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ATSA-CAMEROON

ATSA-CAMEROON. CAMEROON. REINFORCING POLICIES FOR SMOKE-FREE PUBLIC SPACES AND HEALTH WARNINGS ON CIGARETTE PACKS IN THE ANTI-SMOKING CAMPAIGN IN CAMEROON.

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ATSA-CAMEROON

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  1. ATSA-CAMEROON CAMEROON

  2. REINFORCING POLICIES FOR SMOKE-FREE PUBLIC SPACES AND HEALTH WARNINGS ON CIGARETTE PACKS IN THE ANTI-SMOKING CAMPAIGN IN CAMEROON • The African Tobacco Situational Analyses (ATSA) is an initiative launched by the IDRC and the Bill & Melinda Gates Foundation (BMGF) which aims to understand the determining factors likely to ensure the success of tobacco control and orient the development and implementation of tobacco control strategies in Africa in the short and long terms. • ATSA-Cameroon is comprised of research professors from the Universités de Yaoundé 1 and 2; members of the Expert Panel on smoking; officers of the Ministry of public health; members/activists from civil society organizations and the media. The ATSA-Cameroon team is represented here by Dr. Z. Njoumemi and Dr. H. Mimche. The ATSA project is being carried out by the Ministry of public health and the School of Medecine and Biomedical Sciences of the Université de Yaoundé 1. • ATSA Pre-conference, Mumbai, India, March 7, 2009.

  3. EVALUATION OF THE BASELINE SITUATION IN CAMEROON Epidemiology of Smoking • Prevalence: 17.5% of the population are tobacco smokers, • of which 28.8 % are men and 8.1% are women. • Smoke exposure: 37% of Cameroonians are exposed to tobacco smoke in public spaces and home environments. • Around 15% of young people under 15 years old are affected, • with a much higher prevalence in schools, where 44% of students have tried tobacco, • of which 5% before the age of 7. • In university settings, 60% of smokers are approximately 20 years old: • boys start smoking at 15 years old and girls at 18 years old.

  4. The Baseline Situation in 2008 (GYTS) • 15.2% of students have already tried smoking a cigarette (of which 21.8% of boys and 9.2% of girls) • 31.2% of students experimented with tobacco before the age of 10 • 10.9% of non-smoking students are considering experimenting with tobacco in the next 12 months (before the end of 2009) • 45% of students are exposed to tobacco smoke in public spaces • 75.7% of students think that tobacco smoke is harmful to the overall health of society • 87.7 % are in favour of banning smoking in public spaces

  5. FCTC and the National Policy on Tobacco Control Act No. 64/LF/23 of November 13, 1964 regarding public health protection. Act No. 90/O31 of August 10, 1990 governing commercial activity in Cameroon. Act No. 98/004 of April 14, 1998 regarding the orientation of education in Cameroon; this act prohibits the sale of alcoholic beverages, tobacco and drugs in educational institutions. Act No. 2005/005 of July 24, 2005 authorizing the President of the Republic to ratify the WHO Framework Convention on Tobacco Control (FCTC). Act No. 2006/018 of December 29, 2006 governing advertising in Cameroon. Decree No. 93/720/PM of November 22, 1993 setting out the enforcement approach of Act No. 90/O31. Decree No. 2005/440 Bis of October 31, 2005 regarding the ratification of the WHO Framework Convention on Tobacco Control (FCTC).

  6. FCTC and the National Policy on Tobacco Control • Order No. 0016/AI/MINDIC/MSP/CAB of June 8, 1998 regarding health warnings on the packaging of tobacco-based products. • Order No. 967 MINSANTE/MINCOMMERCE of June 25, 2007 regarding health warnings on the packaging of tobacco-based products. • Decision No. 0222/D/MSP/SG/DMPNP of November 8, 1988 regarding the smoking ban in Ministry of public health institutions and training courses. • Decision No. 0180/D/MSP/SG/DPS of May 28, 2004 regarding the creation and implementation of the Expert Panel on smoking. • Letter No. 07/788/CF/L/MINEFI/DRH/SP of June 15, 2007 relating to the smoking ban in Ministry of economy and finance buildings at that time. • Circular Letter No. 012/B1/1464/MINEDUB/SG/DRH/SDSSAPPS of August 17, 2007 relating to the creation of smoke-free spaces and anti-tobacco clubs in educational environments. • Circular Letter No. 19/07MINESEC/SG/DRH/SDSSAPPS of September 11, 2007 relating to the creation of anti-tobacco clubs in educational environments and making educational institutions "smoke-free spaces." • MEMORANDUM No. 1913 of June 12, 2007 of the Government Delegate to the Communauté Urbaine de Yaoundé [Yaoundé urban community organization] informing all employees and visitors to respect the slogan "no smoking inside."

  7. CAMEROON'S NUMBER ONE PRIORITY IN CONTROLLING TOBACCO • I - Promotion of smoke-free public spaces: 100% smoke-free public spaces is the only proven way to effectively protect non-smokers from the harmful effects of passive smoking and help smokers to give up tobacco. Smoking bans in public spaces reduce the social acceptability of tobacco and discourage youth and adult non-smokers from starting smoking.In Cameroon, approximately 37% of the population (more than 6,000,000 people) are exposed to second-hand smoke in public spaces. Promotion of smoke-free school, university and socio-educational public spaces is crucial to reducing smoking rates among students, for which the prevalence of smoking is rising; it was at 15.2% among students aged 13-15 and 25.3% among educators in 2008. This is why the government of Cameroon would like public and work spaces to be 100% smoke-free, so much so that policies and ratified laws are on the verge of being adopted at the national level to provide legal and regulatory bases for the promotion of smoke-free public spaces in Cameroon.

  8. GOAL AND OBJECTIVES OF CAMEROON'S NUMBER ONE PRIORITY IN CONTROLLING TOBACCO • Public spaces include: restaurants, bars, taxis and any and all other public transportation, busses, bus and train stations, airport terminals, community recreation spaces, movie theatres, video arcades, sports fields and centres, community and local markets, malls, shopping centres, government and community buildings, primary and secondary schools, universities, institutes of higher education, socio-educational centres, public gardens, theatres, conference halls, public libraries, fairs, etc. • Goal: To promote the establishment of and compliance with smoke-free public spaces in Cameroon. • General Objective: Protect non-smoking populations from second-hand smoke and reduce the social acceptibility of tobacco to discourage young people and adults from picking up smoking and help smokers to stop in order to create public spaces in the Mfoundi area and models of "smoke-free zones" in Cameroon.

  9. GOAL AND OBJECTIVES OF CAMEROON'S NUMBER ONE PRIORITY IN CONTROLLING TOBACCO (Cont. 1) • SPECIFIC OBJECTIVES: • 1 – To conduct a baseline study on the existence, level of application, effectiveness, opportunities and constraints of implementing legislation and internal and external regulatory measures in the anti-tobacco campaign in all listed public spaces publics in the Mfoundi area. • 2 – To advocate, raise awareness and involve all stakeholders and participants including the media and civil society organizations in the process of establishing a total smoking ban in all listed public spaces in the Mfoundi area. • 3 - To strengthen the abilities of all stakeholders and participants including the media and civil society organizations in order to mobilize the political, administrative and community responsible parties and the public to support the establishment, strengthening and spread of the total smoking ban in all listed public spaces in the Mfoundi area.

  10. GOAL AND OBJECTIVES OF CAMEROON'S NUMBER ONE PRIORITY IN CONTROLLING TOBACCO (Cont. 2) • SPECIFIC OBJECTIVES (Cont.): • 4 – To establish, enforce, monitor and evalute the total ban of smoking in all listed public spaces in the Mfoundi area. • 5 – To create, copy and distribute a document summarizing data on the successes made and best practice principles of "smoke-free" public spaces in order to inform political decision-makers, anti-smoking activitists and the media and help them in their efforts to replicate them and spread them to all public spaces throughout Cameroon's other areas.

  11. PLAYERS INVOLVED IN THE IMPLEMENTATION OF CAMEROON'S NUMBER ONE PRIORITY • Ministry of territorial administration and decentralization (Office of territorial management, Office of civil protection, etc.) • Prefecture and subprefectures of the Mfoundi area • Tobacco control associations and civil society and public health organizations registered at the Mfoundi prefecture • Communauté Urbaine de Yaoundé [Yaoundé urban community organization] and Mairies d’Arrondissements du Mfoundi [Administration of the Mfoundi arrondissements] • Ministry of public health (Office of health promotion, the Expert Panel on smoking, National committee for the fight against drugs, National epidemiology committee, etc.) • Health services of the Mfoundi sanitary districts • The directors, administrative personnel, teachers, and students of primary and secondary schools, socio-educational centres and universities of Mfoundi

  12. PLAYERS INVOLVED IN THE IMPLEMENTATION OF CAMEROON'S NUMBER ONE PRIORITY (2) • The Ministries of: commerce; small and medium-sized enterprises; social affairs; the status and promotion of women; youth, sports and physical education; primary and secondary education; higher education; communications, etc. • Public and private print and audiovisual media • Members of Parliament and Mfoundi opinion and political leaders • Mfoundi religious leaders and traditional chiefs • The managers and persons in charge of the public spaces in Mfoundi • The unions and insurance companies of managers, workers, and users of Mfoundi's public spaces • The people of Mfoundi

  13. The participants in the consultation workshop have reservations on the effectiveness of the scope and impact of Order No. 967/MINSANTE/MINCOMMERCE of June 25, 2007 regarding health warnings on the packaging of tobacco-based products. Given that tobacco is consumed by the majority of smokers in the form of cigarettes sold mostly in retail establishments to poor and/or illiterate consumers, and so that the regulatory measures are properly implemented, it will be necessary to document the proportion and characteristics of the smokers exposed (or not) to the awareness-raising and dissuasion messages on the packaging of tobacco-based products in Cameroon. What is the level of compliance with and knowledge of the health warnings written on the packages of tobacco-based products and what are the beliefs, perceptions, attitudes and practices of cigarette vendors, smokers and non-smokers with regard to this labeling/warning policy or health warnings on cigarette packs? What effect do written health warning labels (not illustrated with images or photos) regarding the health consequences of smoking have on the demand and consumption of cigarettes? What obstacles prevent the written health warning label (with no images or photos) policy from being effective? How can we strengthen or redirect this written warning label policy with health warnings illustrated with images or colour photos on the health consequences of smoking? CAMEROON'S NUMBER TWO PRIORITY IN CONTROLLING TOBACCO II - Evaluation of the effectiveness of the health warning label policy: ‘tobacco seriously harms the health of smokers and that of the people around them, tar: 14mg, nicotine: 1.2mg’ on at least 50% of the total surface of each of the two main sides of cigarette packs in Cameroon. The scope and impact of the health labels are not guaranteed to be as effective in changing the behaviour of smokers as they are in changing that of non-smokers. Given that tobacco is consumed by the majority of smokers in the form of cigarettes that are sold mostly in retail establishments to poor and/or illiterate consumers, this written warning label policy must be strengthened or redirected with health warnings with illustrated images or colour photos on the health consequences of smoking. Printing illustrated health warnings requires a synergy of actions. However, civil society players/partipants are not familiar with each other and are poorly known by their government counterparts. Because of this, it is difficult to rely on civil society organization networks, including the media, that currently are participating or could participate in the fight against tobacco and that are fundamental to the improvement of both institutional and individual capabilities to implement anti-smoking.

  14. GOAL AND OBJECTIVES OF CAMEROON'S NUMBER TWO PRIORITY IN CONTROLLING TOBACCO IN CAMEROON • Goal: To promote printing of health warnings on cigarette packs in Cameroon. • General objective: To mobilize all participants to reinforce the policy of labeling cigarette packs with images or colour photos with the aim of improving awareness of the risks of smoking on the health of youth and adult smokers and non-smokers so that they change and adopt behaviours that are in line with Cameroon's anti-smoking campaign. • Specific objectives: • 1 - To conduct a pilot study in the Mfoundi area on the knowledge, attitudes, perceptions, practices and behaviours of smoking and non-smoking populations with regard to the non-illustrated written health warnings on the dangers of smoking;

  15. GOAL AND OBJECTIVES OF CAMEROON'S NUMBER TWO PRIORITY IN CONTROLLING TOBACCO (Cont. 1) • Specific objectives (Cont.): • 2 - To establish a map of the profiles of the non-governmental organizations and/or associations working in tobacco control in Cameroon; • 3 - To lead an advocacy and awareness-raising campaign with the aim of involving all the governmental and non-governmental participants, including the media and civil society organizations, in the process of printing health warnings illustrated with images or colour photos on cigarette packs in Cameroon; • 4 - To design, validate and get all the governmental and non-governmental participants, including the media and civil society organizations, to adopt the project of health warnings illustrated with images or colour photos on cigarette packs in Cameroon; • 5 – To establish, enforce, monitor and evaluate the health warnings illustrated with images or colour photos on cigarette packs in Cameroon.

  16. PLAYERS INVOLVED IN THE IMPLEMENTATION OF CAMEROON'S NUMBER TWO PRIORITY • Cameroon's prefectures and subprefectures • Associations and anti-smoking civil society and public health organizations registered at prefectures and subprefecturs and the regional cooperative registries of the Ministry of agriculture • Cameroon's urban communities and urban and rural administrations • Ministry of public health (Office of health promotion, the Expert Panel on smoking, National committee for the fight against drugs, National epidemiology committee, etc.) • Regional health delegations and the health services of Cameroon's sanitary districts • The Ministries of: commerce; small and medium-sized enterprises; social affairs; the status and promotion of women; youth, sports and physical education; primary and secondary education; higher education; communications, etc. • Public and private print and audiovisual media • Research institutions and community organizations

  17. Lessons Learned • The results of the GYTS 2008 reveal a slight increase in the prevalence of smoking among young Cameroonians • Development and validation of the National Policy on Tobacco Control in Cameroon document (with the active participation of members of the ATSA-Cameroon team) in February 2009 • Development and validation of the National Bill on Tobacco Control in Cameroon (with the active participation of members of the ATSA-Cameroon team) in February 2009 • Submission of the National Bill on Tobacco Control in Cameroon for debate, deliberation and adoption by the Deputies of the National Assembly of Cameroon in March-April 2009 • Redirection of the ATSA strategy toward concrete and operational interventions in favour of short and long-term tobacco control policies in Cameroon • Increased political will and mobilization of local players/participants in favour of tobacco control in the society • Introduction of questions regarding tobacco and health at the College of Medicine and Biomedical Sciences, Université de Yaoundé I

  18. Importants Points of the Work Plan • More comprehensive and multisectorial operational definition: SMOKE-FREE PUBLIC SPACES in Mfoundi or ‘Smoke-free Yaoundé’ • Promote the establishment of and compliance with SMOKE-FREE PUBLIC SPACES and ILLUSTRATED HEALTH WARNINGS on cigarette packs • Specific objectives that are attainable in the short term (after 6-8 months of intervention efforts)

  19. Long-term Goals • Completely enforce the ban on tobacco advertising, promotion and sponsorship in the media and all other advertising media • Limit access to tobacco products through tax increases, a ban on selling cigarettes to youth/minors as well as the sale by minors. Combat the smuggling of tobacco products in border areas.

  20. ATSA -Cameroon Team

  21. END OF THE PRESENTATION THANK YOU FOR YOUR ATTENTION

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