Assessing Nigeria’s anti-tobacco campaign

Okeoghene Oghenekaro, CNS Correspondent, Nigeria 
(First published in News Agency of Nigeria)  
The World Health Organisation (WHO) estimates that tobacco causes over six million deaths every year, and over 600,000 of these deaths are induced by second-hand smoke. In adults, second-hand tobacco smoke causes several diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death, while in pregnant women, it causes low birth weight.

The WHO says that tobacco is a risk factor of at least six of the eight leading causes of death worldwide, insisting that unless something tangible is done, tobacco-related deaths would peak at eight million each year by 2030. The global health agency further says that more than 80% of these preventable deaths will occur among people living in low and middle-income countries.

Experts stress that a pragmatic way of strengthening the anti-tobacco campaign is by raising taxes on tobacco products and their argument appears to be plausible as the theme of the 2014 World Tobacco Day is “Raise Taxes on Tobacco”. The World No Tobacco Day, which is celebrated annually on May 31, is aimed at protecting the people from the health, environmental and socio-economic consequences of tobacco use and exposure to tobacco smoke. A major goal of the 2014 campaign is to encourage governments across the world increase taxes on tobacco to levels that will provoke a significant reduction in tobacco consumption. The campaign also aims at mobilizing individuals and civil society organizations to encourage their governments to raise taxes on tobacco.

Under the WHO Framework Convention on Tobacco Control (WHO-FCTC), countries are supposed to implement tax and price policies on tobacco products so as to reduce tobacco consumption. This is because research shows that higher taxes are especially effective in reducing tobacco use among lower-income groups and in preventing young people from picking up the smoking habit. According to the WHO, “a tax increase that increases tobacco prices by 10% decreases tobacco consumption by about 4% in high-income countries and by up to 8% in most low-and middle-income countries.

Yet, only 32 countries, less than 8% of the world’s population, have tobacco tax rates greater than 75% of the retail price. Tobacco tax revenues are on average 175 times higher than spending on tobacco control, based on available data.

The 2010 WHO Report indicated that 50% increase in tobacco excise taxes would generate about 1.4 billion U.S. dollars in additional funds in 22 low-income countries. The report also said that if these funds are allocated to health, government health spending in these countries could increase by about 50%.  The Institute of Medicine of the National Academy Of Sciences in its 1998 report on “Taking Action to Reduce Tobacco Use”, concluded that increasing tobacco products’ prices was the most direct and reliable way of reducing tobacco consumption.

Dr Ehsan Latif, the Director (Tobacco Control), International Union against Tuberculosis and Lung Disease, said: “Increasing taxes on tobacco products is the most effective policy measure which a government can take to reduce tobacco-related mortality across a population. It is also seen as an attractive measure for governments, as it increases their revenues. The question we need to ask now is how are these new resources being used? Some countries like the Philippines, Thailand and Vietnam are using this extra income to fund tobacco control projects and invest in other preventative health measures”.

Latif urged other low and middle-income countries to similarly create resources for tobacco control, while creating a tobacco control fund. Going from the general to the specifics, how is Nigeria faring in the global campaign against tobacco use? Analysts recall that the Federal Government signed and ratified the WHO Framework Convention on Tobacco Control (WHO-FCTC) in 2004 and 2005 respectively.

The WHO-FCTC comprises some provisions aimed at reducing trade in tobacco products, which include comprehensive ban of tobacco advertisement, sponsorship and promotion, warning messages on tobacco packs, comprehensive ban of smoking in public places and increased taxes, among others.

Besides, the Senate and the House of Representatives passed the National Tobacco Control Bill (NTCB) in 2011 but the bill failed to receive the presidential assent. This bill is particularly aimed at domesticating the WHO-FCTC, as Nigeria is a party to the international convention. As a result, civil society groups have been agitating for the speedy passage of the NTCB, which has yet to reach the third reading stage in the current National Assembly.

Mr Olanrewaju Oginni, the National Coordinator of the Nigerian Tobacco Control Alliance (NTCA), underscored the need for the speedy passage of the bill, saying that it would promote the citizens’ wellbeing. “We are worried about the slow pace of work on this bill, which was originally passed by the 6th National Assembly. We had expected a swift passage by the current National Assembly but here we are again. This is a public health bill that will save the lives of many citizens from tobacco addiction and associated ill health and deaths; it is a matter of national priority.”

“It is the responsibility of the National Assembly to make laws that would promote healthy lifestyles of the citizens; such laws must, however, be made on time and with the necessary implementation mechanisms,” he added. Sharing similar sentiments, Mrs Hilda Ochefu, the West Africa Sub-Regional Coordinator, Campaign for Tobacco-Free Kids, also urged the legislators to be unwavering in their efforts to ensure the early passage of the bill. She noted that by the delayed action on the bill, Nigeria had tacitly breached an international convention which it signed and ratified, adding that the situation was bad for the nation’s health care delivery index.

“This bill aims to reverse an epidemic that currently claims the life of one in every 10 adults, particularly in developing societies like ours. Smokers pollute our environment and put us, the non-smokers, at risk as well. We will expect nothing short of accelerated passage of the NTCB to safeguard our lives and lives of our children,” Ochefu added.

However, Mr Okeke Anya, the Advocacy Officer, Civil Society Legislative Advocacy Centre (CISLAC), said that civil society groups would continue to explore litigation as an option to discourage smoking. “We will condemn tax breaks, financial relationship and other incentives for tobacco companies, so as to discourage government from assisting tobacco businesses to thrive. The civil society group will also ensure compliance with tobacco control policies at the local government level,” he said.

All the same, it is pertinent to note that the Federal Government is planning to enact a pragmatic tobacco control law. The draft bill on tobacco control, which has been approved by the Federal Executive Council (FEC), stipulates that anyone, caught smoking in places designated as non-smoking areas, would be liable to a fine of N50, 000 or face six months imprisonment or both.
If the new tobacco control bill is passed by the National Assembly, companies which flout the law’s provisions will be liable to a fine of between N1 million and N5 million, while their chief executives may also face one to two years’ jail terms.

The Minister of Health, Prof, Onyebuchi Chukwu, told journalists after the FEC meeting that the National Tobacco Control Bill, 2014, would be forwarded to the National Assembly for consideration and passage. Chukwu said that the bill also aimed at protecting the environment, adding: “We want to create a 100% tobacco-free environment for people who do not want anything to do with tobacco use and so places will be clearly designated as non-smoking areas.”

Besides, the minister said that the bill totally prohibited advertisement by tobacco companies. “Advertisement is totally banned under this law. Some states have already taken the lead; Cross River State, for instance, passed its own law on advertisement of tobacco last year. Now, we want to make it national. Any form of advertisement is not permitted, either in broadcast, print, outdoor. The bill is also looking at packaging, 50% of the package should warn people about the dangers of tobacco use,” he added.

The minister conceded that a survey carried out in 2008 showed that tobacco consumption was increasing in Nigeria. “Nigeria conducted the global youth tobacco survey and the youth between the ages of 13 and 15 constituted the target group of that survey. The outcome clearly showed that 15% of our children between the ages of 13 and 15 years were already smokers while 55% of our children in that age category were exposed to the dangers of tobacco use as passive smokers.”

Chukwu also said that 10% of Nigerian men smoked tobacco, while 1.1%  of the women similarly smoked. “In a nutshell, almost six% of all adults in Nigeria smoke or use tobacco products, apart from 20% of the adults who, despite the fact that they do not smoke, were similarly exposed to the risks as passive smokers,” he added

The minister said that the bill would, therefore, protect Nigerians against the numerous harmful effects of tobacco, while creating the “Tobacco Control Fund”, which would be funded by the federal and state governments as well as individuals. He said that a national committee, which would be comprised of representatives of the federal ministries of health and justice, the customs service and major stakeholders, would also be set up to monitor developments and oversee the fund’s management.

The anti-tobacco campaign is waxing stronger in the country, as some states are joining the crusade. For instance, the Lagos State Government in February passed a law which prohibited smoking in public places. The law forbids anyone from smoking in public places such as libraries, museums, public toilets, schools, hospitals, day care centres, public transportation facilities and restaurants, among others. The law prescribes some penalties for violations, which include N10, 000 to N50, 000 fines or three to six months’ imprisonment.

Commenting on the nascent anti-tobacco campaign in Lagos State, Oginni said: “We expect our national legislators to follow the example of Lagos State and expedite action on the NTCB; Nigerians have waited for too long for this bill.” The Tobacco Control, an international journal for health professionals and others involved in tobacco control, said that tobacco control groups had mounted a campaign, urging all levels of government to stop endorsing the tobacco industry’s activities which portrayed it as “responsible”.

“We will continue doing this by pointing out relevant sections of the WHO-Framework Convention on Tobacco Control that condemn such partnerships,” the journal added. All in all, analysts believe that the increase of taxes on tobacco products will definitely reduce tobacco consumption and save the lives of millions of people globally. They, nonetheless, underscored the need for Nigeria to step up the campaign against tobacco use by ensuring the speedy passage of the tobacco control bill.

Okeoghene Oghenekaro, Citizen News Service - CNS 
(First published in News Agency of Nigeria, on 7 June 2014 in Nigeria)  

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