Shisha Smoking: The Evil Within

It has an Arabian origin, then travelled through the western world. Shisha has arrived Nigeria and is gradually gaining presence. More common in the northern region of the country than other parts, it can mostly be found in bars, night clubs and can also be personally owned. Contrary to what many see as benefits involved in shisha smoking, research findings are very alarming, Amarachi Egbeogu writes.

Many may find the word Shisha very strange, wondering what it is. Shisha, also known as Hookah, is a flavored tobacco which is smoked via a long pipe connected to an exotic-looking vessel filled with water.

Shisha smoking is becoming a common sight especially in the city of Abuja. Its awareness is more in this part of the country than in the south. Once the preserve of older men from the countries it originated from, shisha smoking is the latest trend to hit parties, bars, night clubs and lounges.

The flavoured tobacco water pipe smoking is particularly fashionable among young people today and has now become a trendy, multicultural activity particularly with students and youths.

Shisha is believed to be best 'enjoyed' in a group, having a session that can last over an hour.

Anna, an undergraduate of University of Abuja, said she enjoys smoking shisha with friends. Asked if she can smoke it alone, she replied “No, I smoke shisha in the company of friends.”  She went further to say that she finds the act very soothing and also very exciting.  “I love the nice fruity flavours; it is very soothing and also very safe” she stated.

Just like Anna, Ibrahim, a civil servant who lives in Kaduna is a shisha smoker. Ibrahim says he quit smoking cigarettes four years ago and started smoking it late last year. Ignorant of the health hazards associated with the smoking of shisha, Ibrahim claimed that it is harmless. “Shisha is really cool and unlike cigarettes, I get to smoke it occasionally.” Ibrahim mentioned that he has a shisha vessel which he entertains friends with when they visit.

Research shows that contrary to popular belief, shisha is not safer than smoking cigarettes. It usually contains tobacco and is therefore linked to the same serious life-threatening illnesses as cigarettes, such as heart disease, lung cancer, respiratory disease and problems in pregnancy.

The worst part is that shisha smokers are exposed to more toxins than cigarette smokers, because they also breathe in smoke from the charcoal used to burn the tobacco – it’s like breathing deeply next to a smoky barbecue, something most of us try to avoid.

There are added risks with shisha because it is often smoked for far longer sessions than cigarettes. Smoking shisha is a leisurely, sociable activity that is done with friends and family. In fact, a typical shisha session lasts about an hour, which is significantly longer than the usual couple of minutes people take to smoke a cigarette.

Many people are unaware of the health risks from smoking the flavored tobacco, which can be as damaging as cigarettes.

Night clubs and bars offering the traditional Middle Eastern pipes have started springing up across the country.

Shisha smokers inhale tobacco with added flavorings or sweeteners through a vessel filled with water.

Although the water cools the smoke and makes it feel less "harsh", the tobacco can still cause ill health, including lung and mouth cancer. Because the smoke is cooler, some experts say people inhale it more deeply into their lungs, which increases the risks even further.

Some shisha bars do not use tobacco, rather they offer customers with flavored herbal mixtures; but the challenge with that is people may not know the difference.

In a statement by Dr Mike Knapton, associate medical director at BHF during the course of this research, states: "Contrary to popular belief, shisha is not safer than smoking cigarettes. "Don't be duped by the sweet smell and wholesome-sounding fruity flavours. If you use shisha, you are a smoker and that means you are putting your health at risk.’’

A similar response was given by Dr Akin Orioke, a Nigerian doctor working with Julius Berger Construction Company, he said:  “shisha is filled with a lot of health hazards just like cigarettes. It can be more harmful than smoking cigarettes as a matter of fact, but most people feel more comfortable because it is smoked occasionally unlike cigarette smoking.”

Experts warn it can do more damage than cigarettes because users take more puffs of smoke. This is because a cigarette smoker typically takes between eight and 12 puffs, inhaling 0.5 to 0.6 liters of smoke. But during hour-long shisha sessions, smokers may take up to 200 drags, ranging from 0.15 to 1 litre of smoke each.

Shisha smoking is a growing concern because people are not aware of the risks involved like with cigarette smoking. The greater the exposure in terms of duration and amount smoked, the greater the risks to your health.

This is because, although shisha tobacco tastes nicer than cigarettes, it contains all the same toxicants known to cause lung cancer and heart disease.

So before you think of sucking that pipe, it is important you think about the dangers associated with the act.



SOURCE

Smoking A growing pastime for Nigerian girls

Cigarette smoking in Nigeria used to be an exclusive preserve of the male gender in the past,  but with modernisation, it appears the trend is changing as Nigerian women, especially the youth, are now taking to smoking, writes TADE MAKINDE and BANJI ALUKO.

It was a Friday night, and expectedly, fun lovers-guys and ladies alike-gathered to have fun. The regulars were at hand—red lights, heart-shaking cacophony coming out of speakers and alcoholic drinks. Not that the scene was unusual. As a matter of fact, clubbing, or gathering together to enjoy music-spiced fun, is as old as civilisation itself. It is also a known fact that human nature abhors vacuum, something must spice living or else ‘it’ won’t be worth it.

However, clubbing and night parties in this part of the world were dominated by the male gender for a very long period.  The few women who made it to the club houses and the dance parties were regarded as the bad ones and they were few then. Majority of them were students of higher institutions who where kilometres away from the prying eyes of their parents. That was the age the number of guys in night parties more than quadruple that of girls who, most of the time, accompanied their boyfriends to the parties. Then, guys who brought ladies to night parties were regarded as “big boys”, while boys who managed to secure a dance with a lady would see it as an achievement.

Such was the dominance of the male gender at night parties and club houses some decades ago. The dominance also goes beyond the numerical dominance; guys were also in full control of the attendant activities that go with night gatherings such as drinking and smoking.

In fact, it was a taboo to see a lady smoking cigarette in the past. But with the passing of time, the popular saying that “what a man can do, a woman can do better” would later be used, albeit by Nigerian women, to challenge male dominance of fun, smoking, consumption of alcoholics and debauchery in general.

Nigerian ladies have risen to the challenge and are not showing any sign of waning.

Years ago, ladies that smoked and drank alcohol could be counted.  It was inviolable of sort to be seen with a stick of ‘stogie’.  But nowadays, more and more Nigerian young girls are taking up smoking and it is no more a surprise seeing girls smoking. The resentment many had for women cigarette smokers is gradually disappearing and girls are more determined to prove that they could do better in areas men had held sway.

Though the Nigerian society still resent female cigarette smokers, the club houses and drinking spots where many young girls now spend a considerable part of their time, don’t. The number of women—middle age and teenagers alike—in club houses these days is growing. And they are not just there to make up the numbers, they are key participants. It appears they don’t want to be left out of the fun that the male had maintained a lead over the years.

In clubs and drinking spots, they now have a presence that competes favourably with that of the male gender. Apart from this, they now thread on surfaces that used to be an exclusive preserve of men.

This position can be easily affirmed by a trip to night clubs in the major Nigerian cities. From the Sharia-dominated north to the largely Christian south, young ladies, especially from higher institutions of learning, boldly smoke, and guzzle liquor to show that “they belong.”

At a club house in Ibadan, a group of ladies, an admixture of teenagers and young adults, appeared out of the blues demanding for beers. Few minutes after, one of them brought out a packet of cigarette and a couple of them started smoking. Suddenly, the light went out and dimmed light from cigarette dotted the hall like a convergence of witches.

The above scenario will pale into insignificance if one visits a brothel or hotel where prostitutes regularly gather. These days, it now appears that cigarette smoking, at least, is a sine qua non for prostitution and without it, a woman cannot make it in the ‘old profession.’

Blessing, a teenager who only finished her secondary school education in 2010 told the reporter that she took to smoking last year because she saw a couple of her friends smoking. “I never thought I would smoke. Often, I see some girls do it and I actually dislike it.  But somehow, I have started smoking too,” she admitted.

Really, there have been grave concerns over the increasing rate at which women now smoke cigarette. The recently released statistics by the World Health Organisation (WHO) of an increasing global trend of women and girls who have taken to the deadly habit of tobacco smoking is scary. Of the 5.4 million victims that die every year, 1.5 million are girls and women. The report also stated that half of the 151 countries surveyed, approximately as many girls use tobacco as boys.

Unlike the Asian and European countries where many often say that the weather and the freedom enjoyed by females allow them to smoke and drink without raising eyebrows, the sudden rise in the number of ladies smoking and boozing has got many fearing that there could be more women smokers than male ones in the nearest future.

However, for those trying to ape European ladies who smoke on the excuse that it warms them up from inside in the cold region, Dr. Adeyefa Adeniran of All Souls Medical Centre, Oke-Ado, Ibadan, says it’s not true as cigarette smoking and alcohol consumption does not warm up human beings.

“It’s the norm in Europe among the ladies, smoking and drinking has nothing to do with the weather.  The proven fact is that cigarette smoking kills, but millions still smoke despite the glaring warnings on cigarette packs.  Do you know why? It’s because the nicotine in it is addictive”. Latest reports indicate that out of the more than one billion smokers worldwide, 250 million are women. About 5.5 per cent of them die annually from smoking-related ailments, corroborating Dr. Adeyefa’s statement.

In Nigeria, a recent study shows that there are more than 13 million active cigarette smokers, out of which about 1.5 million are women.  This is the warning signal that shows that cigarette smoking has gained foothold among Nigerian women, especially the young ones.

According to another medical expert, Dr John Ademola, at the Obafemi Awolowo University, Ile-Ife, “the number of women that smoke would triple over the next generation and millions will die prematurely if nothing is done about it,” he observed.

But danger lurks ahead for women cigarette smokers.

He says research has shown that smoking affects the human cardio vascular system, lung function, reproductive system and bone density, adding that smoking accounts for nearly one in three cancer deaths worldwide. He listed other major health problems peculiar to women cigarette smokers as menstrual problems, pelvic inflammatory disease, infertility and premature menopause.

The medical practitioner also added that smoking constitute higher risks to pregnant women. He said that smoking could lower the amount of oxygen available to a pregnant woman and her baby, increase a baby’s heart rate, increase the chances of miscarriage and stillbirth and increase the likelihood of premature birth and low birth weight.

Dr. Adeyefa also adds that the same disease that affects males, “throat, bronchitis, trachea and lung cancer”, are suffered by females.

For pregnant women who smoke, the babies are easily exposed to diseases such as liver and cerebral problems. “They also weigh less than 3 kilograms, which is not good. These diseases have no cure”, he warns.

Another concern for female cigarette smokers is addiction. The U.S. Centre for Disease Control and Prevention found that while 29 percent of male smokers have been able to quit, only 19 per cent of female smokers have permanently broken the habit. Women are three times more likely than men to relapse while trying to quit smoking without any help, the centre stated.

According to Dr Ademola, “while men smoke to feel more alert and vigorous, enjoying the positive feelings associated with smoking, women smoke because they find it relaxing.

He added that while nicotine appears to promote aggression in men, it has a calming effect on women. Women also appear to be more likely to take up smoking to help control theirs.

A Psychologist, Mr Tayo Abejide, added that the new strategy being used by manufacturers and marketers of cigarettes is to link smoking with attractiveness, which easily fascinates young girls, ultimately making them helpless victims.

“There is this erroneous belief that smoking offers some relief, even if temporarily. Up North, seasonal harsh weather sometimes induces more people into smoking. Unfortunately, they end up harming their pulmonary system more than they care to know”’, he said.

“Advertisers also lure young smokers so that they can be hooked on nicotine for many years”, added Dr. Adeyefa.

Another reason Mr Abejide gave for the rise in smoking among women is lack of watch by parents over their wards. “Many of the girls pick up this attitude while leaving at home with their parents. Since they do it most of the time in the nightclubs, bars and other similar places of entertainment, the question is, how these girls, including teenagers, became so free that they spend nights outside of home? This is where the root of the problem,” he stated.

Without these girls, however, club owners will have no business to run.

“They are the salt of showbiz, without women, guys who spend the money won’t come here to spend money on drinks and ladies. On Wednesdays when we have our ladies night, we make between N1.3 and 2 million. There is no way we can make such an amount if there are no women available. Women in a way are the reasons why men patronise clubs”.

But what is responsible for the upsurge in the number of female cigarette smokers in Nigeria? A female student at Lead City University, Ibadan, who prefers not to be named, said that in some circus, ladies who don’t smoke or drink “are not considered big girls and are therefore not respected.”

“When you see girls ‘puffing away’ in a club, the first impression is that such girls are “bad”, or loose.  However, many girls want to be labelled such because it draws attention to them from the guys.  It’s like guys immediately label them as sluts to be taken away and for the girls, it is like, ‘these are my wares; do you wanna buy? Smoking and drinking sells them”.


SOURCE

‘Two per cent of men’s deaths in Nigeria caused by tobacco’

At least two per cent of all deaths of men in Nigeria every year is related to tobacco use, a new global report has shown.

 The 2012 Tobacco Atlas said this is the most preventable cause of death in the country and globally.  $591 million is lost annually by the country to tobacco use in terms of health care and related expenses. Besides, it shows that Nigerians smoke about 17 billion sticks of cigarette annually. 

The Atlas, which is the world’s most comprehensive analysis of tobacco related activities, shows that 21.7 per cent of youths are exposed to second hand smoke in their homes and as such are at risk of cancer and other allied diseases. 

Girls who use tobacco are put at 1.3 per cent, while boys, between ages 13 and 15 who use tobacco, stand at 5.6 per cent. The percentage of men who use tobacco is put at 8. 

Experts say if this trend continues,  the country will soon be dealing with a tobacco epidemic.  A tobacco control activist, Akinbode Oluwafemi said: “ This madness must be stopped before it consumes more people. Imagine the number of people dying annually from the killer products of the tobacco giants. This sure must stop, and a way of doing that is to have the Tobacco Control Bill signed into law and implemented.”

Akinbode added: “We have to prevent a situation where Nigeria will become Europe or America where at least 20 per cent of all male deaths have been blamed on cigarette smoking. In China, tobacco use is the number one killer, causing 1.2 million deaths annually and this is expected to rise to 3.5 million deaths annually by the year 2030. We must not get to this state.”

The report said last year, tobacco use killed about six million people globally, with nearly 80 per cent of these deaths in low- and middle-income countries such as Nigeria. It shows that the industry realises almost $6,000 (Sh498,000) in profit for each death caused by tobacco. 

President, American Cancer Society (ACS) John Seffrin said tobacco giants’ activities in countries like Nigeria calls for concern. Seffrin said they are already growing in developing countries. “We can no longer deny or accept the massive human and economic harm costs by tobacco,” he said.

Chief Executive Officer, World Lung Foundation Peter Baldini  said:”The tobacco industry thrives on ignorance of the true harms of tobacco and using misinformation to subvert health policies that could save millions.” 

The high number of deaths has made the WHO recommend higher cigarette prices to make them unaffordable to children and make the habit expensive for regular smokers. 

A professor of Obstetrics & Gynaecology at the University of Benin, Edo State, Friday Okonofua, said: “Indeed, the rising cases of cancer deaths in Nigeria is becoming a national embarrassment, It is my considered opinion that the government needs to develop a comprehensive policy on cancer prevention and treatment, and set up an emergency task force to implement the related plan of action. Such a policy must be hinged on the tripod of the prevention of cancers, early recognition of the disease and prompt treatment. We must go back to the days of Professor Olikoye Ransome-Kuti when he emphasized the importance of preventative health care. I dare say, our failure to heed his advice has continued to plague our health care system and is the major reason for the continued under-performance of this country in key health indicators.”

The Atlas, produced by the ACS in partnership with  the World Lung Foundation and endorsed by the WHO, noted:  “Worldwide, smoking causes almost 80 per cent of male and nearly 50 per cent of female lung cancer deaths.

 “Uniquely among cancer-causing agents, however, tobacco is a man-made problem that is completely preventable through proven public policies.  These cost-effective policies are among those included in the WHOs Framework Convention on Tobacco Control, a global treaty endorsed by more than 174 countries.”

By Olukorede Yishau,

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

WHO, rights' groups take on 'Big Tobacco' over smoking

• Two new reports released yesterday in Singapore by the Tobacco Atlas  and the Tobacco Watch Monitoring Countries’ Performance on the Global Treaty, reveal how tobacco companies in Nigeria and other countries lure people to smoke and die slowly, reports OLUKOREDE YISHAU in Singapore

Which does the world prefer: tobacco or health? Expectedly, the global community settled for health, but tobacco companies are doing all they can to lure more people into smoking.  

A report released yesterday by the Tobacco Atlas and Tobacco Watch Monitoring Counties Performance on the Global Treaty painted a graphic picture of the tobacco epidemic, and the progress that has been made in tobacco control.  The report also highlighted the latest products and tactics being deployed by the lucrative tobacco industry such as the new meida, trade litigation and aggressive development of smokeless products to roast control .

These are contained in the Fourth Edition of the Tobacco Atlas unveiled yesterday by the American Cancer, Society (ACS) and World Hung Foundation at the 15th World conference on Tobacco or Health (WCTH) in Singapore.  Before the report was unveiled. 

Akinbode Oluwafemi, director in charge of Corporate Accountability at the Environmental Rights Action (ERA), who is attending the conference, told  reporters at a seminar organised by the Campaign for Tobacco Free Kids (CTFK), that statistics suggests that less people in Nigeria and the rest of Africa smoke cigarett, adding: “This should be good news, but tobacco giants are using this to advantage by focusing attention in Nigeria and the rest of Africa because they are facing heat in the developed world.”

His observations are supported by the Tobacco Atlas  report. 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. 

The Tobacco Atlas said the burden of tobacco cultivation, consumption, illness and death is moving from developed to developing parts of the world and is taking an increased toll on low and middle-income countries to the extent that nearly 80 percent of those who die from tobacco-related illnesses are in low and middle-income countries.

According to the Tobacco Atlas, estimates of revenues from the global tobacco industry likely approach a half trillion U.S. dollars annually. In 2010, the combined profits of the six leading tobacco companies, the British American Tobacco (BAT), which is the market leader in Nigeria, Phillips Morris International, and others, was U.S. $35.1 billion. This, noted the report, is equal to the combined profits of Coca-Cola, Microsoft, and McDonald’s in the same year. 

A statement by ACS said: “If Big Tobacco were a country, it would have a gross domestic product (GDP) of countries like Poland, Saudi Arabia, Sweden and Venezuela.”

The statement added: “In 2011, according to the Tobacco Atlas, tobacco use killed almost six million people, with nearly 80 per cent of these deaths occurring in low and middle-income countries. When considering 2010 deaths with tobacco industry revenue, the tobacco industry realises almost $6,000 in profit for each death caused by tobacco.

“If trends continue, one billion people will die from tobacco use and exposure during the 21st century –one person every six seconds. 

Globally, tobacco-related deaths have nearly tripled  in the past decade, and it is responsible for more than 15 percent of all male deaths and 7percent of female deaths. Tobacco is also a risk factor for the four leading non-communicable diseases (NCDs) –cancer, heart disease, diabetes and chronic respiratory diseases which account for more than 63 percent of global deaths, according to the World Health Organisation (WHO).

“Tobacco use is the number one killer in China, causing 1.2 million deaths annually; this is expected to rise to 3.5 million deaths annually by the year 2030. Tobacco is also responsible for the greatest proportion of male deaths in Turkey (38 percent) and Kazakhstan (35 percent), and the greatest proportion of female deaths in the Maldives (25 percent) and the United States (23 percent).

“Uniquely among cancer-causing agents, however, tobacco is a man-made problem that is completely preventable through proven public policies. Effective measures include tobacco taxes, advertising bans, smoke-free public places, mass media campaigns and effective health warnings. These cost-effective policies are among those included in the WHO’s Framework Convention on Tobacco Control (WHO FCTC), a global treaty endorsed by more than 174 countries, and recommended by the WHO in its MPOWER policy package.”

The Tobacco Atlas shows that countries such as Nigeria, where tobacco giants operate, bear direct costs that arise from health care expenditures for treating smoking-related illnesses and indirect costs as a result of lost productivity and cost of premature deaths. 

Chief Executive of the ACS John Seffrin said: “We can no longer deny nor accept the massive human and economic harm caused by tobacco. This book is a vital tool for not only public health advocates, but also for governments, economists, educators and the media to use to tell the story of how a cohesive, well-funded tobacco industry is systematically causing preventable deaths and crippling economies. We know what needs to be done to counteract these tactics and save up to hundreds of millions of lives.” 

For the Chief Executive Officer of the World Lung Cancer Organisation,  Peter Baldinin, “The tobacco industry thrives on ignorance of the true harms of tobacco use and using misinformation to subvert health policies that could save millions. The Tobacco Atlas graphically illustrates the human toll and massive scale of the tobacco epidemic, breaking the best and most recent evidence out of the research world for an audience that can affect change. We urge advocates, media, governments and health professionals to visit tobaccoatlas.org website and use the available data to expose the deadly harms of tobacco and the industry that benefits from those harms.”

Another report released at the WCTOH, which paints the danger in the tobacco giants is the Tobacco Watch: Monitoring Countries’ Performance on the Global Treaty.

 The report accused BAT, Phillip Morris International and Japan Tobacco of blocking plans in their host countries  to control use of cigarettes.

The Framework Convention Alliance (FCA), which issued the report, said by blocking tobacco control plans, tobacco giants are increasing death rates associated with tobacco use. Tobacco use, said the report, is responsible for the death of nearly six million people annually, 70 percent of them in the developing world. It added that if current trends continue, one billion people will die of tobacco-related causes in the 21st century. The report documents activities in countries that are parties to the first global health treaty, the WHO-FCTC to interfere with regulations.

FCA Director Laurent Huber said: “For example, half of the national NGO partners that collected research indicated that the tobacco industry is running so-called corporate social responsibility (CSR) campaigns in their countries.

“Tobacco industry activities like those reported in Tobacco Watch do more than violate Article 5.3 of the FCTC: they impede progress on implementing all other measures in the Convention, which are proven to be effective and cost-effective.

“In fact, the Political Declaration of the United Nations NCD Summit recognised the key role of tobacco control in combating NCDs –which account for 60 percent of the world’s deaths and specifically recommended accelerating implementation of the FCTC.”  

 Yul Francisco Dorado of Corporate Accountability International said: “This year’s Tobacco Watch reminds us that the primary challenge the treaty faces is not a lack of political or public will, but a defiant, invasive and ultimately deadly industry. Ending tobacco industry interference is paramount to the success of the treaty at large.”

Oluwafemi said: “With more than 170 Parties, 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.” 

 Tursan d’Espaignet of the WHO’s Tobacco Free Initiative, in a paper entitled: “Mortality Attributable to Tobacco- a Global Report,” said tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers. He said: “Direct tobacco smoking kills five million people per year; second hand smoking kills 600,000 people per year, which means tobacco kills more than tuberculosis, HIV/AIDS and malaria combined.  If effective measures are not urgently taken, tobacco could, in the 21st century, kill over 1 billion people.”

No wonder WHO Director-General Dr. Margaret Chan, in a keynote address at the WCOTH, described tobacco smoking as a drive-by shooting capable of killing even by-standers.

By OLUKOREDE YISHAU 

Keynote address at the 15th World Conference on Tobacco or Health, Singapore

• Galvanizing global action towards a tobacco-free world 

Excellencies, honourable ministers, distinguished delegates, members of civil society, ladies and gentlemen, I am pleased to speak at the opening of this 15th World Conference on Tobacco or Health. I thank Singapore’s Health Promotion Board for organizing this event, and am pleased that WHO has provided technical support.

This conference is being held at a time when we are at a crossroads in our efforts to rid the world of a killing addiction. In principle, the balance is entirely in our favour. In a perfectly sane, reasonable, and rational world, with a level playing field, the anti-tobacco community would surely speak with the loudest voice and carry the biggest stick.

Evidence for the physical harm, and economic costs, of tobacco use keeps growing, and I am certain that this conference will expand the evidence base even further.

Tobacco use is the world’s number one preventable killer. We know this statistically, beyond a shadow of a doubt. In a world undergoing economic upheaval, with populations ageing, chronic diseases on the rise, and medical costs soaring, tackling a huge and entirely preventable cause of disease and death becomes all the more imperative.

We know that tobacco directly harms the user’s health in multiple ways. We know that tobacco products kill their consumers.

We know that tobacco smoking, like a drive-by shooting, kills innocent bystanders who are forced to breathe air contaminated with hundreds of toxic chemicals. We know what tobacco exposure during pregnancy does to the fetus, another innocent, blameless, and entirely helpless victim.

We know that tobacco use is not a choice. It is a powerful addiction. The true choice is between tobacco or health.

We have evidence, and we have instruments. As a tool for fighting back, we have the WHO Framework Convention on Tobacco Control, with 174 parties now committed to implementing the treaty’s articles and obligations. These parties govern nearly 90% of the world’s 7 billion people. If safety from tobacco lies in numbers, we have them.

But we also know that implementation falls short, for many reasons, in many countries. We have addressed this problem as well. We have a practical, cost-effective way to scale up implementation of provisions in the treaty on the ground. That is, the best-buy and good-buy measures for reducing tobacco use set out in the MPOWER package.

We have abundant country experiences that demonstrate the effectiveness of these measures. Evidence also shows how these measures can have a value-added impact.

For example, in a study published earlier this year, researchers demonstrated that smoke-free workplaces actually decrease smoking in homes. These findings soundly refute industry-sponsored propaganda.

Just two weeks ago, another major study, involving more than 700,000 deliveries, found that smoking bans have significant health benefits for unborn babies. This proved true for women who smoke but also for women who have never consumed tobacco yet were exposed to second-hand smoke.

And we have an enemy, a ruthless and devious enemy, to unite us and ignite a passionate commitment to prevail.

Unfortunately, this is where the balance no longer tips so strongly in our favour. The enemy, the tobacco industry, has changed its face and its tactics. The wolf is no longer in sheep’s clothing, and its teeth are bared.

Tactics aimed at undermining anti-tobacco campaigns, and subverting the Framework Convention, are no longer covert or cloaked by an image of corporate social responsibility. They are out in the open and they are extremely aggressive.

The high-profile legal actions targeting Uruguay, Norway, Australia, and Turkey are deliberately designed to instil fear in countries wishing to introduce similarly tough tobacco control measures.

What the industry wants to see is a domino effect. When one country’s resolve falters under the pressure of costly, drawn-out litigation and threats of billion-dollar settlements, others with similar intentions are likely to topple as well.

Numerous other countries are being subjected to the same kind of aggressive scare tactics. It is hard for any country to bear the financial burden of this kind of litigation, but most especially so for small countries like Uruguay. This is not a sane, or reasonable, or rational situation in any sense. This is not a level playing field.

Big Tobacco can afford to hire the best lawyers and PR firms that money can buy. Big Money can speak louder than any moral, ethical, or public health argument, and can trample even the most damning scientific evidence. We have seen this happen before.

It is horrific to think that an industry known for its dirty tricks and dirty laundry could be allowed to trump what is clearly in the public’s best interest.

And there are other tactics, some new, others just old butts in new ashtrays.

In some countries, the tobacco industry is pushing for joint government-industry committees to vet or screen all policy and legislative matters pertaining to tobacco control. Don’t fall into this trap. Doing so is just like appointing a committee of foxes to look after your chickens.

More and more, investigations are uncovering the tobacco industry’s hand in court cases filed against tobacco control measures.

Paying people to use a country’s judicial system to challenge the legality of measures that protect the public is a flagrant abuse of the judicial system and a flagrant affront to national sovereignty. This is direct interference with a country’s internal affairs.

Members of civil society,

We need you, now more than ever.

Experience has shown that, when government political resolve falters or weakens under industry pressure, coalitions of civil society can take up the slack and carry the day. We need this kind of outcry, this kind of rage.

Shaping public opinion is vital. If tough tobacco legislation wins votes, politicians will back it, and fight back against industry.

Last year’s high-level UN meeting on noncommunicable diseases adopted a political declaration. To reduce risk factors and create health-promoting environments, heads of state and government agreed on the need to accelerate implementation of the WHO Framework Convention on Tobacco Control.

They recognized that substantially reducing tobacco consumption contributes to reducing NCDs and has considerable health benefits for individuals and countries. They also recognized the fundamental conflict of interest that exists between the tobacco industry and public health.

When I addressed that meeting, I reminded participants that full implementation of the WHO Framework Convention on Tobacco Control would deliver the single biggest preventive blow to heart disease, cancer, diabetes, and respiratory disease. I called on heads of state and government to stand rock-hard against the despicable efforts of the tobacco industry to subvert this treaty.

Ladies and gentlemen,

I have a final comment.

I come from a culture that shows great respect for its elders. So let me say that some of the older people in this audience may recall the Virginia Slims marketing campaign that targeted young professional women.

That campaign sought to hook teenaged girls and young women by portraying smoking as a symbol of emancipation and self-assertive freedom. Its slogan was memorable: “You’ve come a long way, baby.”

Let me turn that around, addressing my own personal marketing campaign to the tobacco industry.

“We’ve come a long way, bullies. We will not be fazed by your harassment. Your products kill nearly 6 million people each year. You run a killing and intimidating industry, but not in a crush-proof box. Tobacco industry: the number and fortitude of your public health enemies will damage your health.”

Ladies and gentlemen,

I sincerely hope that this conference, including the high-level ministerial panel on countering tobacco industry interference, will again tip the balance entirely in our favour.

This conference is our watershed event. I sincerely hope that this event further damages the health of an industry that aggressively sells a health-destroying addiction.

We can, and must, stop this industry’s massive contribution to sickness and death, dead in its tracks.

I wish you a most productive meeting. Thank you.

Director-General of the World Health Organization 

Global profits for tobacco trade total $35bn as smoking deaths top 6 million

• New figures reveal worldwide profits but big companies insist they are not switching to emerging markets to avoid regulation

Revenues from global tobacco sales are estimated to be close to $500bn (£316bn), generating combined profits for the six largest firms of $35.1bn – more than $1,100 a second.
Much of this profit is ultimately channelled to pension and insurance investors in the UK – British American Tobacco and Imperial are two of the largest companies listed on the London stock market.
London's role as a hub of the multinational tobacco trade is in part a legacy of the British empire. While BAT sells very few cigarettes in the UK, for example, it is a big player in many emerging economies. In Turkey it sells Viceroy and Pall Mall brands; its Kent cigarettes are big sellers in Russia, while Gold Flake and John Player Gold Leaf are popular in Pakistan. Rothmans in Nigeria and Kent and Montana in Iran are also important for BAT. India, Vietnam, Bangladesh, Iraq, Egypt and Yemen are also promising markets for the company.
The big four tobacco firms – Philip Morris, BAT, Imperial and Japan Tobacco – insist they do not recruit new smokers in developing countries; rather, they grow sales by converting existing smokers of local tobacco products to their stable of aspirational Western brands – often "safer" products, they say.
A British American Tobacco spokesperson said: "There is constant speculation that we're breaking into emerging markets to avoid regulation. But this is not true. We didn't invent smoking, nor 'export' it anywhere, and we have been in many of these developing markets for hundreds of years – in the case of Africa, India and Brazil, since the early 1900s.
"As disposable income grows around the world, particularly in developing countries, more smokers are upgrading to premium brands rather than low quality local alternatives – and this doesn't just apply to cigarettes."
And yet almost 80% of the 6 million people killed last year by tobacco-related illnesses were from low- and middle-income countries, according to new research from health lobby campaigners.
The study identified tobacco as the No 1 killer in China, where smoking is said to cause 1.2 million deaths annually. It is also blamed for more than a third of male deaths in Kazakhstan and in Turkey – other major smoking nations.
China accounts for about 40% of the global market for tobacco. The big four western firms have been eager to gain a foothold, but the industry remains firmly in state control.
The New Tobacco Atlas – produced by the World Lung Foundation and the American Cancer Society and published in Singapore at the World Conference on Tobacco or Health – found that tobacco-related deaths had tripled in the last decade: they now account for more than 15% of male deaths and 7% of female deaths.
The study indicated cigarettes had become an average of 21.7% more affordable in low and middle-income countries.
Health campaigners insist the industry is in fact lobbying hard to block international standards on tobacco control. "The tobacco industry thrives on ignorance of the true harms of tobacco and using misinformation to subvert health policies that could save millions," said Peter Baldini, chief executive of the World Lung Foundation.

Simon Bowers