Smoking of tobacco has been listed as one of the major causes of preventable deaths. It is a risk factor for lung cancer, hypertension, emphysema, cardiovascular disease, myocardial infarction, prostate cancer, colorectal cancer, breast cancer, congenital malformation, coronary heart disease, bladder cancer, peptic ulcer, high blood pressure, oesophageal cancer etc. Besides children are at risk of developing asthma, throat inflammation and respiratory illnesses due to exposure to the smoking of other people. The above mentioned diseases are regarded as chronic diseases with a rapidly increasing burden in a developing country like Nigeria which also have a large disease burden from communicable diseases.
The control of tobacco use will no doubt help in efforts aimed at reducing the disease burden from non-communicable diseases. Therefore, it is time for the signing into law of the National Tobacco Control Bill by the president and its implementation by all stakeholders. Governments at all levels need to take a stand on the production of tobacco in the country in order to show its disapproval and lack of interest in the commercialization of the product.
While there are legislations on substances such as heroine and cocaine, nicotine which is contained in tobacco and is as powerful as the former substances has been left without a comprehensive law regarding it. Smoking of tobacco is a major public health challenge Nigeria is faced with in the epidemiological transition from communicable diseases to non-communicable diseases. Looking at the risk factors for chronic diseases, tobacco use seems to be the most prominent among other factors such as physical inactivity, unhealthy diet, alcohol use etc. Hence, there is a need for an intensified tobacco control efforts in Nigeria and the enforcement of global standards for tobacco control by relevant authorities.
According to the second edition of Disease Control Priorities in Developing Countries, on the average, smokers will lose 20 to 25 years of life and will die between the ages of 35 and 69 years and quitting raises the chances of survival no matter how long an individual has smoked. Though the phrase “smokers are liable to die young” is a famous one. But with the daily consumption of tobacco by Nigerians, one wonders what the level of awareness is about the risk of mortality and disease posed by smoking.
Gone are the days when the billboards and mass media were inundated with advertisements for tobacco products with the pay-off line “smokers are liable to die young” so that consumers could at least be aware of the dangers of smoking tobacco. But these days one hardly see such advertisement especially those that are aimed at making the general public aware of the health risk of tobacco which has led to the death of many around the world. Though the ban of advertisement for tobacco product may have been in an attempt to control smoking but this measure has not been effective, Nigerians need to be informed from time to time that the eventual risk from smoking is high. Statistics show that worldwide, tobacco use accounts for 1 of every 5 deaths among men and 1 of every 20 deaths among women over the age of 30.
The use of tobacco cuts across all the social class of our society with the smoking group comprising of young people, adult, men and women; and these are also the major categories of people in the society.
Dangers of smoking tobacco are there for all to see except we decide to close our eyes to it. Different logic has been put forward by smokers to defend their smoking practice but it is important to know that life is a precious gift and it would be painful to lose it to a substance that has more negative effect on health than positive and which affects all members of the society. Smokers impose health risk on non-smokers as they passively smoke tobacco when smokers inhale the vapour besides secondary smoking has been proven to be as dangerous as primary smoking. Secondary smoking is associated with a somewhat high risk of lung cancer, so both the smokers and non-smokers are affected.
This shows that there are a lot of interest groups asides the farmers and those who smoke tobacco as far as curbing the use of tobacco is concerned in our country.
Many countries around the world have concluded debate on this important health problem while other countries are still debating this issue due to its highly contentious nature. The scientific evidence of the negative effect of tobacco consumption has led to its control in countries like the USA, UK, Canada, Australia, and Denmark to mention but a few.
These countries which are developed and have a high burden of non-communicable diseases realize what the lack of paying proper attention to the issue of tobacco smoking portends for the health of their citizens. They have been able to achieve a reduction in the number of people consuming tobacco over the years thereby addressing the problem of non-communicable diseases which most developed countries are faced with due to increased life expectancy.
Although some countries are still battling with this issue of tobacco use. A country like Nigeria that needs to control the fast rising disease burden from non-communicable diseases just recently passed a bill on the control of smoking tobacco which is one of the hottest topics in medicine. WHO have forecasted that by 2030, 10 million people will die per year of smoking-related illness, making it the single biggest cause of death worldwide with the largest increase to be among women.
Reports also have it that tobacco-related deaths are the fastest growing cause of death in low-and-middle income countries on par with HIV/AIDS pandemic. This dual epidemy of both communicable and non-communicable diseases calls for urgent measures and interventions to reduce the incidence from these diseases before it becomes uncontrollable. The passage of the National Tobacco Control Bill early this year by the last senate, though an important step, shows that we still have a long way to go. Despite the non-inclusion of increased taxes on tobacco products in the highlights of the bill, the bill is expected to come to force six months from the date of assent. However, those who have been at the forefront of ensuring the passage of the bill from inception must be commended for their efforts at trying to reduce the health risk of tobacco on the people and also documenting a comprehensive law providing for regulations of supply and demand measures of tobacco products after the Tobacco Control Smoking Act of 1990 championed by late Minister of Health, Professor Olikoye Ransome-kuti.
Twenty –one years after the signing into law of the Tobacco Control Smoking Act and two years after the presentation of the National Tobacco Control Bill on the floor of the National Assembly, the senate eventually passed the bill. But the question is—what is going to be the fate of the bill as we start a new dispensation?
It is a known fact that any bill that fails to receive presidential assent in the previous republic will have to be re-presented for its passage and eventual assent in the new administration. This means that those pushing for the passage of the National Tobacco Control Bill into law will have to go through the hurdles of lobbying and attending public hearings. The thoughts of having to face the obstacles to the successful passage of the bill into law could dampen people’s enthusiasm for controlling tobacco use.
If the above narrative is anything to go by, then, the control of smoking in the nearest possible time may be a tall order because a new legislation on the consumption of tobacco is instrumental to its effective control.
According to the bill, there is a ban on selling cigarette to persons under age of 18; this implies that individuals above 18 years are at liberty to smoke but the smoking practice of this group of people pose a health risk on other members of the society.
Also, studies have shown that children of smokers end up smoking, so if a child of a smoker cannot smoke tobacco because he is less than 18 years of age, all he needs do is wait till he becomes 18 and above.
Much as the highlights of the National Tobacco Control Bill are important, we need to go a step further by ensuring the price increase of tobacco products. This has proved to be the most cost-effective approach to controlling tobacco consumption among other interventions not contained in the bill. There is no excuse for inaction as this preventive measure alongside the highlights of the bill has been proven to be cost-effective in the control of tobacco consumption.
Another issue aside from the long time it may take to pass the bill by the current members of the National Assembly is the implementation and enforcement of the bill when it becomes law. Nigeria has many policies and laws that are made to address different problems confronting the nation but those responsible for the implementation and enforcement of these policies and laws have failed woefully and it is hoped that the new government will usher in good governance and purposeful leadership.
In the meantime, there is need to intensify the level of awareness about the dangers of tobacco smoking to the public as the expansion of information and education to the different smoking groups about the ill-effects of smoking will go a long way in discouraging people from smoking and using tobacco.
