Tobacco use is arguably the single most avoidable cause of death in the global society and the most important public health issue of our time. Smoking apparently kills more people than alcohol, AIDS, car accidents, illegal drugs, murders, and suicides combined – and thousands more die from other tobacco-related causes such as exposure to environmental tobacco smoke (also called passive smoking), smokeless tobacco use, and fires caused by smoking.
Africa has continued to record persistent increases in the prevalence of smoking, prompted primarily by the tobacco industry’s commitment to create new markets in the developing world. This drive for new markets is a result of the backlash faced by the tobacco Industry in the developed countries championed by governments and anti-tobacco groups since the mid-1990s.
In Africa, as is everywhere in the world, general health effects of tobacco products include the potentially fatal diseases; and tobacco contributes significantly to the current upsurge in Non-Communicable Diseases (NCDs) which the continent is currently registering and which forms part of the theme for the 6th Ordinary Session of the AU Ministers of Health. Our Member states already remain challenged by resource limitations in financing the health system, thus if the tide of the impact of tobacco as it relates to NCDs is not stemmed, the huge financial burden associated with NCDs may further cripple the system.
The link between poverty and tobacco use is also clear with numerous researches showing that in the poorest households (in some low- and middle-income countries), more than 10% of total household expenditure is on tobacco. Tobacco consumers from poor households also tend to consume higher doses of tar than those from upper income families. Their plight becomes compounded by the fact that their indulgence in such an unhealthy habit often starts when they are very young resulting in higher risk of tobacco-related morbidity.
On the continent, tobacco is the dominant cash crop for a significant number of farmers, presenting an opportunity for these small scale tobacco farmers to supplement their household income from tobacco farming, as tobacco fetches higher prices in the market compared to the traditional food crops. However price fluctuations and environmental impact of farming practices render the farmers and community at large vulnerable. More importantly, the enormous cost of tobacco-related mortality depriving the nation of economically active workers; the cost of treating NCDs caused by tobacco; and the workdays lost due to morbidity of tobacco use such as respiratory disease more than offset whatever economic gains are accrued from growing tobacco. In any case, the farmers can always embark on a more profitable and environmentally sustainable crops than tobacco.
There is one more important area we need to address – smoking amongst young people - young girls and adolescents and women. We know that most of them start smoking when they are younger, even as young as 8 or 9 years. There is therefore a need to send a clear and early message to children when they are still in primary school about the dangers and devastating consequences of smoking. This has led to legislation in a number of African countries, banning smoking in a car in which a child under the age of 12 years is riding. This is justifiable in terms of the African Charter on the Rights and Welfare of the Child (ACRWC) and the UN Convention on the Rights of the Child (CRC).
Moreover, children are often exposed to smoke at home and they are extremely vulnerable to passive smoking. If Smokers have a right to choose whether they smoke, nonsmokers have a greater right to be protected from the harmful effects of the smoke that smokers produce.
In addition, it is imperative to tackle cigarette smoking among the adolescents. Studies have shown strong association between cigarette smoking and the use of hard drugs such as Marijuana, Cocaine, Heroin and Amphetamine-Type Stimulants (ATS). A link has been established which suggests that cigarette smokers are seven (7) times more likely to have tried marijuana and cocaine, and 14 times more likely to try heroin.
Then, there is the gender aspect of smoking. Traditionally, African women do not usually smoke. However, adolescent females are taking up smoking at a faster rate than adolescent males and at an earlier age. This has made adolescent girls a target for the tobacco industry’s attempts to recruit lifelong smokers through nicotine addiction in adolescence. As a Physician, I have seen the devastating effect of tobacco on pregnant women and the resulting maternal and newborn mortality and morbidity.
The challenge posed by tobacco to health and socio-economic development gravely threatens the future of the world’s poorest nations through disability and premature death, high personal and national economic costs and environmental damage.
Considering the foregoing, it is therefore, essential to formulate a clear response in order to protect human health and ensure that it is placed at the center of our strides in combating the avoidable health and socio-economic consequences of tobacco use. In this regard the leadership of our member states is critical and the support of our partners indispensible.
By H.E. Dr. Mustapha S. Kaloko
AU Commissioner for Social Affairs.