Tobacco war gets graphic

As Kenya marked the World No Tobacco Day Sunday, one thing stuck out like a sore thumb; and that is the fact that the country is yet to meet all the World Health Organisation recommendations on tobacco control.

However, the government is intensifying its efforts to tighten the noose on tobacco business, and the effects are quite evident.

According to the Ministry of Health, non-communicable diseases (NCDs), for which tobacco is a known risk factor, are responsible for more than 55 per cent of mortality in the country and 50 per cent of public hospital admissions.

The Ministry of Health has published the Tobacco Control Regulations, 2014, aimed at reducing the prevalence of tobacco smoking by five per cent by 2016.

A notable regulation is that cigarette packages should now carry health warnings and pictograms on the front and back (the pictograms are yet to be implemented). The health warnings must cover 30 per cent of the front and 50 per cent of the back of the package, and must be displayed in English and Kiswahili languages.

These regulations ban cigarette manufacturers, distributors and importers from printing brand names or trademarks on cigarette packages and wrappers.

The regulations in part reads: “A person shall not manufacture, sell, distribute or import a tobacco product for sale in Kenya, whose packaging carries a name, brand name, text, trademark or pictorials or any representation or sign that suggest that the tobacco product is less harmful to health than other tobacco products.”

To make the tracing process easier, the regulations require that cigarette packets contain a batch number that will help determine the place, manufacturing date and country of origin.

It restricts the sale of tobacco products to children under 18 and the sale of single cigarettes, with each packet required to have at least 10 sticks. It further limits public smoking, public education and information campaigns, and provides for smoke-free environments in all indoor workplaces and public places. A fine of Sh50,000 is imposed on those who break the law.

Financial contributions by the tobacco industry are restricted but not banned, but the publicity of any financial contributions is prohibited.

Here, a look at the changing tobacco trends since Kenya became a party to the WHO Framework Convention on Tobacco Control on June 25, 2004: 

TIMELINES 

1992

Tobacco control campaigns initiated in the country as part of the World No Tobacco Day celebrations. 

2001

Ministry of Health establishes the National Tobacco Free Initiative Committee (NTFIC) to coordinate tobacco control activities and designates a tobacco control focal point. 

2004

Kenya becomes a Party to the WHO Framework Convention on Tobacco Control, on June 25. 

2007

The government publishes the Tobacco Control Act. 

2008

Taxes on the most sold brand of cigarettes rise to 55 per cent. 

2009

State inaugurates the Tobacco Control Board 

2014

December sees the enforcement of the Tobacco Control Act 

2015

Introduction of pictograms on cigarette packaging by June 5.

GRAPHIC WARNING 

What others are doing on packaging

For the package front, which is more important because it is seen more often than the back, Paraguay has the largest warning in the world, at 60 per cent. Sixteen jurisdictions are tied at 50 per cent, including Albania, Bolivia, Brunei, Cameroon, Canada, Chile, Djibouti, Egypt, Eritrea, Hong Kong, Islamic Republic of Iran, Madagascar, Panama, Singapore, Thailand and Uruguay.

The United Kingdom on January 21 this year backed standardised packaging of tobacco that will take effect from May 2016.

The proposed regulations are:

•  Specifying mandatory colours for retail packaging (dull brown for the outside and white for the inside)

•  Permitting only specified text, such as the brand and variant name, and making sure any permitted text conforms to particular requirements

•  Allowing required markings such as health warnings and fiscal marks, including covert markings and any future requirements that may be introduced to tackle illicit trade, to remain in place.

In 2012 Australia became the first country in the world to introduce plain cigarette packets that have no branding. All cigarettes Down Under must have dark-brown packaging with large health warnings. 

KENYAN SMOKERS

Over half of Kenyan smokers started the habit before the age of 20, and almost all started before the age of 25. Central province leads with 30.4 per cent, Eastern 26 per cent, Coast 22.6 per cent, Nairobi 17.1 per cent, North Eastern 15.6 per cent, Rift valley 14.3 per cent, Western 11.2 per cent, and Nyanza 7.9 per cent. 

The World Health Organisation estimates that if all countries increased tobacco taxes by 50 per cent, there would be 49 million fewer smokers within the next three years.

According to the fifth World Tobacco Atlas in 2013, profits in the tobacco industry were more than Sh4.3 trillion while 6.3 million people died from smoking-related illness, an equivalent of a profit of Sh700,000 for each death caused by tobacco. The Atlas quotes new evidence that tobacco smoke contains at least 69 cancer-causing ingredients.

Jeffrey Drope, one of the authors, said: “The harm to the human body from tobacco use is staggering… and, remarkably, we’re still finding out that there are other diseases that are linked to tobacco use. For example, recent research from the American Cancer Society suggests a significant connection between kidney failure and tobacco use, which was not known previously.”

According to World Lung Foundation: “If a person smokes 10 cigarettes per day, he sees the pack health warning 3,650 times a year.”

HEALTH RISKS

Tobacco risks to body

1. EYES: Cataracts, blindness, stinging, excessive tearing and blinking

2. BRAIN AND PSYCHE: Stroke, addiction/withdrawal, altered brain chemistry, anxiety about tobacco’s health effects

3. HAIR: Odour and discoloration

4. NOSE: Cancer of nasal cavities and paranasal sinuses, chronic rhinosinusitis, impaired sense of smell

5. TEETH: Periodontal disease, loose teeth, discoloration and staining

6. MOUTH AND THROAT: Cancers of lips, mouth, throat, larynx and pharynx; sore throat; impaired sense of taste; bad breath

7. EARS: Hearing loss, infection

8. LUNGS: Lung, bronchus and tracheal cancer, chronic obstructive pulmonary disease (COPD) and emphysema, chronic bronchitis; shortness of breath, asthma, chronic cough

9. HEART: Heart attack

10. CHEST AND ABDOMEN: Esophageal cancer, gastric, colon and pancreatic cancer, abdominal aortic aneurysm, peptic ulcer

11. LIVER: Liver cancer. Possible increased risk of breast cancer

12. MALE REPRODUCTION: Infertility, impotence, prostate cancer

13 FEMALE REPRODUCTION: Cervical and ovarian cancer, premature ovarian failure, early menopause, reduced fertility, painful menstruation

14. URINARY SYSTEM: Bladder, kidney and ureter cancer

15. HANDS: Peripheral vascular disease, poor circulation (cold fingers)

16. SKIN: Psoriasis, loss of skin tone, wrinkling, premature aging

17. SKELETAL SYSTEM: Osteoporosis, hip fracture, back problems, rheumatoid arthritis

18. WOUNDS AND SURGERY: Impaired wound healing, poor postsurgical recovery

19. LEGS AND FEET: Peripheral vascular disease, cold feet, leg pain and gangrene. Deep vein thrombosis

20. CIRCULATORY SYSTEM: Buerger’s disease (inflammation of arteries, veins and nerves in the legs), acute myeloid leukemia

Tobacco companies raise a stink

 Highlights of the health risks associated with tobacco use.

 Advocating for effective policies to reduce tobacco consumption.

According to WHO, the illicit tobacco market may account for as much as one in every 10 cigarettes consumed globally.

How is illicit trade of tobacco products detrimental to your health?

1. It hooks young people into tobacco experimentation and use because they are more affordable.

2. Misleads young tobacco users by not displaying health warnings and sometimes involving children in illegal selling activities.

3. Illicit trade takes tax revenue away from the Government, which could have otherwise been spent on the provision of public services, instead directing such funds into the hands of criminals.

4. Illicit trade strengthens corruption and weakens good governance.

5. Tobacco companies have been known to use loopholes in tobacco control governance systems and indulge in the illicit trade of tobacco products.

What a packet of cigarettes can buy:

The average amount spent on one pack of manufactured cigarettes (containing 20 cigarettes) is Sh100 It can buy two packets of milk, or a packet of maize flour.

Effectiveness of tobacco warnings

• According to a WHO report dubbed Tobacco Health Warnings in China, there is evidence of effectiveness of the introduction of large, pictorial — or ‘graphic’ — health warnings on all tobacco packages in the country which warn smokers about the health hazards of smoking and encourages  them to quit.

•  Pictorial warning labels are much more effective at encouraging smokers to quit and stopping youth from starting.

•  Smokers get information about the health risks of smoking from warning labels than any other source, except television.

•  Since the 1950s, many research studies have demonstrated that “fear appeals” are effective in motivating health behaviour change (quitting), especially if paired with information about how to avoid the fearful consequences (where to find help about quitting)

•  Messaging has been cited by former smokers as an important factor in their attempt to quit and has been associated with increases in the use of effective cessation services, such as toll-free telephone helplines.

•  Although all warnings are subject to wear-out over time, pictorial warnings have also been shown to sustain their effects longer than text-only labels, and also appeal to populations with low literacy rates.

   

FYI

• 6 million people are killed by tobacco each year, with more than five million as a result of direct tobacco use. Of these, about 12,000 are Kenyans. 

• Globally, more than 600,000 who die are non-smokers exposed to second-hand smoke. 

• Over 8 billion sticks of cigarettes are smoked in Kenya every year. 

• About 77 million African adults currently smoke.

• According to the 2014 Global Adult Tobacco Survey, approximately 2.5 million adults in Kenya currently use tobacco.