Nigeria: the health, economic and social menace of smoking – Time for concerted actions.

From available information, it appears as if the Federal Capital Territory remains the only part of Nigeria conscious of the harmful effects of smoking. The recent prohibition of smoking in public places remains a commendable step but actions are still necessary to combat the monster called smoking. The Third World is further impoverished by the harmful effects of smoking on the health of the populace. The undeveloped economies of these nations can also not cope with the surge on the insufficient health facilities occasioned by the myriad of health-related problems induced by smoking. While the recent efforts of the Nigerian government, especially in recent times, remain commendable as regards some appreciation of the menace of smoking, however, all hands must be on deck to counter the resurgent ability of the super-rich tobacco industry. The ability of the tobacco industry to stage a come back was buttressed by the statement credited to the Minister of the Federal Capital Territory, that as a reaction to the recent ban on public smoking in the FCT, tobacco companies made unsolicited overtures to his office. There is no doubt that more concerted efforts are needed on the parts of the Federal and State governments to ensure that Nigeria becomes a smoke-free country. This is a position devoid of religious or other parochial overtones. It is simply borne out of the need to create a healthy nation that can aggressively tackle its myriad of socio-economic problems.

 

Epidemiological and Health Implications of Smoking A habit, which at one time was considered fashionable and acceptable has been proven after many years of study and linkages with many ailments to be as deadly as the scorpion sting. Smoking is a universal problem, which though may have peculiar geographical approaches in terms of solutions, but yet remain one with universal determination in tackling. To date, no nation has ever admitted benefiting economically from smoking and hence the numerous efforts by nations in tackling this man-made monster. The United States Centre for Disease Control and Prevention describes tobacco use as “the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide”. To further reinforce this view, let us consider the following facts about smoking:
– About 93 million sticks of cigarette are produced yearly in the country and every one of those cigarettes is consumed here in Nigeria.
-  World Health Organisation (WHO) estimates that about 1.3 billion people in the world are currently smoking and most of them are in developing countries.
-  Tobacco kills close to five million people yearly worldwide with over 70 percent occurring in developing countries including Nigeria. It is the cause of death of 17.7 per cent of all deaths in developed countries.

– By 2020, the World Health Organisation (WHO) expects the worldwide death toll from smoking to reach 10 million.

 -  Tobacco is responsible for over 25 diseases in man, including hypertension,   heart attack, cancer and other conditions such as asthma, emphysema. It is also responsible for some pregnancy-related problems and other conditions such as tuberculosis, blindness, deafness and nutritional and psychological disorders.
 
– Tobacco kills 50 per cent of lifetime smokers and half of these deaths occur among people in their middle age (35-69years).
The extremely high tar content of the Nigerian tobacco was highlighted by the trio of Awotedu, Higenbottam and Onadeko in a study conducted in 1983 (J Epidemiology Community Health 1983; 37:218-20). It should be emphasised here that the dangers of smoking are directly proportional to the tar content of cigarettes. Tobacco smoke pollution has been classified as a known human carcinogen in the USA. Smoking harms nearly every organ of the body, causing many diseases and affecting the health of smokers in general. Smoking also harms people of all ages. For instance, toxic ingredients in cigarette smoke travel throughout the body, causing damages in several ways. Nicotine reaches the brain within 10 seconds after smoke is inhaled and it has been found in every part of the body, breast milk inclusive.
Smoking has been implicated in the following disease conditions or states:

Tooth Loss
Diabetes
Impotence
Stomach Ulcers
Ocular Histoplasmosis (Fungal Eye Infection)
Acute Necrotising Ulcerative Gingivitis (Gum Disease)
Hearing Loss
Osteoporosis
Duodenal Ulcer
Reduced Sperm Count
Dysmenorrhoea (Painful periods)
Early Menopause
Psoriasis
Colon polyps
Cataracts
Asthma
Reduced Fertility
Buerger’s Disease
Angina
Optic Neuropathy (Vision loss)
Premature wrinkling
Crohn’s Disease

This month (October 2008), Dr Julie Pasco of the University Of Australia, Melbourne published the outcome of a research that showed that smoking increases the risk of major depressive disorder by 93% in women who smoke, compared to those who do not smoke. The odds are said to more than double for those who smoke in excess of more than 20 cigarettes a day. Dr Pasco concluded: “It is becoming increasingly clear that smoking is not innocuous to mental health and may in fact aggravate mental illness or contribute to its onset”.

It is common practice for cigarette packets to carry warnings approved by health authorities but none ever lists the diseases caused by smoking. In appreciation of this significant deficiency, Reuters reported on Saturday 27 September, 2008 the efforts of the British authorities to further inform its populace on the dangers of smoking via warnings on packets. This report states as follows: “Gruesome pictures of rotting teeth and throat cancer tumours will appear on all tobacco products in Britain from next month as the government steps up its campaign to encourage the country’s 10 million smokers to quit. The images will be printed on the back of cigarette packs to illustrate written health warnings introduced in 2003, the Department of Health said on Saturday. The photos also include a flaccid cigarette to depict male impotence and a comparison of healthy and tar-filled lungs”. The concerns of the British authorities are justified considering that smoking is Britain’s single killer, causing the premature death each year of 87,000 people in England alone.

The introduction of photo warnings was a desperate action by concerned governments over a habit that refused to abate despite numerous interventions. Canada was the first country to put photo warnings on cigarettes in 2001. In Europe, Belgium and Romania followed suit but Britain will be the first in the European Union. Britain intends to put photo warnings not only on cigarette packs, but also hand-rolling tobaccos and cigars. Britain is taking this extra step despite the ban on smoking in enclosed places imposed in July 2007.

Another positive action to combat the menace of smoking was the recent effort by the leaders of one of the most populous nations on earth. On the 2nd of October 2008, India became the latest country to take measured actions at combating smoking. A ban on public smoking came into effect nation-wide. The law aimed at fighting tobacco use which has been responsible for a fifth of all deaths in the world’s third-largest consumer of tobacco. India has nearly 240 million of tobacco users (more than the entire population of Nigeria). A fine of £2.00 was also imposed on those caught breaking the fan. A token penalty may be, but significant nevertheless.