It is an established fact that tobacco consumption is a major cause of death worldwide. Unlike HIV/AIDS, malaria, and tuberculosis that are caused by microorganisms, tobacco - related diseases are man-made.
The Vector (tobacco industry, causing the tobacco epidemic) produces agents (tobacco products) that cause immediate pleasurable effects to the host (humans) followed by short and long term devastating health consequences. Some of the tobacco-related diseases include lung cancer and some other cancers, chronic obstructive pulmonary disease (chronic bronchitis and emphysema), stroke, ischaemic heart disease, impotence to mention a few.
Globally, tobacco causes about 5.4 million deaths yearly compared to 3 million, 2 million and 1 million deaths caused by AIDS, tuberculosis and malaria respectively. Thus, tobacco causes almost the same number of deaths as malaria, tuberculosis and AIDS combined.
Ironically, the global funding of tobacco control, according to WHO, is below $400 million compared to $18 billion for AIDS, $2.5 billion for tuberculosis and around $2 billion for malaria. As a result, while there has been a gradual decrease in the incidence of AIDS, tuberculosis and malaria, tobacco-related deaths have been on a sharp increase.
The WHO FCTC (Framework Convention on Tobacco Control) is a treaty with an overall objective of protecting present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke; and to reduce continually and substantially the prevalence of tobacco use and exposure to tobacco smoke.
The domestication of the WHO FCTC by most developed countries to protect their citizens from the harmful effects of tobacco, has translated to marked reduction in tobacco consumption in these countries. The effect of which is the migration of tobacco companies to developing countries where there is no effective legislation to curb their activities.
The components of the FCTC include; taxation on tobacco products that is continuously adjusted to the annual inflation rate, smoke-free public places, health warnings on tobacco products-to include pictures or pictograms on cigarette packages, ban on advertisement, promotion or sponsorships by tobacco companies, regulation of tobacco products, tobacco products disclosures e.t.c.
About 168 countries including Nigeria are signatories or parties to the FCTC. While Nigeria is yet to fully domesticate the FCTC, South Africa, a fellow African country has one of the most comprehensive tobacco control policies in the world.
The Nigeria National Tobacco Control Bill which is one of the efforts geared towards the domestication of the FCTC in Nigeria will soon be presented to the House plenary session by the Senate Committee on health.
The tobacco industry is the major challenge to the FCTC implementation. The industry comes up with different tactics to frustrate the passage of a bill such as this. One of their strategies is to come up with erroneous arguments either directly or indirectly by lobbying legislators, scientists and even journalists to counter the passage of the anti-smoking bill.
Several evidence-based researches have been conducted to nullify some of the arguments of the tobacco industry. One of such is a research conducted by Tei-Wei Hu et al, on the role of taxation in tobacco control and its potential economic impact in China. The result clearly states that increasing the tobacco tax in China is the most cost-effective instrument for tobacco control. He established that a tax of $0.13 per pack of cigarettes would decrease cigarette consumption by 3 billion packs of cigarettes, reduce number of smokers by 3.42 million, save 1.14 million lives and increase the Chinese government revenue by $17.2 billion. The effect of increased tobacco taxation on employment was minimal.
Similarly, studies in the USA, UK and Indonesia, using their national input/output industry tables, showed that a cigarette tax increase led to gain in income and employment in other sectors, greater than the loss in the true tobacco sector.
Increased tobacco taxation also leads to an increase in government revenue which can in turn be used in sponsoring tobacco control programs in form of dedicated tobacco tax. The effect of this is a reduction in the smoking population and an overall improvement in the health of Nigerians. However, concrete steps should be taken by the government to continuously adjust tobacco taxation to the annual inflation rate and to guide against illicit tobacco trade (smuggling), which can neutralize the tobacco control measure of a tax increase.
Revenue derived from tobacco taxation can also be used to provide alternative employment for tobacco farmers, who are already exposed to a lot of occupational hazards like Green tobacco sickness. Crop diversification is the best alternative for these tobacco farmers. Government can assist them in cultivating food crops that will boost food production in the country, alleviate poverty, and provide more income for the farmers. This generates more revenue for the government and it is more economically productive when compared to tobacco farming with its attendants direct and indirect health costs.
Another component of the FCTC is the enforcement of smoke-free public places. This is yet another measure that has been proven to help reduce the smoking population. This policy helps protect non-smokers including pregnant women and children from the harmful effects of passive smoking (second hand smoking). It also helps to "denormalise" tobacco smoking, which some of our youths see as the norm. Similarly, it reduces the number of cigarettes smoked per smoker, since there would be fewer smoking areas.
The implementation and enforcement of the Nigerian National Tobacco Control Bill is the best thing the National Assembly can do to improve the health of Nigerians in this century. The passage of this bill is just the beginning of the struggle to save Nigerians from the harmful effects of tobacco, because the tobacco industry will fight back in diverse ways. Adequate measures should be put in place for monitoring, evaluation and surveillance, for effective coordination of the various components of the bill and the actualization of the intended objectives.
Furthermore, government will need to collaborate with tobacco control programs and other Non-governmental Organisations in the implementation of certain components of the FCTC such as in educating the masses and creating awareness about the harmful effects of tobacco; provision of smoking cessation clinics for those that want to quit smoking and also sponsorship of research work on tobacco control particularly in the areas of monitoring and evaluation. In addition, achieving a great impact in the area of tobacco control in Nigeria requires an effective and efficient coordination of all tobacco control activities.
Tobacco consumption and exposure to tobacco smoke (passive smoking) can cause premature deaths. All stakeholders should support the implementation and enforcement of this bill to help prevent our youths from starting a health-damaging behavior; help current smokers quit; protect non-smokers including children and workers at bars and restaurants from the harmful effects of second hand smoking; generally improve the health of Nigerians and prevent millions of deaths globally.
