By Ngumbo Njoroge
Ratification and implementation of a protocol seeking to ban illicit trade in tobacco products will tame prevalence of Non-Communicable Diseases (NCDs) and reduce tobacco related deaths.
The Protocol on Elimination of Illicit Trade in Tobacco Products, currently before parliament for approval, was developed under the WHO Framework Convention on Tobacco Control (FCTC) in response to the growing illegal trade in tobacco products posing a threat to public health.
WHO estimates that seven in 10 people worldwide die every year from cardiovascular diseases, cancers, chronic obstructive lung disease, diabetes and mental health because of tobacco use, harmful use of alcohol, unhealthy diets, physical inactivity and air pollution.
Dorcas Kiptui, head of the Tobacco Control Unit at the Ministry of Health, told Health Business that the tobacco epidemic is a result of consumption of tobacco products as well as exposure to tobacco smoke. “Tobacco use is a major cause of chronic diseases like cancer, diabetes, lung diseases and cardiovascular diseases.”
She further pointed out that tobacco use can be linked to seven million deaths annually with about 890,000 occurring among non-tobacco users as a result of exposure to second-hand tobacco smoke.
According to the Global Adult Tobacco Survey (GATS), 2015, 2.5 million Kenyans consume tobacco, mainly manufactured cigarettes.
“Cigarettes contain harmful chemical and toxins, making tobacco use the most common risk factor of NCDs, contributing to nearly 50 per cent of all hospital admissions in public facilities countrywide and 55 percent of in-patient deaths,” the survey notes.
It further shows that 69 in every 100,000 deaths for individuals aged 30 and above result from tobacco use.
Kenya signed and ratified the WHO-FCTC in 2004, a global legislation, obligating the government to put in place measures to control the demand and supply of tobacco products. To implement the treaty, the country passed the Tobacco Control Act in 2007.
It aims to control the production, manufacture, sale, marketing and use of tobacco products. “Illicit tobacco products are unregulated hence are more affordable and accessible,” Kiptui noted.
She added that rising consumption of these products undermines government’s efforts to halt and reverse the rapidly rising burden of NCDs.
Because of stringent laws in developed countries, trade laws and awareness among the public, Kiptui said tobacco companies are shifting base to developing countries, aggressively interfering with tobacco related legislation, policy development as well as implementation.
Kiptui said the tobacco industry has taken to applying intimidation, threats and litigation strategies to deter governments from implementing tobacco control measures and enforcing those in place.
“Availability of illicit tobacco denies government revenue while compounding the health situation. The government diverts a lot of money that would have gone to development to treating externalities of tobacco use.”
The Tobacco Control Act requires manufacturers to place health warnings on tobacco products while disclosing contents, emission of tobacco products and the resulting effects.
It further prohibits all forms of tobacco advertising, promotion and sponsorship while banning sale of cigarettes in sticks and through vending machines.
A study by the American Cancer Society indicated that a drop in cancer rates over the last three decades can be attributed to tobacco control initiatives in the United States.
Kiptui said previous tobacco control initiatives in Kenya led to reduction in tobacco consumption among the youth, adding that there is a drop in the prevalence of tobacco consumption among school going children aged 13-15 years and a stagnation of prevalence among adults.
Data by the Global Youth Tobacco Survey (GYTS), 2013, shows 10 percent of school going children aged 13-15 currently use tobacco products. Among these, 7 percent smoke tobacco while 5 percent smoke cigarettes. Previous GYTS showed prevalence of 13 percent in 2001 and 18 percent in 2007.
GATS shows that 19 percent of men and 5 percent of women in households were consuming tobacco products, consumption among men has been stagnant while rising among women. This means that fewer men are initiating consumption and more people are quitting or dying from tobacco-related issues.
“There are stages of tobacco consumption and impacts on the population. Initially when consumption is low, tobacco related illness and deaths are low. In the second phase, deaths start to rise and consumption picks up among groups such as women.”
The protocol provides key time bound obligations that Kenya needs to put in place. First is the establishment of a track and trace regime to facilitate government to identify origin and destination of tobacco products and details of the manufacturer.
Second, the inclusion of unique markings on tobacco packages to determine details about manufacture of the tobacco product.
Kiptui acknowledged the efforts of other government agencies in the implementation and rolling out of the framework for the protocol.
Under Article 9 of the Protocol, parties agreed to establish within five years of the Protocol entering into force, a global tracking and tracing regime for tobacco products.
Kiptui said Kenya has achieved this already, providing capacity building for over 50 countries globally.
At least 40 countries are needed to ratify or accede to the protocol in order for it to become international law. In June, Britain and Northern Ireland ratified it, bringing the number of required parties to 41, breathing legal life into the protocol. Currently there are 48 Parties to the Protocol. Ms. Kiptui hopes that Kenya will be 50th.
Public Health concerns on illicit trade in tobacco products:
- Increase in accessibility, affordability and consumption of tobacco products
- Undermines national tax/pricing policies.
- Deprives governments of lost revenues – to combat smuggling or fund health programs
- Permits tobacco companies to subvert national and international cooperation in tobacco control.
- Undermines legal restriction & health regulations, such as those that deal with health warnings and sale to minors.
- Promotes corruption and linked with criminal activities.