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OPINION

Achieving Success In Tobacco Control

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The battle between tobacco companies and their allies on one hand and anti-tobacco groups on the other has been long and drawn-out worldwide. Tobacco is unique; it is the only product which kills up to half of all lifetime users. According to the World Health Organisation (WHO), the tobacco epidemic is one of the biggest public health threats which kills more than 7 million people each year. It is estimated that by 2030, the number of tobacco-related deaths will increase to 8 million each year (WHO Report on the Global Tobacco Epidemic, 2017). 80% of these deaths will be in low and middle-income countries (including Nigeria), where the burden of tobacco-related death and disease is the heaviest.

   With Nigeria’s signature and ratification of the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC) in 2004 and 2005 respectively, the Nigerian government demonstrated its intention to join several other countries in a bid to protect the public health of its citizens.  WHO developed the FCTC; the first treaty negotiated under the auspices of the World Health Organization in response to the globalization of the tobacco epidemic. The treaty came into force on 27 February 2005 and has now been signed by over 180 countries.

Signing the Convention was only the beginning of a very long and challenging journey. The FCTC had to be domesticated in the form of a National Law for it to be operational. This attempt took 10 years and culminated in the National Tobacco Control (NTC) Act, 2015. It is worth stating that the NTC Bill was signed into law by former President Goodluck Jonathan, two days before he left office. The Act contains some important provisions which include ban of smoking in public places, ban of tobacco advertising, promotion and sponsorship, ban of sale of cigarettes in single sticks, implementation of graphic health warnings on all tobacco products, amongst other live-saving provisions. The passage of the Act was an important victory for tobacco control because the NTC Bill was signed despite a considerable amount of pressure, lobbying and threats by tobacco companies and their front groups.

With the NTC Act in place, tobacco control advocates had to devise a new strategy on how to ensure that the Act is effectively implemented, and that leadership is provided by the Federal Ministry of Health, the key agency responsible for its application and enforcement. Providing leadership is critical to ensure that the Act does not end up on the shelves of government offices like many other legislations in Nigeria. What has become clearer to many advocates is that implementation of the Act will not be a “walk in the park”. Since the enactment of the Act, more tobacco companies have opened shop in Nigeria.

For example, Philip Morris International opened its office in Lagos in 2014. The battle line has been drawn in the fight to protect and save the lungs of millions of Nigerian citizens, especially the younger generations. With the dangerous mix of a fast-growing population (approximately 60% are below 30 years) and the current epidemic of substance abuse by the youth in Nigeria, government at all levels and civil society groups have their work cut out.

Nigeria is unique in many ways; being the most populated black nation in the world, the country with the highest GDP in Africa and the country with the largest number of vulnerable people living in extreme poverty. Africa has been described as “the new playground” for tobacco companies who continue to increase their presence on the continent because of its huge potential market for their current and emerging products. New technology tobacco products like Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS) are currently being aggressively marketed by tobacco companies as “safer alternatives”, and being promoted as “acceptable” options.

A report by the WHO on Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS) in 2016 clearly states that evidence regarding the effectiveness of ENDS/ENNDS as a smoking cessation aid is scant and of low certainty, making it difficult to draw any credible conclusions. The report also highlights the engagement of tobacco transnational companies (TTCs) in the marketing of ENDS/ENNDS as “a major threat to tobacco control”.

Apart from marketing these new products to African governments, tobacco companies use several tactics to intimidate governments across the continent. Some of these are bullying, threats of lawsuits and actual lawsuits like in the case of Kenya where tobacco companies, through several law suits, have delayed the implementation of the TC Act for over 10 years.

Furthermore, a Guardian UK investigation in 2017 revealed that global multinational tobacco companies have threatened at least 8  African countries to dilute or completely remove from their legislations, important FCTC-recommended provisions (such as ban of smoking in public places, ban of tobacco advertising, promotion and sponsorship, ban of sales to and by minors) that have saved millions of lives in Western countries. This begs the question: Are lives in African countries worth less than those in the West for Tobacco Companies? A Reuters investigation in 2017 titled “Inside Philip Morris’s campaign to subvert global anti-smoking Treaty” reveals how the company is deploying its vast resources to subvert international efforts to reduce tobacco use.

Nigeria cannot afford a tobacco-induced epidemic. Not when the country faces annual deficits in its health budget and experiences frequent health outbreaks while still trying to grapple with communicable diseases like malaria, HIV/AIDS and lower respiratory infections and, when in balance, there are more benefits for the country in effectively regulating tobacco use than allowing its deadly impact to affect the lives of the citizens. With the emerging problem of increasing deaths from non-communicable diseases (NCDs), government at all levels will be attempting to actualize the citizens’ rights to health by ensuring that they put in place effective mechanisms for the implementation of the NTC Act.

Tobacco remains the number one preventable cause of NCDs; it is also the only risk factor shared by all four main categories of NCDs. The increasing cases of cardiovascular diseases and various forms of cancers in Nigeria point to the urgent need for the public health of millions of our citizens to be protected through the implementation of proven tobacco control strategies all of which are contained in the NTC Act.

There is also the need for relevant government agencies (Consumer Protection Council, Nigeria Police Force, Nigeria Civil Defence Corps, Advertising Practitioners Council of Nigeria, etc.) under the leadership of the Federal Ministry of Health, to take up this national call to duty by ensuring that they effectively enforce all the provisions in the NTC Act.

Furthermore, on 11 March 2018, the Federal Government announced a new excise duty rate on tobacco products. The new rate is a combination of the existing ad-valorem base rate of 20% and specific rate of N1 per stick (N20 per pack of 20 sticks) in 2018, N2 per stick (N40 per pack of 20 sticks) in 2019 and N2.90k per stick (N58 per pack of 20 sticks) in 2020. This new rate took effect from 4 June 2018. For tobacco control advocates, this effort is commendable.  However, like the Minister of Finance, Mrs. Kemi Adeosun explained, Nigeria is lagging behind other African countries. Nigeria’s cumulative specific excise duty rate for tobacco at 23.2% of the price of the most sold brand, is lower than Algeria’s 38.14%, 36.52% in South Africa and 30% in the Gambia. Nigeria’s excise duty rate also falls short of WHO recommended rate of 70%.

According to the WHO, increasing the price of tobacco through higher taxes is the single most effective way to decrease consumption and encourage tobacco users to quit. The Nigerian Government has no other option but to ensure a very substantial increase in tobacco excise duty rate in 2020 when the current rate ends.

The upcoming Conference of Parties (COP) of the WHO FCTC offers Nigeria a unique opportunity to assess its tobacco control progress and learn how other countries have effectively implemented strong tobacco control laws and policies to protect the public health of their citizens. Effective implementation of the NTC Act will certainly accelerate Nigeria’s progress towards achieving multiple Sustainable Development Goals (SDGs).

–Mrs.Ochefu is a public health campaigner with Sub-Regional Responsibility for the Tobacco Control campaign in Africa



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