Nigerians at risk of looming tobacco epidemic

In recent times, the issue of uncontrolled tobacco use has continued to attract comments from public health experts globally. This is so, following the high morbidity and mortality associated with tobacco use compared to any other risk factor.

While 2011 World Health Organisation (WHO) report revealed that tobacco currently kills over 5.4 million people annually; it also disclosed that tobacco use was the second cause of death globally (after hypertension).

Currently, it is responsible for killing one in 10 adults worldwide. Tobacco use is the number one preventable epidemic that the health community faces.

As Nigeria joined the rest of the World to mark ‘World No Tobacco Day’- a day set apart to draw global attention to the tobacco epidemic and its lethal effects, as well as promote adherence to WHO Framework Convention on Tobacco Control (FCTC), environmental and health experts have tasked government at all levels to adopt preventive comprehensive health education programmes on smoking cessation and control even as they urged President Goodluck Jonathan to sign the National Tobacco Bill (NTCB).

In an interview with BusinessDay, Akinbode Oluwafemi, director, Corporate Accountability & Administration, Environmental Rights Action/Friends of the Earth Nigeria (ERA/FoEN), disclosed that countries across the globe have made strategic efforts to combat the dangers of smoking, especially among the youth by putting laws in place to regulate the production and marketing of tobacco products.

While the enactment of national laws and domestication of WHO’s FCTC are singular efforts in this direction, Akinbode revealed that the National Tobacco Bill, which was passed by the Senate on March 15, 2011 and concurred by the House of Representatives on May 31, 2011, is awaiting the President’s signature in order to make the bill a law.

According to Akinbode, “Nigeria has made giant strides in fulfilling our international obligations by attempting to domesticate the FCTC through the National Tobacco Control Bill. The bill seeks to end advertisement, sponsorship, promotion and prohibit the sale of cigarettes to minors. It recommended pictorial warnings on cigarette packs and ban smoking in public places.

“More importantly, the bill seeks to create a committee, National Tobacco Control Committee which will serve as an advisory role in terms of reviewing the policy. That, essentially, is what the bill is all about.”

Akinbode explained that while the bill seeks 50 percent pictures of the health implications on cigarette packs, Mauritius has already enforced 70percent and Ghana thinking of about 60 percent.

“In fact, some countries like Australia have even gone beyond the pictures and talk about plain packaging. They know it that they cannot debate this because the international community has moved beyond what is even in the bill as at today. This is a bill that has direct impact on Nigerians but we are afraid these gains that we have worked for as civil society organisations, legislators and the Ministry of Health may become futile if the President does not sign the bill. We need to save Nigerian youths from the looming tobacco epidemic,” Akinbode concluded.

Sylvester Osinowo, Africa Regional president, World Association of Family Doctors, (WONCA), pointed out that smoking had been identified to cause the heaviest burden of morbidity and mortality on Nigerians compared to any other risk factor.

Osinowo stated that smoking causes coronary heart diseases, cancer and reduction in fertility for women and poses adverse social, economic and developmental effects on the lives of individuals, their families and the community at large.

“Tobacco consumption causes multiple health risks as cigarette smokers are 2.4 times more likely to develop coronary heart disease than non-smokers. WHO’s cancer agency also indicates that smoking has been linked to about 90 percent of all lung cancer cases. The economic burden includes direct medical care cost for tobacco-induced illnesses, absence from work, reduction in productivity and death,” Osinowo stated.

The physician hinted that the primary health care (PHC) centres nearest to the people should be empowered to do push programmes with vigour to catch the youths before they adopt the serious health hazard habit.

The WONCA president, however, recommended that anti-smoking clinics be established in the PHCs and sickbay of colleges and tertiary institutions to rehabilitate those who were enmeshed already in the habit. He also appealed to family physicians and general medical practitioners to disengage themselves from habits such as smoking so as to be good role models for the society to follow.

While the intervention of the Minister of Health, Onyebuchi Chukwu is a singular action that many generations of Nigerians will not forget, it is believed that safeguarding the health of Nigerians from the dangers of tobacco use remains critical in view of rising communicable and non communicable diseases such as hypertension, diabetes, cancer of different types, etc.

SOURCE

The tobacco control bill

As the elections inch closer, the Senate last week passed a bill that will eventually give Nigeria one of the strongest anti-tobacco laws on the continent. Sponsored by Olorunimbe Mamora, a senator (Lagos East) on the platform of the Action Congress of Nigeria, the bill is called the Nigerian Tobacco Control Bill.

It’s essential components include: raising a National Tobacco Control Committee to shape the future of tobacco control policies and guide implementation; A comprehensive ban on smoking in public places, and the sale of cigarettes by or to minors; and detailed specifications on points of sale notice. That is not all, however. The bill has finally given legal backing to a directive by the Advertising Practitioners Council of Nigeria (APCON) which a few years ago banned all sorts of advertisement, sponsorship, promotion, testimonials and brand stretching of tobacco products across the country.

The bill is also to ensure that health messages cover 50 per cent of the areas where tobacco products are to be displayed, while the minister of health is empowered to prescribe pictures or pictogram and ensure that the law is effectively implemented. As it is now, the bill has only been passed by the Senate. It is to be sent to the House of Representatives which will hopefully pass it before it goes to Goodluck Jonathan for his assent. We at NEXT do not expect the House to have any fundamental disagreement with the version that has been passed by the Senate.

The upper house had, in the two years the bill was with it, ensured that all the stakeholders – civil society groups, tobacco manufacturers, health experts and the general public – had their say at the public hearings that preceded the debates and the passing of the bill. Mainly, the Nigeria Tobacco Control bill domesticates the World Health Organisation (WHO) initiated Framework Convention on Tobacco Control (FCTC). The treaty is the first global health treaty which is mandatory on all WHO members. Nigeria has signed and ratified the treaty.

We commend this step by the Senate and plead with the House not to water down this laudable bill. Passing it into law could help this set of lawmakers become one of the most proactive to have passed through the hallowed chambers. It is a great contribution to public health. We make this appeal because we know that tobacco products have for several years wreaked havoc on our people. This is our opportunity to curb this terrible scourge.

A few years ago, some states like Lagos, Gombe, Kano and Oyo sued some tobacco companies, asking them to pay billions of naira for the damages their products had caused their citizens. For instance, Lagos sued for ₦2.7 trillion claiming that research carried out by its staff in hospitals across the state show that at least two people die daily owing to tobacco-related diseases; and that the state had recorded about 20 per cent increase in the smoking rate over the past two decades with reported cases of 9,527 tobacco-related diseases in government-run hospitals monthly, in one of Nigeria’s most populous states.

This is a high figure and a high price to pay for a disease with a cause that is known and preventable. And that is only for a state that has cared to carry out research on what it costs it to treat tobacco-related diseases.

We salute the doggedness of Mr. Mamora, the civil group Environmental Rights Action (ERA), the United States based Campaign for Tobacco Free Kids (CTFK), the media and other groups that fought for the enactment of this bill. However, the fight will not simply be over because the House and the President assented to it. Implementation of the clauses of the bill must be monitored and adhered to. Only then would it help our public health and protect us from the fatal tobacco-related diseases.

SOURCE

Tobacco: Experts blame poor taxation for increase in smoking

-Yekeen Nurudeen

INCREASE in the number of smokers has been attributed to the cheap price of tobacco products, which in turn is caused by Federal Government’s inability to impose heavy tax on the products.
An expert in tobacco control, Akinbode Oluwafemi, made the observation yesterday in Abuja at a one-day workshop organised for journalists on the role of the media in the campaign against smoking in public places in the Federal Capital (FCT).He said if heavy taxation can be imposed on tobacco, the cost of production will increase and this will in turn lead to the increase in the price of the products thereby discouraging youths from smoking. A pack of cigarettes that sells for N200 in Nigeria, according to him, goes for about $5 in the United States of America due to the heavy taxation placed on the manufacturing companies, even as he stressed that “smoking is a sure gateway to drug addiction.”Describing smoking as a major risk factor for different cancer cases, Akinbode said it is also linked to about 15 various cases of cancer in the human body.

SOURCE

LEAD DEBATE ON THE NATIONAL TOBACCO CONTROL BILL, 2009

BY SEN. OLORUNNIMBE MAMORA


Preamble

It is established fact, both scientifically and legally, that tobacco is dangerous as it contains over 4,000 potent, toxic and carcinogenic chemicals, associated with over 200 diseases, preventable deaths and a significant drain on world economy, particularly the healthcare sector. The World Health Organisation (WHO) and several organizations are unanimous that tobacco consumption is a scourge; failure to control its spread would have serious and fatal consequences for citizens of the world.

The increasing hostility and regulatory restrictions from western and other more developed nations have caused tobacco companies to flock to developing countries in order to increase their business and profitability. Sadly, developing countries like ours, with notorious drawbacks of illiteracy, corruption, weak institutions and regulatory competencies, but which have teeming populations, are increasingly becoming targets of the exploitative and deliberately deceptive strategies of marketing by these profit- driven companies. Furthermore, Nigeria's health system remains inadequate and unable to cope with the scourge and the impending epidemic. A majority of smokers in Nigeria are illiterate, living in rural areas that hardly have sufficient facilities to treat tobacco related diseases. The major tertiary hospitals do not have the necessary interventions that are so important and needed timely. Consequently there is an urgent need to enact legislation to curb this preventable scourge, with appropriate modalities for holding the industry accountable for the injuries it causes.

WHO promoted the Framework Convention on Tobacco Control (FCTC) which is a model legislation that many health-conscious countries have signed and ratified, Nigeria is a signatory to the Convention and as such has an obligation to enact the required legislation controlling the distribution and consumption of tobacco products. It is further to our obligations under this Convention that I seek to introduce this legislation, with the range of restrictions and provisions therein.

Justification

Most western countries have enacted similar legislation, which has successfully diminished high smoking and exposure rates. Legislation, similar to the one at hand, is also known to have brought about significant tangible benefits for the health systems in those countries. Of the several efforts and initiatives worldwide, the most effective have been when lawmakers rise in unison to make the wide ranging provisions to control the adverse effect of tobacco, as contained in this Bill. The industry has been known only to change its behaviour when it is confronted with serious statutory provisions that regulate and control its operations. Further, some of the greatest success stories in tobacco control both legally and health-wise have been due to legislation, since they have had the singular effect of holding the industry accountable and responsible for the injuries it causes.

Tobacco is the only product that when used as designed by manufacturers will surely kill or harm the user. Legislation is required to compel tobacco manufacturers to take responsibility for their actions, to secure and safeguard our future by curbing the consumption by our youth and children and to ensure that our citizens remain healthy, in a smoke-free environment. In the absence of comprehensive legislation, Nigeria would be unable to either regulate the industry or protect our current and future generations from the hazards of tobacco consumption.

We do not only need to act, but we need to act urgently. Current statistics show that in Nigeria:

i) Smoking and exposure to smoke has gone up to 20% from 2% in the 1980's
ii) The smoking rate amongst young women under 18 has increased by over 16% in the last 10years.

iii) 90% of cocaine, hemp and other drug user begin such habits from smoking cigarettes.
iv) Most armed robbers, rapist and cultists admit to either smoking or using drugs before embarking on their nefarious activities.

The Tobacco industry has long deceived us into believing that smoking is a matter of choice. Most smokers picked the habit as children, from peer pressure or in school, all in a bid to 'belong'. Most countries in the world, inclusive of Nigeria, understand that persons under 18 are incapable of making informed choices, hence the age of voting, criminal responsibility and obtaining drivers license is pegged at 18 and above. From the health standpoint alone, the reality of escalation of tobacco consumption and its adverse effects in our midst is staggering. In Lagos State, reports from 11 of 26 public hospitals where research was conducted show that about 2 people die everyday from tobacco related diseases. The average tobacco related disease can take up to 20years to manifest. If what we are seeing now is alarming and only a result of past consumption, we cannot even begin to imagine what to expect in the future, now that smoking rates have increased dramatically. The time to act is now!

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(including women and children), our communities the society and the environment.

We are grappling with many contending issues of priority at this stage of our development. We certainly need to provide leadership to our people and other parts of this Continent by creating a system where the tobacco industry can be compelled to submit to appropriate regulation and control.

GOAL OF THE BILL
Essentially the proposed Legislation, if supported, will succeed in providing a framework for the:


· Protection of the Nation's public health by enhancing public awareness of the hazards and dangers associated with tobacco use.
· Protection of young persons and others from the inducement to use tobacco and tobacco products and the consequent dependence on them by restricting access to tobacco.
· Protection of the rights and health of non-smokers, endangered through environmental tobacco smoke whilst also protecting the environment.
· Controlling and restricting the sale of tobacco in sticks and in public places.
· Providing effective warnings in graphics and languages spoken in Nigeria, such measures being most beneficial to the non-literate of our population.
· Restricting the promotion of tobacco products, adverts and sponsorship which particularly target minors and promote industry-funded awareness, campaigns and education.
· Affording us with the appropriate legal mechanisms to assist Government and injured persons to seek redress against the tobacco industry for injuries caused as a consequence of tobacco consumption.
· Making the profit-driven tobacco industry responsible and accountable for their activities, as they currently remain oblivious to the adverse effects and concerns that emanate from the consumption of its harmful products.


CONCLUSION

Our Constitution under Section 14 subsection 2(b) specifically states that
"the security and welfare of the people shall be the primary purpose of government".
If we passed this bill into law, we would have fulfilled a fundamental objective of government more so as responsive and responsible representatives of our constituents.

I thank you in anticipation of your most cherished support.




Sen. Olorunnimbe Mamora.