31 May 2017

Tanzania: High Time Tanzania Strictly Enforced Smoke-Free Policy


Worldwide, there are about 1.3 billion tobacco users, and every year about 6 million people around the world die from tobacco use. Each year, today, the Centres for Disease Control and Prevention (CDC) join the World Health Organisation (WHO) in observing World No Tobacco Day (WNTD).

The thematic issue in this article is to join hands with the WHO and CDC's commitment to fight the ongoing smoking epidemic. Strategically, we are being asked to enforce the smoke-free policy in public and workplaces so as to protect non-smokers from secondhand smoke.

Similarly, other strategies described below should be applied. Some authorities have projected that by 2030 there will be 10 million deaths caused each year by tobacco, and if current smoking prevalence trends continue approximately 70 percent of the above deaths will be in developing countries.

Statistics show that there has been a dramatic increase in smoking in most developing countries over the last 25 years. However, in much of the sub-Saharan African countries, there aren't many validated comparable population-based data.

In Tanzania, most data on smoking are from surveys carried out mostly among men. According to the World Development Index (WDI) the trend in smoking prevalence appears to have declined from about 37.6 per cent in 2000 to 29.2 per cent in 2012 but if you extrapolate to 2017 it reaches about 28.7 per cent.

One limitation of smoking data from countries such as Tanzania is that there is lot of under-reporting of smoking habits particularly among women from cultures where social and economic constraints exist.

We have had other data sets from Tanzania whereby, for example, Konrad Mmuni in 1994 reported data showing a smoking prevalence of 41.4 per cent in males compared with 9.6 per cent in females.

The tendency has been that self reported smoking prevalence may be underestimated, particularly among women. An example of such dilemma was reported in Tanzania way back as 1998 when Jagoe and colleagues reported findings from Dar es Salaam.

They found that smoking was more common in Tanzanian men than women 27 percent and 5 percent, respectively. This was after carrying out direct standardization to the new world population.

The findings by Jagoe and others were similar to the WHO estimated smoking prevalence in Africa and other areas of Africa where population based studies have been carried out.

However, when Jagoe and others tried to validate the self reported information by measuring carbon monoxide levels in the respondent's lungs the result showed at least 7.3 per cent of men compared with 27.3 per cent of women had more than 9 parts per million of carbon monoxide in their lungs.

The WHO's Tobacco Free Initiative and the World Bank have also urged countries to develop comprehensive tobacco control strategies. A key requirement for the development and monitoring of such strategies is valid population based smoking prevalence data.

Tanzania is among the countries that ratified that it will implement the various strategies to mitigate the efstrategies to mitigate the efstrategies to mitigate the ef fects of smoking especially in public places.

In addition, it agreed to increase knowledge of the health effects of tobacco is poor knowledge of the health effects of tobacco to vulnerable populations including women and young children.

Also it approved that the dangers of smoking will be clearly indicated on cigarette packets. If you drive your vehicle on major roads and especially near schools you will notice many adverts marketing different brands of cigarettes.

If you try to examine the issue of tobacco you see some ambivalence and lack of seriousness. In one way you see policy makers like tobacco and in another way they are being asked to do away with it.

Reliable sources show tobacco growing depletes 45 percent of nitrogenous substances from the soil. In areas where tobacco is grown we have observed desertification of the land because the trees that existed in the area have been cut down to dry tobacco.

When it comes to the Government's budget, each year, you are told that the policy makers have decided, once again, to increase the price of cigarettes so as to generate more revenue.

I will not be surprised to see the same trend being the norm. In 1981, for example, I was working at Bagamoyo teaching unit (BTU), a practical station of community health department of MUHAS, by then.

In that year, I recall the price of one packet of cigarette was fifteen shillings (TShs 15). Because I used to be a social smoker and called it quit. I left a packet of cigarette and match box on the table stopped smoking completely from that year until today.

Today the price of a packet has increased by 40 times and more compared with the price in 1981. We seem not to be serious at all. It is sheer "kudanganya toto". It is high time we agreed to forgo capitalizing on cigarettes as a source of government revenue and focus on other sources.

In the meantime, we should embark on mass media campaigns to educate people about the dangers of smoking. We should tell them that smoking and tobacco use is significantly associated with increased chances of getting cancer of the lungs, (larynx) voice box, stomach, tongue and the ovaries.

We should also educate and discourage young people from starting smoking and encourage adult smokers to quit. We should also educate adults to refrain from smoking in their house also they should avoid smoking in front of their loved ones including children and wives because passive smoking is much more dangerous.

Advertisement boards should not be located near school premises and children should not be given cigarettes whenever they are sent to nearby shop to buy a stick or two of cigarettes.

In primary and secondary schools teachers should always check if their students do not smoke cigarettes and those caught smoking in the toilets at should be seriously punished to discourage the others from copy bad behavior from their peers.


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