Smoking Through the Valley of Death

By Sefy Megafu, This Day, 31 May 2002

Lagos—Today is the world’s No Tobacco day and various activities will be organised to commemorate it across the globe. Sefy Megafu writes on the contending issues affecting the consumption of tobacco in Nigeria

Today is world No Tobacco Day. There is doubt whether Nigeria is marking the day with other countries of the world given the controversy that still underlies the passage of the Tobacco Bill at the National Assembly. Although the bill has been passed by the House of Representatives after a sensitization workshop on tobacco legislation organized by the Federal Ministry of Health. It was done in collaboration with the World Health Organization, Nigerian Heart Foundation and Environmental Rights action/ Friends of the Earth.

Participants wanted the tobacco smoking (Control) Decree 20 of 1990 to be amended while observing that tobacco is an addictive product already causing so many deaths in developing countries including Nigeria. They harped on the alarming influx of tobacco products from the developed countries into Nigeria and protested against the aggressive marketing and promotion of tobacco products in contravention to existing laws. They would also want the government to provide adequate and comprehensive tobacco control policy that will introduce legislation in advertising, taxation, product packaging, content regulation and other programmes. In fact they want a total ban of direct and indirect advertising of tobacco and legislation on every aspect of tobacco trade.

But a major industry player, British American Tobacco (BAT) protested that the company and other stakeholders were not invited to the workshop. They insisted that, tobacco is not just a product that is smoked and enjoyed but worldwide, political, economic, social, cultural factors and forces interwine to play a critical role in an individual’s decision to start or stop smoking. These factors, they said, must be carefully considered in the Nigerian context. They assert that it is not just enough to increase tobacco excise duties, eliminate tobacco advertisement or promotional activities or ban smoking in public places. our deliberations should go beyond these measures and the major players in the industry, smokers, producers and marketers of the product should be involved in fashioning an appropriate legislation.

Perhaps it was on this premise that the Chairman of the Senate Committee on Power, Senator Nnamdi Eriobuna recently withdrew the bill seeking to regulate the advertisement of and tariff on tobacco in the country already forwarded to the senate. His colleagues claimed that the upper chamber lacked constitutional power to make laws on issues within the jurisdiction of the local governments. The senate, which noted that the United Nations had advised manufacturers to caution smokers on the dangers of the product insisted that the law on the advertisements falls under the council bye—laws.

However the draft bill was not to ban smoking or the importation of tobacco into the country as explained by Eriobuna but to increase the import and excise duties chargeable on the product. The bill also was meant to impose stricter regulations on trade and commerce on the products by restricting their advertisement, promotion, smoking in public places and prohibiting sale to minors. Though WHO had made unsuccessful attempts to improve a global framework convention on tobacco control on sovereign national governments, some countries have successfully implemented anti-tobacco law and more are following suite.

In South Africa, the Tobacco Amendment Act, 1999 (Act No. 12 of 1999, was signed into law By President Thabo Mbeki two years ago and became operative in the same year. The law protects people from harmful effects of tobacco smoke. It ensures that public places are smoke- free while making provision for special smoking areas within public places. The law, which banned all forms of tobacco advertising, sponsorship and promotion came into effect last year.

Tobacco smoke is a cocktail of over 4000 chemicals and poisons including tar, nicotine, carbon monoxide, hydrogen, cyanide and ammonia. When combined with caffeine and strychnine, nicotine becomes alkaloids. These are bitter tasting poisonous substances. However, tobacco was once claimed to be medicinal and effective against diseases like rheumatism, asthma and ulcerated wound. As the substance became popularised in Europe, severe punitive measures accompanied the use in China, Japan, Russia and the Muslim countries. The Roman Catholic church did not have it banned but excommunicated those that smoked in the church. Thus, some of the clergy took to sniffing its powdered form.

Experts revealed that nicotine has a short ’half life’. They explained that inside the body, nicotine dissolves very fast and affects the rate of smoking. A breath of cigarette smoke moves from the lungs into the blood stream and goes to the brain where it resides in some receptor areas. The smoke loses its strength after 40 minutes and the smoker gets another urge to smoke.

Researches show that a cigarette which contains 1.2 milligrams of nicotine could kill seven adults if injected.

However when you smoke, you get an incredibly diluted dose. Most of it literally goes up in smoke. Nicotine that remains in the lungs is in five to seven litres of air. It then diffuses through the wall of the lungs into the bloodstream where it is further diluted. There may be around 100 nanograms of nicotine per ml of the arterial blood which is about one billionth of the nicotine content written on the side of the cigarette packet. So by the time the substance gets to the brain, it is at a level of about 40 nanaograms per ml and that amount seems to satisfy smokers, observed experts.

Unfortunately, many smokers do not know the deadly consequences of smoking or simply do not care. It means that more carbon monoxide and tar which have so many cancer causing chemicals are involved. Carbon monoxide is a risk factor of heart attack. The risk of heart attack is more pronounced if a victim has high blood pressure or high blood cholesterol or is on pills. In as much as cigarettes have the ability to calm nerves, boost concentration and even help in loss of weight, it is addictive and adversely affects babies in the utero. Not only that, it is linked to sudden infant death syndrome, stroke, hardening of the arteries in the lungs, gangrene and high cost financially.

To curb the unhealthy lifestyle, WHO’s tobacco free initiative tries to galavanize support for tobacco control. Director-General of the organization, Gro Harlem Brundtland, recognises the need for co-operation in combating the phenomenon. She attested that smoking is a rapidly increasing cause of death in the world. She cautioned on the advertisement and subsidy of the product. Brundtland said: Adolescents should not be allowed to mortgage their lives to the seductive advertisements of the industry. WHO applauds the decision of the European Union to introduce a total ban on all forms of advertising and sponsorship as a landmark public health event with profound implications far beyond the borders of the Union.

But the British American Tobacco has argued against the claims. It argued against the claim that passive smoking (environmental tobacco smoke) is a cause of the various ailments. It disclosed that the result of the largest study done on passive smoking, lung cancer by WHO was not consistent with an increased risk from passive smoking.

Even when WHO, other public health agencies and some governments have concluded that exposure to environmental tobacco smoking is a health problem. Many Nigerians are perplexed at the recent concluded multi billion naira investment deal between the Federal Govern-ment and BAT. BAT is to build a tobacco plantation in Ibadan for production of tobacco related products at the detriment of Nigerians. Already, Nigerian youths are being offered cigarettes through promotions, and musicial concerts.

As such, many have condemned the deal. The health of Nigerians will be negatively affected. At the moment, Nigeria is battling with infectious diseases and cannot afford to be saddled with chronic health disorders and social problems associated with a preventable ailment. Apart from that, critics also inquire about the credibility of investing in a product that is banned in developed countries because of its health risk. They admit that there are other ways in which the developed countries could be of help to Nigerians. To them, government is being hypocritical as they failed not to recall that President Obasanjo flagged off the celebration of the first World Heart Day in the country by leading a group of Nigerians on a five-kilometre walk in Abuja.

Mr. Dapo Rotifa, past president, United Nations Association of Nigeria, I would not have bothered about the bit of BAT, if it was not that they are going to build a factory and create jobs for Nigerians. Does it make sense? But if they give money for other social amenities, we will accept their money but to build a factory that will produce more deaths, it is conscience money. We have to educate the government and its other arms not to encourage the establishment of the plantation in Ibadan. Afterall, the old Nigerian tobacco companies at Ibadan, Kaduna and Zaria were closed down. Why the sudden change of mind ? Why are they going back on it ? It does not make sense. Rotifa called on the Federal Ministry of Health to wake up to its responsibilities, saying, Whatever is banned in European countries are being dumped in Africa. They said that nobody should smoke in public places abroad. Why is it that the same people who banned it over there are bringing the same product to us here. And why should we accept such a thing? Why can’t we develop our industries? We should stand up and say that we don’t like it. There are other ways they can help us instead of bringing tobacco

Furthermore, the Secretary-General of African Heart Network, Dr. Kingsley Akinroye urged Nigerians not to be in partnership with industries that are injurious to them even if they cannot prevent their establishment.

As the National Assembly foot drags on the issue, non-governmental organisations are taking steps to stem the the situation. Nigeria, through the Nigerian Heart Foundation participated for the third time in the International Quit and Win 2002 competition. The smoking cessation competition was organised by the National Public Health Institute in Finland in collaboration with WHO this month. The competition was to motivate adult smokers to quit smoking for good. It was part of the global effort to reduce the prevalence of smoking and smoking-related conditions, ranging from behavioural disorders to cancers of various body organs.

WHO and the World Heart Foundation’s current data posit that in Nigeria 22.1 per cent of school youth age between 12 to 17 years use tobacco. In South Africa, it is 19.4 per cent; 15.1 per cent in Ghana and 16.2 per cent in Kenya. The government seems to lose sight of its responsibilities, though it claims that tobacco should be regulated but in a market-oriented framework, which strikes an optimal balance between the need to attract investment and the need to ensure healthy work force. Fear is that youths are lured into early death from cardio vascular disease (CVD), lung cancer and other tobacco-related diseases.

Inadvertently, heart disease is on the rise throughout the world and it is envisaged to be the leading cause of death especially in the developing world. Experts foresee great toll of the disease in Nigeria and Africa.