31st of May of every year serves as a global opportunity for countries to deepen awareness on the harmful and deadly effects of tobacco use in any form, take stock of progress in advancing tobacco control and make policy recommendations for action on tobacco control.
This year’s commemoration is on the theme, ‘Commit to Quit’. It aims to ensure that policies and initiatives are in place to help smokers quit smoking to save their lives and the lives of non-smokers. The outbreak of the COVID-19 pandemic globally has reaffirmed the need for governments to protect citizens (both smokers and non-smokers) from tobacco deaths and related diseases such as cancers, kidney diseases, respiratory conditions etc. The pandemic has led to millions of tobacco users wanting to quit due to the established link between smoking and COVID-19 as records of Covid-19 deaths were people suffering from tobacco related diseases and non-communicable diseases (NCDs). However, quitting tobacco is challenging due to many factors such as the addictive nature of the product, affordability and accessibility of the products, tobacco industry interferences, hence the need for governments to ensure strict adherence to laid policies and interventions.
It is evident that tobacco use exacerbates other NCDs, mental health illness, and substance abuse problems, and undermines human development. It is estimated that annually, about 8 million deaths are recorded from tobacco-related diseases globally while 600,000 are also killed annually from secondhand smoke.
The implementation of Ghana’s Tobacco Control Law (Act 851) is seriously challenged as such this is time for stakeholders to rise and take action.
Issues of concerns:
Sale of cigarettes in single stick: the sale of single sticks of cigarettes is cheaper and more affordable to the youth and the poor in society. It facilitates experimentation among the youth who have not yet become regular smokers. This is one major reasons the tobacco industry vehemently opposes sale of cigarettes in a pack of 20 sticks. Selling in single sticks is an avenue for minors and the poor to easily purchase this harmful products at the peril of their lives. It is important to note that the Tobacco Control Measures of the Public Health Act (Act 851) bans the sale of tobacco in single sticks.
Sale to and by minors: The availability and accessibility of cigarettes in single sticks allows low income setting individuals to buy tobacco products. It is common to see minors selling tobacco and being sent to buy or light tobacco. Generally, young people and the poor are price sensitive. Increase in tobacco prices prevent initiation of tobacco use, promote cessation, and reduce prevalence and intensity of tobacco use among the youth and adult.
Shisha: This has become the most admired and used tobacco product among the youth today and mostly patronized by females due to the flavors it produces. Shisha smokers often believe it is safer than smoking cigarettes, a notion which must be dispelled by thorough, aggressive educational efforts. A recent observation by VALD reveals that only the outer package of some of these shisha products have health warnings but the primary containers do not have any health warnings.
The Ghana 2017 Global Youth Tobacco Survey in Junior High Schools showed that 8.9 percent of boys and 8.2 percent of girls currently use any form of tobacco products. 7.0 percent of boys and 5.3 percent of girls currently smoke tobacco while 0.4 percent of boys and sadly 1.7 girls currently smoke shisha.
Tax for health: The lack of commitment by government to impose taxes on tobacco products and change the tax regime from ad-valorem to a more appropriate and acceptable regime called the specific tax makes tobacco very affordable. Currently, a stick of cigarette is sold at 0.50p on the market making it one of the cheapest commodity in the Ghanaian market today. Given the higher price sensitivity among the poor, as taxes increase, it is expected that the poor will quit or reduce the quantity of tobacco intake.
Cessation: Ghana has a Cessation Guideline but unfortunately it has not been implemented since it was adopted in 2017. Smoking cessation is one of the best ways to add years to a smoker’s life. As specified by the Public Health Act, the Minister of Health shall ensure that every region and district has a place for the treatment of persons addicted to tobacco who wish to quit tobacco use, the question therefore is how many have been established or dedicated to treatment of addition.
Governments are obliged to help tobacco users quit through the “promotion of tobacco cessation and tobacco dependence treatment” (cessation) which includes both population and individual level interventions. The World Health Organization (WHO) calls on “all governments to ensure their citizens have access to brief advice, toll-free quit lines, mobile and digital cessation services, nicotine replacement therapies and other tools that are proven to help people quit.” The Article 14 Guidelines of the FCTC emphasize that cessation should, among others be protected from “all commercial and vested interests” including the tobacco industry and all other actual and potential conflicts of interest.
In view of this the Vision for Alternative Development recommends the following policy action:
● Government ban shisha or water-pipe to safeguard the health and wellbeing of present and future generations especially our young girls from Chronic tobacco diseases
● Government must amend the tobacco control law for effective control of tobacco especially to ban smoking in public places
● Continuous/regular increase in the price of tobacco products is a cornerstone of tobacco control. Tobacco tax increases will over time, make tobacco products less affordable and attractive
● Ensure effective enforcement of the sale of tobacco in single sticks and legislate to ban 10 sticks of cigarettes to a pack of 20 cigarette only
● Consider licensing of retail vendors of tobacco products to control the sale of single sticks of cigarette products
● Government through relevant agencies such as the Food and Drugs Authority (FDA) should collaborate with anti-tobacco groups such as the Vision for Alternative Development to intensify surveillance and education on the harmful effects of tobacco use to the public
● Penalty for offenders who sell tobacco products to minors and allow minors to sell tobacco should be put into vigorous action. This will serve as a deterrent for others to strictly abide by the rules set
For More Information:
Labram M. Musah
Program Director, Vision for Alternative Development
National Coordinator, Ghana NCD Alliance