The Battle for Hearts and Lungs

Sue Armstrong investigates the growing pressure on developing countries as tobacco companies battle for the hearts and lungs of new smokers. At the same time, some poorer tobacco growing countries like Malawi are becoming ever more dependent on tobacco as a cash crop. How do they resolve the dilemma between health and wealth?
Listen now (40 minutes)

In much of the rich world, smoking is on the wane in the face of rising taxes on cigarettes, bans on promotion and lawsuits against tobacco companies. Less than 21% of British people and 24% of Americans now smoke -the lowest rates on record. But elsewhere, smoking is exploding.

The World Health Organization predicts that tobacco will kill more than eight million people worldwide each year by 2030, with eighty percent of these premature deaths in low- and middle-income countries.

In China alone more than 300 million people smoke. That's equivalent to the entire population of the US, and one third of the world's smokers.

We hear about Malawi's growing dependency on tobacco as a cash crop. Although the government has tried to introduce minimum prices, small farmers like Elson Matope hardly cover their costs, and continue to live on less than a dollar a day, despite supplying the raw material for one of the richest industries in the world.

Malawi has not yet signed up to the WHO's international Framework Convention on Tobacco Control, and rules about cigarette advertising and promotion are lax compared to rules in the developed world. Are cigarette manufacturers trying to take advantage of poor regulation to build up new markets in Africa and elsewhere in the developing world, as smoking has declined in the developed world?

Producer: Ruth Evans
A Ruth Evans production for BBC Radio 4.




SOURCE

ERA flays BAT’s smoking party

THE decision of the British America Tobacco Nigeria (BATN) to carry on with secret smoking parties where underage persons are conscripted into smoking is not only offensive but a strategy aimed at getting more girls into the smoking habit, the Environmental Rights Action/Friends of the Earth Nigeria (ERA/FoEN) has said.
ERA/FoEN, in reaction to a smoking party organised by BAT as part of its “Bursting with Flavour” promotion of the Pall Mall brand in Lagos, said the event was “a shameless disregard for public health and lack of respect to the laws of the country”.
According to a statement made available to the Nigerian Compass, ERA noted that in the last two years, BAT had staged the smoking parties in Sokoto, Kano, Ilorin, Akure, Abeokuta, Ibadan and other parts of the country.
The latest party was held last Saturday at the Abayomi Awodiora Hall, Cardoso Street, Ajegunle, Lagos.
While denouncing the act, the organisation said the event was criminal, and that the company as a corporation had been bent on ruining the lives of young Nigerians who are the major targets of the smoking parties.
“It is incredible that even with the growing number of Nigerians dying from tobacco-related illnesses and confirmed studies that tobacco use worsens poverty, the only fitting contribution of BAT to Ajegunle is a product that will gradually kill off its army of youths,” said ERA/FoEN Director, Corporate Accountability Campaigns, Akinbode Oluwafemi.
Oluwafemi said it was extremely disappointing that Terry G, a notable hip-hop artist and supposed youth role model who should be an ambassador of change in Ajegunle, performed live at the event, which started 10p.m. and ended 4a.m. the following day.


SOURCE

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

Why smoking feels good...

By Olatunji OLOLADE

Big girls don’t cry. Guess when they look like Abimbola Cole, they rise above little vanities, like tears. The 26-year old’s mien is so cool, so controlled, even in the grip of a terrible ailment.
In the dimness of the private ward, the Assistant Regional Manager of a South-east courier firm snuggled under her blanket. Fat has thinned on her bones and her favourite Dalmatian dog-spotted T-shirt is too big for her now.
Sweat beads glisten her arms and forehead and she wheezes for breath, like some child caught beneath its comfortable wooly blankets, drowning there. Her lungs probably wouldn’t take some air although she wills it to, eventually.
"Pele (Sorry) Abimbola," she whispered to herself in the third person. Her whisper, more like a gasp, pervaded the room like an interior dialogue of guilt and extenuation.
Drawn silence, sparse breathing, crushing symbolism; she simply displaces the banality of anything happening. And then she said, "I would give anything for a puff now but I dare not, do I? I started smoking at the age of 15…my first cousin; Bodunde who was 17 at the period was a chain smoker. She probably picked up the habit from one of her boyfriends. But I couldn’t care then. All I felt was a sense of freedom. I was getting to rebel in my own little way and fit into some peer culture…hmm…I sucked on Rothmans Pallmall like my life depended on it. The fact that I had a boyfriend named Rotimi imbued my habit some poetry or sort. He smoked the same brand too and between us; we consumed at least a pack and a half everyday. Even when we had little to eat, it paid us to suck on cancer sticks…yeah, that was the name we coined for it…cancer sticks."
There is much pain in her recollection. Bitter-sweet memories steal from her lips with a nostalgic peal. The effect is awesome.
"Now they said I got lung cancer (Non-small cell Stage three lung cancer) but it’s funny that I feel no regret. Whatever will be will be; a human has to die in some way," she says with the perception of someone who understands that peace might be attained by the suppression of certain feelings, like regret.
That affect is somewhat elegiac which made talking to the sick undergraduate not just exploratory but oftentimes, charming. It’s a mood that says: "This pretty young lady’s been there."
Shakiru Agarawu too has been there but he summoned the courage to get off early enough from what he recollects as "a first class journey to hell." The 44-year old proprietor of a Laundromat disclosed that he started smoking at age 12. He said: "It was a given in my neighborhood that you either smoke marijuana or cigarettes. I opted for cigarettes because I was scared of the bad stereotype given smokers of marijuana. So I started smoking cigarette. At first, I used to hide the habit from my folks but no sooner than I secured university admission, I summoned courage to light a stick in front of my siblings and then my mother. She was totally against the habit but the more she condemned it, the more I stuck to the habit. Hence her joy know no bounds when after 20 years of chain-smoking, I decided to quit."
Agarawu had his epiphany at a chance encounter with the father of a childhood friend. The latter was battled advanced stage 4 cancer until his death. "He suffered a terrible stroke that led to his death 13 days before his 81st
birthday. The man was a chain-smoker," disclosed Agarawu.

SOURCE

Download - All FCTC Guidelines

Cigarette smoking: Killing a killer-habit

-Yetunde Akintola

Habits are behaviours people develop over a period of time. Some habits are almost totally harmless, others are so dangerous that they could actually kill the person. Smoking cigarretes, however, has the tendency to kill even a non-smoker. Yetunde Akintola reports on why smokers should quit and how.

JUNE 26 every year is the United Nations’ International Day Against Drug and Illicit Trafficking. The day is set aside to enlighten the public on the dangers of doing drugs like Indian hemp, cocaine, cannabis, cigarette, etc.

While all the other drugs are more dangerous and banned by the government, cigarette is, however, legal, and can be smoked in public. It is with this impression that smokers feel that cigarette is less dangerous to the health.

However, smoking cigarette can be as dangerous as smoking Indian hemp, or taking other hard drugs, the only difference is just that the effect takes a while to manifest. This is probably why cigarette smokers feel it is safe. Often times, you even hear smokers say that they have been at it for several years and nothing has happened to them.

Now that there is a sustained campaign against those into hard drugs, special focus must be given to those who are already smoking cigarettes. The reason for this is that, it is generally believed that most of those who go into hard drugs started from cigarette.

Somebody who had never smoked before, is most unlikely to pick up a wrap of Indian hemp and light it. The genesis of most drug adicts starts with smoking cigarette.

This is why it is important to find ways towards discouraging those who are into smoking cigarette to put a stop to it before they graduate into taking harder substances.

Justifying this line of thought, a private medical practitioner based in Ibadan, Dr. Olukayode Samuel, agreed that most people who do drugs start with cigarette, before graduating into harder substances.

Dr. Samuel said that, after a smoker had smoked cigarette for a while, he would be tempted, mostly by fellow smokers, to try Indian hemp or cannabis and other forms of hard drugs.

He, therefore, suggested that, “it is important that tougher sanctions be given to those who smoke cigarettes like other hard drugs.”

But since that is not likely to happen anytime soon, the medical doctor then gave a piece of advice to smokers, saying, “before you stick another cigarette into your mouth, take a look at the effects of smoking, and then decide if you want to go ahead.”

In the society today, smoking is considered a status symbol, especially among the youth. However, many people are not paying much attention to the effects of smoking, which can result in deadly diseases like cancer. The damage smoking causes is not suffered only by the smoker, but the environment also gets its share of the damage as the smoke released into the air is dangerous. Those that also hang around smokers are at risk, they are refered to as passive smokers. According to a scientific study, those who inhale the smoke from a cigarette, are at an equal risk with the real smoker.

It is even more dangerous for those that have certain health conditions to smoke or stay around smokers as this could cause complicatons. An asthmatic patient, for instance, might have an attack or crisis if exposed to cigarrete smoke.

Smoking harms nearly every organ in the body, causing lung and throat cancer, as well as chronic heart diseases, and so on. It also gives rise to sicknesses like Conductive Heart Failure (CHF), also known as heart attack, hypertension and so on.

Before looking at how to get people to stop smoking, we must first look at how many started in the first place.

According to Mr. Ademola Ogundele, an official of a non-governmental organisation, Creative Actors Initiative for Development (CRAID), some people start smoking just because they are curious, while others start because of peer-pressure or they feel it is a way to act or look like an adult.

While advising those who smoke to put an end to the habit, Mr. Ogundele said, “why do tobacco producers include it on the pack that smoking is injurious to health? This is a clear and unambigous way of telling smokers that they are killing themselves.”

The disadvantages of smoking are so much, among which is the fact that smoking cigarette stains the teeth, as well as have effect on the breath. It also affects the immunity level in the body, making it prone to contracting diseases.

However, quiting smoking is not so easy because of the nicotine in the cigarette. Nicotine makes smokers addicted, thereby making it difficult to stop.However, smokers who decide to quit must realise they can, provided they have firm determination, which is what determines whether they will be able to witstand the withdrawal symptoms.

According to Dr. Bashiru Akande Lasisi, Executive Director, CRAID, withdrawal symptoms are symptoms one gets when one wants to stop something, like drugs. Once in a while, or even frequently, the person who has stopped taking cigarettes, or other drugs, will experience headaches, body aches, dizziness, etc, due to what the body had been conditioned to, but which the person had stopped doing.

Dr. Lasisi, however, advised smokers who are planning to quit, to visit doctors, or even the National Drug Law Enforcement Agency (NDLEA), on the rehabilitation towards overcoming withdrawal symptoms.

Some people may, however, have justifiable reasons to engage in smoking cigarretes. Those living in colder regions of the earth, the in Europe, definitely need to keep warm. But, it could still be argued that, there are others who live in these places, yet they do not smoke. Those that have no excuse, whatsoever, are those who live in temperate regions like Nigeria.

Although it is an inevitable fact that death must eventually come to everyone, but, should a person hasten up the process through an habit that is in one’s power to control? Smoking is killing one’s self, one stick at a time.

SOURCE

TOBACCO FACTS: WHERE IS THE NATIONAL TOBACCO CONTROL BILL?