Kigali — Rwandans ought to be aware that liberalisation of trade is certainly not good news for the smoking epidemic in developing countries. Smoking has proved chronic in both urban and rural areas in Rwanda.

Several people have for long been smoking in public without bothering about the consequences to community. Smoking is more disastrous for the people in the developing world than those living in the developed world. It has already claimed thousands of lives over the years and caused untold misery and suffering to millions.

Statistics indicate that governments spend huge resources annually to deal with the effects of smoking. This habit has now affected 800 million people, half of whom will have to die. Smoking has a vector and it takes political will to destroy the vector. It is our responsibility to convince our governments to make tobacco control a top priority and illustrate that tobacco exacerbates poverty.

We need community based health programmes in place. In communities where two-thirds of the population do not read and write, it is crucial to devise simple and low budget programmes.

The Health ministries, health groups and non- government organisations (NGOs) should play an active role in spearheading the campaign for tobacco control programmes. There are simply not enough tobacco control advocates to handle this project alone. Health groups and other anti-tobacco lobbies can play a key role in the development of comprehensive national tobacco control programmes.

We have to face up to tobacco crop cultivation and stop all subsidies for cultivation. We must also continue to push for bans in all forms of direct and indirect advertising and promotions of cigarettes. Smoking is one of the health hazards whereby if not stopped or minimized at an early stage can result into the outbreak of diseases such as encephalitis, ulcerations in the chest and also dangerous to digestive tract organs.

While fighting tobacco, the war must be fought both nationally and internationally. We must stop market expansion activities in developing countries. This includes Free trade to international or outside markets.

Tobacco control is cost-effective. Anti-smoking campaigns are the most cost-effective measures to improve health after childhood immunisation. An anti-smoking campaign is very expensive. Lung cancer is one of the diseases caused by chain smoking and its treatment is hectic. By spending less on treatment that many poor countries cannot afford anyway and more on anti- smoking efforts, more years of life can be changed with our limited resources.

If health budgets for developing countries are not more than 10 per cent of the national budget, then it is unrealistic to expect any resources from the government for comprehensive tobacco control programmes.

Perhaps it will be more realistic to generate money by increasing tobacco prices. Raising tobacco prices is one of the simplest and most effective methods for significantly reducing tobacco use, especially among young people. Surveys indicate that smokers in developing countries are much more sensitive to price changes than their counterparts in developed countries. We must also set aside tobacco tax for tobacco methods control.

Experiences from many countries actually show that tobacco tax proposal is politically popular. And it can significantly increase revenue. Such measures of tobacco smoking were once applied in Australia and worked effectively.