How second-hand smoke affects you

Thursday February 14 2013

How second-hand smoke affects you

There is need for a law to regulate usage of tobacco, especially to protect both smokers and non smokers from the adverse effects of smoking such as cancer and heart disease. 

By Sarah Tumwebaze

If you are like many people who do not like the smell of tobacco, you will most likely hold your breath while passing by a person who is smoking.

Unlike this priviledge you have and might take for granted, Mr Sean Carroll could not afford to do such a thing. A website tells a story of the bus driver in Australia, who did not have a choice. Every day of his life for the 36 years he had the job, he had to drive a bus that had no restrictions on smoking. As a result, Carroll, a non-smoker developed lung cancer from years of passive exposure to tobacco smoke. He sued his employer, the Melbourne Metropolitan Transit Authority. The case was settled out of court, he was compensated $65,000 (Shs173.2m). But we all know this could not be compared to the life he was going to live with lung cancer.

Mr Carroll’s condition was one of the side effects of second hand smoking. Uganda’s law on smoking in public places defines second hand smoke as the smoke exhaled from a person smoking a tobacco product, and includes side-stream smoke which the law defines as the smoke of other emissions released from a tobacco product or the smoke exhaled by a person smoking a tobacco product.

Because little attention has been given to the damage tobacco poses, especially on the passive smoker who does not use it, in Uganda, there is limited documentation of such cases.

Mr Andrew Kwizeera, a member of Campaign for Tobacco Free Kids, says since the fight for the control of tobacco usage in Uganda is new, “There is limited documentation and most of what we have is just recent. But global statistics show that 600,000 people globally are exposed to second hand smoke and in adults, it causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death while in pregnant women, it causes low birth weight.”

Ms Christine Namulindwa, the public relations officer of the Uganda Cancer Institute, says, “The ratio of patients who present with lung cancer at the institute as a result of secondhand smoking is one out of 10.”

The law on public smoking in Uganda
Lung cancer and other side effects of smoking on the non-smokers were raised by the Ugandan public in the early 2000s and this saw the government formulating the National Environment (Control of Smoking in Public Places) Regulations 2004. This is the law being “observed” in Uganda as regards public smoking.

Besides the pressure from the public, this law was formulated as a follow-up on Uganda’s signing of the World Health Organisation’s Framework Convention on Tobacco Control. Formulated by the National Environment Management Authority (Nema), the 11-paged legislation highlights certain issues.

Article 4 states, “No person shall smoke a tobacco product or hold a lighted tobacco product in an enclosed, indoor area of a public place.”

Article 6(1) indicates that, “No person shall smoke in any public service vehicle or in any aircraft, train or other public transport.”

Article 7( 1) says. “The owner of a public place or any public service vehicle or other public transport where smoking is prohibited shall post clearly legible signs, prominently, stating that smoking is not permitted.”

However, the results of this law are yet to be felt as it is not a rare occurrence to pass by someone either smoking in a public place or in an enclosed bar or restaurant.

In an informal survey that was done by this newspaper, in 10 popular bars, and nightclubs around Kampala, most had a No Smoking sign somewhere, and fortunately, people were not allowed to smoke from inside. Those who wanted to smoke would get out to do so.

However, in 25 middle and low class bars we visited, people would smoke freely, inside, without being stopped. Some of these bars even had a No Smoking sign but, people just turned a blind eye and the operators of such places also gave them leeway to smoke since they had ash trays on the tables.

A waitress in one of the nightclubs along Kampala Road who preferred anonymity said they let the patrons smoke from wherever they want to because some of them are popular customers and they give the bar a lot of money. As such, it is hard for the bosses to say anything about what they do.

Besides places like bars, night clubs and restaurants, it is a common occurrence to find someone smoking in a place that is not gazetted for smoking such at the bus stop and yet, no one is even trying to stop them.

The coordinator of Uganda Health Communication Alliance (UHCA), Mr Richard Baguma, blames the continued public smoking on the weak policies of the National Environment (Control of Smoking in Public Places) Regulations 2004.

Article 13(6) of this law indicates, “A person who obstructs an environmental inspector in the execution of his or her duties under these Regulations commits an offence and is liable, on conviction, to a fine of not less than twenty thousand shillings and not more than one hundred thousand shillings.”

Mr Baguma explains, “Such policies in the law against public smoking have made it impossible for operators of places like bars to cooperate. The fine they have to pay is very small, they will have no problem in paying the amount every day.”

The State Minister in Charge of Primary Health Care, Ms Sarah Achieng Opendi also states that while the law is in place, it has not been implemented.

On the other hand, the director of Shalom Evangelical and Prison Outreach Ministries a Nongovernment Organisation (NGO) that rehabilitates smokers and drug addicts, Rev. Shalom Muwanguzi blames the noncompliance on the general public.

He says, it is hard for the people that are supposed to implement the law to know who is breaking it. “Enforcement of the National Environment (Control of Smoking in Public Places) Regulations is difficult because the public has not cooperated with the law enforcer. The public knows who smokes and from where but they have not bothered to report such cases.”

The Kampala Metropolitan Police spokesman, Mr Ibin Ssenkumbi confirms Rev Muwanguzi’s statement when he says, people do not think smoking in public is a “serious offence”.

“We have arrested some people and taken them to court but this is only if we have zeroed them out on our own since the public does not report them,” he says.

Since the current law is “weak” government plus Civil Society Organisations have come up to push for a new bill that will be inclusive on all tobacco issues.

What has been done
On January 29, 2013, the State Minister in Charge of Primary Health Care launched a campaign dubbed, Tobacco Control Advocacy Campaign. The purpose of the launch was to kick off the struggle towards having a legal framework to control the production and consumption of tobacco in Uganda and the related foetal consequences. The law is expected to reflect the Framework convention for tobacco control (FCTC) which Uganda signed in 2005 and 2007 respectively and was obliged to have a comprehensive Control Act by the end of 2012.

Currently, the draft of the legal framework is in place under the title of The Tobacco Control Bill 2012. The private members bill is being pushed by the Kinkizi East Member of Parliament, Mr Chris Baryomunsi who is being seconded by Ndorwa West Member of Parliament, Mr David Bahati.

This bill which is expected to be tabled before Parliament in February, highlights various issues on tobacco consumption and production issues.

“In view of protecting people from second hand smoke, the government is proposing to amend the existing legislation on exposure to second hand tobacco smoke in order to make it compliant with the FCTC guidelines to achieve 100 per cent smoke free public places. The government will also build capacity for all stakeholders and raise awareness amongst the general public and any other designated enforcers of prohibition of smoking in public,” the State Minister in Charge of Primary Health Care explained during the launch.

Ms Opendi added, “We are going to look at the tax and price policies where by taxes on tobacco products are going to be increased. This will affect the retail prices too, so as to make it hard for people to consume such products.”

Besides the bill, Uganda signed the Protocol to Eliminate Illicit Trade in Tobacco Products (ITP) on January 10. The principal medical officer, Mental Health and Control of Substance at the Ministry of Health, Dr Sheila Ndyanabangi said that after it is discussed, cabinet will give permission for the protocol to be implemented.

Demands from activists
While the bill and the protocol are in place and are considered to be progressive, they have not been formulated into law. Ms Robinah Kaitiritimba the Team leader at Uganda National Health Consumers’ Organisation (UNHCO) calls upon Parliament to act soon.

“The struggle to the right to health is not complete without a perfect law. That is why we want Parliament to pass the bill into law so that we can fight the effects of tobacco on not only on smokers but even the people who inhale it.”