The Uganda Tobacco Control Bill (2014) is currently before Parliament for deliberation with the press reporting that a handful of legislators expressed misgivings. Actually, the story began much earlier.
In 1950, a British doctor observed an increase in the number of lung cancer cases. Dr Richard Doll decided to investigate this puzzle in 20 London hospitals. What he discovered was ground-breaking. But his results would be kept from most of the world for more than 40 years.
Doll discovered that patients with lung cancer case had in common history of tobacco smoking. To be sure, he conducted the study again in 1954. This time following up on 40,000 British doctors who smoked. The results confirmed his earlier findings. Lung cancer was strongly linked to tobacco smoking.
The world would have to wait much longer to know these results. At the time, global tobacco sales were on a high and the powerful tobacco industry would have no one spoil the party.
That Uganda should spend more than four years debating whether we need a tobacco control law, in defiance of science, speaks volumes, partly on the power of the tobacco industry in Uganda today. The UK’s University of Bath has published research results detailing how the tobacco industry in Uganda has interfered in the tobacco control legislative process since 2011. This has included peddling falsehoods that the Bill bans smoking when all it does is ban smoking in public places.
Although tobacco control has largely been constructed as a public health matter, research we conducted in Uganda last year shows that tobacco use is also solidly a poverty issue. Ugandans in the two lowest income groups have higher tobacco use rates than those in higher income groups even when they can afford it the least.
We analysed two combined Uganda household expenditure data sets of 2009/2010 and 2010/2011 and asked a basic question. How much do poor households in Uganda spend on tobacco per week and what could this money potentially buy the household? We then looked at the prices of commodities in the Uganda Consumer Price Index of June 2010 and the potential purchases of selected alternative items with regard to food, health and education.
We found that money Ugandan households spent on tobacco every week could have bought eight litres of fresh milk or two loaves of bread. Studies done in Bangladesh show that households which spend on tobacco suffer more malnutrition than those which don’t. In the case of Uganda, we found that households’ weekly expenditure on tobacco was equivalent to the price of three and a half kilogrammes of maize flour during the same period.
The results also showed that money spent by a parent on tobacco could buy their children a set of primary school exercise books or 21 ball-point pens.
The study also looked at the spending habits of households which use tobacco. We found that they spent less on eggs and consumed less litres of milk than the average household. These households would potentially spend 39 per cent more on five selected food items if they didn’t spend on tobacco.
Research has determined that the poorer a smoker is, the less cigarettes they will consume if their price is increased through government taxes. Uganda has one of the lowest tobacco taxes in East Africa.
The Uganda Tobacco Control Bill proposes an inter-ministerial committee whose brief would include pushing for a pro-poor tobacco tax policy.
Mr Zakumumpa is a research Fellow of the Economics of Tobacco Control project of American Cancer Society and the University Of Cape Town School of Economics. [email protected]