Tobacco.org

• Africa heading for 'smoking epidemic' 

Since the smoking ban in Kenya, people can only smoke in special zones

At Jeevanjee gardens in Nairobi, smokers gather during their lunch hour to read, chat and light up.

It is one of the few zones in the Kenyan capital where people can smoke in public, since the ban on smoking in public came into effect in 2007.

As he takes a puff, one of the young men describes his habit.

"I've been smoking for 40 years but I hate it," he says. . . .

Dr Twalib Ngoma, president of the African Organisation for Research and Training in Cancer (AORTIC), says that Africa is on the brink of a smoking epidemic.

"Africa is in the area of the pre-epidemic and so we should prevent the epidemic," he told the BBC World Service.

"We should not wait until there is an epidemic and then work on it. We should prevent the epidemic."

Tobacco-related cancer was one of the key topics discussed at a recent international cancer conference in Tanzania.

One of the reports presented there warns that African nations are set to undergo the highest increase in the rate of tobacco use among developing countries. . . .

"For the first time in history, we have the tools in hand to prevent a pandemic," says Dr Otis W Brawley, chief medical officer of the American Cancer Society.

"Smoke-free public places are one example of a low-cost and extremely effective intervention that must be implemented now to protect health."

As well as Kenya, Niger also recently introduced a smoking ban in public places. . . .

"If a consumer is addicted to tobacco, then it is possible to put prices up and they will go without lunch."

But Mr Spielman says that he expects that over time, increasing advertising restrictions and bigger health warnings will come into place in African countries.

But in the meantime, as long as there are smokers who will sacrifice lunch for a packet of cigarettes, there will always be consumers.

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For the first time in history, we have the tools in hand to prevent a pandemic.
Dr Otis W Brawley, chief medical officer of the American Cancer Society.

• Report: Cancer Risk High as Smoking Surges in Africa 

Medical experts say tobacco-related illnesses are becoming a serious health issue in Africa as a new report warns tobacco use may double in some parts of the continent during the next 12 years. The report, from the Global Smokefree Partnership, warns that 90 percent of people in Africa have no protection against second-hand smoke.

Almost 15 percent of the world's population is in Africa, but right now the continent only accounts for four percent of world smokers.

The Global Smokefree Partnership, an initiative aimed at developing smoke-free policies around the world, says the continent needs to introduce strong smoke-free laws and high taxes on cigarettes in order to keep the number of smokers down and to limit the affects of second-hand smoke.

Antonella Cardone, project manager of the Partnership, says in some parts of Africa governments are taking important steps towards protecting their populations from the affects of tobacco.

"There are several countries now in Africa, which have developed smoke free policies," said Antonella Cardone. "We can definitely mention Niger and Kenya, then Mauritius - those are just a few."

But Cardone says in many African countries citizens still have no protection. Ghana, the Democratic Republic of Congo, and Uganda are highlighted in the report as countries that are failing to implement smoke-free laws.

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• Out of Africa: The Tobacco War's New Battleground 

Africa is already beleaguered by infectious diseases, such as AIDS and malaria, but now the continent's residents face growing health threats from preventable illnesses brought on by lifestyle changes, such as from poor diets and smoking.

In an effort to stave off these maladies, advocates have turned their sights on tobacco use, which is on the rise throughout Africa and projected to double by 2021. Of the approximately one billion people across the world who use tobacco, 60 million to 80 million live in Africa.

Along with lobbying for higher tobacco taxes and broader public health messages, advocates are hoping to eliminate smoking in public places in an effort to protect people from both first- and second-hand smoke.

About a billion people worldwide live in municipalities where smoking is outlawed in public places, according to a report published Tuesday by Global Smokefree Partnership (a joint initiative backed by the American Cancer Society, Johns Hopkins Bloomberg School of Public Health, Johnson & Johnson, Pfizer and 14 other entities) and announced in time for the African Organization for Research and Training in Cancer's (AORTIC) "Cancer in Africa" conference taking place this week in Dar es Salaam, Tanzania. Reducing secondhand smoke exposure can reduce the rates of lung cancer, heart attacks and breathing trouble in populations.

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• Cancer Experts Meet to Head Off Rise in African Tobacco Use 

Health officials say they have a "golden opportunity" to head off an epidemic in tobacco use in Africa and prevent many cancer cases.

While rich nations have taken action to reduce smoking, the World Health Organization says tobacco consumption in Africa is expected to grow by than four percent a year. That's why cancer experts are holding a major conference this week in Tanzania (Nov 11– 14).

Among those attending is Dr. Thomas Glynn, Director of International Cancer Control for the American Cancer Society and acting head of the Global Smokefree Partnership.

"This is really the first time in the history of public health that we have the opportunity to prevent an epidemic…. There's no doubt tobacco is on the rise here, but it's the one continent where we are ahead of the ball at this point," he says.

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• Five nonsmokers’ paradises: a guide for globe-trotters  

The world's biggest tobacco-consuming countries that I profiled in my last post, including Greece, Russia and Austria, are also among the top travel spots, but the opposite isn't quite the case.

Countries with the lowest reported adult smokers, as you'll notice in the list below, don't all provide dream vacations. . . .

1. Ethiopia: This very well might be the first time that this landlocked African country was listed at the top of a travel guide. Just 4.3% of Ethiopians are tobacco users. . . .

2. Ghana: Adult tobacco use in this African country is at 5.5%. . . .

3. Republic of Congo: . . .

4. Nigeria: . . .

5. Cameroon: Nigeria's neighbor to the east has a similar proportion of smokers, at 7.4%.

If you'd prefer a trip outside of Africa, the United Arab Emirates is at No. 22 and Fiji is at No. 23 on the list.. Further down the list, Ecuador is at No. 28, Egypt at No. 33 and the Dominican Republic at No. 35.

Between Egypt and Ecuador is Jamaica

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• Cheap tobacco driving youth to become smokers 

Lebanese health experts calling for a comprehensive smoking ban have been given additional impetus to their cause after a major international public affairs magazine published a major study warning youth smoking rates were increasing dangerously. In a report published earlier this month by the Economist Intelligence Unit with sponsorship from international pharmaceutical company Pfizer, researchers warned that cheap and easily accessible tobacco was driving Lebanon's youth to take up smoking, a habit many will continue into adulthood.

The 28-page report, entitled "Tomorrow's regular customers? Stamping out tobacco use in the Middle East and Africa," also noted that while many countries were now introducing smoking bans in public places, the developing world was seeing a steady increase in smokers, accounting for some 70 percent of the world's total smokers in 2005, compared to about 40 percent in 1970.

The developing world will thus pay the highest price for tobacco use: the World Health Organization (WHO) estimates that by 2030, 80 percent of tobacco-related deaths will occur in low- to middle-income countries, the report said.

In Lebanon, over 3,500 people die each year because of tobacco exposure at a cost of around $900 million, according to the Health Ministry.

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• Tomorrow’s regular customers? Stamping out tobacco use in the Middle East and Africa (PDF) 

Tomorrow’s regular customers? Stamping out tobacco use in the Middle East and Africa is a research paper written by the Economist Intelligence Unit and sponsored by Pfizer. . . .

The findings are based on more than 40 interviews with experts from government, academia, NGOs and the tobacco industry in the Middle East, Africa and elsewhere. We would like to thank the Economist Intelligence Unit’s extensive network of country analysts for organising and conducting most of these interviews. . . .

This report focuses on one portion of the developing world—the Middle East and Africa (MEA)— which has become a key battleground in the struggle over government policy and public attitudes.

Although the region can lay claim to adult smoking rates mostly on par or lower than those of many Western and developing nations, expanding populations mean that even if rates were to stay relatively steady, the absolute numbers of smokers would still rise.

The MEA region also poses other deeply entrenched challenges. These include rising youth smoking rates, particularly among girls, a prevailing culture of acceptance around tobacco, especially the water pipe, widespread governmental ambivalence and a strong tobacco industry lobby. But charities and other non-governmental organisations (NGOs) have gained a foothold in recent years. They often work on a shoestring, but are increasingly supported with much-needed financial lifelines from rich Western philanthropists.

“There is a change in mentality in our region. Ministries of health are working with the WHO and other NGOs—bringing together all the people working on tobacco control,” says Dr Jean-Pierre Baptiste, a regional adviser with the WHO’s Tobacco Free Initiative in Algeria. He is one of more than 40 experts from government, academia, NGOs and the tobacco industry interviewed for this report.

But are their efforts enough? In this paper, we investigate the progress that has been made, the challenges that remain, what lessons can be drawn from successful policies elsewhere and how the landscape could look in a decade or two. We examine ten major markets in-depth—four in North Africa: Egypt, Algeria, Morocco and Tunisia; two in Sub-Saharan Africa: Nigeria and South Africa; and four in the Middle East: Lebanon, Jordan, Saudi Arabia and the United Arab Emirates (UAE). The key findings of the report are highlighted below.

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• Smoking Threatens Africa With Cancer Epidemic 

Tobacco use in Africa is growing faster than in other continents, says Dr. John Seffrin, who has been on the frontlines in the war against cancer for several years and now serves as the chief executive officer of the American Cancer Society. Taking part in the recent LIVESTRONG Global Cancer Summit in Dublin, Ireland, he hailed the global unity shown in reducing the stigma of cancer and working harder at prevention, early diagnosis and treatment. He spoke with allAfrica.com.

How did the cancer summit come about?

Lance Armstrong [the American professional road racing cyclist who has survived cancer] and the Lance Armstrong Foundation decided that it was important to have not just another meeting on cancer, but a special summit that would bring together people from all over the world and a diverse group of people that would include scientists, public health professionals, survivors and advocates. The foundation raised money and worked with other organizations like the American Cancer Society to put this summit on. It was a smashing success and we hope it will be a launch pad for people to work better together to solve the cancer problem. . . .

How does Africa fit in when it comes to global tobacco use?

Africa has relatively low tobacco use prevalence rates. But it has the fastest increasing prevalence rates. They're low compared to China, where 60 percent of the men smoke, but they're going up faster than anywhere in the world. We at the American Cancer Society are committed to doing tobacco control in Africa because here's a chance to prevent an epidemic of disease that otherwise will happen.

The tobacco industry is rapaciously promoting its product in all areas of the world where prevalence rates are low. So we're targeting Africa and we need to get on the ground with prevention programs before it's too late. It's a lot easier to prevent people from starting ever to smoke than it is to get them to quit because it's so addictive. Here's an opportunity to get dramatic results and that is to prevent what has become the single largest cause of preventable death in the world: addiction to tobacco.

How might you go about doing that in Africa?

The number one thing that can be done in any part of Africa is to change current public policies. If every country in Africa would implement the protocols of the Framework Convention on Tobacco Control they could get dramatic results.

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• Big Tobacco Sets Its Sights on Africa 

In recent years, the world has increasingly been cleaving into two zones: smoking and nonsmoking. In the U.S. and other developed countries, Big Tobacco is in retreat, chased to the curbs by a combination of lawsuits, smoking bans, rising taxes and advertising restrictions. Fewer than 20% of adult Americans now smoke -- the lowest rate since reliable records have been kept -- and a tobacco crackdown is under way in Europe, Canada and elsewhere. In April, Congress boosted federal cigarette taxes threefold, from 32 cents a pack to $1. In June, President Barack Obama signed a law giving the FDA the power to regulate cigarettes like any other food or drug.

But the West is not the world, and elsewhere smoking is exploding. In China, 350 million adults are hooked on tobacco, which means the country has more smokers than the U.S. has people. Smoking rates in Indonesia have quintupled since 1970. In Russia, boys as young as 10 start lighting up. This year, tobacco companies will produce more than 5 trillion cigarettes -- or 830 for every person on the planet.

It's in Africa, however, that the battle for the hearts, minds and lungs of new smokers is being waged most aggressively -- and Nigeria offers a telling look at how the fight is unfolding. . . .

Big Tobacco's footprint in Africa has been hard to miss for a while. British American markets its wares — which include Dunhill and Pall Mall — in a vast crescent sweeping from South Africa to Congo and west to Ghana, as well as throughout North Africa. In 2003 the company planted its stakes deeper, building a $150 million factory in Nigeria. Philip Morris, whose brands include Marlboro and Chesterfield, has a smaller presence on the continent. "We are a minor, minor player," says spokesman Greg Prager. But that could change. The company does no business in Nigeria, but it controls about 15% of the market across North Africa and has a scattered 10% share elsewhere. It has also built a new factory in Senegal.

That expansion increasingly happens through the single-stick model, and that's the traffic that causes the most worry.

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• Organized crime plundering West Africa: UN 

Fewer drugs have been flowing into Europe from West Africa in recent months but organized crime is plundering the sub-region through illicit trafficking in arms, women, cigarettes and toxic waste, according to a UN report released Tuesday.

"Less drugs are flowing through West Africa. We must ensure that this downward trend continues," said Antonio Maria Costa (photo), executive director of the United Nations Office on Drugs and Crime (UNODC).

Since 2004, Colombian drug traffickers have increasingly made use of West African countries (Ghana, Senegal, Sierra Leone, Guinea Bissau, Togo, …) as a transit area for their cocaine shipments to Europe, according to UNODC.

But while the amount of cocaine passing through West Africa has dropped from a high in 2006 of 40 tons, one-quarter of all cocaine entering Europe, other illicit items such as cigarettes, arms, toxic waste, counterfeit medicines as well as oil and other natural resources like hardwood and diamonds are being trafficked through the region, according to the UNODC Threat Assessment. . . .

As much as 80 percent of the cigarette market in some west and north African countries is illicit, meaning that most of the smoking going on in these countries is profiting criminals.

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• Quit Smoking for Africa 

SOS Children is launching a new campaign asking smokers to "quit for Africa".

"Even though everyone understands the health benefits" said ex-smoker and fundraising director Kathie Neal "giving up smoking is a long and painful haul which requires sticking power. Knowing that the money you save is directly helping children alone could really help".

Even if they buy some cigarettes abroad, smoking ten cigarettes a day typically costs a smoker between £60 and £120 a month, the same as the cost of 3 to 6 child sponsorships. SOS Children suggests that to increase the satisfaction of quitting and help smokers to celebrate their ongoing achievement they use just 60p a day, a small part of this saving, to sponsor a child in Zambia, Zimbabwe or Malawi, tobacco-growing areas of Africa. SOS Children helps children throughout Africa

"The actual benefit to the African worker from a tobacco smoker is tiny, since the losers when you quit smoking are mainly the tax man and tobacco companies (who get most of the money from cigarettes" explained SOS CEO Andrew Cates "but nonetheless it seems appropriate to give something back to the countries which will lose the export".

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• Smoking in Ghana: A review of tobacco industry activity  

FINDINGS

British American Tobacco, and latterly the International Tobacco Company and its successor the Meridian Tobacco Company, have been manufacturing cigarettes in Ghana since 1954.

After an initial sales boom in the two decades after independence in 1957, the sustained further increases in consumption typical of the tobacco epidemic in most countries did not occur. Possible key reasons include the taking of tobacco companies into state ownership and a lack of foreign exchange to fund tobacco leaf importation in the 1970s, both of which may have inhibited growth at a key stage of development, and the introduction of an advertising ban in 1982. BAT ceased manufacturing cigarettes in Ghana in 2006.

CONCLUSION

The tobacco industry has been active in Ghana for over 50 years but with variable success. The combination of an early advertising ban and periods of unfavourable economic conditions which may have restricted industry growth are likely to have contributed to the sustained low levels of tobacco consumption in Ghana to date. . . .

What this paper adds

This paper provides the first account of tobacco industry activity in Ghana.

It indicates that the current low prevalence and tobacco consumption in the country are likely to be attributable at least in part to:

• Constraints on industry growth arising from foreign exchange shortages and the taking of the industry into majority government/public ownership at a time of rapidly increasing demand in the mid 1970s

• The imposition of a comprehensive advertising ban soon afterwards, in 1982 It also demonstrates that progression of the tobacco epidemic in developing countries is not inevitable, and that early restrictions on industry growth and advertising may be important steps in prevention.

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• 'Big tobacco firms now targeting Africa' 

Africa has become the main target of tobacco corporations that are being driven out of developed countries by tougher laws, high taxes and more consumer awareness of the dangers of smoking.

A conference aimed at curbing the spread of tobacco products worldwide, convened by the World Health Organisation, starts in Durban, South Africa, on Monday.

This is the third meeting of the organisation's Framework Convention on Tobacco Control, a treaty that already has the support of 160 countries and binds signatories to measures aimed at cutting down on smoking - a major cause of several illnesses, particularly cancer.

The organisation says tobacco use kills about 5,5-million people every year, with 70 percent of deaths occurring in developing countries.

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• African farmers turn backs on tobacco 

Most African farmers grow tobacco because they are poor and lack alternative ways to earn a living, but with encouragement, many Tanzanian farmers are giving the killer crop the cold-shoulder.

This is according to Lutgard Kagaruki, from the Tanzania Tobacco Control Forum, who addressed a panel at the World Health Organisation's tobacco control conference in Durban this week.

Tanzania is the second biggest grower of tobacco in Africa after Malawi, but many tobacco farmers were "enslaved in permanent debt to the tobacco companies" and wanted to get out, said Kagaruki.

"The tobacco companies give subsidies and loans for them to buy fertiliser, chemicals (pesticides) and seed.

"But then they under-grade the crops and set low prices. The farmers can't repay the loans and find themselves enslaved in permanent debt bondage," said Kagaruki.

The 80 000 tobacco farmers in Tanzania earned an estimated US$1 (R10) a day, she added.

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• MAJOR MULTINATIONAL INITIATIVE LAUNCHED TO PROMOTE TOBACCO C  

International leaders in cancer and tobacco control have announced the launch of an unprecedented multinational effort to promote more aggressive tobacco control measures across sub-Saharan Africa. The Africa Tobacco Control Regional Initiative (ATCRI) is design to promote the adoption, implementation and enforcement of effective in-country tobacco control policies, legislation and programmes.

ATCRI is being supported by Cancer Research UK and American Cancer Society (ACS) and will be hosted by the Environmental Rights Action/Friends of the Earth, Nigeria (ERA/FoEN). The Executive Director of ERA/FoEN, Nnimmo Bassey, said "This is an important and long-overdue initiative". There is significant concern that if current smoking patterns continue, Africa will be faced with the loss of millions of her people to tobacco-related disease within the next few years and also be faced with major infrastructure challenges to manage and treat these chronic diseases.

According to the World Health Organisation (WHO), tobacco currently kills about 5.5 million people every year with seventy percent of the deaths occurring in developing countries. Tobacco companies have in the recent past targeted African countries for development, distribution and marketing of tobacco products because of the limited tobacco control legislation to date.

The launch of ATCRI comes as the World Health Organisation hosts the third Conference of the Parties of the WHO-initiated Framework Convention on Tobacco Control (FCTC) on-going in Durban from 17 -22 November. The WHO FCTC is the world's first global public health treaty, ratified by more than 160 nations, and requires parties to adopt a comprehensive range of measures designed to reduce the devastating health and economic impacts of tobacco.

John R. Seffrin, PhD, chief executive officer (CEO) of American Cancer Society, is optimistic that ATCRI will go a long way in helping to reduce the burden of diseases, deaths and other costs associated with tobacco use. He noted, This effort represents the first major coordinated, multinational effort in Africa to specifically address tobacco control.

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