Tobacco-The silent ‘tsunami’

Alice Tembe, Swaziland
Tobacco kills nearly six million people each year, of which more than 600 000 are non smokers, usually called second-hand-smokers (SHS), according to World Health Organization Fact Sheet Number 339, May 2013. It also notes that approximately one person dies every six seconds due to tobacco and accounts for one in ten adult deaths. Tobacco is a silent assassin, which is usually ignored by most health response programs because it takes several years between when a person starts using tobacco and when the health effects are felt. Further, most second hand smokers have minimal appreciation of the health risks caused by smoking and in particular SHS.

The International Union against Tuberculosis and Lung Disease states that in 2004 children accounted for 28% of tobacco death toll. In raising tobacco as a public health priority, The Union recorded that there are more than 4 000 chemicals in tobacco smoke, of which 250 are known to be harmful and more than 50 are known to cause cancer. It further notes that without urgent action, death from tobacco could reach 8 million in 2030.

In Swaziland, a self report to the WHO Report on Global Epidemic of 2011, shows that 5,9% of the population smokes daily, men accounting for 11,1% and women at 1,5%. It was reported that despite having a one-man show national agency for tobacco control, bans on tobacco advertising on television, radio, local magazine and newspapers as well as a mandatory law to display health warnings on packages of both cigarettes and smokeless tobacco, there is no mandated size of the warning coverage on the package and there are no deliberate government objectives for tobacco control.

An international health expert, Dr. Anne Jones, Technical Adviser, International Union Against Tuberculosis and Lung Disease (The Union) and Chief Executive Officer to Action on Smoking and Health (ASH) Australia, states that, while some progress to curb the epidemic may have been achieved, “we need governments to show leadership by putting health ahead of the commercial interests of the tobacco industry. Comprehensive bans on tobacco advertising and promotions are an important step along the way but the biggest challenge is ending the tobacco industry’s exploitation with a ban on their interference, political donations and corporate social responsibility (CSR)”.

It is notable that with the high burden of disease, the health education of the public on public health concerns like tobacco falls on the sidelines, says a Medical Doctor at the national referral hospital, Mbabane Government Hospital, Swaziland. He further noted that, when a patient walks in for consultation, we treat the disease at hand and there is hardly time to educate the person on the causes of the problem, how they can prevent recurrence and protect those around them. With most mothers who give birth to low birth weight babies, there is usually no direct connection made to smoking or SHS, the mothers usually do not even know how to account for the exposure, he said. As noted by the international health expert, Dr Anne Jones, Technical Adviser, International Union against Tuberculosis and Lung Disease (The Union) and Chief Executive Officer to Action on Smoking and Health (ASH) Australia, “to stop the devastating tobacco epidemic in its tracks, each and every country needs its own law to end interference by the tobacco industry in health policies”.

There are key steps that countries can take to curb and manage this silent pidemic, WHO simplified them through the six MPOWER measures that correspond with the provision of the WHO Framework Convention on Tobacco Control. The six MPOWER measures are to monitor tobacco use and prevention policies, protect people from tobacco use, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising, promotion and sponsorship and raise taxes on tobacco.

The effects of the tobacco epidemic include cardiovascular and respiratory diseases including coronary and lung cancer. In infants, SHS is known to cause sudden death while in pregnant women it accounts for low birth weight. Beyond the physical health impact are the social and economic loses created by premature death. An Employee Wellness Officer at Swaziland Water Services Corporation (SWSC), Mr. Eric Ndlovu, commented saying, in previous years the immediate reaction to cigarettes and other substances smokers whose work performance declines was to fire them, however, he has taken steps to partner with organizations in neighboring South Africa to have employees supported to stop smoking including counseling services. He further developed a policy to guide SWSC in managing the employee assistance program.

Alice Tembe, Swaziland
Citizen News Service - CNS
May 2013