Monday May 12 2014

Banning tobacco growing will prevent diseases caused by smoking

By Vivian Asedri

My attention was drawn to a statement by Mr Jonathan D’Souza, the managing director of British American Tobacco (BAT) in Uganda in a story titled “Women MPs rally support for Tobacco Bill”, in the Daily Monitor, of May 1. D’Souza was quoted saying that “most outdoor places are open air spaces, and there is no risk of secondary smoke as alleged.” Such a misleading statement coming from an official of one of the world’s powerful cigarette manufacturers comes as no surprise because he must protect the corporate interest. He would never make such an utterance in the UK or any other developed country because he would be swiftly challenged.

Clause 11 of the Tobacco Control Bill 2014 prohibits the smoking of tobacco within 100 metres (328 feet) of a public place. Coincidentally, on the same day, May 1, Dr Tom Frieden, Director of the U.S. Centre of Disease Control and Prevention (CDC) said in a statement that tobacco remains the leading preventable cause of death in the U.S. and around the world. “Tobacco use is a major factor in four out of the five leading causes of death: heart disease, cancer, lung disease and stroke’, he stressed, pointing that tobacco use “causes about a third of heart disease and cancer, and most of emphysema’, CNN Health, May 1 : “CDC: 5 things cause two-thirds of U.S. deaths.”

Numerous scientific studies have been conducted around the world with empirical evidence to prove that banning tobacco use in public transportation, workplaces, restaurants, and outside public arenas drastically reduces the exposure to and effect of secondhand smoking for non-smokers.

Two such independent studies conducted by the British Medical Journal in the U.S. and UK saw more than a 70 per cent drop in cotinine concentration in U.S. non-smokers between 1998-2000, and a 52 per cent drop in UK between 1988-2003.

This proves that legislation can significantly reduce secondhand smoking to non-suspecting section of the population who don’t smoke. Cotinine is a toxic carcinogen product formed after chemical nicotine from tobacco enters the body. Whereas legislation hardly has any control over secondhand smoke in peoples’ homes and cars, the exposure to secondhand smoke in workplaces, public transportation, and public arenas in Uganda is outrageous.

According to a 2007 World Health Organisation (WHO) report, besides tobacco related disease such as lung cancer, chronic bronchitis, emphysema, and heart disease, there are mental health problems like mood disorders, anxiety disorders and stress that non-smokers exhibit from secondhand smoke without realising it.

Another WHO report in 2000 states that about five million people die each year globally from tobacco-related diseases, and this mortality is projected to rise to over 10 million deaths per year by 2030, with 70 per cent of the deaths in developing countries. Because in Uganda we are not diligent enough in conducting health metrics and maintaining national databases on morbidity and mortality, accurate figures on tobacco-related deaths may be hard to come by.

Uganda is part of a developing country where multi-national tobacco corporations like BAT and Rothmans, Benson and Hedges have shifted their main operations after stiff legislations against tobacco use in developed countries started stifling their market share and revenue bases.

Tobacco control laws in most developing countries are either non-existing or are too weak to address potential health dangers. For instance, after Canada passed the Tobacco Products Control Act, market shares for RBH in Canada plummeted from 43 per cent in 1975 to 17 per cent in the mid 1990s.

While Mr D’Souza must protect his organisation’s financial interests, our legislators must act to protect the interest and health of not only non-smokers but also smokers in Uganda because tobacco-related diseases are a major drain on Uganda’s poorly maintained healthcare delivery system.

Revenue generation has been the major reason for existence of tobacco industry in Uganda, where over 80 per cent of excise tax collected comes from cigarettes, beer, soft-drinks and mobile airtime. Hence advocates for tobacco industry will continue to justify their existence by boosting the country’s revenue base, which concept is a total fallacy.

Tobacco growers in Uganda are some of the poorest people in the country. We should move away from addressing the symptoms of the problem, to instead address the root cause of the problem: ban growing of tobacco in Uganda. Evidently, there are many alternatives to tobacco as a cash-crop, such as vanilla, pineapple, fruit and maize growing, among others with guaranteed market within the country, the region and the world. Tobacco farmers just need incentives to make the shift.

Besides banning tobacco growing as the ultimate solution, other legislative measures that must be put in place are imposing of higher excise taxes on tobacco products to make it prohibitively expensive (empirical evidence indicates that higher tobacco taxes significantly reduces tobacco use in both adults and teenagers), the banning of tobacco advertising on radio, TV and billboards which is often geared towards attracting youths to start smoking, and aggressive public health campaign in primary and secondary schools about the insidious dangers of tobacco use.

The tobacco industry, through their powerful lobbyists, must already be fighting the Tobacco Control Bill 2014 in every way possible. But Ugandan legislators must put the health interests of Ugandan population before the financial interests on these multi-national corporations.
Mr Asedri is a health information and substance abuse technician