Tobacco use continues to be one of the preventable causes of death, disease, and environmental hazards globally, accounting for significant mortality, morbidity, and economic consequences. Every year, it kills over 8 million people, including 7 million from direct tobacco use and over 1.2 million from secondhand smoke exposure.
Its annual worldwide economic burden is estimated at $1.4 trillion (healthcare expenditures plus productivity losses). Of the world’s 1.3 billion smokers, 80 percent live in low- and middle-income countries (LMICs), where tobacco-related illnesses are underfunded.
Tobacco use has substantial and widespread health consequences, impacting almost every organ in the body. It is the leading cause of cancer, cardiovascular illness, respiratory disease, reproductive system problems, and numerous other health dangers.Furthermore, tobacco growing has serious environmental repercussions, accounting for 5% of global deforestation due to tobacco cultivation. It also has a negative impact on the environment due to pesticide exposure in tobacco-growing regions. Tobacco growing has also been linked to child labor and other forms of cruelty.
Tobacco farming causes soil degradation since it is usually produced as a monoculture, which depletes soil nutrients and can degrade soil over time. Furthermore, the extensive use of chemical fertilizers and pesticides in tobacco production can contaminate soil and water, damaging local flora and fauna.
It is also one of the sources of water contamination. Because the chemicals used in tobacco cultivation can contaminate neighboring water bodies, affecting aquatic ecosystems and drinking water sources.
The conversion of natural environments into tobacco plantations has the potential to reduce biodiversity, putting many plant and animal species at risk. This is especially alarming in locations where tobacco production threatens delicate ecosystems.
Recognizing these facts, the world has responded with initiatives such as the World Health Organization (WHO)’s Framework Convention on Tobacco Control (WHO FCTC) and the WHO’s sixth MPOWER strategies. These strategies include: monitoring tobacco use and prevention policies; protecting people from tobacco smoke; offering help to quit smoking; warning about the dangers of tobacco; enforcing bans on tobacco advertising, promotion, and sponsorship (TAPS); and raising taxes on tobacco.
The WHO FCTC is the first international public health treaty, adopted in 2003 and entered into effect in 2005. It is a legally binding agreement designed to reduce tobacco-related deaths and diseases. As of 2024, the pact had been approved by 182 parties (181 nations plus the European Union), representing more than 90 percent of the world’s population.
Here, it is vital to raise the following questions: how is Ethiopia striving to avoid and control the detrimental effects of tobacco? What tangible changes and outcomes have been achieved thus far, and what should be the future focus?
Ethiopia has been active in tobacco control, owing to the Government of Ethiopia’s strong political commitment to protecting its citizens from the harmful effects of tobacco use, as evidenced by the ratification of the WHO FCTC in 2014 and the privatization of the tobacco industry in 2016, among other efforts.
The country has also issued a robust tobacco control proclamation 1112/2019 that is consistent with the WHO FCTC. The primary element of 1112/2019 requires a comprehensive prohibition on smoking in public places. It restricts all forms of direct and indirect tobacco advertising, including media, sponsorships, and promotional campaigns. Additionally, it forbids tobacco corporations from sponsoring events or providing free samples.
The proclamation requires graphic health warnings on at least 70% of tobacco product packaging and prohibits flavored tobacco products. Importantly, it restricts the sale of tobacco products to people under the age of 21, and sellers must verify age if there is any doubt.
Despite Ethiopia’s efforts to combat tobacco use, the government undertook the Global Adult Tobacco Survey (GATS) twice, in 2016 and 2024, to monitor progress. GATS is a thorough study designed to collect data on tobacco use among adults in several nations. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have launched this program to provide trustworthy statistics on tobacco consumption, its public health consequences, and the success of tobacco control strategies. It also seeks to comprehend usage patterns and gather information related to initiation, cessation, and frequency of tobacco use.
Ethiopia used GATS to better understand tobacco consumption patterns, as well as knowledge, attitudes, and behaviors associated with tobacco use. Accordingly, the 2024 GATS findings show that the number of cigarette smokers in Ethiopia has fallen nationally.
Specifically, the total percentage of tobacco users in Ethiopia was 5 percent in the 2016 GATS, while the 2024 GATS shows a decline to 4.6 percent. Contrastingly, exposure to second-hand smoke at workplaces decreased from 29.3 percent in 2016 to 19.8 percent in the 2024 survey.
In 2016, 60.4 percent of individuals in bars and nightclubs and 31.1 percent in restaurants were exposed to secondhand smoke, a figure that dropped to 20.2 percent by the 2024 GATS. Additionally, the percentage of female smokers fell from 1.2 percent in 2016 to 0.5 percent in 2024.
According to Heran Gerba, the Director General of the Ethiopian Food and Drug Authority, these remarkable results are achieved due to the country’s firm commitment and resolve. The government’s strong political commitment to protecting its citizens from the harmful effects of tobacco is notable, as evidenced by the ratification of the WHO Framework Convention on Tobacco Control (FCTC) in 2014, the privatization of the tobacco industry in 2016, and the robust tobacco control proclamation 1112/2019, which is consistent with the WHO FCTC.
She stated that smoking is prohibited in all public venues, including indoor areas, businesses, and public transit. Furthermore, it outlaws both direct and indirect tobacco advertising, which includes media, sponsorships, and promotional campaigns.
She elaborated that the country regulates e-cigarettes and develops tobacco products while also enforcing strict tobacco taxes and pricing policies. Furthermore, it establishes tight rules for pictorial health warnings, requiring that 70% of the front and back of cigarette packs carry rotating health warnings every two years.
Ethiopian Ministry of Health State Minister Dr. Dereje Deguma indicated that approximately 5 percent of Ethiopia’s total population smokes tobacco. Consequently, the country has been diligently creating a strong legal framework designed to reduce smoking rates and safeguard the health of its citizens.
Despite achievements, tobacco use poses a challenge in Ethiopia, claiming over 17,000 lives each year. Thus, smoking is considered a public health issue in the country.
He confirmed that the government will continue to strengthen the enforcement of smoke-free policies, enhance cessation support, regularly increase tobacco taxes, boost public awareness campaigns, expand periodic research, and promote cross-sector collaboration.
Ethiopian Public Health Institute (EPHI) Director General Dr. Mesay Hailu stated that the GATS results show that, while Ethiopia has achieved significant progress in tobacco control, much more work remains.
For instance, while GATS indicates improvements in public spaces with reduced tobacco smoke exposure, there is a need for stronger enforcement. It has also been identified that tobacco users require access to professional assistance to quit smoking, while community awareness-raising platforms should be established, and tobacco products made less accessible.
In general, GATS is critical for understanding tobacco use trends and their consequences for public health and environmental risks. GATS contributes vital data to the development of effective tobacco control policies, which aim to reduce tobacco use while mitigating related health risks and environmental issues. Continuous monitoring and evaluation via surveys such as GATS are critical for improving health outcomes and environmental protections.
BY EPHREM ANDARGACHEW
THE ETHIOPIAN HERALD TUESDAY 8 APRIL 2025
