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TOBACCO CONTROL: A NECESSITY TO ACHIEVE A CLEAN AND HEALTHY

ENVIRONMENT

Analysis by Primah Kwagala

The World Health Organisation (WHO) estimates that five million people die every year due to tobacco

related illnesses. Tobacco use kills more people than HIV/AIDS, TB, Malaria, homicide and accidents

combined. In Uganda alone it has been reported that at least 13,500 people die from tobacco-related

illnesses every year.

On July 4th, 2014, the Ministry of Health (MoH) and Uganda Bureau of Statistics (UBOS) releasedstatistics  showing that 1.3 million adults currently use tobacco products. The Global Youth Tobacco

Survey (GYTS) 2011, showed youth consumption at 19.3% for males and 15.8% for females (ages 13-15)

currently using tobacco products.

The Center for Health, Human Rights and Development (CEHURD) with support from UNDP Uganda

conducted a study  among university students in Kampala, Mukono and Wakiso districts that placed

tobacco consumption rates at 15% of current tobacco smokers. 9% of the students who participated in

this survey smoked shisha, which was the most commonly used tobacco product other than cigarettes.

More than 40% of respondents reported living in homes where parents smoke while 10% reported

having friends who smoke. Over 60% of students had smoked for less than a year while 57% had been

exposed to pro-cigarette advertisements.

Secondhand smoke is a known cause of lung cancer, heart disease, low birth-weight births, and chronic

lung diseases such as bronchitis, as well as other health problems. Tobacco is addictive and most adults

found to be habitual smokers start smoking as teenagers. These facts coupled with survey data highlight

the public health challenge of tobacco use and the need for regulation to restrict the ease with which

young people have access to tobacco products.

In Uganda, the only regulatory measures against tobacco use are the National Environment (Control of

Smoking in Public Places) Regulations 2004 which prohibit tobacco smoking in public places but are not

enforced by law. It was not until 2007 that Uganda signed the WHO Framework Convention on Tobacco

Control (FCTC). This convention requires Uganda to act against tobacco use by taking steps to protect

the health of all its citizens through enacting and enforcing a comprehensive tobacco control law in the

country.

Against this background, in February 2014, through a motion introduced by an NRM Member of

Parliament (Hon. Chris Baryomunsi), the Tobacco Control Bill of 2014 was read to Parliament as a private

members Bill and moved to Parliament’s sessional Committee on Health for scrutiny. The Tobacco

Control Bill seeks to protect and prevent present and future generations from tobacco use; enhance

public awareness of the hazards of tobacco use; and ensure that consumers are provided with

information to make fully informed decisions about using tobacco.

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The proposed law futher seeks to protect individuals from exposure to tobacco smoke; bans tobacco

advertising, promotion, and sponsorship; it proposes complete bans on sale of tobacco products to and

by minors and offers a regulatory mechanism on tobacco products to mitigate against the harmful

effects of tobacco.

Reaction from the Tobacco IndustryThe Bill has been opposed by the tobacco industry and tobacco farmers, reportedly backed by British

American Tobacco Uganda (BATU), with both parties writting to the Health Committee. BATU arguesthat the Bill is unreasonable as it seeks to treat 21year olds as minors in relation to tobacco, lacks

evidence that it will work and that in seeking to ban displays and graphic health warnings (Section15) on

cigarrettes, it will promote illegal trade of tobacco products by driving legal tobacco trade to the black

market.

There is no statistical evidence showing that banning of displays at points of sale leads to illicit trade in

tobacco products. There is however, evidence that polices that ban tobacco product displays at points

of sale (POS) may reduce adult smoking by deterring purchases. In 2013 Russia adopted a

comprehensive tobacco control law,  and by 2014 Russian officials reported a decline in cigarette

consumption by 12 percent – 16 billion cigarettes – in the first quarter of 2014 compared to the previous

year.

A  leaked statement  to the Health Committee shows that BATU seeks to further support sale of single

cigarettes to young adults –a practice considered illegal in many countries with tobacco control policies,

as it is known to appeal to children and under-age smokers who may not have the purchasing power to

obtain a whole pack of cigarettes. British American Tobacco (BAT’s)  International Marketing Principles 

acknowledge the appeal of single stick cigarettes to youth but emphasises that they do not support the

selling or marketing of single sticks1. Their tactic to pursue this in Uganda is in contradiction of their

own principles and promotes a practise which is outlawed across the globe.

1 British American Tobacco (BAT’s) International Marketing Principle 3.2 States “While we recognize that single stick sales are a

reality in many of our markets, we do not give marketing support to them and will not provide retailers with any incentives to

sell cigarettes as individual sticks.” 

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Tobacco farmers have argued that poverty levels will escalate among households that solely depend on

the crop for their day to day expenses if Parliament agrees to ban displays at points of sale. The Ministry

of Trade has called for a balance between trade and health interests since tobacco contributes a

significant sum of tax revenue to Uganda. However, the Ministry of Agriculture and the National

Agricultural Advisory Services (NAADS) do not recommend tobacco as a model crop for agricultural

subsistence. In addition, the Ugandan President has on numerous occassions asked tobacco farmers to

seek alternative crops since tobacco farming is hectic, harzadous to their health and places them in a

vicious cycle of poverty. The World Bank  has stated that for every dollar earned as tax revenue on

tobacco products, three are spent on treating tobacco related illnesses.

Support for Tobacco ControlFurther, the latest GATS Uganda survey  shows that more than 94.6% of Ugandan adults (87.0% of

current smokers and 95.0% of non-smokers) believe that smoking causes serious illness. About one

third (36.3%) of current smokers believe that smoking causes stroke. As a result, 88.2% of Ugandan

adults are in favour of increasing taxes on tobacco products and 9 in 10 (89.3%) Ugandan adults have

spoken out in favour of a complete ban on tobacco advertising.

This data from Ministry of Health if backed by Parliament will allow for a law with sufficient regulatory

flexibility to respond to new technological and scientific innovations, findings and changes in consumer

behaviors. It will provide for rules of evidence and procedures for addressing tobacco industry liabilityfor damage caused by tobacco use and exposure to tobacco smoke. The law will provide for protection

of public health policies related to tobacco control from commercial and other vested interests of the

tobacco industry. It will create a national coordinating committee for tobacco control and go a long way

in meeting Uganda’s obligations to the WHO Framework Convention on Tobacco Control.