Tobacco use in Africa: strategies to curb the coming epidemic

Globally, 8 million tobacco-related deaths occur every year, 80 percent of which occur in low- and middle-income countries (LMICs). 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 than in other regions and is predicted to become the future tobacco epidemic epicentre.

The significant increase in the number of tobacco users in SSA is attributable to the fast growth rate of the population and an increase in consumer purchasing power, leading to larger and more accessible markets in Africa. In addition, there are the intensive efforts by the tobacco industry to expand African markets.

Tobacco use in Africa has received little attention. The perceived low smoking prevalence in Africa, alongside the more immediate need for interventions for infectious diseases, has resulted in a low priority for tobacco control on the continent.
The perceived low smoking prevalence in Africa, alongside the more immediate need for interventions for infectious diseases, has resulted in a low priority for tobacco control on the continent

However, tobacco use poses a significant health, economic, and social burden globally, particularly in Africa, where resources are limited. African governments must therefore urgently arise to implement effective tobacco control strategies to save their populations and economies from the negative consequences of tobacco use.

The rising tobacco epidemic in Africa

In 2000, Africa was estimated to have about 52 million tobacco smokers. This increased in 2015 to 66 million and 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.

Unfortunately, tobacco control (TC) laws on the continent are weak and not fully implemented and enforced. Effective national governance of tobacco use and political willpower to implement tobacco legislation is often lacking and there is the significant interference from the tobacco industry. Tobacco markets are mostly unregulated and cigarette prices are low, causing an increase in access to and availability of tobacco products. So it is small wonder that there is a growing prevalence of tobacco use even among girls and boys in Africa.

In a continent where there is limited allocation of resources to healthcare and health infrastructure is poor, these factors create a possibility of significantly devastating health consequences if the predicted tobacco epidemic occurs in the region.

Impact of tobacco use on public health in Africa

Tobacco is the leading preventable cause of death in the world and kills up to half of its users. Tobacco use increases risks of developing lung cancer, oral cancer, heart disease, and blood clots. It also increases the risk of heart attack and stroke and leads to tooth and gum decay and wrinkled skin. Tobacco also poses a significant threat to non-smokers who experience second-hand smoke.

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

Key strategies to curb the rising tobacco epidemic in Africa

The negative consequences of tobacco use can be averted through effective tobacco control actions that substantially and continually reduce the prevalence of tobacco use and exposure to tobacco smoke.

To achieve this, the World Health Organisation developed the WHO Framework Convention on Tobacco Control (WHO FCTC), which lays out different TC measures to be implemented in order to prevent young people from starting to use tobacco, help current tobacco users to quit, and protect non-smokers from exposure to second-hand smoke.

However, although in the African Region, 44 countries have ratified or agreed to the WHO FCTC, implementing the convention has remained a major challenge for African countries.

In view of these, Bloom Public Health proposes the following key strategies to curb tobacco use in Africa:

1. Development of comprehensive tobacco control policies and legislations: African governments need to develop TC policies, legislations and national plans that reflect the WHO FCTC such as protection from tobacco smoke, support for cessation programmes, increasing public awareness about the dangers of tobacco, bans on tobacco advertising and promotion, and increasing taxes on tobacco products. This also includes building the capacity of government and advocacy personnel to strengthen tobacco control governance and implementation of legislation.

2. Regional and institutional cooperation: There is a need for collaboration between governments, research institutions, and civil society organizations to enhance knowledge sharing and transfer and ensure judicious allocation of scarce resources. Regional cooperation will also strengthen resource mobilisation and increase support from international funders for national tobacco control programmes.

3. Establishment of effective surveillance and monitoring systems: African governments must step up the monitoring of tobacco use and the tobacco industry to proactively counter industry activities that undermine tobacco control in the region. This includes increasing public awareness on the role of the tobacco industry in promoting nicotine addiction and diverting attention from the harms of tobacco and nicotine products.

Conclusion

Prevention is the most cost-effective measure to avert the negative consequences of the impending tobacco epidemic in Africa. Given the rapid population growth, policymakers need to strengthen tobacco control policies that discourage young people from ever starting to smoke. The time to act is now!

Anyakora is the CEO of Bloom Public Health and a public health expert & Odibeli is a pharmacist and the regional communications manager at Bloom Public Health