The Ghanaian Journal

On the global burden of disease ranking, tobacco-related diseases are identified as the most preventable cause of death. An estimated 4.9 million lives, both young and old, are lost through tobacco-related diseases annually.

Furthermore, about 500 million people who are alive today would die of tobacco-related diseases while approximately half of these would taste death before their 65th birthday, irrespective of the fact that life span has increased dramatically across the length and breadth of the globe.

Projections indicate that if the current trend continues, by the year 2020, tobacco-related diseases would claim more lives than any single disease, including HIV/AIDS, violence, road accident, malnutrition, and war.

Today, one third of the world’s population aged 15 and above uses tobacco. Currently, there are over 1.2 billion tobacco users in the world.

It is worrying that of these, well over 800 million are living in developing countries.

Out of the total burden of tobacco-related diseases globally, 70 per cent will occur in developing countries by 2030. The figure is presently about 50 per cent.

Tobacco consumption has fallen over the past 20 years in most high-income countries such as the United States, Australia, Britain, Canada, Finland and most European countries. On the contrary, tobacco use has risen to unprecedented levels in low-income countries, especially in Asia and Africa.

Thus, Africa and Asia are the current target of the tobacco industry.

In the pursuit of this agenda, the industry has employed various strategies and tactics including cigarette smuggling, recruiting of new and young smokers, denying the health consequences of smoking, manipulating governments to delay tobacco control legislations and the sponsoring of health professionals and academic institutions to act in their favour.

The tobacco manufacturers have been reported to be involved in organising smuggling of tobacco products in many developing countries.

This is aimed at making tobacco cheap and available on the market in order to outweigh governments’ efforts at controlling tobacco supply and consumption through increased taxation.

The harmful effects of tobacco have been well established scores of decades ago, yet the tobacco industry still denies the health consequences of their products.

Tobacco advertising, promotion and sponsorship pose another great challenge to the fight against tobacco control in developing countries.

Tobacco advertising also influences adolescent smoking. It encourages non-smokers to initial smoking and existing smokers to increase consumption.

On the other hand, a ban on advertising, promotion and sponsorship of tobacco products reduces its consumption.

Studies have shown that smokers who noticed less tobacco advertising and promotion after the comprehensive ban of advertising in the UK were 1.5 times more likely to quit smoking.

Similarly, a comprehensive ban in Finland, France, Norway and New Zealand was reported to have reduced the per capita consumption of cigarettes by 14-37 per cent.

The WHO estimates that the ban of tobacco advertising and promotion could reduce worldwide demand for tobacco products by seven per cent.

Such policies would contribute immensely to the effort of fighting against the menace in developing countries especially sub-Saharan Africa where the epidemic has already started.

Therefore a ban on advertising, promotion and sponsorship of tobacco products is a powerful tool in tobacco control.

Aware of this, the tobacco industry is fiercely confronting directly and indirectly tobacco legislations, a measure which is one sure way of controlling the epidemic in the world, irrespective of the well established health and economic benefits of such restrictions and the support of civil society for such actions.

Indeed, many nations (including most developing countries) have embraced the Framework Convention on Tobacco Control (FCTC), the world’s first public health treaty, but there are more challenges in implementing the policies that will counteract the activities of the tobacco industry.

For instance, Benin was one of the many 178 states that signed the FCTC but has admitted that the nation lacks the power to interfere in the activities of the tobacco industry because of the jobs and revenue that the industry gives to the economy of that country.

One big key target of the tobacco industry is the youth. The aim is to get them while they are young so that they become lifetime addicts and consequently lifetime buyers.

To achieve this, lately, tobacco is being associated with things that attract the youth; sexy looking girls, slimness, basketballs; movie acting etc. purposely to lure the youth into smoking.

Recent studies conducted in Senegal and Indonesia indicate that most of the basketball courts in the cities in these countries are painted with the logos of cigarette brands.

In Guinea, there are the so-called ‘cigarette girls’ who are recruited and paid attractive salaries as marketing executives.

These girls promote and market cigarettes at nightclubs, in front of shops and in public places. Reports say that these girls virtually tour every corner of the country to promote and market this killer called tobacco.

In Ghana, tobacco consumption is relatively low. Besides, there have been some commendable efforts of tobacco control in Ghana in recent years.

Not until the beginning of the new millennium, there were a lot of huge billboards advertising one brand of tobacco product or another.

There were other tobacco promotional activities such as sponsoring of sporting activities, musical shows and beauty pageants.

The peak of these was the painting of the front views of the then two largest markets in Ghana, Kaneshie and Kejetia markets in Accra and Kumasi respectively, by the British American Tobacco company (BAT).

Today, such physical and open strategies are out of sight and contrary to these, there are “no smoking” signs at a few public places, even though there is no tobacco legislation in Ghana.

It is gratifying that today “no smoking” signs are visibly displayed on the main entrances of the Accra Mall —the largest one-stop shopping mall in the country.

Despite these efforts, there are a number of issues that still raise concern about tobacco control in Ghana.

The prime of this is the fact that, regardless of the outcry of the public, the draft tobacco bill presented to the cabinet since 2005 is yet to get to parliament for debate.

Also, occasionally there are flashes of what may be called indirect promotion of tobacco on some TV channels in Ghanaian movies, as was the case on Sunday August 10, 2008 in a popular Ghanaian movie.

In that movie there were scenes of young men smoking which portrayed smoking as urban lifestyle.

Also, on Sunday August 24, 2008, in a Ghanaian movie on the same TV channel, there were scenes of university girls smoking, thus misinforming the public to believe smoking is a “cool” campus life.

Both telecasts can be described as tobacco advertising, promotion and sponsorship as stated in Article 1 of the Framework Convention on Tobacco Control (FCTC) which defines tobacco advertising and promotion as “any form of commercial communication, recommendation or action with aim, effect or likely effect of promoting a tobacco product or tobacco use either directly or indirectly” and tobacco sponsorship as, “any form of contribution to an event, activity or individual with the aim, of effect or likely effect of promoting a tobacco product or tobacco use either directly or indirectly”.

Certainly, such scenarios on our television sets call for concern because the media has a significant role in the fight against tobacco use in this country, in Africa, and in the world at large.

While lauding the demonstration of the political will of many governments both in the developed and developing world in tobacco control through such things as the signing of the FCTC, it is equally incumbent on these nations, especially, those in the developing countries, to work out pragmatic and realistic modus operandi of dealing with the menace in a way that will yield significant and sustainable results.

The tobacco industry is seeing a bright market in the developing world, especially Africa.

It has not given up yet. Increase in tobacco taxation; ban on advertising, promotion and sponsorship; and a counter public education on the health consequences of tobacco use; checking tobacco smuggling and surveillance are some of the measures that can nullify the strategies and tactics of the tobacco industry and consequently help control the tobacco epidemic, particularly in developing countries and in the world at large.

By David Doku

• The writer is a Researcher and PhD Candidate at the University of Tampere, Finland