World No Smoking Day was marked on May 31. Uthman Abubakar takes a look at the habit, and shows that the global population of smokers is on the rise
For Ya'u Abdu, tobacco is an all-times and an all-moods consumable. When he is angry, he consoles himself with a stick of cigarette; when he is happy, he lights one. When he is hungry, he sustains himself with a stick; when he takes a meal, he tops it up with one. When he rises from bed in the morning, he starts the day with a stick; when he retires to bed at night, he ends the day with one.
He wouldn't want to be described as a chain smoker, but he is a compulsive one - most times he lights a stick after an average of every twenty minutes, or thirty minutes, sometimes. He rarely breathes for an hour at a stretch without a stick between the fingers or between the lips at the left end of his mouth, when he is working on a pair of shoes or sandals.
He seems happily married to his beloved, call it affordable, brand of cigarette - Aspen King size, although he sometimes takes London King Size. He takes Rothmans King Size and Benson and Hedges King Size when he is offered by persons who can afford them.
Ya'u Shushana is a cobbler at Suleja in Niger State. He smokes his cigarette as much as he wants, or as much as he can afford. How it erodes his health and his meager earnings seems entirely the business of whoever pities him over that. For him, it is a part of life, it seems, not a part of death. With a stick of cigarette, he gets moving.
Ya'u is among an estimated regular tobacco smoking population of 1.3 billion worldwide. According to World Health Organisation (WHO) studies, tobacco is the second major cause of mortality in the world, with half of its regular smoking population - 650 million, liable to dying of smoking it eventually. It is feared that if current smoking patterns continue, tobacco will kill some 10 million worldwide each year by 2020, with 70% of these deaths occurring in the developing countries. Now, one in every 10 adults worldwide is killed by tobacco, adding up to an estimated 5 million every year.
Secondary, passive or second-hand smoking is equally dangerous. Hundreds of thousands of people, who have never smoked tobacco, die each year as a result of illnesses related to inhalation of other people's tobacco smoke. Half of all children worldwide are exposed to tobacco smoke, particularly in the home. According to estimates, at least 200,000 workers die each year worldwide from secondary smoke exposure at their respective workplaces. A person is a secondary, passive or second-hand smoker of tobacco if he does not smoke it directly, but inhales the smoke puffed out or exhaled by its direct smoker - primary, active or first-hand smoker.
Most tobacco smokers worldwide begin the habit in expression of juvenile delinquency, adolescent come-of-ageness or status symbol, peer group influence or emulation of smoker-parents and elder relations and close associates.
Tobacco-inflicted ailments
According to studies, tobacco is responsible for more than 25 diseases in humans. These include pulmonary diseases, cardiovascular diseases, high blood pressure, impotence, wrinkling of skin, mouth disease, respiratory infections and ulcer. Rise in cigarette smoking by parents may also elucidate asthma epidemic in children. A recent study shows that cigarette smoking inflicts head and neck cancer more than boozing.
No other consumer product, it is believed, is as dangerous, or kills as many people, as tobacco. Smoking increases the risk of erectile dysfunction because blood flow into the penis is blocked by atherosclerosis. Smoking causes abnormal sperm shape, impaired sperm motility damage, reduced number of sperms and reduced volume of ejaculate. Tobacco smokers are also less productive while they are alive due to increased sickness. A 1994 report estimated that the use of tobacco resulted in an annual global net loss of $200 billion, a third of this loss being in developing countries.
Smokers risk damage to almost all major organs in their bodies. The list of diseases caused by tobacco now includes cancers of the kidneys, stomach, cervix, and pancreas, as well as leukemia, cataracts, pneumonia, and gum disease. These illnesses are in addition to diseases previously known to be caused by smoking- bladder, esophageal, laryngeal, lung, oral, and throat cancers, chronic lung diseases, coronary heart and cardiovascular diseases, and sudden infant death syndrome.
The situation is profoundly pathetic with pregnant women who smoke. The developing embryo - and later the newborn infant - encounters many risks from faults in its genes, following the mother's cigarette smoking. The infant loses weight.
Smoking also reduces overall health, contributing to conditions such as hip fractures, complications from diabetes, increased wound infections following surgery, and various reproductive problems. Smoking cigarettes with lower machine-measured yields of tar and nicotine does not help. "There is no safe cigarette, whether it is called 'light,' 'ultra-light,' or any other name," U.S. Surgeon General Dr. Richard Carmona once commented. "The science is clear: the only way to avoid the health hazards of smoking is to quit completely or to never start smoking," according to Health and Human Services.
A clear scientific consensus grounded in many studies holds that exposure to tobacco smoke causes serious and deadly illnesses among adults and children. Tobacco smoke contains more than 4000 known chemicals, of which more than 50 are carcinogens. Second-hand smoke also causes severe forms of heart disease and many respiratory and cardiovascular illnesses, most of them deadly.
Exposure to second-hand smoke also carries economic costs for individuals, companies and the society at large. These costs relate not only to direct and indirect payments for medical expenses, but also to loss of productivity.
The hazards of primary, active or first-hand smoking are known by all. Very dangerous now is the substantial persistent ignorance on the hazards of secondary, passive or second-hand smoking. WHO laments gravely: "The tobacco industry has constantly misled and misinformed the public on both health risks and dangers of passive smoking. It has continued its efforts to slow down the implementation of effective legislation aimed at protecting workers and the public from second-hand smoke."
May 21st 2003 was a historic day for global public health. At the 56th World Health Assembly, WHO's 192 Member States unanimously adopted the world's first public health treaty, the WHO Framework Convention on Tobacco Control. Negotiated under the auspices of WHO, this new treaty is the first legal instrument designed to reduce tobacco-related deaths and disease around the world. Now the key is for countries to sign and ratify the convention as quickly as possible. Since then, No Smoking Day is celebrated the world over on May 31 of every year. The 2007 World No Smoking Day was celebrated last Thursday, May 31.
The treaty became the world's first international public health treaty when it came into force on February 27, 2005. It has been signed by 168 countries and is legally binding in 147 ratifying countries representing over 2.3 billion people. Notable non-parties (currently at 48) are Russia and the United States of America.
The treaty is sponsored by the World Health Organization's Tobacco Free Initiative, an organization dedicated to reducing the health effects of tobacco use. The Tobacco Free Initiative is part of the WHO Noncommunicable Disease and Mental Health Division based in Geneva, Switzerland.
The purpose of the treaty is to set broad limits on the production, sale, distribution, advertisement, taxation, and government policies towards tobacco.
The tobacco industry has sought to limit the influence of this treaty, but with limited success. Most nations worldwide are finding that ever larger numbers of their citizens are getting ill and dying of lung cancer, emphysema, and heart disease sequel to the rise in tobacco smoking. Since national health systems in many nations pay for treatment of these diseases, there is a strong financial incentive for governments to control spending on health and thus discourage tobacco use.
The Nigerian situation
Like most modern societies, in Nigeria, cigarette smoking is more or less perceived by young people as a glamorous thing. A survey conducted by the United States Centre for Disease Control in recent years in Cross River State in Nigeria, found that as many as 45% of the young people surveyed think boys who smoke and 28% think girls who smoke have more friends. Again, 17% think boys who smoke and 16% think girls who smoke, look more attractive. Therefore, as many as 22% of the sample population currently use tobacco with as many as 20% of those who had never smoked likely to start smoking in the following year. A different study found fewer smokers (only 4.4%). According to the survey, kids smoke in the street, and the situation is seen as something that concerns the individual's family rather than one for the police or social workers. These people probably have their hands a bit too full to care, and it is not seen as their role to find a solution.
Smoking is seen as attractive probably because of the way it is presented in Nigeria. Young people see their role models-film stars, musicians, and celebrities-smoking or portraying smoking as something glamorous. Many also see it as a status symbol, a way of telling your peers and contemporaries that you have come of age. In Nigeria there is no age restriction on buying cigarettes. People sell anything to anybody without batting an eyelid. Most adults prefer to send children to buy cigarettes and alcohol for them. There are effectively no laws in this regard.
"I started smoking when I was 13," Ya'u Shushaina, 45, obliged, explaining, "I started with Flight, Target and SM (Sweet Menthol). I started in Kano when I was accompanying my elder relations and friends to Sheila (WAPA), Plaza or Queens Cinemas whenever my uncle took me to Kano. Those were the good old days. Whenever we were watching the film, we would do whatever we liked, like spoilt children."
According to the cobbler, "I started by smoking the leftover, the butt thrown away or about to be crushed by the older members of our cinema-going group. The first time I took it, I was severely dizzy, and it knocked me off, and I fell. My elders laughed at me and I felt ashamed. Since that day, I learnt to withstand the force of the smoke. Shortly after, since we were not working to earn money, we learnt to dupe our aunties. Whenever they sent us to buy food items or soup ingredients at the market or at Kofar Mazugal abattoir, we would always find a way of reducing the money to collect enough for the daily package of a cinema ticket, sticks of cigarette and a bottle of soft drink, including a wrap of biscuits, if we could still afford it after buying the first three."
Ya'u said to this day, he had smoked no fewer than 15 brands of cigarette. He said since he started smoking in the mid seventies, he did not do it for only two years at a stretch in the early eighties, when he ailed severely, and his father threatened that if he did not stop smoking, he would hands-off him on any treatment.
"I know it is injurious to my health. Every smoker knows that, of course. But, like most smokers, I find it difficult to conduct my daily life without it. We know it brings death slowly, but cigarette aggravates your ailing situation when you don't feed well. Death comes when it will. Because it is already in our blood, we believe it gives us life, we believe it moves us in all our daily activities. But I don't mean to tell you that I don't hope to stop smoking one day. I pray to stop it before I die," he offered. According to studies, there are several millions of tobacco smokers in Nigeria. The exact figure has not been determined yet.
The smoking prevalence in the general population in Nigeria is high, judging by a 1990 survey of 1270 adults which showed that as many as 24% of men and 7% of women smoke cigarettes on a daily basis. The adult population reportedly increased its consumption by as much as 32% from what it was in 1970. Another survey, this time in 1998, suggests that there may have been a decline (15% of men and 2% of women), the possibility of the actual current prevalence being higher, cannot be ruled out.
This situation is largely because many cigarettes consumed in Nigeria today are smuggled into the country ,and the fact that a lot of adults would not easily own up to indulging in the habit. The amount of smuggling is high to avoid the huge taxes and import duties on tobacco. Apart from the taxes and duties, traders also smuggle to avoid corrupt customs officials, who inflate the duties and charge their self decreed illegal duties and taxes. As to why adults do not easily own up, the fact remains that although the practice is widespread, tobacco smoking is still not socially acceptable here in Nigeria. Few ladies would own up for fear of scaring away prospective suitors. A good number of young people would even not own up, so as not to incur the wrath of their parents and guardians.
In 1990, during the military administration of President Ibrahim Badamasi Babangida, the then Minister of Health, the late Professor Olikoye Ransome Kuti, initiated a ban on smoking in public places and ensured the enactment of the Anti-Tobacco Decree of 1990. The decree bans smoking in public places and mandate tobacco manufacturers to put on the pack of their cigarettes a warning that smokers are likely to die young and tobacco smoking is injurious to your health. This caveat was also to be added at the end of adverts on radio and television, long before the voluntary withdrawal of such adverts by the manufacturers.
Dr. Mike E. Anibueze is the National Coordinator, Non-communicable Diseases Control Programme of the Federal Ministry of Health. "A 1991 statistic shows that about 4.14 million Nigerians were smoking, 11% of who were heavy smokers. Heavy smokers are those who smoke above 10 and above sticks a day. But I must say that the data should be much higher than that now. If you check the population growth rate and use it to extrapolate, you will see that it is incredible how many people should be smoking now. Even with the very aggressive adverts by the tobacco companies, you will see that much more people should be smoking in Nigeria now. We are currently trying to do a survey that will give us the accurate information on that."
According to the expert, "We also are aware that smoking is a major problem because smoking and tobacco use is a bridge factor for almost all non-communicable diseases - hypertension, heart diseases, asthma, tuberculosis, pregnancy-related diseases and all others."
Dr. Anibueze delved into the antecedents of laws on tobacco control in Nigeria. "The first major attempt by government to control tobacco smoking was in 1990, with that decree which was championed by Professor Ransom-Kuti at that time. It was banning smoking in public places. It also talked about advertising, that if you have to advertise, you must tell people that it kills, that it is injurious to health. That was the first attempt. Incidentally, the implementation of that Decree 20 was not efficient and effective. Therefore, there was need for government to protect its people. There was a bill tabled before the National Assembly by a member. It was passed by the House of Representatives, but the Senate did not pass it. Therefore, it was not law. What it tried to do was focus on adverts and smoking in public places."
"However," he went further, "it is important to inform you that we are very grateful to the Advertising Practitioners Council of Nigeria (APCON) because a resolution by them which prohibited their members from advertising any tobacco product, and it was from a negotiation with the ministry of health. That ban has been most effective, more effective than even our decree, because now you don't see any advert on tobacco anymore, you won't see anywhere. That was just by a resolution of APCON. Imagine when we now come with this bill which prohibits advert, promotion and sponsorship. We already have a draft of this bill which will be discussed next month at the stakeholders' level, multi-sectoral level. All line ministries - Trade, Commerce, Industries, Justice, Education, Customs, Police, Youth and Sports, Environment and Science and Technology."
Dr. Anibueze said to be represented at the discussion are also WHO and NGOs concerned with tobacco control as well as Journalists Against Tobacco. "We will look at this bill. If it is approved, we will send it to our top management in the ministry."
He gave the absence of a law dealing with it as the reason why tobacco smoking seems intractable in the Nigerian society. "No strong law. Now if this country comes out with a law that takes care of demand issues, supply issues, fiscal measures, the sales and consumption will be effectively addressed. If you increase the cost of cigarette by 10%, you will reduce smoking by about 4%. These are some of the fiscal measures we must adopt, and also check illicit trade, because with illicit trade when they bring it across the border without paying tax, they can sell it very cheap, which encourages people to smoke."
The bill also spells out penalties. "If you sell cigarette to someone below 18 years you can go to jail or pay a fine. Smoking in all public places, all government buildings, workplaces, stadia, cinema halls, theatres and markets are all captured in the bill."
The legislation covers tobacco farming. "Government should inform tobacco farmers on the effect of tobacco and get them to change. If you address the tobacco farmers, if you get them to change, the factories will not see it to buy. They are an important part of our control measures, so they should be addressed. To address them, we are going to work with the Ministry of Agriculture to teach them how to be farmers of some thing else, and they are going to be happy because with the tobacco companies, such farmers are the most impoverished among farmers in the world. The companies provide them everything to grow the product and at harvest they deduct all such facilities cost, leaving the farmers with a pittance."
He said government would seek the help of religious leaders to preach to people against smoking. "They have a big role to play, because all our religions - Christianity, Islam, prohibit taking anything that kills. They all preach against you taking something that will kill you."
Dr. Anibueze revealed: "Because smoking is an addiction, it is not very easy to stop. It is easier to prevent people from going into it. For those who are inside, we must provide a away for them to come out. We have, therefore, planned to set up cessation clinics all over the country. For any medical check you come for, the doctor will ask if you smoke. If you say you do, he will counsel you like people are being counseled on HIV/AIDS. There are treatments now available, not in this country though, but abroad, but we are trying to negotiate with some of our partners to see how they can send in these drugs which contain a different make of nicotine which is not injurious to health. With this drug, you fade down consumption of cigarette until you leave it. Nicotine is the greatest addictive substance known to man."
Already, some state governments in Nigeria, most prominently Lagos, Kano and Gombe have sued the tobacco industry to court over the effect of the ever billowing smoke to the health of their peoples, demanding compensations amounting to billions of naira for environmental pollution.
Mallam Ahmad Muhammad is learned in Islamic jurisprudence. "Tobacco smoking is prohibited in Islam. Anything that will in the near or distant future be injurious to your health is prohibited. It is also prohibited because it has no nutritional value for the human body. It has nothing for your body. If you buy that thing that is not important to your body at all and you burn it, then you are being extravagant. Extravagance in Islam is prohibited. So, if you consider the disease it inflicts in you and the extravagance, wasting money on something that does not benefit you and instead injure you, you will arrive at the conclusion that tobacco smoking is directly a prohibited act."
As government at various levels admits lack of any legislation banning tobacco smoking and makes systematic efforts to tackle the injurious habit, the population of tobacco smokers in the Nigerian society, as is generally the case globally, is on the rise. The smoke billows thicker and higher.
Source : allafrica.com
