagnosed, does Nigeria have enough facilities to treat the ailment. Investigations show that currently, Nigeria has five radiography machines to serve a population of 140 million people. A radiotherapy machine is a major instrument for the treatment of cancer. A linear accelerator, an advanced form of radiography, costs N1bn, including the funds for the building and accessories.
The hospitals that have functioning radiotherapy machines include, LUTH; the University College Hospital, Ibadan; Eko Hospital, Lagos; Ahmadu Bello University Teaching Hospital, Zaria and the National Hospital, Abuja.
The five radiotherapy machines are not evenly spread in all the six s zones of the country. Three are in the South West, while one each is in the Federal Capital Territory and North Central.
Osinubi, ”In Nigeria, an average of one linear accelerator per 20 million is available when compared to 3.4 and 8.2 radiotherapy machines per million population in the United Kingdom and the United States of America respectively.
Besides radiotherapy, other treatment options available for cancer patients in Nigeria include, surgery, chemotherapy, and hormone therapy.
Management of cancer is multi-disciplinary. This, a consultant radiation oncologist at the UCH, Dr. Atara Ntekim, in an interview in Lagos, said was one of the reasons why the treatment was expensive.
Explaining treatment options in Nigeria, Ajekigbe said, ”Before anybody can be said to have cancer, the growth in any part of the body is taken by a surgeon and passed to a pathologist, who examines it under a microscope and give a written conclusion on the type of cancer the person has.” He added that the surgeon could remove the growth after diagnosis.
Other method of treatment is chemotherapy, which involves the use of chemicals that kills cells. ”They kill both cancer and non-cancer cells,” stated Ajekigbe.
The use of hormone therapy is common in cancer that is hormone -dependent. According to Ajekigbe, ”When we are treating any cancer that is hormone -dependent, we attack the hormone which the cancer feeds on. In breast cancer treatment, we give anti-estrogen hormone.”
With only five radiotherapy centres available in the county, it is obvious that the treatment of cancer is not accessible to Nigerians. Ajekigbe said that a cancer patients needed about N10m a year complete his or her treatment in Nigeria.
With 70 per cent of Nigerians living below $1 (N146) a day, most people cannot pay for the treatment from their incomes. This is compounded by the fact that the National Health Insurance Scheme, which currently covers about three million Nigeria, does not fund cancer treatment. It only covers cancer screening as well as mastectomies and prostatectomy for breast and prostate cancers.
The coordinator of the cancer control programme acknowledged this in an email sent to our correspondent. Osinubi said, ”Cancer treatment is expensive to treat any where in the world. In Nigeria, the challenge facing patients is the inability of the National Health Insurance Scheme to fund cancer treatment.”
A mammogram (an X-ray of breast cancer) goes for N3,000 - N5,000 in public hospitals in Nigeria, where the minimum wage still remains N9,500 a month.
Cancer patients normally undergo CT scan or a magnetic resonance imaging to detect organs that have been affected by the ailment. A CT scan costs between N30,000 and N40,000. An MRI, an advanced form of a CT scan, costs about N80,000 for just a part (chest for example). A patients may be required to do an MRI of three parts (the head, chest and abdomen).
Ajekigbe disclosed that a patient would require between N500,000 and N12m for chemotherapy ;and N2.5m for hormone therapy in a period of five years.
Cancer drugs are expensive considering the income an average Nigerian. For example Adriamycin, a breast cancer drug is N2,000 per bottle. Another breast cancer drug, Eprirubicin, meant for breast cancer patients with heart problem, costs N10,000 per bottle.
Investigations show that a mastectomy, which is the removal of a cancerous breast through surgery, costs about N50,000 in the country. A breast cancer patient that requires radiotherapy through a linear accelerator should be prepared to pay N100,000. A cervical cancer patient would pay N50,00 more. Chemotherapy costs an average of N100,000 per course of treatment.
The high cost of treatment is compounded by dearth of manpower. Treatment of cancer requires a multidisciplinary approach. Experts needed for treatment include surgeons, pathologists, physiotherapists, oncologists.
In the country, total number of oncologists is less than 100. A consultant oncologists, Ajekgbe, who conformed this, said, ”There are 20 consultant oncologists and 40 others that are at different levels of training.”
Also, the coordinator of government cancer control programme, stated, ”For a country of 140 million population, there is a shortage of trained personnel like radiation oncologists, therapy radiographers, medical physicists and oncology and palliative care nurses. As at the last count, three years ago, there were about 27 qualified radiation oncologists, eight medical physicists and 14 oncology nurses.”
With the high cost of treatment, does cancer afflicts the rich alone? Experts, including Ajekigbe and Ntekim, said that it was common in both the rich and the poor.
According to Ajekigbe, ”There are some cancers associated with being poor. An example is cancer of the cervix. If a girl is pretty, but comes from a poor home, she may use her beauty to get what she wants. This may lead to her being loose or promiscuous, thus exposing herself to cancer of the cervix.
”Also, a rich person, who can afford certain things like food that is rich in high cholesterol may expose himself to cancer. He may shun local foods which can protect him against cancer of the colon..”
Besides these, some habits such as smoking and drinking alcohol may also predispose people to cancer.
Explaining further, Ajekigbe said, ”You cannot place your finger on a cause when you are talking about cancer, but there are factors that predispose one to it. For example, if your parent has certain cancer, you have a higher chance of having it than a person, whose parent does not have it.”
Experts said that Nigeria had facilities for the treatment of cancer. The major hindrance, however, is that they are few. Also, there are late presentation of cases, uneven spread and the high cost of treatment.
Ajekigbe explained why some Nigerians travelled abroad to treat cancer. He said, ”We normally do not refer patients abroad. But if a patient says we should refer him abroad, we do that. But we do not on our own refer patients abroad.”
On referrals, Osinubi said, ”The advantage of going abroad is the availability of several choices of cancer treatment centers. But Nigerian patients still have to pay a lot of funds except they have dual citizenship making them eligible for national health schemes.
”Only the rich, as has been observed in Nigeria, can go abroad for treatment. The outcome of their treatment will be the same unless the cancer is detected early.”
Explaining reasons for misdiagnosis of cancer, she said that it was not peculiar to the ailment. She said, ”Several diseases have similar presenting symptoms. A patient‘s diagnosis also depends on the level of competence of the medical facility he visits.”
With more Nigerians coming down with cancer, the Federal Government has intensified efforts to combat it. The government is partnering with organisations such International Atomic Energy Agency, Vienna to fight cancer.
Osinubi said, ”The partnership with the IAEA is called Programme of Action on Cancer Therapy. Within the next eight years, nuclear medicine equipment, which can diagnose cancer efficiently ,and linear accelerators, will be available in federal tertiary hospitals in all the six geopolitical zones.” The government has already paid the first $2m to the IAEA as part of the counterpart fund for the programme.
Government‘s efforts as laudable as they may be, experts and non-governmental groups said preventive measures should be intensified. The Executive Director of the African Tobacco Control Regional Initiative, Mr. Olufemi Akinbode, disclosed that only Osun State and the Federal Capital Territory had passed bill on smoking.
According to him, the bill is still in the second reading in the National Assembly. Akinbode said that tobacco-related cancer accounted for 30 per cent of cancer deaths globally.
Chronic Human Papilloma Virus can cause cervical cancer. It can be prevented through the administration of HPV vaccines. The National Cervical Cancer Control Policy states that girls from the age nine-years should be eligible for the vaccine. Adults can also get it.
The implementation of the programme is yet to start fully. But, Osinubi said, ”The Federal Ministry of Health is trying to get Global Alliance for Vaccines and Immunisation‘s assistance to procure the vaccines at an affordable cost to sustain its inclusion in the National Programme on Immunisation.”
While Nigerians await the full implementation and success of government‘s anti-cancer measures, who will tame the rampaging monster?

SOURCE

Lung cancer patients who quit smoking live longer

Nigerian Compass

People with early lung cancer who quit smoking could double their chances of surviving, a new study says.
Until now, there has been little proof that quitting smoking after developing lung cancer makes any difference to survival.British researchers analysed previous data from 10 studies examining how long smokers survived after being diagnosed with lung cancer.

People with lung cancer who continued smoking had a 29 per cent to 33 per cent chance of surviving five years.

But those who kicked the habit had a 63 per cent to 70 per cent chance of being alive after five years.

The research was published in the BMJ, formerly known as the British Medical Journal.Lung cancer is the top cancer worldwide and the prognosis is usually poor.

Only about seven per cent of patients make it to five years, though about 20 per cent of patients are diagnosed early enough to be treated.

“The message is you should never give up on giving up (smoking),” said Amanda Parsons, of the United Kingdom Centre for Tobacco Control Studies at the University of Birmingham, who led the study.

“Even at the stage where you have been diagnosed with early stage lung cancer ... if you give up smoking, your body can still partially recover and your risk is reduced,” she said.

While some doctors recommend lung cancer patients quit smoking, not all do. Some doctors and nurses “think it is inhuman to dwell on the matter — that it adds to feelings of guilt and takes away a lifelong comfort from the dying patient,” wrote Tom Treasure of the University College London and Janet Treasure of King’s College London in an accompanying editorial in the BMJ.

They said patients and their families should now be told about the study results “because the potential benefit is great.”

The research might also provide some clues on how smoking causes cancer. Scientists aren’t sure if tobacco smoke or nicotine affect lung cancer once it has developed, though there is some evidence they may speed up the disease.

Knowing how cigarettes impact cancer could potentially lead to new treatments, Parsons and colleagues wrote.

The study was paid for by the British Heart Foundation, Cancer Research UK and other governmental bodies.

SOURCE

Cigarette smoking: Easy path to ill-health, death

EBENEZER EDOHASIM, Features Editor

EVERY one knows that smoking hurts, it causes sickness, disability and death. But the harmful effects of smoking may be worse than you really imagine because smoking damages nearly every organ in the human body. Little wonder Mr. Tunji Buhari of the Environmental Rights Action, (ERA), and Friends of the Earth, lamented that, “Tobacco or cigarette smoking is the only known medication that kills half of its users when used as prescribed by the manufactures. It kills over 10,000 persons per day and 4.5 million people yearly.”

As he further disclosed, “Sadly, 70 per cent of this figure are from developing countries, including our own nation, Nigeria and if this trend continues, this figure is anticipated to rise to 10 million a year by 2030.” The history of tobacco is as old as the world itself because almost all parts of the earth has knowledge of tobacco usage and therefore had smoked one form of cigarette or narcotics even in dark ages.

However, modern attention on the manufacturing of this killer sticks came to light during the slave trade era, when the western world found in Africa, cheap and strong labour which they bought from local greedy African slave merchants, who sold their brethren to the white man, to be used as slaves. These slaves in their millions were wickedly exported to the Americas in special slave ships under very dehumanizing conditions, where most of them worked in tobacco plantations on arrival to the new world, as America was then called, especially in the city of Virginia, United States, to produce raw materials for the production of cigarettes and other dangerous narcotics.

Unfortunately, several years after the abolition of slave trade and slavery, which claimed the lives of many innocent Africans, the tobacco plantations which those slaves nourished for their wicked white masters continued to produce killer narcotics for blacks in developing world as some western nations have banned smoking, having discovered that cigarettes smoking is dangerous to health. In Nigeria, commercial growing of tobacco started in 1934 when British American Tobacco,(BAT), decided to source tobacco leaf locally in preparation for the establishment of a cigarette plant in 1937. BAT has been part owners of the moribund Nigeria Tobacco Company, (NTC).

Tobacco cultivation first started in Ogbomosho, Iseyin and Ago Are, all in the present day Oyo State, before spreading to the northern part of the country. After the collapse of the Nigeria Tobacco Company, there was another spirited attempt by BAT to relaunch cigarette production in Nigeria. Therefore on September 24, 2001 at an event tagged Nigerian Investment Summit held at Park lane Hotel in London, BAT signed a memorandum of understanding with the Federal Government to set up US$150 million ultra modern cigarette manufacturing plant in Ibadan, Oyo State. Since then, BAT and other cigarette plants have been producing cigarettes to millions of Nigerians who savour these deadly sticks on daily basis. It is estimated that 18 billion cigarettes are sold yearly in Nigeria, with one in every five young Nigerian a smoker, while women smokers have raised to10-fold during the 1990s – 2000. In the United States, acknowledged as one of the world’s highest consumer of cigarettes, 400, 000 Americans die every year from smoking and that is 1,200 per day. Also one every five deaths in this God’s own country was the result of smoking.

Despite the fact that cigarettes contains over 4,000 different chemicals that make them deadly, with 60 per cent of these chemical being carcinogens, which means they can cause cancer, people still puff this sticks as if their lives depended on them. Investigation shows that people smoke for different reasons and which some of them are ready to justify, no matter how long you spend to alert them on the inherent dangers associated with cigarettes or narcotics. Generally, people said they smoke to make them look mature, older and respected and this reason was mostly advanced by teenage smokers.

Others smoke to relax their tensed nerves. Still some see it as status conferrer to set them apart or make them higher than their peers, while some claimed they do it to keep their weight down. And for another set, they come from family of smokers and therefore embraced smoking as family business which they must continue. Again, cigarettes makers spend millions of dollars on adverts, making smoking look cool, elegant, and highly successful, as they usually use music, film, television or even sports stars, and very beautiful, sexy and erotic ladies to send their outwardly innocent but inwardly deadly adverts, publicity and promotion campaigns across their target audience all over the world. The dangerous thing about smoking is that once people get hooked, it is very hard to stop and this is called addiction. And addiction on the other hand is caused by the nicotine contained in cigarettes.

According to Dr.Stephen Oladele of Ola Ayoka Memorial Conval (Health) Clinic, Ogudu, Lagos, “Nicotine stimulates the brain, giving it a sense of euphoria. It raises alertness and lifts a person’s mood, but as time goes on, it takes more nicotine to have this effect. When a person is slowing down or trying to quit smoking, nicotine levels in the blood stream drops but withdrawal is never easy.” However, whatever was gained as the result of the decision by a smoker to quit is lost the moment he or she starts smoking again which gets the nicotine level in the blood stream going higher once again, like a diabetic patient who allowed too much carbohydrates into his system, thereby shooting up his or her sugar level.

Dr. Oladele further said that, “Smoking primarily causes cancer, cardiovascular diseases, respiratory ailment, and harms reproduction.” On a broader spectrum, smoking has been linked to cancers of the lungs, mouth, throat, larynx (voice box), esophagus, pancreas, kidney and bladder. Smoking could also lead to cancer of the stomach, cervix and acute myeloid leukemia or cancer of the blood. Smoking it was disclosed causes more cases of lung cancer as smokers are about 20 times more likely to develop lung cancer than non- smokers. Smoking causes 90 per cent of lung cancer deaths in men and 80 per cent in women. Smokers are four times likely to die from coronary heart diseases than non- smokers. It causes atherosclerosis, or hardening and narrowing of your arteries which may lead to strokes. Smokers could suffer from abdominal aortic aneurysms, a dangerous weakening and ballooning of the major arteries near your stomach. If you smoke during childhood and teenage years, it slows your lung growth and causes your lungs to decline at a younger age. Smoking is related to chronic coughing, wheezing and asthma among children, teens and adults. It also causes half of all cases of adult periodontitis, a serious gum infection that can cause pain and tooth loss. Dr Oladele equally stated that, “Smoking seriously harms reproduction as it causes lower fertility in women, induces placenta previa and placenta abruption which are conditions that can make the baby to be born too early and then be sick. The nicotine in cigarettes smoke reduces the amount of oxygen reaching the fetus and could also retard baby’s growth in the womb resulting to low birth weight.”

Further investigation showed that smokers are less healthy than nonsmokers, have increased risk of cataracts, and low sexual drive. They are linked with inability of wounds to heal fast, and respiratory problems, with women smokers’ bones losing density very fast after attaining menopauses. One crazy revelation about smoking is that while smokers risk their lives by inhaling nicotine into their lungs and other vital internal organs, nonsmokers who stay near smokers as they puff their stick are also, unfortunately, at risk of tobacco death. Non smokers who innocently inhale smoke from smokers engage in second-hand smoking equally called environmental tobacco smoke or passive smoking, because some quantity of nicotine also enter their system and could damage some organs and cause sickness to unfortunate non smokers. According to WHO report, “It has been confirmed that for every eight smokers who die, one innocent bystander also dies from second-hand smoke and if one is exposed to second-hand smoke for about 120 minutes, then the person must have smoked the equivalent of four sticks of cigarettes.”

Surprisingly, despite these frightening health hazards associated with smoking, people still smoke as if without it they will die the next moment. This writer had interesting interaction with some smokers to find out why in the first place they decided to smoke cigarettes, what they gain from smoking, the health hazards they experienced and when they hope to finally drop this deadly habit. Mr. Oyetunde Olusoji, a young Interior Decorator disclosed that he started smoking cigarette in 1998 due to peer group influence. “Honestly, I still don’t understand why I joined my friends who smoke to do the same. I just wanted to belong to the big boys group and to be seen as one of the movers and shakers of the school environment in which I found myself. One thing led to another and before I knew it, I got hooked into this deadly act and I don’t know how to remove myself from it.” Mr. Olusoji stated that sometimes, certain conditions stimulate the need to smoke. For instance, “If Iam alone and feel bored, I will have the urge to smoke and also whenever I drink beer, only God could stop me from smoking because once Iam taking beer, the next thing that comes to my mind is to smoke and I must satisfy that urge. Interestingly, Mr. Olusoji is aware of the health hazards linked to smoking and even postulated that 60-70 per cent of chest and lung pains come from smoking. However, he argued that since some people developed cancer of the lungs without even touching a stick of cigarette, he no longer bothers himself on the dangers inherent in smoking as long as his urge is satisfied each time the feeling to smoke envelopes him, fully aware that one day, he will die of one illness or the other. As he further disclosed, “One negative effect of smoking on me which I regret so much is the social stigma it hangs on me as some of my girlfriends refused to kiss me because my mouth always smelled of cigarettes. My girlfriends at a stage, individually, asked me to choose between them and cigarette and when I chose my stick over all of them, I knew that my liberation from smoking was still very far. If you smoke, you can hardly get responsible girlfriends because any girl that accepted to befriend you as a smoker if you investigate well, equally has bad habit which when you discover and want to make noise over it, she will blackmail you with your smoking act and you will have no option than to keep tolerating each other’s vices.”

But in a very interesting swift, Mr. Olusoji dramatically decided to quit smoking in 2006 only to resume in2009. According to him, he returned to smoking when he encountered serious challenges which mounted pressure on him, thereby tensing him up. So till today, he is still helplessly addicted to nicotine, hoping that one day God will grant him the grace to quit what he tagged “this destructive habit that robbed me of all my responsible girlfriends, leaving me with the bad ones as I don’t expect any reasonable girl to date a smoker.”

A former chronic smoker, Pastor James Okoro, founder and general overseer of the Word Foundation Assembly, Lagos, who by what he identified as the special grace of God and his will power, discipline and determination quit smoking in 1997, a habit he acquired in 1983 said that, “There is an evil spirit in cigarettes that induces people to smoke. The day that unclean spirit of nicotine addiction left me, I knew that I have been liberated. The very bad aspect of smoking is that every smoker will advance reasons to justify his action. Some light a stick each time they wanted to go the toilet as thy claim it helps them to empty their bowels. To others, it simply gives them joy and any attempt to stop smoking takes the joy in their lives away which is ploy by the devil to get them permanently hooked to smoking. Others will tell you that whenever they drink beer, they must smoke so that the beer will go down their throat very well.”

Pastor Okoro said that smokers should be pitied because quitting cigarette smoking is not an easy task. But he counseled that because of the health hazards linked to smoking which he experienced while he smoked, people should halt smoking without further delay. Those who want to stop must involve God in the process as no smoker can automatically quit smoking with power of the flesh because of cigarette’s addictive nature. Before he stopped smoking, he first bid farewell to alcohol which stimulates him to smoke, cut off from his friends who smoked to avoid any temptation, and fully declared himself a born again Christian before all his friends and neighbours, preaching fiercely against smoking. He said that after few weeks, when the urge came up, he looked for a very secret place to hide and smoke so that people he had already told that he was now born again will not see him smoking. However, when he found that there was no hiding place for the gold fish, he used will power and prayers to suppress the urge and subsequently became freed from nicotine addiction.

He advised those who want stop smoking to reject suggestion by some people to go for an alternative to smoking like kola nut, bitter kola, and alcohol, sweets among others, disclosing that if one quits smoking to embrace kola nut for instance, he could again be addicted to kola nut which contains caffeine that is equally harmful if taken constantly in large quantity. “Once you have prayed to God to direct the Holy Spirit to help you stop smoking, let your yes be yes and no be no because anybody who said no to something and could not maintain his no, is a fool. And since I don’t want to be classified as a fool, I totally rejected smoking, and the urge disappeared after two weeks. Up till today, I have never gone back to smoking. Smoking is almost like a curse for an addicted smoker can even go and wake up his worst enemy for cigarettes, once the urge sets in.”

For Mr. Rowland Chukwuka, an Immigration expert, he started smoking in 1996 when he was still in secondary school, stopped in1997 only to go back in the year 2000. “I started smoking through the influence of friends in school. I felt that they are high up there and what they were doing by smoking was very good, and I wanted to belong to the big boys club. Again in 2003, I quit smoking only to return to this bad habit in 2007. It is not as if one deliberately went back, but it is only God Almighty that can help me stop smoking by taking care of me whenever Iam under pressure which actually triggers my quest for cigarettes. I assured my wife on several occasions that I was quitting, only to disappoint her by embracing smoking again.”

Mr. Chukwuka admitted like others that he was fully aware of the hazards linked to narcotics but said that addiction is a very dangerous thing for once you are hooked to a habit, it becomes very difficult to pull out. “Before I temporarily stopped smoking, I experienced terrible headache, which was near a migraine, my dress sense nose-dived as I found myself unkempt and could go without bath for days, stinking even to myself of congealed smoke. I was excommunicated in some quarters and I utterly appeared near irresponsible.”

Lamenting further on the plight of addiction, he said, “It is a big shame to even think that as a member of the Red Cross Society, I still indulge in this awful habit. I hope to one day develop the will power to quit smoking, if not for any other reason, for my children’s future, so that I will not die young and make them fatherless at tender ages. Non smokers should never think of embracing it because all those things you see on cigarettes adverts are false life styles, tailored to get you hooked to smoking. They should obey the warning by the Federal Ministry of Health that cigarettes smokers are liable to die young, for once diagnosed of cancer, then, your days are really numbered on this earth.”

A journalist, who simply called himself Jones, said that he has been smoking for the past 20 years. According to him, he left secondary school, came to Lagos to stay with his big uncles and then look for job. It happened that most of his uncles were smokers and he innocently grew up with them to believe that smoking was a good way of life and has been puffing since that regrettable informal initiation into the club of smokers by his uncles, which could be described as a navigational error. As he recounted, “I started smoking due to peer group pressure as I tried to belong. In those days in question, if you don’t smoke, womanize or drink what then makes you a good big boy. I craved to belong and even when I entered higher school in 1986/87, I continued smoking to maintain the big boy status on campus. I smoke whenever Iam tensed up or under pressure, if Iam drinking beer or when Iam lonely, driving alone back home after work. I saw smoking as part of growing up as those I emulated never told me that it was a dangerous habit until I became addicted because I did not realize what I was doing to myself in the first place and when to call it quits.”

Jones said that though he has not been clinically diagnosed of any ailment linked to tobacco smoking, “I knew that some serious pains I do feel at my back were induced by smoking because if I leave smoking for some time, the pains disappear only to return when I resume.” He disclosed that the warning on cigarettes packs meant to serve as deterrent has no effect on him, for if it did, he would have stopped smoking long time ago. “So the best I could do is to stop it before it stops me for if I don’t stop smoking, cigarette will stop me. A situation where hide my mouth from my wife even after using mouhfreshner so that she would not decode that I smoked is certainly not the best.”

Another journalist, who pleaded anonymity, told this writer that he derailed into this dangerous zone of nicotine consumption since 1975, made a failed attempt to stop in 1996 but resumed almost immediately and had not considered making another move to quit since that botched attempt. He stated that his smoking habit has caused him breathing difficulties, lack of energy to do strenuous jobs meant for young men, and has seriously lowered his libido or sex drive. Again, he disclosed that smoking made him cough always as he said that there is what is called smokers cough, which is recurrent whether one has cough or not. He experienced pains in his chest, lungs and had fractured relationships with women because of smoking.

This journalist, who is a prolific writer, condemned attitude of Africans to smokers when he blasted, “I don’t see why Africans claim to be holier than the Pope, as smoking in most parts of Africa is still regarded as sin with serious moral burden. Those who smoke in some parts of Africa are viewed as direct candidates to hell fire, who require no visas to enter that terrible place meant for Satan and his servants. In Europe where I grew up, people were concerned only with the health implications of nicotine to smokers and not whether they will go to hell or heaven. In Italy, ashtrays were placed on tables in classrooms and both students and teachers were free to express themselves by smoking if the urge was instigated.”

He disclosed that he is chain smoker who buys cigarettes in rolls and could smoke up to four packs in a day. Speaking further, this articulate journalist who from the way he puffed as our interaction interview progressed has actually mastered the act of smoking yelled again, “Don’t condemn or sympathize with smokers, feel for them and hope that they change because you may be suffering from other forms of addictions, more dangerous than cigarette. It is very difficult to quit smoking because nicotine is involved which is addictive. In my case, I once commenced fasting all in the struggle to stop smoking. During the fasting, whereas I did not eat food, I couldn’t resist the urge to add more nicotine into my system, and therefore I broke the fasting by smoking some sticks. It is indeed better not to start smoking than to think of the gruesome road that leads to quitting this habit.”

Asked if he is not afraid of Federal Ministry of Health’s warning that smokers are liable to die young, he exploded again, “That is outright hypocrisy. How can the government that granted license to these tobacco firms to operate in Nigeria turn around to discourage people from buying the products of companies that pay huge taxes to them? That is why nobody is taking the warning on cigarettes packs serious. If government is honest, let them revoke those firms’ operating licenses and ban them from producing cigarettes in Nigeria, because government posture only amounts to giving with the right hand, only to retrieve with the left hand, which is day light robbery.”

On how to stop the inherent dangers in smoking, he went philosophical; “Every age has its own poison. There was time when alcohol was in vogue, and then tobacco came on board. At a point in history, people took designers drugs like ecstasy and Chinese pill. Then Indian hemp or Marijuana became status conferral on musicians, actors, dancers among others sometimes ago. Today, they take cocaine, heroine, and tobacco. If only for medical implication, I support the clamor to ban cigarette smoking. But again, people will find other poisons to fill their system with but I believe that one day, cigarette will go out of fashion.”If cigarettes smokers themselves have testified that smoking is dangerous, what is the government doing to ensure that its citizens don’t die young as the result of smoking. Interestingly, the Federal Government instituted a case in court against three tobacco firms some years ago, demanding 22 billion British pounds for glamorizing cigarettes smoking through deceptive adverts targeted to lure youths into smoking. Though the case is yet to be decided, it is a step in the right direction but we had expected the Federal Government to consider the health implications of tobacco in its entirety before granting license to tobacco firms to start producing this dangerous product in our country just because government wanted funds from these companies.

Again, the compulsory inscription by cigarette makers on their packs, warning on the side effects of smoking is also encouraging, only that it is one thing to warn somebody to desist from doing something, but the onus to adhere to the warning lies on the reader. It now becomes a typical case of leading the horse to the river but not forcing it to drink. Worthy of mention and emulation by other states was the decision by the Federal Capital Territory, (FCT), Abuja which banned smoking in public places on June 1, 2008, to ensure safer air and also prevent second-hand smokers from suffering innocently while the real smokers burn their hearts.

However, the silence maintained by the Federal Government on taking long lasting decision on how to control smoking or ban it out rightly is not in the interest of the nation. The Federal Government should take a cue from the governments of South Africa and Kenya who summoned courage to enact laws regulating smoking in their countries. In South Africa, a law banning smoking in public places and cigarette adverts was enacted, making the people to be conscious of their environment and health for there are penalties for offenders. Also in Kenya, there is a standing law which banned smoking in public places, especially in the capital city, Nairobi. Though the law became effective for sometimes before it slacked, it was a step in the right direction and we expect the Nigerian government to come out with a holistic direction that will make smoking in public places a thing of the past. In fact, against the background that tobacco firms target youths who are the leaders of tomorrow, should make the Federal Government react fast and safeguard the teeming population of our youths, before these glamorous tobacco adverts lure them into smoking today, only to render them useless by one tobacco related disease or the order tomorrow, when we shall look up to the youths to take over from the old and aging leaders.

For smokers who want to quit, physicians developed and monitored website, Healthcommunities.com suggested the following five steps towards final disengagement from cigarette smoking. The are, Get Ready, Get Support, Develop Strategies, Ask Doctor about Prescription Medications and Prevent Relapse. In getting ready, the smoker should outline reasons for quitting, keep diary on when he/she smokes and what triggers it on, research on available information in your area about quitting, set date for quitting and on this date, get rid of ashtrays, lighters and all tobacco products.In getting support, ask health provider for advice on quitting, sign up for a smoking cessation programmme, talk to friends and family for support and keep journal of your thoughts and feelings during this challenging process.

Developing strategies should make the person learn yoga, meditation, deep breathing, start physical exercises, talk to counselors and research into nicotine replacement therapy (NRT) options. In asking doctor about medications, consider medication that can help reduce nicotine withdrawal symptoms and improve your chance of success, research your medication and other withdrawal treatment options. Finally according to these distinguished doctors, in preventing relapse, keep busy. When the urge comes, take one deep breath at a time until it passes. If you relapse, don’t give up; remember many people who quit had to try several times before succeeding.

SOURCE

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.”

SOURCE

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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