June 3, 2018

SMOKING ON THE RISE: Tragically, more Nigerians want to die young

COVID-19: For the tobacco industry, it’s all about profit

By Chioma Obinna

Smoking is becoming a way of life for many Nigerian youths despite the World Health Organisation, WHO, warning that tobacco kills up to half of its users and statistics, from the Nigerian Tobacco Atlas 2015, which revealed that, every year, more than 16,100 Nigerians are killed by tobacco-caused disease.

Significantly, more than 25, 000 children (10-14 years old) and 3,527,000 adults (15+ years old) continue to use tobacco each day. Also, WHO report, in 2017, shows that tobacco kills more than 7 million people each year while more than 6 million of those deaths results from direct tobacco use.

In the report, Nigeria was also among the low and middle-income countries that account for 80 per cent of tobacco-related morbidity and mortality. Although Nigeria, in 2016, became part of the WHO Framework Convention on Tobacco Control and later passed into law the Nigerian Tobacco Control Act in 2015 that would have helped to reduce tobacco use among youths, the implementation is yet to commence.

Today, investigations show that tobacco use is taking epidemic dimension among Nigerian youths and experts fear that, with the rise in the number of Nigerian youths smoking, increasing deaths from tobacco is imminent in the next 20 years. Complacency in the face of the tobacco epidemic insulates the tobacco industry in Nigeria and ensures that tobacco’s death toll will grow every year. Sunday Vanguard reports:

!3 years ago will remain evergreen in the heart of Gerald Iluchie. It was the day he mortgaged his future for N500 bet.   Today, Gerald lives with the guilt. The bet was to determine who was the bigger boy among his peers? Before the bet, arranged by his friends, Gerald never thought of smoking. From there, he became a regular smoker at 14. He was in JSS2. At home, he would sneak out frequently to smoke alongside his friends in the neighbourhood.

By the time he secured admission into secondary school, he had started smoking a pack of cigarettes a day. By the time he was preparing for his SSCE, Gerald thought that smoking was helping him to calm the stress of examination but he was wrong.

“I thought I was enjoying it and also helping myself.   My parents did not know I was smoking because I was careful at home. When I could not help but smoke during my exam that was when I knew smoking was bad for anyone.   But I could not help myself”, he told Sunday Vanguard recently.

“I could not finish my SSCE.   Smoking took that away from me”.

Today, still smoking at age 25, Gerald has developed chronic cough and he goes about smoking other substances.”

Gerald is not alone, as the story of Joseph, 18, is not different.   At age six, he started buying cigarette for his uncle.   He found it rewarding as his uncle will ask him to keep the balance. One day, Joseph, like every other adventurous child, wanted to know how cigarette tasted.

“I thought it was sweet. I tried the first time. I almost choked, so I dropped the stick. One day, I told my uncle I would want to try it.   Initially, he thought I was joking until I insisted.   He gave me to try and I did”, he said.

“Although, it was not easy at first, I later perfected the act.   This is how I began to smoke.”

Today, Joseph has developed lung cancer from smoking.

“I regret ever trying to smoke in the first place.   At 15, I smoked two packs of cigarette in a day. I hope people will learn from my mistake.   I wish I could be given another opportunity.   I have smoked weed, “he added.

Sadly, Gerald and Joseph, among millions of other Nigerian youths, have ingested the 7,000 chemicals in tobacco out of which hundreds are toxic and 70 per cent known to cause cancer, according to WHO. They are also among the one billion death estimates by the body in the 21st century.

Cardiologists’ worry

Meanwhile, Nigeria cardiologists are worried that, with studies showing epidemic of tobacco use among Nigerian youths and the fact that damages from tobacco manifest after 20 years, increased deaths from tobacco were imminent in the next two decades.

In a WHO report on the global tobacco epidemic in 2017, about15.4 per cent of Nigerian youths are using tobacco (19.2 males and 11.1 females) compared to adult which the survey put at 5.6 per cent.

Investigations show that the number of youths using tobacco is increasing by the day due to the activities of tobacco companies in Nigeria.

In a regional report tagged, “Tiny Targets Big Tobacco”, by the African Tobacco Control Alliance, ATCA, in Africa, smoking prevalence is estimated to be 21 per cent among adult males and 3 per cent among adult females.

The report, which shows that, among young Africans, tobacco consumption is increasing and estimates show that 21 per cent of boys and 13 per cent of girls use any kind of tobacco products, reveals that these companies, through their activities, are recruiting young school children to use tobacco.

Although prevalence is relatively low in Africa compared to other regions of the world, it is expected that, in the absence of tobacco control measures, it will increase by nearly 39 per cent by 2030, the largest expected regional increase globally.

The report also shows that most shops, where cigarettes are sold, are located around schools and the sale of single sticks of cigarettes around those schools encourages experimenting with smoking among youth non-users by making them affordable and accessible. In Nigeria and Uganda, the report put it at 94 per cent and 67 per cent respectively.

The report further shows that in Nigeria, 78 per cent of the schools surveyed had kiosks in the vicinity selling cigarettes.

Also, a 2012 Global Adult Tobacco Survey, GATS, report shows that south-easterners in Nigeria are the highest consumers of tobacco, with about 9 per cent of its adult population smoking.

The next zone to the South-East in terms of the prevalence of smoking is the North-Central with 8.5 per cent of its adult population indulging in it while the North-West has the least smokers with only three per cent of its adult population indulging in tobacco. The North-East, South-South and South-West regions come in-between.

The survey is Nigeria’s first official data documenting the prevalence and pattern of adult tobacco use in the country.

It also shows that Nigeria has 4.5 million adult smokers while 10 per cent of adult men consume tobacco and only 1.1 per cent of women do. Regrettably the 4.5 million smoking adults expose 27 million others to harmful second smoke.

The survey also estimates that an average smoker in Nigeria spends N1, 202.5 on tobacco products monthly. On the whole, Nigerians spend an average of N7.45 billion on tobacco monthly and N89.5 billion yearly.

The Federal Government through the Ministry of Health endorsed the report, stating that 4.5 million Nigerians consume 20 billion cigarettes yearly.

The Minister of Health, Prof. Isaac Adewole, who was aghast, said preventive measures would be taken by government through the Tobacco Control Act, which would include prohibition of smoking for persons under 18 years of age as well as the ban on smoking in parks, markets, restaurants and other public places.

He said, “According to Nigeria’s adult tobacco survey, over 20 billion sticks of cigarettes are consumed in the country by 4.5 million adults. This is 5.6 per cent of our population annually. The survey shows that 4.1 million men and 500,000 women smoke in Nigeria, while 6.4 million adults are exposed to smokers. We have to fight this looming epidemic now”.

Dangers of smoking

According to experts, smoking causes damage to nearly every organ of the body and it is directly responsible for a number of diseases.

Smoking has been found to cause more deaths each year than the combined alcohol use, firearm-related incidents, HIV, illegal drug use and motor vehicle incidents. Investigations also show that smoking shortens the life of a male by about 12 years and the life of a female by around 11 years.

Specifically, experts have identified carbon monoxide and tar as two poisons in tobacco that affect peoples’ health.   Carbon monoxide is found in car exhaust fumes and is fatal in large doses. It replaces oxygen in the blood and starves organs of oxygen and stops them being able to function properly. Tar is a sticky, brown substance that coats the lungs and affects breathing.

Smoking affects many different areas of the body.   It increases the likelihood of having a stroke by 2 to 4 times which can cause brain damage and death.   It can also make bones weak and brittle, which is particularly dangerous for women, who are more prone to osteoporosis and broken bones.

All chemicals in tobacco smoke increase the chance of heart problems and cardiovascular diseases.

A cardiovascular health physician, Dr. Olufemi Mobolaji-Lawal, said although tobacco affects every organ in the body, the most devastating effect is found in the blood vessels.

Mobolaji-Lawal explained that tobacco smoking affects the blood vessels adversely by making them thick and inelastic and, by narrowing blood flow, it causes restriction in the flow of blood to vital organs.

Throwing light on why tobacco affects the heart, the expert, who is also the Executive Council, Nigeria Heart Foundation, NHF, said: “The heart is unique because it is supplied by very tiny vessels called coronary arteries.   These arteries have very small lumen normally. When tobacco has its effects on them, it thickens the up and narrowed the lumen, blood cannot flow into the muscles of the heart and when blood stops   to the muscles of the heart, the muscles of the heart does not get the nutrients that it requires to function and that is where you have a heart attack.   It is the same process that makes it to cause stroke when the blood vessels going to brain are affected.

“Another effect from that action on blood vessel is that it also makes it easier for cloth to form inside the blood vessels. When that happens that is instant problem. Tobacco causes all these problems in various ways. It also weakens the lungs through other factors like; it causes what we call COPD, Chronic obstructive pulmonary diseases.

Those ones causes problems to the lung, you find people who cannot breathe well. They are suffering from effect of chronic tobacco use.   Now, because the heart pumps blood into the lungs, when there is problem with the lungs it affects the heart indirectly through the effects on the lungs. Tobacco also causes lung cancer.   Tobacco is a very major cause of cardiovascular disease, especially coronary artery and other forms of cardiovascular disease.   The effects on the blood vessels also causes stroke.”

Unfortunately, the new trend in Nigeria confirms the Global Youth Tobacco Survey, GYTS, which shows that, globally, youth tobacco use is widespread and Nigeria is not exempted.

Another cardiologist, Dr. Kingsley Akinroye, said Nigeria may witness more deaths from tobacco in 20 years’ time.

According to him, damages from tobacco use manifests in most users after 20 years.

Akinroye stressed that unlike the national survey done by the Akinkugbe group in 1990, which showed then that prevalence of tobacco was about 5 per cent of the population, recent reports show a sharp rise in the young population.

The Executive Director of NHF lamented that revenue on tobacco was gaining ground in Nigeria

On his part, the Secretary, United Nations Association of Nigeria, UNAN, Ganiyu Owolabi, said there was urgent need to raise tax on tobacco products given the currently low tobacco tax levels, its dangers to public health and benefit for public finance.

However, as Nigeria joins the rest of the World to mark this year’s World No Tobacco Day, health watchers condemn the rise in tobacco use among youths.

They are urging government to urgently commence in earnest the implementation of the National Tobacco Control Act 2015. Government should demonstrate the political will to implement the extant law against smoking in public places as enshrined in the National Tobacco Control Act.

  • This story/investigation was made possible with support from Code for Nigeria via the Naija Data Ladies programme