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Advocacy and health communication: A key strategy for tobacco control in Africa

‘Tobacco consumption responsible for 8 million deaths yearly’

Tobacco use is a major risk factor for cardiovascular and respiratory diseases, over 20 different types or subtypes of cancer, and many other debilitating health conditions. It is the single most preventable cause of death. Every year, more than 8 million people die from tobacco use; about 80 percent of these deaths occur in low- and middle-income countries, which are often targets of intensive tobacco industry interference and marketing.

African countries are experiencing an increasing rate of tobacco use. Sub-Saharan Africa (SSA) has witnessed the largest relative increase in the number of tobacco users compared to other regions and is predicted to become the future epicentre of the tobacco epidemic.

The tobacco industry in Africa, and indeed globally, uses all kinds of tactics to subvert tobacco control measures. For example, the tobacco industry targets children and young people with its advertising and promotion tactics.

In a continent where there is limited allocation of resources to healthcare and health infrastructure is poor, the rapidly increasing use of tobacco in the region creates the possibility of significantly devastating health consequences

Advocacy and communication on the health and economic effects of tobacco are crucial to engaging and empowering the public, especially youth, and to informing and educating policymakers and other stakeholders on solutions to the global tobacco epidemic.

Tobacco use in Africa: Health and economic effects

It is projected that by 2025, Africa will have about 84 million smokers, a 61.5 percent increase in the number of smokers from 2000. Also, the youthful population in the African region is predicted to double by 2050, making Africa an attractive destination for the tobacco industry. However, in a continent where there is limited allocation of resources to healthcare and health infrastructure is poor, the rapidly increasing use of tobacco in the region creates the possibility of significantly devastating health consequences.

Unfortunately, tobacco kills up to half of its users as it increases the risk of developing lung cancer, oral cancer, heart disease, and blood clots. Tobacco also poses a significant threat to non-smokers who experience second-hand smoke. A significant reduction in tobacco use will therefore ensure declines in noncommunicable diseases (NCDs) and a healthier global population.

Tobacco use also presents an increasingly significant economic burden for African countries. This includes the cost of treating tobacco-related diseases as well as the productivity losses from premature illness and death.

Advocacy and health communication strategies for tobacco control in Africa

Among other strategies, the World Health Organisation (WHO) recognises the key role of advocacy and health communication in promoting tobacco control. Health communications in tobacco control can empower both individuals to change their behaviour and communities to adopt policies that reduce tobacco use, prevent initiation, and limit exposure to second-hand smoke.

Health communications are an essential part of a comprehensive tobacco control program because they:

1. Reduce tobacco use and second-hand smoke exposure: Mass-reach health communications reduce tobacco use among youth and adults, increase quit attempts, increase use of cessation services, and prevent youth initiation. They can also reduce the likelihood of relapse among people who quit.

2. Counter the industry’s extensive advertising and promotion efforts: Health communications can counter industry advertising with messages about the health consequences of tobacco use. As the industry finds innovative ways to promote its products, the importance of effective health communications in tobacco control continues to increase.

3. Support tobacco control policy and program efforts: Health communications build public support for strong tobacco control policies and programs by educating the public and decision-makers about the importance of reducing tobacco-related disease and death.

4. Reduce tobacco-related disparities: Health communications efforts can reduce tobacco-related disparities among diverse groups. Communications about the negative health consequences of tobacco can reach and be influential among populations of different ages, education levels, incomes, races, and ethnicities.

5. Create a return on investment: Health communications efforts can save lives and billions of dollars in health care costs. In 2012, the USA Tips From Former Smokers® national tobacco education campaign cost $48 million and prompted 100,000 smokers to quit for good, which is estimated to have prevented over 17,000 premature deaths.

Health communications can be delivered through several strategies, including paid media strategies (paying to place ads on TV, radio, billboards, transit, online platforms, or print media); earned media strategies (generating free coverage in the press and through public service announcements); social media strategies (sharing messages and engaging audiences on social networking sites like Facebook and Twitter); and program communications (delivering messages through program websites and stakeholder communications).

Read also: Embracing tobacco harm reduction to save lives: Sweden’s experience and lessons for Nigeria

Communications campaigns may be brief or run for long periods of time. They may focus on reaching tobacco users, their families, specific populations, health care providers, the media, or decision-makers. Campaigns are most effective when they are integrated into a larger program.

For example, campaigns may include a quitline number or raise awareness about a new tobacco control policy. There is no one-size-fits-all approach to developing a communications campaign. Programs with smaller budgets may want to plan one well-executed campaign to support multiple goals.

In conclusion

Advocacy and health communication can be powerful tools to achieve tobacco control goals in Africa, but implementing effective communication campaigns is not easy. Successful campaigns require adequate funding, careful planning, and hard work. Support from African governments, public health professionals, grassroots organisations, funders, and other relevant stakeholders is therefore imperative to achieve desirable tobacco control outcomes.