According to 2016 Global Burden of Disease (GBD) research, more than 16, 800 people die in Ethiopians per year by non communicable diseases in connection with tobacco, says Sisay Derso Communicable and Non Communicable Diseases Researcher of Ethiopian Public Health Institute (EPHI). According to the researcher, tobacco takes the lion share for high health damage which leads to chronic diseases plus the main cause for non communicable diseases.
Tobacco is also among the main causes to initiate cancer and respiratory health problems. Sisay noted citing researches that before the implementation of Millennium Development Goals, in 1990s, 56 per cent of deaths were due to communicable diseases while noncommunicable diseases take 32 per cent. But, according to 2016 health researches, in Ethiopia the major cause for the death is a non communicable disease which takes 49 percent while the communicable diseases decreased to 43 per cent.
This indicates that although the country decreases communicable diseases through highly investing on it, the effect on non communicable diseases has been increasing and the wide spreading of tobacco contributes for the increment of non communicable killer diseases in Ethiopia. Currently, 3.4 million which is 5 per cent of the country’s total population is active smoker, Sisay told The Ethiopian Herald, adding that the number increasing from year to year. Hence, there is a need for strong controlling mechanism to limit the expansion of tobacco and to decrease the number of smokers.
“When we think the passive/ second hand smokers, the side effect of tobacco in Ethiopia is too worse”, Sisay said. According to 2011 Ethiopia’s Demographic Health Survey (DHS), only 37 female smokers were found, but in 2016 the number of female smokers were 0.8 per cent. According to the Global Adult Tobacco Survey of the country held recently, a survey to measure fully tobacco effects and distribution, since Ethiopia signed the WHO Framework Convention on Tobacco Control (WHO FCTC), 1.2 per cent female users’ are found, the researcher stated.
The increment of female smokers’ has an effect for societal crises as females’ social responsibility is higher than males. This all indicated that Ethiopia is on a critical time to limit the expansion of tobacco seriously to protect the health of its citizens and to save additional budgets for non communicable diseases caused by the effect of tobacco, the expert underlined.
According to Sisay, to control the effects and expansion of tobacco and to decrease the number of smokers, there should be strong laws approved by the parliament with strong enforcement mechanism, raising up the tariff, lifting designated areas in hotels and restaurants, properly implement prohibition of selling/buying single unit cigarette, implementing sanctions on smoking free public areas and other legally forcible systems seriously.
Sisay said that although Ethiopia has a regulation to prohibit smoking tobacco in public areas, the regulation is relative and weak, only a directive and not approved by the House of People’s Representatives. Not only that the regulation has no enforcement mechanism with specified sanctions and no legally responsible organization for the implementation at the grassroots level, although the Ethiopian Food, Medicine and Healthcare Administration and Control Authority (FMHACA) is the regulatory organ.
The legislation should specifically put the designating area with the distance, the sanction of smoking in smoking free places and institutions, the enforcer of the law up to the grassroots level, although permitting smoking without any technology is not yet preferable to control tobacco. Even after the implementation of the regulation, recent researches by EPHI to evaluate the performance of the law, in indoor work places 30 per cent of non smokers are exposed to tobacco effect.
This number indicated that more than six million productive human power is exposed to the effect of tobacco due to the weak implementation of the prohibition of smoking free places in work place, Sisay further noted. According to him in health institutions the level is seven per cent (although it is totally prohibited), in transport 11 per cent, in government institutions 20 per cent, in restaurants 11 per cent, in higher education institutions 30 per cent, more worse in night clubs more than 60 per cent of the people which are not active smokers are affected by tobacco.
The problem shows that the available regulation is not strong and secondly even the available regulation is not properly implemented to controlling tobacco. In our country the smoking area doesn’t have any sophisticated technology to absorb the tobacco. Hence, prohibiting smoking areas in hotels, restaurants and other public areas is the best mechanism to control cigarette.
According to the expert, in Ethiopia more than 80 per cent smokers’ buys cigarette unit by unit, although the regulation prohibited selling/buying single unit cigarette, hence forcefully prohibiting selling single unit forced the buyers to buy a packet cigarette, which is another system to limit the users. Sisay noted that tax rising is among WHO most effective tobacco controlling mechanisms.
Even by only by increasing 10 percent of the tax rate in tobacco products, it decreases more than eight percent users, he stated. According to WHO proclamation which Ethiopia has approved, 70 per cent of retail price of tobacco is tax which means the price of the cigarette is only 30 percent while 70 per cent is tax. By implication to compensate the revenue, the company or retailer increases the price of the cigarette, he stated. Sadly, the price of tobacco in Ethiopia is too cheap, where the price of 20 cigarettes is averagely 18 birr only.
And more than 82 per cent of the country’s total consumption of tobacco is produced locally, although the factories imported leaf with 20 per cent excise tax and some finished products. According to recent research not published yet, up to 82 per cent are local products. So by increasing the tax on the local products, it means decreasing non communicable diseases, saving extra expenditure budgeted for non communicable diseases caused by tobacco, protect health of citizens, decreasing the number of smoke.
Herald January 26/2019
BY DARGIE KAHSAY
