Evidence-based Research on Tobacco Harms and Societal Well-being

1. Establishing the evidence-base on health and socio-economic impacts of tobacco harms on individuals and societal well-being By WILFRED JEKETE KAC SCHOLAR

2. Introduction • Tobacco production in Africa is one of the largest sources of income • As the levels of tobacco smoking declines in developed countries, the tobacco industry has increased its efforts to expand its market share in the developing world, especially in Africa where tobacco consumption is rapidly increasing (African Union, 2015) • However, as tobacco production in the country increases, there is also a rapid increase in number of young smokers, as well as the proliferation of multiple forms of tobacco use

3. Introduction, continued • The need for educating consumers about harms caused by tobacco is growing in some other countries (E.g. USA) as different tobacco products which also differ in their relative health harms enter the market place • However, little is known about the patterns of the public’s knowledge of relative harms caused by tobacco smoking, despite the fact that tobacco smoking places substantial social, economic, health and environmental costs on the family and community at large, (Nitzkin, 2012

4. WHY THIS STUDY? • This study was conducted to: (1) Establish the evidence base of the health and socio-economic impacts of harms caused by tobacco smoking on individuals and societal well-being (2) Promote interventions to enhance public and professional understanding of tobacco harm reduction

5. Tobacco Harm Reduction? • Tobacco Harm Reduction (THR) is the most promising policy option to reduce tobacco-attributable illness and death in every society which youths and old smokers cannot be restricted from smoking • THR, in operational terms, is education and counselling to encourage smokers who are unable or unwilling to quit, to switch to a much-lower-risk smoke-free tobacco/nicotine product to reduce their risk of cancer, heart and lung disease and other impacts tobacco smoking has on an individual or family and community (Nitzkin, 2012)

6. Research Results The study has established impacts of tobacco smoking in three dimensions of: {1} Health {2} Social {3} Economic

7. Health Impacts of Tobacco Smoking • It has been discovered that smokers expose themselves to respiratory related disease including lung cancer and tuberculosis among other diseases that also affect smokers • The study has also revealed that 73.4% of smokers seeking medical attention over the various cases in the past 12 months • 59.7% of the cases that brought by smokers are attributed by medical professionals to tobacco smoking

8. Health Impacts, continued

9. Cases Attributed to tobacco smoking by Health Professionals

10. Social Impacts of Tobacco Smoking It has been discovered that socially individuals start smoking at a young age as shown below:

11. Social Impacts, continued • 46% and 44% of smokers being introduced to smoking started smoking 1 cigarette for 30 days in a row at below 19 years of age, resulting in the generation of addicts in later ages • Furthermore, it can be noted that most individuals start smoking tobacco without being informed about the underlying consequences that could be helpful in making informed health choices

12. Social Impact, continuedAddiction

13. Social Impact, continuedAddiction • The probability addicted smokers continue smoking in the future during the study was set at 66.2% with 27.2% of smokers not being sure of whether to they can manage to quit or not • As more people are becoming addicted to tobacco smoking, It will mean a continuous exposure to the harms that are caused by smoking which may result in premature death in society

14. SOCIAL IMPACTS…SECOND HAND SMOKING60% of key informants revealed that non-smokers are also highly likely to be suffering from tobacco smoking attributed diseases58% such non smokers suffering from tobacco related diseases were found to have been living in a smoking environment

15. Second Hand Smoking • it is therefore evidenced that public health policies and tobacco consumption control measures in the country are too loose to protect the under aged and the general public including pregnant women • It is now a common aspect in our social setting for people to smoke in public because there are no clear public health policies and control measures regulating such behaviour to protect the general public which is suffering unknowingly the adverse harms caused by passive tobacco smoking

16. A Call for Action!

17. Economic Impacts of Tobacco Smoking • Beyond the face value of cigarette purchases, the cost of tobacco use has more far reaching health and economic implications on private individuals, families, employers and taxpayers • The economic impacts of tobacco smoking are classified into tangible and intangible impacts • Tangible impacts include both the direct and indirect costs. The direct costs of smoking include the cost of illness due to smoking on affected patients, and the health care expenditure involved in the treatment of smoking related illness (cost of drugs and administration)

18. Economic Impacts of Tobacco Smoking • 71.4% of smokers were found to be either uneducated or of PSLCE level with 64.4 % of them solely depending on farming as their economic activity in order to earn a living together with their families • 86.6% of the smokers were found to be males who according to our culture they are breadwinners who are regularly exposing themselves to the health harms such as lung cancer, tuberculosis etc through smoking • Such respiratory diseases make up a total of 49.1% of illness attributed to smoking hence the cost of treating such disease fall on the family, community and government on micro, intermediate and macro levels respectively

19. Economic Impacts of Tobacco Smoking • 55.6% of household revealed that they divert their resources meant for household basic needs such as food, clothing and even school fees to the treatment of the disease so does the community hence pushing the family into extreme poverty • These economic impacts become more vicious when the breadwinner dies with high chances of perpetuating through generations with the economic cost of smoking becoming hard to bear

20. Existing Knowledge of THR strategies • Only 71.1 % of the health professionals and 10.4% of smokers agreed to have ever heard about Tobacco Harm Reduction strategy but none of have attended any training on it • Hence it’s difficult to help individuals who visit the centre for assistance to reduce the harm caused by smoking tobacco • Smokers find it hard to reduce the harms caused by smoking strategically

21. Conclusion and Recommendations • Train professionals including health experts on tobacco harm reduction so as to reach as large a number of smokers as possible with information so that they are informed as they make better health choices for themselves and their families • There is a need to raise awareness to the public on the harms of tobacco, both health and socio-economically • Promote tobacco harm reduction strategies to the public through knowledge dissemination, campaigns and workshops so that both smokers and non-smokers will be in a position to make informed health choices regarding smoking and tobacco use, and help people dependent on smoking to reduce the harm they expose themselves to

22. Conclusion and Recommendations There is also a need to advocate for policies that advocate against tobacco smoking in public places in order to protect non-smokers from second hand smoking, since the study has discovered that a large percentage of non-smokers were found being affected by smoking-related disease as confirmed by health experts

23. THANK YOU END OF PRESENTATION