Banning tobacco in NigeriaACTA
There have been repeated campaigns, warning and awareness programmes by health experts, advocacy groups, non-governmental organisations and government agencies against tobacco consumption due to its adverse health effects.
Despite all these, millions of smokers in Nigeria have refused to yield to the warning, while tobacco companies and distributors still smile to the bank with huge profits from the tobacco trade.
With over 20 billion sticks of cigarettes consumed annually in the country, many smokers pay with their health, as reports from the World Health Organisation (WHO) and other resource centres indicate that millions of smokers die annually in Nigeria from tobacco-related ailments.
Reports from the Dun and Bradstreet website, a global provider of Nigerian business data and analytics shows that Philip Morris Limited generates US$26.89 million yearly from sales revenue, while British American Tobacco Nigeria Limited generates US$6.12 million annually.
Also Gozie Nwaogu Nigeria Limited generates an annual sales income of US$26.89 million, as well as other tobacco-producing and distribution companies.
According to medical experts, second-hand smoke is responsible for an estimated 166,000 child deaths each year worldwide. There is also third-hand smoke, which is the result of chemical residue on surfaces where smoking occurred. Experts say that this type of smoke has adverse effects on the liver and lungs. Research shows that healthy living is the greatest gift one could give to oneself.
According to the Canada Heart and Stroke Foundation (CHSF) tobacco smoking is a leading risk for disability and premature death. Tobacco is made from leaves of tobacco plants. It contains nicotine, which is an addictive drug. When tobacco is smoked in cigarettes or pipes frequently, the body absorbs toxic and cancer-causing chemicals that affect the health.
According to a study by a renowned oncologist, who is also a Professor of Surgery at the Cancer Institute in Senegal, Prof. Abdoul Kassé, there is need to put harm reduction at the centre of all public health development strategies, adding that harm reduction is a powerful public health tool that has the potential to reduce cancer by 30 per cent. The award-winning health expert further stated that tobacco enlightenment campaigns should be enforced as a preventive measure in tobacco control.
“When we talk about smoking, we mean tobacco misuse, which has increasingly become a public health issue in many states of Nigeria. Awareness creation and education apply to areas where there is a need to reduce the harm associated with practice or consumption of a substance that is overused in society leading to increased morbidity and mortality,” he said.
He said such studies would continue to gain traction in view of the devastating effect of tobacco and the fact that cessation or outright quitting has continued to prove impossible for most smokers.
Kasse observed that tobacco harm awareness initiatives, including the use of popular e-cigarettes, nicotine patches and chewing gums, have continued to generate misunderstanding in both the public health community and in the media. Like other health experts, he believes that there is evidence that the use of potentially less harmful alternatives than cigarettes for those who are not willing or cannot give up smoking with currently approved methods may be a solution, not necessarily the best for everyone but by far better than continuous smoking.
In view of the trend in tobacco smoking and its health implications, experts also estimate that at least half of lifetime tobacco smokers will die before they reach 70, even as a smoker loses about 10 years to smoking. Reports also indicate that over 25 million Nigerian children and adolescents are at the risk of tobacco use or smoke exposure.
According to Mr. Amadou Mahtar Alioune, co-founder of All Africa.com and CEO, African Media Initiative, the government should reduce the risks of cigarette smoking by enforcing laws that restrict tobacco consumption in public places and encourage the most viable alternative use of vaping.
Alioune submitted that burning tobacco produces more than 4,000 chemicals, including nicotine, carbon monoxide and tars. He said: “Cigarette smoking boosts increased mucus production, clogging of the airways, increasing susceptibility to infections, pneumonia, development of chronic obstructive pulmonary disease (chronic bronchitis and emphysema), irritation and destruction of lung tissue, exacerbation of asthmatic attacks and lung cancer.”
His submission is based on the finding that the use of vaping, heated tobacco, oral nicotine and smokeless tobacco is certified 95 per cent safe because of their smokeless nature which drastically reduces risks associated with tobacco smoke. Vaping is gaining traction with reports indicating that as of 2021, there were 82 million vapers worldwide. Vaping is the action or practice of inhaling and exhaling vapour containing nicotine and flavouring produced by a device designed for this purpose.
Health authorities say vape is considered to be a tool that has the potential to reduce cancer by 30 per cent and should be made affordable, accessible and available for smokers. That is why Alioune agrees that harm reduction has already benefitted many people in public health and is the most viable alternative in tobacco control.
Despite efforts to persuade smokers, the use of alternative products has been met with stiff opposition from stakeholders, including the WHO, which has continued to insist on total cessation.
Mr. Kgosi Letlape, an ophthalmologist and president of Africa Medical Association as well as the president of the Association of Medical Councils of Africa, urged African countries to heed the advice of health experts on the use of tobacco products and accept other safer alternatives.
He said: “We have a responsibility to make smokers aware of the alternative product available, which is vaping, so they can conveniently make informed decisions. Tobacco cessation is a key factor in the prevention of cardiovascular diseases and cancer. Abstinence from tobacco smoking is one of the primary goals for health promotion and management globally but it is unachievable in a huge number of cases. This task remains unaccomplished despite extensive public campaigns on the health dangers of tobacco smoking.”
She said: “They continue smoking despite the adverse health consequences. Conventional smoking cessation proposals should be complemented with alternative, but more realistic options through harm reduction.
Laying more emphasis on the alternative use of vapes as recommended by health experts, the New York Times reported that most western countries such as Canada, America, United Kingdom, etcetera, have legalised the sale of vaping products with nicotine as a less harmful option for smokers. E-cigarettes, or vapes, are battery-operated devices that heat and vaporise a liquid that users inhale or vape to imitate the smoking experience. The liquid usually contains nicotine in a mixture of propylene glycol, vegetable glycerine, water and flavouring agents.
However, there is evidence about the toxic effects of e-cigarette vapour on the cells that line the mouth, nose, lungs and blood vessels. Vaping is also linked to respiratory injury and an increase in blood pressure.
Experts also warned that it is dangerous to use e-cigarettes and regular cigarettes together (dual use). They disclosed that dual use can be more harmful than either smoking or vaping alone, adding that e-cigarettes should not be used by young people, by non-smokers or by ex-smokers who have quit altogether.
An Ilorin based health expert speaks on the adverse effects of dual smoking. He said: “Daily dual use may increase your risk of a heart attack five times more than if you did not use either vapes or cigarettes. The best approach is to stop smoking. Speak to your healthcare provider if you have tried quitting without success. Programmes and medically approved cessation aids will increase your chances of success. Many people find it hard to quit smoking. It is often a physical and psychological addiction. Many use smoking to manage unpleasant feelings such as stress, depression, loneliness and anxiety. Some feel that smoking helps them to concentrate or control their appetite.”
A patient who was admitted in General Hospital Ilorin for lung cancer as a result of excessive smoking, Rashid Abdulsalam revealed that he had been a chain-smoker for 25 years, until he began to vomit blood and was later rushed to the hospital where he was diagnosed with the deadly disease.
When asked if he was not aware of the health risks caused by tobacco smoking, he said: “I am an addictive smoker, even on this sick bed, I still feel the urge to smoke cigarettes. I cannot help my situation. But kidney cancer has helped me to stop. I always know that smoking too many cigarettes is bad. I have seen it on the television, I read the warnings in the newspapers and hear doctors saying it is bad. But I just could not stop smoking. I feel sorry for my situation and pray to God for healing. Now I am the one to warn people who are smoking to stop smoking because of the situation I find myself in.”
Another cigarette user (names withheld) said: “I have been smoking for five years now and whenever I smoke cigarettes or weed, it gives me a feeling of greatness. I love the feeling. I cannot explain it. It also helps me to relax my brain and my nerves. I get inspiration to think well when I take it.
“As a bricklayer, I get more energy and stamina to do my work, that is why I take it before I start my work and, in the night, to sleep well. I have heard that smoking cigarettes is bad for my life, but I believe that it is only when you smoke it too much and you don’t eat good food that it will disturb you.So, I don’t see myself stopping it anytime soon because of the benefits I get from it.”
In an interview Minister of Health Dr Osagie Ehanire, said tobacco smoking cannot be stopped in Nigeria as it is impossible to control smokers. However, the country needs more advocacy programmes that creates awareness on the dangers of excessive tobacco smoking in rural communities.
He said: “The challenge about tobacco smoking is that it doesn’t only affect the person smoking the cigarette. Anyone close or around the smoker is also at risk. That is known as second-hand smoking. The reality is that it is impossible to ban or stop persons who smoke. Even if we succeed in stopping public smoking of cigarettes, how about those who smoke in their private spaces or houses?
“However, what we do as a Health Ministry is to carry out more advocacy campaigns on the dangers associated with excessive tobacco smoking. We use radio jingles, place newspaper adverts and billboards to sensitise people on what to expect if they continue. We also collaborate with advocacy groups and healthcare centres to reach those in the rural communities who are at greater risk to this harmful substance, since most of them are not educated and enlightened. This is the most we can do as it concerns tobacco smoking.”
Source: The Nation Online