Tobacco . . .Fresh Challenges Before Healthcare Givers

Source from:  By Damilola Oyedele, 01.21.2008 01/23/2008

Sheriff Ali (not real names) gained admission into one of the nation's universities at the age of 16 to study civil engineering. He attended the campus party to usher in the new students popularly called the jambites. His friends invited him to smoke so as to look hip. He accepted and thus started a 14 year old addiction to cigarettes. "I did not realise I was addicted, until I tried to kick the habit and I realised I could not," he told THISDAY. "Now I wish I had never started. I have tried to stop smoking so many times but I always go back. My lips are now black, my clothes smell, and I have lost promising relationships to this habit. The lady I was in love with, told me she didn't want to become a widow at an early age, and left me." John Nwankwo (not real names) told THISDAY, he picked up the habit at the age of 19 in Enugu in 1990, out of curiosity. What is puzzling is John (now married with a beautiful daughter) admits he knows the habit is dangerous and that he is addicted, but he has never tried to stop, said he intends to control it. He philosophically justifies his stance "something has to kill somebody, some people die in their sleep; some are knocked down by cars." But he agrees that it would break his heart to see his daughter smoke. "My wife married me that way, so even though she doesn't like it, she has learnt to accept it," he said. It used to be a sign of irresponsibility to smoke, but among the young ones, it is now considered hip and fashionable. In the south west, it is still considered irresponsible and children hide it from their parents. In the North east, children start to smoke as early as 10 years of age and by time age 16, they have graduated onto harder stuff. According to available statistics, 18.8 per cent of ever smoked a cigarette (male- 20.4 per cent, female 13.7per cent), 22.1 per cent currently use a tobacco product (male- 23.9 per cent female-17.0 per cent), and 9.1 per cent currently smoke cigarettes (male-9.7 per cent, female 5.7 per cent. A recent survey by the Federal Ministry of Health put the smoking rate among Nigerians above 15 years at 17.1 per cent. In 1994, the smoking rate among youths was 4.4 per cent, but by 2001, the smoking rate among youths between 13 and 15 years had jumped to an alarming 18.1 per cent. The physical features of an average smoker are a wrinkled face, blackened teeth, lips and hands. Heavy smokers tend to eat less and careless about their looks. The direct and indirect economic cost of tobacco use in Nigeria is about N12 billion annually. In 2006, Lagos State alone had over 9,527 tobacco related cases and in a survey run by the Lagos State Government, two persons die each day to tobacco related diseases. The state government estimated that it spends about N216, 000 on each case of tobacco, while the individual involved spends about N70, 000. A cigarette contains about 2000 chemicals including tar and nicotine and over 40 of these chemicals are carcinogenic, which means they cause cancer. Nicotine is the most addictive substance on earth and it is a deliberate additive by the tobacco companies to create a lifelong habit; it reaches the brain within eleven seconds of inhalation. Studies have shown that the non inclusion of nicotine does not take away or add to the taste of the product. Tobacco has no proven benefit to man and it is the only consumable whose use is intended to harm the user. Most users of tobacco believe it helps them deal with stress or manage their weight, but studies have shown that these are physiological and behavioural reactions to the product. Advocates of a smoke free society may wave a lot statistics at the society, but the reality remains that tobacco related disease would kill 50 per cent of users in their lifetime, especially in developing countries like Nigeria. Developing countries are easy prey for the multimillion dollar tobacco companies for several reasons which include that their home countries are becoming in conducive for their business because of the stringent measures that are being taken to curb smoking, and reduce diseases related to it, monumental litigation costs and more research that has linked tobacco to more diseases. Secondly, developing countries seek foreign investors to invest in their local economy and help develop their economy. But how do granting investment rights to tobacco companies help develop the economy when their products cause more havoc than good to the society? Tobacco destroys a nation's manpower and environment through curing of tobacco leaves and ruins social relationships. Children who pick tobacco leaves have been known to experience Green Tobacco sickness which is a form of nicotine poisoning characterised by nausea, dizziness, difficulty in breathing and fluctuations in blood pressure and heart rates. Tobacco companies see Nigeria as a 'huge market to conquer 'because it is home to over 140 million people and operates weak and ineffective tobacco laws which include a parsimonious fine of N200 for smoking in public places. The big question is: "Is Nigeria endorsing this silent killer?" On September 24, 2001, the Olusegun Obasanjo Administration signed a Memorandum of Understanding (MoU) with British American Tobacco which granted approval for CAT to build a modern cigarette plant in Ibadan, Oyo State and granted BAT 'special duty concessions' on its operations in Nigeria. Philip Morris Tobacco Company (now known as Altria) completely took over International Tobacco Company in Ilorin, trades as Orion Agric Limited and reintroduced two of its brands; Marlboro and Bond, into the market. According to statistics, British American Tobacco (BAT) is in control of over 75 per cent of Nigerian cigarette market. In June 2003, it commissioned its $150million modern cigarette manufacturing plant in Ibadan, Oyo State and also upgraded its Zaria factory with a $1million new GDXI machine capable of producing 7,200 sticks a minute. The mode being used to veil the Nigerian public and to exert some influence on the government is the intensity of corporate social responsibility being carried out by tobacco companies. In 2004, BAT donated three Toyota Hilux SUV's to the Nigerian Customs Service and another three to the Standard Organisation of Nigeria (SON). It embarked on an intensive anti-smuggling and 'Proudly Nigerian' campaign. The BAT Foundation was created to give scholarship grants to the less privileged, and a partnership was reached with the Nigerian Red Cross. It supports Nigerian fashion shows and holds elaborate annual farmers day. An MOU was signed with Nigerian Media Merit Award for sponsorship and an endowment of the industry reporter of the year award. Since the tobacco companies believe so much in CSR, how about picking the bills of lung cancer patients and victims of other tobacco related diseases. This is not likely to occur anytime soon because it would be an admission of the liability of their products. At a recent training organised by Environmental Rights Action/Friends of the Earth, for journalists in Abuja, tobacco control advocates lamented that getting media coverage for tobacco control is difficult because it is not as popular as AIDS or malaria campaign. Again the media companies want a part of the huge advert budget of the tobacco companies. The filing of an N130b suit against Phillip Morris for selling cigarettes to the under aged, by the Nigerian Government is commendable, but there is a need to be more proactive in the fight against tobacco by putting stringent laws in place. The label '...tobacco smoking is dangerous to health' would be questioned by any school child who would wonder why it is being sold if it is truly dangerous. Experts also say Nigerian government should mandate tobacco companies to channel some of the huge profits being declared annually into defraying the medical expenses of those diseased as a result of consuming their products. Mounting billboards at strategic locations and selling cigarettes by the stick should be disallowed. Studies have shown that passive smoking or second hand smoke is almost as dangerous as the act itself, as there have been cases of people who have never smoked in their lives ending up with lung cancer with accompanied blackened lungs. So it is up to individuals to help their loved ones kick the habit. Smokers experience a significant change in their lives almost immediately they stop, but it needs a lot of determination and persistence. Need help to quit smoking? Smokers are advised to see a doctor. It is being estimated that by the year 2020, tobacco use would kill 10 million people worldwide; It is time for Nigeria to rise up and save the generation yet unborn. As the WHO puts it "...if we do not act decisively today, a hundred years from now, our grandchildren and their children will look back and seriously question how a people claiming to be committed to public health and social justice allowed the tobacco epidemic to unfold unchecked" Enditem