Lagos — Although it is acknowledged that tobacco consumption will not disappear overnight nor is it likely to diminish rapidly, yet its impact on public health and the economy, is incalculable. It is in that context that a recent World Bank report backs tobacco control. Experts and control activists speak on how best to keep the deadly product in check. Godwin Haruna writes

Health experts warn that smoking harms nearly every organ of the body, causing many diseases and affecting the health of smokers in general. Smoking, it is reckoned, harms people of all ages. For instance, toxic ingredients in cigarette smoke travel throughout the body, causing damage in several different ways. Nicotine reaches the brain within 10 seconds after smoke is inhaled. It has been found in every part of the body and in breast milk.

Further more, carbon monoxide binds to hemoglobin in red blood cells, preventing affected cells from carrying a full load of oxygen. Cancer-causing agents (carcinogens) in tobacco smoke damage important genes that control the growth of cells, causing them to grow abnormally or to reproduce too rapidly. Smoking, the experts also contend, affect the function of the immune system and may increase the risk for respiratory and other infections. There are several likely ways that cigarette smoke does its damage to both real smokers and second hand smokers.

This is why its impact on public health generally is high. According to Dr. Olanrewaju Onigbogi, who is of the Department of Community Medicine, University College Hospital, Ibadan, tobacco is the second major cause of death in the world. He said currently, tobacco kills about five million people worldwide and by 2020, the World Health Organisation (WHO) expects the worldwide death toll to reach 10 million. It is the cause of death of 17.7 per cent of all deaths in developed countries.

Speaking to journalists recently when Environmental Rights Action and the Nigerian Tobacco Control Alliance trained some journalists in Lagos, Onigbogi said half of the people that smoke will eventually be killed by tobacco. "There is a 50 per cent chance that eventual death will be smoking-related and half of these deaths will be in middle age. Tobacco smoking is a known or probable cause of approximately 25 major diseases", the consultant said.

According to him, the United States Centre for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide.

He said smoking is associated with higher levels of chronic inflammation, another damaging process that may result from oxidative stress. He added that there is no risk-free level of exposure to secondhand smoke. Breathing even a little secondhand smoke can be harmful. He advised that the only way to fully protect yourself and your loved ones from the dangers of secondhand smoke is through 100 per cent smoke-free environments.

He added that opening a window, sitting in a separate area, or using ventilation, air conditioning, or a fan cannot eliminate secondhand smoke exposure.

Despite these hazards, tobacco companies carry on their business in Nigeria as if they are in the country for some special favours. In particular, the British American Tobacco had recently demanded tax waivers from the federal government.

Also speaking, Mr. Akinbode Oluwafemi, programme manager of ERA, stated that tobacco creates holes in individuals' pockets and therefore worsens poverty. Oluwafemi argues that the product harms the national economy as costs far outweigh whatever benefits accrue to tobacco transnationals who are the beneficiaries of the tobacco trade.

According to him, tobacco destroys national manpower, destroys the environment and also ruins social relationships. Although he said there are the Tobacco Smoking (Control) Act, Decree 20 of 1990, the Code of Advertising Practice (APCON), 1993 and APCON Resolution at its 89th meeting held on July 11, 2001, they have not proved effective control mechanisms for tobacco control in Nigeria.

"Despite its well publicized reformist campaign, BAT continues to explore areas not covered by the APCON directive or existing laws to advertise its products. Those areas include delivery vans, point of sale, traffic signs and umbrellas. It has continued to associate tobacco with arts, music, fashion, etc. BAT has also colour-coded all its brands in Nigeria that the colours speak for the products", he stated.

However, Oluwafemi noted that the advent of the Framework Convention for Tobacco Control (FCTC) created a new wave of tobacco control activism in Nigeria. He said more Nigerian non-governmental organisations (NGOs) became actively involved in tobacco control advocacy.

Nigeria, he added, signed the FCTC on June 20, 2004 and despite spirited attempts by the tobacco multinationals, ratified the treaty on October 20, 2005. He demanded a domestication of all the provisions of the FCTC to provide a platform for firmer control of the deadly product.

"BAT has used its corporate social responsibility projects to create confusion about the need for tighter tobacco regulation. It has used it to remain visible in public domain as well as to leverage political influence. The company has however, from practice shown that what it is interested is how there will be loopholes to continue to market its deadly products to the youths, the poor and further cause more preventable deaths, diseases and poverty", Oluwafemi said.

Therefore, for the strict control measures he wants in place, he recommended complete ban of advertisement including points of sale; high taxes on cigarettes to discourage more people going into the venture; protection of non-smokers, expansion of smoke-free public places; mass education about the dangers of smoking; assistance to tobacco farmers and pro-tobacco victims as well as states instituting litigations for damages.

Also speaking on the issue of control, Mr. Nurudeen Ogbara, an Ikorodu-based activist cum legal practitioner, noted that there are various legislative options that could be relied upon to institute a regime of effective tobacco control in Nigeria. These, Ogbara stated, include the domestication of the FCTC, passage of the draft National Tobacco Control Bill by the National Assembly and effective enforcement of the said bill when passed into law.

He argued that the present legislation could become the offshoots of the tokenist, inappropriate, unenforced and disjointed ones of the past. He advised control activists to intensify their lobby and awareness campaigns in order to achieve the desired end.

Also speaking, Mr. Lanre Oginni, executive director, All-Nigerian Consumer Movement, said tobacco weighs down heavily any economy where it is given unfettered opportunity to operate. Oginni cited the instance of tobacco farmers who are often in a cycle of debts to repay farm input.

"Those employed in tobacco factories or selling tobacco on the streets often earn starvation wages. Far from being rich from their vocation, many of those working in tobacco-related environment are facing multi-generational poverty compounded by illiteracy and poor health", he said.

According to him, the tobacco business is a huge consumer fraud. He added that the tobacco industry has violated practically every article of the eight consumer rights, which were incorporated in the 1985 United Nations Guidelines for consumer protection and which were amended in 1999 to include sustainable consumption.

"The industry has continued to refuse to shoulder the responsibility for its actions. In their statement at the FCTC hearing in 2000, Philip Morris said: 'We agree that smoking is addictive and causes diseases in smokers, but we do not have legal responsibility for those that claim they have been injured. We should not be responsible for their choices'. Can you imagine this?" Oginni asked.

Speaking on the possibility of exploring litigation for tobacco control, Messrs Tunde Irukera and Dapo Akinosoun, agreed that litigation was a very important method of checkmating the industry's many excesses.

Irukera maintained that once there is a legislation framework in place, litigation then readily comes off as a tool to control tobacco use. Akinosoun added that despite the fact that tobacco firms in Nigeria had perfected designs to frustrate litigation, it still remains an attractive option for control activists.

Irukera said tobacco use has been a significant drain on public health system in the country, so state governments are justified in seeking damages from tobacco firms.