Tobacco smoking: Stop the killer before it stops you

- CHIOMA OBINNA


He was walking and all of a sudden he slumped. Thanks to some kindhearted Nigerians who quickly rushed him to the hospital. Unfortunately, he died on the way to the hospital. Further investigations revealed that the victim who was about  28 years old and just finished his youth service never showed any sign of illness before his death.

It was also gathered that young promising graduate of Business administration  was asthmatic. An autopsy carried out by authorities of the hospital to determine the cause of his death revealed that he died of a heart-related disease following his addiction to tobacco smoking.

The victim is just one of the 5.4 million people killed by tobacco use annually and one in 10 adult deaths worldwide.

Mr. Emmanuel Egwu’s case is different. Emmanuel never smoked all through his 35 years on earth.  He had never for once tried to have a drag of cigarette.  Unfortunately, Emmanuel is down with lung cancer courtesy of the environment where he lives.  Emmanuel lives with his three brothers who smoked at least 20 sticks of cigarettes a day! Little did he know that their smoking habit could cause more harm to him instead of the smokers.

Such people as Emmanuel are called passive smokers or secondhand smokers.  According to medical experts, passive smokers are people living among smokers and they are exposed to smoke concentration in the atmosphere they live in. Studies have found that passive smoking is a cause of heart disease and lung cancer and can initiate or aggravate respiratory conditions such as asthma and bronchitis.  If proper care is not taken, Emmanuel may be counted among the estimated 46,000  nonsmokers who die  yearly from heart disease and lung cancer.

Before now, smoking was one habit fashionable and acceptable to the people but has been found  after many years of study and linkages with many ailments to be as deadly as the scorpion sting.

According to medical experts, tobacco smoke in any form and at whatever level, precipitates ill-health.   Smoking has been implicated in about 60 disease conditions including  tooth loss, diabetes, impotence, stomach ulcers, ocular histoplasmosis (fungal eye infection), acute necrotising ulcerative gingivitis (gum disease), hearing loss, osteoporosis, duodenal ulcer, reduced sperm count, dysmenorrhoea (painful periods), early menopause, psoriasis, colon polyps, cataracts, asthma, reduced fertility, buerger’s disease, angina optic neuropathy (vision loss), premature wrinkling, crohn’s disease and asthma amongst others. Clinical records have shown that the odds are said to be more than double for those who smoke in excess of more than 20 cigarettes a day.

Statistics from the World Health Organisation,WHO, estimates that about 1.3 billion people in the world are currently smoking and most of them are in developing countries including  Nigeria.

Globally, tobacco causes about 5.4 million deaths yearly compared to three million, two million and one million deaths caused by AIDS, tuberculosis and malaria respectively.  By 2020, WHO estimates that global death toll from smoking will hit 10 million.

According to an Independent Tobacco Control Activist, Dr. Olusegun Owotomo, statistics available show that about 93 million sticks of cigarette are produced yearly in Nigeria and every one of those cigarettes is consumed and that between 150,000 and 300,000 children under the age of 18 months get respiratory infections such as pneumonia and bronchitis from secondhand smoke. More than 40 per cent of children who visit the emergency room for severe asthma attacks live with smokers.

Despite these dangers, efforts are checking tobacco smoking is still not significant. According to WHO,  the global funding of tobacco control, is below 0 million compared to a billion for AIDS, five billion for tuberculosis and around a billion for malaria. As a result, while there has been a gradual decrease in the incidence of AIDS, tuberculosis and malaria, tobacco-related deaths have been on a sharp increase.

Smoking is a universal problem, which though may have peculiar geographical approaches in terms of solutions, yet remains one with universal determination in tackling.

Critical health watchers say  the ability of the tobacco industry to stage a come back in the country must be checked.

In a write-up, Dr. Olusegun Fakoya, anticipated a huge epidemic of tobacco-related diseases regretting that the resultant strain on public healthcare would be enormous as the majority of these smokers are poor people who have no means to access treatment themselves. Olusegun said with the  pathetic state of the country’s healthcare system, the impending chaos is best imagined.

A big thanks to the recent passage of the National Tobacco Control Bill by the National Assembly. He said the Bill when signed by the President will be one of the ways of forestalling the inevitable doom associated with the current kid-glove approach to the unimaginable disaster associated with smoking.

The Nigeria Tobacco Control Bill is a comprehensive law to regulate the manufacturing, advertising, distribution and consumption of tobacco products. It is a bill aimed at domesticating WHO Framework Convention on Tobacco Control,FCTC.

WHO FCTC  is an evidence-based treaty that reaffirms the right of all people to the highest standard of health. It represents a paradigm shift in developing a regulatory strategy to address addictive substances; in contrast to previous drug control treaties, and asserts the importance of demand reduction strategies as well as supply issues.

The  Bill is a comprehensive law providing for regulations of supply and demand measures relating to tobacco products. However, the recent prohibition of smoking in public places in the Bill would at least save non-smokers from dying of tobacco-related diseases.

A study on “The use of tobacco products among Nigerian adults: A general population survey” by Isidore S. Obot, Department of General and Applied Psychology, University of Jos, showed that Nigerian men smokes more than females, adding that the poor, uneducated smoke more than the relatively rich and educated.

According to the study,  “Smokers had a higher incidence of health problems and both nonsmokers and heavy smokers were less aware of the risk of smoking than light smokers.” The study suggested that  health education should be a major component of tobacco and health policy in Nigeria.

“Exposure to environmental tobacco smoke (ETS) increases the risk of respiratory symptoms and lower respiratory tract illness in children, and it also increases the frequency and severity of asthma symptoms. There is evidence that parental smoking causes acute and chronic middle ear disease.”

Analysis of chemicals in the urine of women who live with smokers demonstrates that tobacco smoke carcinogen, are absorbed by nonsmokers from second-hand smoke. Women who live with smokers absorb five to six times more chemicals linked to lung cancer than do women who live with nonsmokers.

It has also been discovered that the risk of wives developing lung cancer doubled when the husbands smoked over 20  cigarettes a day. There was also an increased incidence of emphysema and asthma, although to a lesser degree.

Many studies have also shown that when parents smoke, their children cough. Babies are most at risk, with the highest percentages for bronchitis and lung ailments in infants under a year old.

Although, cigarette packets carry warnings approved by health authorities, none lists the diseases caused by smoking. The introduction of photo warnings was a desperate action by concerned governments over a habit that refused to abate despite numerous interventions.

Warnings on packs

Critical observers are calling for the inclusion of  large, graphic warnings, which is proven to motivate people to stop using tobacco and reduce the appeal for people not yet addicted to it.

Permanent Secretary, Lagos State Ministry of Health, Dr. Femi Olugbile, said the effective enforcement of the bill when passed into law is also imperative. “Introduction of bold warnings that would  take no less than 30 per cent of the space on cigarette wrappings.

In particular, the introduction of photographic warnings showing cancerous growths caused by cigarettes as obtained in countries like Thailand, Brazil, Canada and Britain, will go a long way in making an informed decision on the part of (potential) smokers to tobacco smoke, death tolls and crippling heart attacks, strokes, cancers and respiratory diseases that are becoming prevalent will be reduced.”

However, Akinbode Oluwafemi, Programme Manager, Environmental Rights Action/Friends of the Earth, Nigeria,ERA/FoEN, sees the passage of the Tobacco control Bill as not an attack on smoker.

Youth markets

Another aspect of tobacco activities is the issue of  youth markets.  Today, Nigeria has become one of the largest markets in Africa. Statistics show that youths form over 40 percent of the Nigerian population and 18 per cent of the youths smoke. Unless drastic steps are taken, many youths may become addicted.  A situation experts say  signifies social concern and also portends dire economic consequences.

Measures for Tobacco ControlComplete ban of advertisement, including points of sale.High taxes on cigarettes to discourage more people going into the venture.Protection of non-smokers from the often underestimated harmful effects of second-hand smoking.Expansion of smoke-free public places.Assistance to tobacco farmers to discourage the planting of tobacco.Assistance to pro-tobacco victims to ameliorate the resultant harmful effects of smoking.

Provision of adequate support to states instituting litigations for damages.

20 tips on how to stop smokingBelieve in yourself. Believe that you can quit.Sit down and write your own list, customised to your personality and way of doing things. Create your own plan for quitting.Write down why you want to quit (the benefits of quitting):Ask your family and friends to support your decision to quit.Set a quit date. Decide what day you will extinguish your cigarettes forever.Talk with your doctor about quitting. Support and guidance from a physician is a proven way to better your chances to quit.Begin an exercise programme. Exercise is simply incompatible with smoking. Exercise relieves stress and helps your body recover from years of damage from cigarettes.Do some deep breathing each day for  three  to five  minutes. Breathe in through your nose very slowly, hold the breath for a few seconds, and exhale very slowly through your mouth.Visualise your way to becoming a non-smoker.Develop your own creative visualizations.Cut back on cigarettes gradually (if you cut back gradually, be sure to set a quit date on which you WILL quit).

Quit smoking “cold turkey”.

Many smokers find that the only way they can truly quit once and for all is to just quit abruptly without trying to slowly taper off. Find the method that works best for you: gradually quitting or cold turkey. If one way doesn’t work do the other.

Find another smoker who is trying to quit, and help each other with positive words and by lending an ear when quitting becomes difficult.

Have your teeth cleaned.

After you quit, plan to celebrate the milestones in your journey to becoming a non-smoker.

Drink lots of water.

Learn what triggers your desire for a cigarette, such as stress, the end of a meal, arrival at work, entering a bar, etc. Avoid these triggers or if that’s impossible, plan alternative ways to deal with the triggers.

Find something to hold in your hand and mouth, to replace cigarettes. Consider drinking straws.

Write yourself an inspirational song or poem about quitting, cigarettes, and what it means to you to quit. Read it daily.

Keep a picture of your family or someone very important to you with you at all times.

Whenever you have a craving for a cigarette, instead of lighting up, write down your feelings or whatever is on your mind.

 - SOURCE

‘There is no good in smoking’

 

  Abah

Betty Abah, project officer of Environmental Rights Action (ERA), has been campaigning against smoking for years. She speaks extensively with OSEYIZA OOGBODO on smoking issues.

Why do people smoke?

Smoking is basically a habit that is most times associated with peer pressure, meaning many people, especially the young ones, find themselves deeply entrenched in the habit before they even realise why they are doing it or if it has any benefit at all. Unfortunately, at that point, most must have become deeply addicted and can’t get out. Some say they smoke to get pressures off their mind and then eventually realise that it worsens whatever situation they are trying to escape from, because when you come down with a tobacco-related cancer, you will realise, too late, that that even dwarfs the so-called pressure. And you know that cancer is no child’s play. Tobacco is evil and a completely senseless one because it has no profit whatsoever. 

What are the dangers in smoking?The dangers associated with smoking are legion. It adversely affects every part of the body and is the cause of several forms of cancer including cancers of the lungs, cervix, breast, skin, oral as well as heart attacks, stroke, impotence, and also several types of respiratory diseases. It is well known in medical circles that it is the leading cause of lungs cancer, and that between 85 to 90 percent of lungs cancer cases are as a result of tobacco use. So, if you take up two packs of cigarette a day, then you can be sure you are a candidate for lungs cancer. And why it is so very painful is the fact that many non-smokers fall victim of smokingrelated diseases and even death because of exposure to tobacco smoke, what is called Second Hand Smoking (SHS) or Environmental Tobacco Smoke (ETS).In China for instance (which has the highest rate of tobacco use in the world), according to the World Health Organisation (WHO), tobacco use kills over a million people every year, about a quarter of the entire global casualty rate, and out of this, about 300,000 are non-smokers who are victims of SHS. I stayed briefly at a cosmopolitan hotel in a city last year while attending a meeting and I had to browse at the lounge. For the two hours or so that I spent there, it was as if I had smoked a whole pack of cigarettes. One of the receptionists, a Lebanese, I think, smoked non-stop and filled up the ash tray in front of him continuously. After some time I had to walk up to him to demand why he had to force me and about a dozen others in the room to smoke. He apologised limply and promised to reduce his smoking rate.Imagine what happens to his colleagues who have to put up with him for several hours every day in that fully air-conditioned and sealed place. Imagine the danger that people across this country face every minute owing to ignorance and also as a result of non-implementation of smoke-free laws.

Why are you campaigning against smoking?I am involved in this campaign as a life-saving measure especially because tobacco- related deaths which happens mostly among young and productive people are completely preventable. I am involved in passing the message that we don’t have to be a dumping ground for the rejects of the earth. As you know, tobacco multinationals are highly stigmatised in Western countries and strict anti-smoking policies are running them out of business, so what is happening is that Nigeria and other developing countries have been targeted as fertile soil for them to recoup lost grounds, to maximise profit. This is also made possible because like many third world countries, we have weak legislations. As you might also have known, until recent years, tobacco multinationals were invited here and greatly pampered with tax exemptions and all kinds of incentives by the government. So, I think the onus is on us as Nigerians to speak out against this evil trend.No company, no matter the jobs it creates, should be tolerated if their end products sicken and kill the best of the land, because at the end it worsens the economy and places additional burdens on an already overstressed health system. It kills them young. And mind you, many of our youths who are hooked on drugs now begin by taking the readily available cigarette, and of course you know how much drugs ruins lives. That’s why we are up against this menace.

Is it true that there is a law against cigarette adverts?Yes, the anti-smoking law prohibits all forms of Tobacco Advertising and Promotions (TAPs). But even before this bill, one of the provisions of WHO’s Framework Convention on Tobacco Control (FCTC), which Nigeria signed and ratified, banned tobacco advertisement. That’s why you don’t see all the tobacco adverts, jingles, and promotional fashion and music shows anymore. But tobacco companies are slippery by nature so they still try to do one thing or the other to promote their deadly product, but no doubt, it’s a dying trade. 

Does smoking affect the environment in any way?Smoking affects mostly the people who use and those who stand or sit by smokers. But it has also been proven over time that tobacco plants kill the soil and endanger other crops, that’s why when you look at a tobacco farm, you hardly see any other crops planted alongside. I have been to the tobacco farming communities in Ago-Are in Oyo State, and I have seen others, so I can tell you it’s true. They are as deadly as they come. 

Adverts say smokers are liable to die young. If this is true, why are people smoking?Majority of people who smoke do so not because they like the habit but because they are hooked on it. This is especially true with long-term smokers. The manufacturers deliberately increase the rate of nicotine in each pack of cigarette to ensure that they can’t get out of the trap. Nicotine is a highly addictive substance and works very fast in the body once it has contact with it, that’s why you see someone who has been diagnosed with lungs cancer as a result of tobacco use but is still smoking heavily. That’s why you see that people expose their families to poverty because of their smoking habit and yet are not about to quit and save money because they are in nicotine bondage. And that is exactly why we try to discourage young people, not to try at all, before they get addicted.But sadly, it is the same young generation that is being targeted by the tobacco companies. As they are gradually losing their aging customers to death and disinterest, they just have to make up for that gap and keep selling the poisonous thing. Sad. In developed countries, there are several cessation programmes in the forms of counselling classes, toll-free quit lines, nicotine therapies, among others, but you hardly find them here because often, health is not a priority of our government. So, if you are hooked, it takes a lot of determination and atimes, the sheer grace of God to get out and live a normal life. 

What are the statistics on how smoking is killing or making Nigerians sick?Like many other things in this country, there is yet to be definite statistics, but one of the few we have is that of a survey carried out by the Lagos State Ministry of Health in 2006 which showed that out of 29 hospitals surveyed, two people die of tobacco-related ailments daily. Also, that in that year, the state recorded more than 9,000 cases of tobacco-related ailments and the Lagos State Government spent as much as N216,000 on each of them.

SOURCE

Smoking: Costly habit, captive addicts

The World Health Organisation (WHO) has declared smoking injurious to health but smokers are still puffing away. OSEYIZA OOGBODO takes a look into this highly addictive practice and its attending dangers.
Smoking for a long time has donned a toga of controversy as to its religious, social, economic and health implications. But, some time ago, the World Health Organisation (WHO) ruled: smoking is injurious to health.

Regardless of this development and the attending compliance at tobacco smoking reduction practically the world over, Nigeria’s case is peculiar: her residents keep smoking in both designated and undesignated areas as if unaware of the WHO proclamation. Betty Abah, an anti-smoking advocate, who is a member of the tobacco control team of the NGO, Environmental Rights Action (ERA) confirms that Nigerian smoking is actually on the increase. “According to the World Health Organisation’s global report two years ago, tobacco use is on the increase in the country especially among young women. It’s not to say women smoke more here, but it implies that more and more women are taking up the habit. It is especially so in tertiary institutions, which is a sad case because the impact of tobacco on the female body is faster and even more deadly than on their male counterparts.”

Getting cigarettes in Nigeria is very easy since they are available on virtually every street through those who have stalls and sitting areas for their cigarette purchasers who want to smoke right at the point of purchase. There are also beer parlours, general goods traders and traditional liquor sellers who offer the popular cigarette brands. Those who are in a hurry smoke while walking along the street. Funny enough, there is a Nigerian law that bans smoking in public places just like in most countries across the world. But it doesn’t seem effective going by the volume of public smoking.

Abah sheds light on the law. “Yes, the law is embedded in the new National Tobacco Control Bill. Public places are supposed to be smoke-free so as to safe-guard the health of non-smokers and also to reduce the general smoking rate. And, by public places, we mean places like restaurants, schools, airports, offices, any enclosed place where people gather. Public places in this context are not roadsides, streets or highways. However, the bill is awaiting Presidential Assent to make it a legal law.”

But even as smoking is rampant, be it in the day or night, there is a method to it. Men can smoke publicly anywhere they like during the day. It is however very difficult to see women smoking publicly in the daytime. But it is not as if they too don’t smoke in the daytime, but they do so in seclusion. For instance, at an event recently, a popular female fashion designer who needed to smoke her favourite brand of cigarette had to hide in a toilet to do so while men smoked care freely in the lobby in full public view. Yet, many of the smokers can’t do so in front of their parents, bosses, landlords and people they look up to because the Nigerian society frowns heavily on smoking. Once a person is known as a smoker, he is most times labelled a doubtful character, hence not taken seriously and treated with condescension. So if a man sometimes faces tribulation because he smokes, a woman who is known to smoke will face quite a tougher time of stigmatisation.

Such is the danger smoking is that it is clearly stated on cigarette packs that smokers are liable to die young. And death is what most humans fear most. If most humans had a choice, they wouldn’t want to die. But some of these same humans prefer to smoke even when they had been warned that smoking could kill them. As smoking is a terrible hazard to smokers themselves, the threat of second hand smoke (non-smokers inhaling cigarette smoke) is probably what is making experts make concrete moves to enforce a ban on smoking in public places. But as a matter of courtesy, people don’t really complain when they see people smoking even when the smell irritates them.

At a press conference to mark the 2008 World Heart Day, Prof. Ayodele Omotoso and Prof. Wale Oke, said, “Government should as a matter of urgency prohibit the habit of smoking in public places as cardiovascular experts have discovered effect of smoking is more harmful to non-smokers than actual smokers.” The issue of smoking is a very strange one, to say the least. Oluwagbohunmi Balogun, a committed chain smoker, says, “I love smoking. I can say I love it more than any other thing on earth.” He however concurs that “I never knew I would be a smoker, though. It is not something I can say that I planned to do. Somehow, it happened and I’m in love with it now.

“That I’m smoking sometimes makes me laugh when I think back to when I was in secondary school. I was a boarder and my seniors who used to smoke would send me to buy cigarettes and say I should smoke with them. Back then, I always refused, because if I had accepted, they would have taken me to the Senior Prefect and reported me that I was smoking and he would have punished me.” Balogun had a further funny tale to recount. “What’s even surprising to me again is that my friends and I who refused to smoke then in boarding school all met up later and we had all started smoking without anyone forcing us the way our seniors were doing but we were scared then so as not to become known as smokers by our teachers and the entire school.”

Such is Balogun’s addiction to smoking a particular brand that he complains if such is presented to him in the pack of another. “It affects the taste,” was his explanation. “Maybe it’s because I don’t smoke any other brand.” Even as Balogun is proud of his smoking habit, Peter, a bass guitarist, regrets his brief romance with smoking. “I used to smoke a lot. Then when I began coughing out white portions of my innards, I knew I had to stop or die. I stopped, but it wasn’t easy, though. I kept returning to it until God took control finally.”

Ayo-Martins

Like Peter, Jare Ayo-Martins, co-presenter/ producer of popular Yoruba TV magazine programme, Owuro Lawa, is also an ex-smoker. “I started smoking when I was in my teens. I began smoking due to peer group pressure.” However, after 12 years of smoking, Ayo-Martins stopped. “I stopped because it wasn’t doing me any good.” When Saturday Mirror asked him if it was perhaps affecting his health, he refuted it, and then added, “The anti-smoking sensitization campaigns also made me realize the need to stop.” He however admitted that he wasn’t a chain smoker. “I was just a normal smoker. The most I ever smoked in a day was four sticks. I never smoked a pack in a day.” Now, Ayo-Martins says of smoking: “It doesn’t do any good, so smokers should stop, but it’s difficult to stop.”

SOURCE

Transmit tobacco bill for presidential assent, ERA tells NASS

The Environmental Rights Action/Friends of the Earth (ERA/FoEN) has asked the National Assembly to immediately transmit the recently passed National Tobacco Control Bill to the Presidency for signing into law in order to save millions of lives endangered by tobacco use.

In a release issued in Lagos and signed by the Director Corporate Accountability & Administration, Akinbode Oluwafemi, the group warned that failure to send the bill to the President for his signature would have negative consequences for public health in Nigeria and roll back any gains made by the passage of the bill in the first instance.

ERA/FOEN’s call is coming on the heels of a similar call by the American Cancer Society (ACS) for comprehensive policy to tackle the cancer epidemic in developing countries. The ACS made the call in New York at a meeting to deliberate on the United Nations High Level Meeting on Non Communicable Diseases (NCD).

The ACS said tobacco use in developing countries account for about 80 per cent of all cancer deaths.

“The two chambers of the National Assembly have put the health of Nigerians above partisan politics and profits of the tobacco multinationals by passing into law the National Tobacco Control Bill. It will be a waste of public resources expended into the process and a betrayer of public health if the Principal Officers in the National Assembly fail to transmit the bill to the president for signing.”



SOURCE

SMOKING - SET THE CAPTIVE FREE

NEWS ALERT: 5 million to die from tobacco-related diseases

Lagos-With over five million people estimated to die from tobacco related diseases globally this year, the Lagos State government has set up a multi-sectoral committee to begin  massive enlightenment campaign to reduce consumption and discourage smoking of all tobacco products in the state.

This  came on the heels of recent concurrent passage of the National Tobacco Control Bill by the National Assembly.

The Tobacco Bill makes it mandatory to affix health warnings on tobacco product packs, bans the sale of cigarettes to minors (under 18 years), strictly regulate tobacco advertising, sponsorship and promotion, prohibites smoking in public places and the introduction of regulations on the manufacture, distribution and marketing of tobacco products in the country.

Briefing newsmen in Lagos, the Permanent Secretary, Lagos State Ministry of Health, Dr. Femi Olugbile, said the committee was part of the state government commitment to ensure that Nigerians were not part of the estimated five million people, who will die from tobacco use.

Olugbile at the briefing to mark this year’s ‘World No Tobacco Day’ WNTD, noted that members of the committee were drawn from relevant line ministries, private sector, civil society and the media and will come up with comprehensive multi-sectoral measures to reduce consumption of tobacco products.

SOURCE

A VOTE FOR PUBLIC HEALTH