Wednesday, January 29, 2014

Action speaks louder...

If you ask a number of people who smoke i.e. teenagers and adults, it is amazing how many, out of ignorance think that there are no effects of smoking on their bodies until they reach middle age. However, the many serious & harmful effects of smoking occur much sooner than we think. In fact, smoking has numerous immediate health effects on the brain and on the respiratory, cardiovascular, gastrointestinal, immune and metabolic systems. While these immediate effects do not all produce noticeable symptoms, most begin to damage the body with the first cigarette sometimes irreversibly – and rapidly produce serious medical conditions and health consequences.

As recent studies show a marked increase in the global number of smokers with developing countries providing the bulk of these smokers, the time to ACT by putting in place comprehensive tobacco-use legislation is NOW!.

In this post, we would like to briefly review certain tobacco control policy acts in the 21st century, with focus on the impact of specific interventions on tobacco use in four countries.

On June 1, 2013, Russia banned smoking in public areas - airports and train stations, schools and hospitals, among other public spots. Tobacco ads were also vanished from streets and as such won’t be featured in Russian movies. It was reported that after this move, half of its citizens that smoked actually stopped and an estimated 200,000 deaths annually will be prevented owing to the new legislation being enforced.

Was the first nation to introduce a country-wide workplace smoking ban in March 2004 on smoking in enclosed workplaces. This new ban was built onto the 1988 sanctions against cigarette smoking in many public buildings and on transportation systems. Since then, other members of the European Union have followed Ireland's good example leading to strong anti-tobacco laws in place across Europe with proper enforcement taking place.

It was recorded in 2005 that the number of people with respiratory issues dropped by 17% with 80% of smokers saying that the ban encouraged them to quit smoking. New research on the effect of the 2004 legislation has found double-digit drops in heart disease and strokes rates.

Meanwhile in a radical move, further legislation banning smoking in private or commercial vehicles carrying children cars has been introduced. Arguing this is a human rights issue, the Children's Health Protection bill was enacted in January and came into force in July 2013.

While legislation to ban smoking was passed in 2003, the guidelines were not solidified until Oct. 2, 2008, which incidentally is the birthday of nonsmoker & global icon Mohandas Gandhi. At the time, India was home to 120 million smokers — 900,000 of whom were dying each year from tobacco-related illnesses — and earlier efforts to curb the habit had proved ineffective owing to inconsistent enforcement.

In 2007, strong advocacy campaigns by civil society groups was key in pushing for the implementation of the 2003 Cigarettes and Other Tobacco Products Act (COTPA) in Chandigarh. Working with the local administration, Chandigarh became India's first smoke-free city via active enforcement of existing laws so they are not just 'paper laws'.

Since then, over fifteen other cities like Chennai and including popular hill resort, Shimla have attained the smoke-free status. In July 2013, Himachal Pradesh became the first 'smoke-free' state in India. For the 2013-14 budget, the state has doubled taxes on tobacco products and imposed VAT as well to discourage sales.

Like the majority of the world, the U.S. does not have a nationwide smoking ban. However, local and state authorities legislate tobacco use in their domain. Therefore to protect minors, the tobacco-use age limit is set at 18years as the statistics show a higher percentage of citizens who smoke are between the ages of 18 to 24.

In 2013, New York City & Hawaii County introduced new measures raising the tobacco-use age to 21years. Legislatures in three other states Vermont, Maryland, Utah had introduced similar measure while these measures are also currently under consideration by lawmakers in Colorado, Texas, Hawaii, New Jersey, Oregon, New York and Washington, D.C.

Schools like George Washington University have further gone to earmark a ban on smoking within 25 ft. of all university-owned public spaces towards achieving a smoke-free zone.
The recent move by the lawmakers in Lagos state passing a law prohibiting smoking in public places in the state is commendable. As the nation's economic hub, leading the fight in such a critical matter of public health & safety is vital to sustaining the health of her working population. However, similar initiatives need to be brought to fruition across the other thirty-five states while enforcing these laws is essential for the attainment of a smoke-free Nigeria. This is because ACTION speaks louder than WORDS as this is the best medium to see concrete improvement in controlling the use of tobacco and its products in the country. 

Ongoing efforts in the National Assembly on tobacco control laws need to be consolidated with the proper laws passed at legislative & executive levels without delay. This is crucial to Nigeria's economic well-being and the health of all her citizens.

Join us in making this strong appeal for the National Assembly to pass this bill, follow us on twitter, add your voice by visiting our facebook page, like our post, drop your comments and share widely with others. Together we can make the change that we all desire.

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Tuesday, January 21, 2014

8million lives is no joke

Smoking has been one of the major issues that has occupied the minds of the medical profession for the past four decades. Until the 1960s, there was no clearly detailed understanding alerting the nations of the consequences of smoking on the lives of individuals, and its impact on society as a whole. This in return has transformed the issue from one of individual and consumer choice, to one of epidemiology, public health, and risk for smokers and non-smokers alike.

More than 8 million lives has been saved since the anti-smoking campaign started in 1964 in US, not counting the effect it has had in other countries. Now this is a huge number as it shows an average of 160 000 lives per year over the fifty years in review. This is in contrast to the number of smokers recorded nationwide in some countries especially Bangladesh, Russia, Indonesia and China helping increase the global population of people who smoke to close 1billion in 2012. Perhaps it could have been double this number if anti-smoking campaigns did not take place recording significant success stories in different continents across the globe.

According to a number of studies published in the Journal of the American Medical Association (JAMA), the anti-smoking measures implemented in the U.S. following the 1964 report from then-Surgeon General Luther Terry that outlined the deadly consequences of tobacco consumption, has managed to save nearly 8 million of lives and a total of 157 million years of life. Terry’s report, which called for stringent measures to curb smoking habits among people, had sparked a massive campaign aided by tax increases, smoking restrictions and bans in public places among other measures. 

It is encouraging to know that there has been a steady progress over the past century, as now, a 40-year-old man can expect on average to live 7.8 years longer than he would have in 1964, and 30 percent of that improvement can be attributed to tobacco control. The gains for women have been slightly less, 5.4 years, but tobacco control accounts for 29 percent of that benefit," stated Theodore R. Holford, the lead author of the study.

Although there were increases in number of cigarettes consumed and global number of smokers over the past five decades, the researchers noted that global smoking prevalence and the number of smokers in proportion to the total population has declined.

While these countries celebrate this achievement, it is disturbing to know that the number of people who smoke in developing countries like Nigeria and other low and middle-income countries has increased over time, offsetting the progress made in countries such as the U.S., Canada, Iceland and Mexico, where smoking prevalence has decreased by nearly 50 percent.
As the overall number of smokers worldwide is still rising, this study shows how important it is for all countries to implement a range of tobacco control measures to curb the terrible and yet deadly toll of tobacco-related illness and death.

Therefore we urge all Nigerians at home and abroad to support our cause and join us in making this strong appeal for both chambers of the National Assembly to pass comprehensive tobacco control legislation that is enforced across the country NOW that the President signs into law speedily!

JOIN US TODAY by following us on twitter, adding your voice by visiting our facebook page, like our post, drop your comments and share widely with others. 

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Wednesday, January 15, 2014

Letting the numbers speak

A look at the number of people who smoke globally showed from 1980 to 2012 a drop from 26 percent to 18.7 percent. This was part of the findings in a study recently conducted by the University of Washington who undertook a detailed analysis of the impact of the presence or lack of tobacco control legislation across 182 countries.

It is therefore astonishing that while there is a drop in global rate of smokers, the actual number of smokers worldwide alongside the sheer number of cigarettes consumed are at an all time high. In a study published in the Journal of the American Medical Association (JAMA), the number of cigarettes smoked globally from 1980 to 2012 has jumped from 5trillion to 6.25trillion, an increase of  about 25 percent. 

In 1980, the number of adults who smoked daily was 721million worldwide whereas in 2012, the number of adults who smoked daily was 967.3 million people with the average daily smoking habit per user staying at eighteen cigarettes over the period in view. This is owing largely to the significant increase in the number of smokers in developing countries despite remarkable reductions in smoking numbers from developed countries.

 Sourced from SeattleTimes

However, there are models to follow amongst the community of developing countries when it comes to achieving success stories concerning the use of tobacco and its products. Two of these are Mexico and Uruguay. For example, since 1980, the smoking rate in Mexico has fallen faster than in the US as they have a policy in place requiring graphic warning labels be displayed on all cigarette packages. The study shows a current 10% smoking level in Mexico which 5 percent less than that of the US and Canada for instance.

Uruguay was the first country to adopt certain elements of WHO's Framework Convention on Tobacco Control (FCTC). This saw the introduction of higher cigarette taxes and restrictions on advertising that has brought dramatic results witnessing a 25 percent drop in just three years of smoking rates across the country.

This means that Mexico and Uruguay for instance, can divert both personal and national funds that would been spent on any tobacco-related deaths to other areas of need. This is instructive as the healthcare costs associated with tobacco use are simply enormous. 440,000 deaths arise from smoking in the US with associated health costs about $193billion. This means an average of almost $440000 is spent per smoke-related death. A number developing countries surely, cannot afford.

This suggests that its a matter of urgency for countries like Nigeria to take appropriate steps NOW to mitigate the impact of smoking on the health of her citizens over the next fifty years as a smoking lifestyle affects not just the smoker but others around them. One of such interventions is the need for increased public awareness and campaigns targeted at getting smokers to understand & map their choices with health challenges for their friends and family.

However, the most critical step to begin to see us write our own success story on tobacco control must be the WILL to first enact correct legislation regarding the use of tobacco and its products that is thereafter, enforced properly at local, state & federal levels. 

Research has shown that the economic growth of any country is closely linked to healthy well-being of her citizens. This is not a myth and accepting that healthcare rights are fundamental must be a key priority of any government since allows us as a society to maximise the productivity lifespan of each citizen.

For tobacco use in Nigeria, it is evident beyond any doubt we CANNOT afford to stand on our hands and fail to act. That action begins with the National Assembly enacting the right legislation to protect and prevent the future generations of Nigerians so we can help make our country a SMOKE-FREE zone!

To join us in making this strong appeal for the National Assembly to pass this bill, follow us on twitter, add your voice by visiting our facebook page, like our post, drop your comments and share widely with others. 

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Wednesday, January 08, 2014

Fifty Years Ago: I have a dream

I have a dream

Fifty years ago, Dr. Martin Luther King's 'I have a dream' speech was beginning to precipitate a major culture change in the US. However, ashtrays littered everywhere and seemed to be on every table and desk. Athletes and even Fred Flintstone endorsed cigarettes in TV commercials. Smoke hung in the air in restaurants, offices and airplane cabins as more than 42 per cent of adults in the US smoked, with a good chance your doctor was among them. 

The turning point came on Jan. 11, 1964. It was on that Saturday morning that U.S. Surgeon General Luther Terry released an emphatic and authoritative report that said smoking causes illness and death — and the government should do something about it.

In the decades that followed, warning labels were put on cigarette packs, cigarette commercials were banned, taxes were raised and new restrictions were placed on where people could light up. “It was the beginning,” said Kenneth Warner, a University of Michigan public health professor who is a leading authority on smoking and health.

It was not the end though as while the U.S. smoking rate has fallen by more than half to 18 per cent, that still translates to more than 43 million smokers. Smoking is still far and away the leading preventable cause of death in the U.S and in other countries like Nigeria, the story is not different.

Nevertheless, the Terry report has been called one of the most important documents in U.S. public health history, and on its 50th anniversary, officials are not only rolling out new anti-smoking campaigns but reflecting on what the nation did right that day.

It is noteworthy to state that although cigarette consumption dropped a whopping 15 per cent over the next three months after the 1964 report was published but then, it began to rebound as health officials realized it would take more than one report.

Thus, from 1965 to 1971, a number of policy changes came in place including the requirement for cigarette packs to carry warning labels, free air time for anti-smoking public service announcements on tv & radio stations and banning of cigarette commercials.

Still, progress was slow as smoking was the norm and many found it difficult to quit despite the known hazards. In the 70s, a movement was born to protect nonsmokers from cigarette fumes, with no-smoking sections on airplanes, in restaurants and in other places introduced. Those would give way to complete smoking bans as cigarette machines disappeared, cigarette taxes rose, and restrictions on the sale of cigarettes to minors got tougher.

With tobacco companies also coming under increasing legal attack, the biggest case of them all saw more than 40 states bring lawsuits demanding compensation for the costs of treating smoking-related illnesses. Big Tobacco settled in 1998 by agreeing to pay about $200 billion and curtail marketing of cigarettes to youths. In 1998, while the settlement was being completed, tobacco executives appeared before Congress and publicly acknowledged for the first time that their products can cause lung cancer and be addictive.

Some key events in the US on the fight over tobacco during the last 50 years:

1964: U.S. surgeon general report concludes smoking causes lung cancer.
1965: Warning labels required on cigarette packs.
1971: TV and radio commercials for cigarettes banned.
1972: Airlines told to provide no-smoking sections.
1987: Aspen, Colo., becomes first U.S. city to ban smoking in restaurants.
1988: Smoking banned on short domestic airline flights.
1998: Forty-six states reach $206 billion settlement with cigarette makers.
2000: Smoking prohibited on international flights.
2009: Food and Drug Administration authorized to regulate tobacco products.

The above snapshot tells us the journey of combating tobacco use in the US. Fifty years ago, Nigeria was four years into her independence and one year old as a republic. Black & White TV was few & far between as most homes relied on radio for receiving information and news. The Internet was non-existent. Telephones were a major luxury. There were no states only sub-regions and agric products was our main source of income as a nation.

As a country, we cannot afford to talk about another 50yrs before we begin to see significant changes made to how tobacco products are used. Infact, with our public health indices not good, the URGENCY to ACT and do so QUICKLY is right before us.

Examining examples from the US and a few other countries too, it is clear that until relevant laws and policies are put in place which is STRONGLY enforced across federal and state lines, little traction on making Nigeria smoke-free might be made.

The mantra 'Prevention is better than cure' remain the bedrock of all public health interventions and the onus is now on us as a nation to define in clear terms how our tobacco use story will evolve. 

As the national assembly resumes next week, there is need to support, advocate and bring more focus to its members in the senate and house of representatives what steps they MUST take by placing comprehensive tobacco use legislation for us to begin to see the emergence of a smoke-free country NOW!

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Thursday, January 02, 2014

Our Tobacco Control Marker for 2014

Earlier today, I was reading an article quoting a doctor with the University of Toronto as stating tripling tobacco tax will reduce smoke by a third and potentially prevent an estimated 200 million lives dying prematurely from lung cancer and other diseases this century. "A higher tax on tobacco is the single most effective intervention to lower smoking rates and to deter future smokers," Jha said.

While this is bound to bring about much debate and generate tons of opinion on its impact, such policy thrust comes from a clear base of thought that has been encapsulated in the laws of any nation defining what is legal and illegal particularly when it comes to tobacco, its products and their use.

For Nigeria, our 2014 new year sojourn begins with  the need for us to set certain markers as essential things to get done over the course of the year that will propel us forward as a people and escalate our growth with better health indices. One such key goal is an enactment & implementation of a comprehensive tobacco legislation in the country with the broad objectives of;

1) Protecting minors from being involved in the distribution of tobacco and its products

2) Protecting minors from being involved in the production of tobacco and its products

3) Protecting minors from being involved in the sale of tobacco and its products

4) Protecting the Nigerian citizen from harmful exposure to second-hand smoke (shs) in public places like hospitals, government establishments, offices, entertainment centers, schools amongst others

5) Stopping the glamourization of tobacco and its products via attractive packaging and advertisements.

When it comes to laws, the legislative arm of government is our umpire as they draft and propose legislation that aims to positively impact the lives of Nigerians across all cadres.

As this year precedes elections in 2015, the window to get the present session of the National Assembly and state assemblies too to conclude all ongoing tobacco legislative efforts is time-bound. 

However, entering into 2014 with fresh hopes and expectations, as citizens of the commonwealth of Nigeria, we can play an active role in supporting efforts to encourage the legislative arm of government that a smoke-free Nigeria is of prime importance to us NOW and thus, is possible and attainable!

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