Effective Tobacco Control Is Achievable Through Multi-Sectoral Action - Health Promoter
Charity Aienobe-Asekharen is a health promoter and tobacco control advocate, the Coordinator of Health Promotion Education and Community Development Initiative (HPECDI) in Edo State, Nigeria. She is also a recipient of the 2017 Tobacco Free Nigeria Champion Award and the 2018 World Health Organization (WHO) World No Tobacco Day Award.
The world of tobacco control seems to be a complicated one; complicated because on the surface it looks like the proverbial cat and mouse story. The Tobacco Industry (TI) keeps coming up with new “product innovations” like Heated Tobacco Products (HTPs) to remain relevant to the changing environment and market, while retaining old clients (of which half are estimated to die), attracting new clients, and thus staying relevant in the scheme of things.
On the other hand, tobacco control advocates and organizations dedicated to prevention of Non-communicable Diseases (NCDs) are working
tirelessly to ensure the health and rights of smokers and passive smokers are protected. In 2012, prostate and liver cancers accounted for over half of the 102,100 new cases of cancer. Also in 2012, deaths due to NCDs reported to
be 792,600 all of which were tracable to
tobacco use.
Tobacco, alcohol, physical inactivity and poor eating habits are the building blocks of NCDs. According to the World Health Organization, tobacco alone accounts for 8 million deaths per year and is attributed to be the number one causal factor of preventable deaths. With about 80% of the world’s 1.1 billion
smokers living in low-and-middle-income countries- and women and children being the most vulnerable when, breadwinners’ income is tied to tobacco addiction, and when a breadwinner
dies or suffers one form of ailment or the other- it becomes a matter of emergency to address tobacco consumption in whatever innovative form it is presented by the TI.
The winner of this dance contest tips in either direction per round as participants on each side of the dance ring are strategic and give their best shot in their pursuits. For instance, a Non governmental organization which was found to be solely funded by Phillip Morris International-Foundation For a Smoke-Free World gave a grant a few months ago to the International Centre
for Biodiversity (ICB) at the University of Nigeria, Nsukka, Enugu State
This grant was supposedly to aid research development in supporting small holder tobacco farmers. “Does the Tobacco Industry (TI) givefree gifts?” “Will the TI give room for tobacco farmers to divert to other crop plants that would impact their business negatively?” For many the answer to both questions will be an emphatic
“No”. But this approach by the TI calls for closer examination; especially if this approach is aimed at making more farmers dependent on them for their livelihood; because he who pays the
piper dictates the tune.
But what is the deciding factor in this dance contest? Is it the will of governments to ensure good
health and well being for their people (SDG 3) or the will of organizations in the field of Public Health to promote the Health For All agenda? The answer, though seemingly farfetched, is actually
simple. The solution lies in an integrated approach that is multi-sectoral and consistent. The TI is a figure with many digits and cannot be approached from one angle alone.
Tobacco use prevention must be integrated and enshrined into: reproductive health/family
planning, school health education, film production, sports, agriculture and legislation. These are the key areas that connect everyone to each other; especially persons in Nigeria. Tobacco use causes reproductive and developmental risks that could manifest in: infertility, early delivery,
still birth, teratogenesis, growth retardation as well as pre and postnatal mortality. Reports show that the TI is targeting schools, and as students are potential users; tobacco control prevention strategies must also target and include them. The film production sector (Nollywood) was reported to have generated 239billion Naira in 2016. Youths and families in general are also partial to what they see on screen, what is supported by their celebrity idols and the kind of life lead by their celebs. This is a clear area to leverage in tobacco use prevention that will have ripple effects and save cost attributed to NCDs. Sport is an avenue to unite people (especially Nigerians) independent of their tribe, religion and political inclination. This is
one sector that should be explored in channeling tobacco (and alcohol) use prevention.
As regards legislation, Parties (countries that have domesticated the WHO FCTC) should develop a comprehensive Tobacco Advertizing Promotion and Sale (TAPS) ban policy (WHO FCTC Article 13) that provides strategies for policy implementation on 'all’ tobacco products. Revenue from tobacco tax (WHO FCTC Article 6) should be directed to comprehensive health campaigns
-social media and television- (WHO FCTC Article 12) and for facilitating health insurance for the treatment of NCDs.
The agriculture sector must not be left behind either; small holder farmers’ associations must be carried along and supported to ensure crop plants that are
environmentally friendly remain their focus. Other sectors that tobacco use prevention should be integrated with for multi-sectoral action includes: justice, finance, transport, women affairs to mention a few.
The tobacco control dance contest must be settled finally so as to ensure that internal and external organizations including upcoming advocates have a solid foundation from which to address tobacco use and related NCDs.
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