A Brief:Tobacco Use and Tobacco Control in Zambia – Centre for Primary Care Research University of Zambia, School of Medicine

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By Local:  Prof. Fastone M Goma

Mr. Richard Zulu

Mr. Evans Kangwa

International:  Dr. Jeffrey Drope

Ms. Qing Li

Dr. Grieve Chelwa

Dr. Ronald Labonte

 

 

Acknowledgements

oSchool of Medicine, University of Zambia

oAmerican Cancer Society

oZambian tobacco farmers

 

 

 

Tobacco is predicted to become the leading single cause of death by 2020, causing more than one in every eight deaths.

Half of all lifetime smokers will die prematurely as a result of tobacco use – losing 20-25 years in life expectancy compared with non-smokers.

: Fagerström K. The Epidemiology of Smoking. Health

Consequences and Benefits of Cessation. Drugs 2002; 62 (Suppl. 2):1-9

What is contained in tobacco

*Tobacco smoke contains nicotine and around 7,000 other chemicals. Many of these are poisonous and over 60 are known to be cancer causing (carcinogenic).

*The prominent chemicals in tobacco include:

* nicotine

*carbon monoxide(similar to exhaust smoke of a car)

*tar.

*Nicotine is a colourless, poisonous substance affects the brain and quickly becomes addictive.

*‘Tar’ is the term used to describe the toxic chemicals found in cigarettes. It’s a sticky brown substance that forms when tobacco cools and condenses. It collects in the lungs and can cause cancer.

*Carbon monoxide is an odourless, colourless gas that is released from burning tobacco. When it is inhaled it enters the blood stream and interferes with the working of the heart and the blood vessels.

Diseases caused by tobacco

Tobacco causes disease and death. Harmful effects of tobacco include;

*Damage to blood vessels causing stroke

*Amputations.

*Cancer.

* Miscarriage, premature birth, still-birth and illness.

*Mouth diseases

* Asthmatic attacks

Tobacco related mortality

• • Tobacco Costs Zambian economy – K2.8 billion/year

  – 1.2% of GDP lost

  • Kills 7, 947 Zambians/year
  • 60% under 70 yrs
  • Causes loss of 116, 427 healthy years of life

Globally, tobacco kills far more people than alcohol and illegal drugs, combined.

In year 2000,

1.1 billion smokers world-wide

Tobacco killed nearly 5 million people worldwide,

Alcohol killed nearly 2 million, and

Illegal drugs killed about 200,000.

Tobacco is a gateway drug that often introduces youth to other drugs.

Zambia Tobacco Consumption

*Almost 1,680,000 men and 180,000 women are daily smokers

*28.6% of men and 2.1% of women

*On average 25% Adolescents use Tobacco

*ETS Exposure in the home

*30% Boys

*24% Girls

A Brief-Tobacco Use and Tobacco Farming in Zambia (3)

Here is the presentation in word.
A Brief: Tobacco Use and Tobacco Control in Zambia
Centre for Primary Care Research
University of Zambia, School of Medicine
Investigators
Local: Prof. Fastone M Goma
Mr. Richard Zulu
Mr. Evans Kangwa
International: Dr. Jeffrey Drope
Ms. Qing Li
Dr. Grieve Chelwa
Dr. Ronald Labonte
Acknowledgements
o School of Medicine, University of Zambia
o American Cancer Society
o Zambian tobacco farmers
o Tobacco is predicted to become the leading single cause of death by 2020, causing more than one in every eight deaths.
o Half of all lifetime smokers will die prematurely as a result of tobacco use – losing 20-25 years in life expectancy compared with non-smokers.

Fagerström K. The Epidemiology of Smoking. Health
Consequences and Benefits of Cessation. Drugs 2002; 62 (Suppl. 2):1-9
What is contained in tobacco
 Tobacco smoke contains nicotine and around 7,000 other chemicals. Many of these are poisonous and over 60 are known to be cancer causing (carcinogenic).
 The prominent chemicals in tobacco include:
 nicotine
 carbon monoxide (similar to exhaust smoke of a car)
 tar.
 Nicotine is a colourless, poisonous substance affects the brain and quickly becomes addictive.
 ‘Tar’ is the term used to describe the toxic chemicals found in cigarettes. It’s a sticky brown substance that forms when tobacco cools and condenses. It collects in the lungs and can cause cancer.
 Carbon monoxide is an odourless, colourless gas that is released from burning tobacco. When it is inhaled it enters the blood stream and interferes with the working of the heart and the blood vessels.
Diseases caused by tobacco
Tobacco causes disease and death. Harmful effects of tobacco include;
 Damage to blood vessels causing stroke
 Amputations.
 Cancer.
 Miscarriage, premature birth, still-birth and illness.
 Mouth diseases
 Asthmatic attacks
Tobacco related mortality
• Tobacco Costs Zambian economy – K2.8 billion/year
– 1.2% of GDP lost
• Kills 7, 947 Zambians/year
• 60% under 70 yrs
• Causes loss of 116, 427 healthy years of life

Globally, tobacco kills far more people than alcohol and illegal drugs, combined.
In year 2000,
1.1 billion smokers world-wide
Tobacco killed nearly 5 million people worldwide,
Alcohol killed nearly 2 million, and
Illegal drugs killed about 200,000.
Tobacco is a gateway drug that often introduces youth to other drugs.
Zambia Tobacco Consumption
 Almost 1,680,000 men and 180,000 women are daily smokers
 28.6% of men and 2.1% of women
 On average 25% Adolescents use Tobacco
 ETS Exposure in the home
 30% Boys
 24% Girls

Why Tobacco Control?
 It is a disease vector
 It is a global agent of death
 It is a growing epidermic
 It is an economic threat
Global death clock
 Every 6.5 seconds, a tobacco user dies. 8 years ago, when the clock started, that interval was 8 seconds. Tobacco’s death toll has accelerated. It will kill nearly 6 million people this year.
 Least developing countries in Africa will face the full brunt of mortalities.
The Costs of Tobacco
Tobacco’s burden on governments, employers, and the environment are largely hidden taxes including:
 Hugely increased healthcare costs
 Loss of foreign exchange for imported cigarettes
 Diversion of agricultural land
 Fires and damage to buildings
 Decreased worker productivity
 Widespread deforestation, pesticide and fertilizer pollution, and trash from butts
Costs to Governments
 Increased Health Care Costs
 In high income countries, annual tobacco-attributable health care costs est. at between 6% and 15% of total health care costs (very few estimates for low income countries
 Lost productivity due to illness (green leaf tobacco sickness) and premature death
 Foreign exchange losses
 Environmental damage
 Just how important is tobacco to Zambia’s economy?
2015 Agricultural crops
% GDP $ millions
Tobacco 0.4 98

Maize 11.5 390
Cotton 0.7 180
Coffee 0.1 17

Tobacco Control

 What is tobacco control?
 It is a range of supply, demand and harm reduction strategies that aim to improve the health of the population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.
Tobacco Laws in Zambia
 1992 Public Health (Tobacco) Regulations
 2008 Statutory Instrument No. 39 Local Govt. Banning smoking in public places
 NOTE: The above pieces of legislation and not fully WHO FCTC Compliant, thus the need for new TC legislation
Advised actions: M-POWER Strategy

 M-Monitor tobacco use and tobacco prevention policies
 P-Protect people from harms of tobacco
 O-Offer help to quit tobacco use
 W-Warn about dangers of tobacco
 E-Enforce bans on tobacco advertising
 R-Raise taxes on tobacco

Call to Action
1) Lobby for the passing of the Tobacco and Nicotine Control BILL;
2) Advocate for Increased taxation of tobacco products and ban the sale of single cigarettes;
3) Support the strengthening of enforcement of the smoke-free law by ensuring strong and consistent enforcement, particularly in bars and indoor workplaces, including strong penalties for violations;
4) Become Tobacco Control “Ambassadors” in in the media;
5) Strengthen social dialogue in communities; and
6) Advocate for Graphic Picture Warning Signs on tobacco packaging