[Intl-tobacco] Kenya: Smoking Makes Us Poor

[Robert Weissman]

http://allafrica.com/stories/printable/200503300260.html
*
Smoking Makes Us Poor*

*The East African* (Nairobi)
ANALYSIS
March 28, 2005
Posted to the web March 30, 2005

By Dagi Kimani
Nairobi

/Studies have shown that in the most deprived households in poor
countries, as much as 10 per cent of the total household expenditure is
committed to tobacco/

FOR GENERATIONS, smoking was depicted as the epitome of sophistication
and glamour. In the past century, popularised by Hollywood stars and
immortalised by revolutionaries like Che Guevara, the habit transcended
all borders, becoming a hallowed rite of passage into adulthood for many
teens.

Now, over 600 years since the habit was introduced to the world by
Spanish conquistadores returning from South American adventures,
however, tobacco is at last becoming a burnt-out case.

Last December, in an unprecedented move, the tiny kingdom of Bhutan in
the Himalaya mountains north of India became the first country in the
world to universally ban all uses of the product. The ban caused rapture
across the globe's anti-tobacco lobby.

"Tobacco is the only legal product that almost always kills its
consumers when used as advised by the manufacturer," points out Phillip
Karugaba, spokesperson for The Environmental Action Network (TEAN), a
Ugandan tobacco control lobby group. "It is now accepted that if it were
introduced today as a leisure product, tobacco would be instantly banned
as an illicit drug."

Things are looking up for lobbyists and activists like Karugaba. The
year 2004 could, in fact, go down in history as the point when the tide
turned against tobacco.

Last December, in perhaps the greatest blow since it became a global
product, the World Health Organisation's Framework Convention on Tobacco
Control (FCTC) became international law after ratification by Peru, the
40th country to do so. More than three-quarters of all countries in the
world have already signed the treaty.

KEEN FOR QUICKER ACTION against the cigarette in particular, some
countries had even earlier decided to take action on their own.

In March 2004, for example, Ireland became the first country in the
world to institute a smoking ban in all workplaces, pubs, bars and
restaurants. Two months later, India similarly banned smoking in all
public places as well as tobacco advertising in the mass media after
statistics showed that smoking killed 2,200 Indians a day.

In June, Norway followed Ireland's example, and Hong Kong announced that
it would follow suit. In November, Scotland announced its own ban, to be
followed a few days later by one of the most anticipated banning
announcements - by Britain, home of the ubiquitous tobacco
multinational, British-American Tobacco (BAT).

According to the British announcement, a public smoking ban would be
imposed across England and Wales starting next year, culminating in full
compliance by over 90 per cent of all bars and restaurants by 2008.

In December, New Zealand joined the fray, extending a 1990 prohibition
on smoking in offices, shops and public buildings. Italian authorities
followed suit in January 2005, sparking countless stand-offs with macho
smokers across the country. Last month, in another dramatic move, Cuba -
home of the cigar and perhaps the only country in the world where the
government dishes out subsidised cigarettes with the ration book - also
banned smoking in public places. The country's revolutionary leader,
Fidel Castro, had kicked the habit in 1986.

The dizzying speed with which countries are moving to make smoking
illegal has left tobacco companies scrambling for fallback plans. Health
agencies and anti-tobacco activists, however, say that the onslaught is
long overdue.

According to the World Health Organisation, tobacco is the second major
cause of death in the world today, accounting for one in 10 adult deaths
globally, or about five million deaths each year. To put it another way,
more than 30 people have died of tobacco-related causes since you
started reading this article, at the rate of one person per six seconds.

Current smoking patterns continue, tobacco will cause some 10 million
deaths each year by 2020," says the WHO. "Half the people who smoke
today - that is about 650 million - will eventually be killed by tobacco."

Such statistics worry people like Joseph Kaguthi, co-ordinator of
Kenya's National Campaign Against Drug Abuse (Nacada).

"In purely human terms, we are looking at a public health problem in the
league of HIV/Aids," says Mr Kaguthi. "Today, more people die of
tobacco-related diseases than from Aids, and smoking is the world's
worst cause of preventable disease, disability and death."

In America alone, for example, cigarette-related illnesses kill about
400,000 people per year - the same as the annual toll from HIV/Aids in
Kenya, Uganda, Tanzania and Rwanda.

In this era of gender equality, a depressing reality for anti-tobacco
activists is that the deleterious effects of tobacco have crossed the
gender divide. Men who smoke, for example, increase their risk of death
from lung cancer by more than 22 times and from bronchitis and emphysema
by nearly 10 times. Women similarly increase their risk of dying from
lung cancer by nearly 12 times, and the risk of dying from bronchitis
and emphysema by more than 10 times.

Between 1960 and 1990, the rise in the prevalence of smoking among
American women is thought to have been the major factor for an increase
of more than 400 per cent in the number of deaths related to lung
cancer, enabling it to exceed breast cancer deaths in the mid-1980s.

DESPITE THESE STATISTICS from the US, which show that the tobacco
epidemic is truly global, troubling questions have started to arise on
the ethics and morality of tobacco marketing around the world as health
agencies such as the WHO raise the visibility of tobacco-related ill
health.

Key among the questions is that although the big four countries as far
as cigarette manufacturing and marketing are concerned - the US, Japan,
Britain and Germany - are all developed; 84 per cent of the world's
smokers, or over a billion people, live in the developing world. By
2020, the WHO says, developing countries will account for 70 per cent of
all tobacco deaths.

"As developed countries come up with all manner of public relations
exercises, such as Tony Blair's Commission for Africa, perhaps it's time
we asked ourselves why their companies continue to sell to our people
what are essentially poisons," says TEAN's Karugaba.

"The tobacco industry is impoverishing Africa, and perhaps this is a
good starting point for effective poverty alleviation interventions."

Karugaba's seemingly radical argument is grounded in the findings of
numerous studies by the World Bank and the WHO.

As far back as 1994, for example, a study established that the annual
global net loss associated with tobacco due to illness and death of
productive workers ran up to $200 billion - equivalent to East Africa's
gross domestic product for about eight years.

For poor countries, tobacco's relationship with poverty, however, goes
deeper than death and illness.

IN DEVELOPING COUNTRIES LIKE Kenya, Malawi and Zimbabwe,
commercially-grown tobacco has been blamed for encouraging single
cropping among peasants, resulting in food insecurity as farmers forsake
food crops. What is more, before purchase by multinational corporations,
peasant farmers often have to treat the tobacco leaves in dingy,
unventilated shacks using scarce wood resources. Here, they are exposed
to toxic chemicals even as they deplete valuable fuel biomass.

Dr Catherine le Gales-Camus, assistant director-general for
non-communicable diseases and mental health at the WHO, said last year,
"A big part of the health and economic costs related to tobacco are
endured by small farmers and their families, who grow the tobacco crop.

Precarious working conditions, including the use of child labour and
exposure to highly toxic products, and a highly negative impact on the
environment make tobacco an issue inextricably linked to developing
countries."

On the consumption side, things are not much better. Several studies
have shown that in the most deprived households in poor countries, as
much as 10 per cent of total household expenditure is committed to
tobacco, usually by the head of the household. Affected families
subsequently have less money to spend on basic items such as food,
education and health care, fuelling a cycle of malnutrition, illiteracy,
poverty and early death.

In East Africa, circumstantial evidence suggests that this reality is
played out with sickening regularity - a Nairobi casual worker earning
Ksh150 ($2) a day, for example, only needs to smoke eight cigarettes -
each costing Ksh3 - daily to go through nearly 20 per cent of his pay.
The same money can buy half a litre of milk from a supermarket, or five
eggs - enough protein to pre-empt serious malnutrition in a family of four.

It is these realities, says the WHO, which compelled it to give last
year's World No Tobacco Day - observed on May 31 - the theme "Tobacco
and Poverty: A Vicious Circle."