The Star Early Edition

Nigeria slow to stub out smoking

- CATHERINE EGBE, STANTON GLANTZ AND STELLA BIALOUS | The Conversati­on Catherine Egbe, PhD, South African Medical Research Council; Stanton Glantz, Professor of Medicine, University of California; Stella A Bialous, Associate Professor, University of Califor

TOBACCO remains the biggest public health threat, killing more than 7 million people globally each year.

The World Health Organisati­on (WHO) has recognised progress in Nigeria, but concerns remain about implementa­tion.

Nigeria is a key tobacco industry market in Africa because of its population size and access to other markets in the region. One of the largest publicly-traded tobacco companies in the world, British American Tobacco (BAT), built a state-of-the-art manufactur­ing plant there in 2003. In 2016, BAT opened its new West Africa head office in Lagos.

A Global Adult Tobacco Survey six years ago estimated that 4.5 million Nigerian adults smoked, of a population of 198 million. Nearly a third of the adult population was exposed to second-hand smoke.

Nigeria started trying to regulate tobacco smoking in the 1970s, but only enacted its first tobacco smoking control decree in 1990.

This made Nigeria one of the first African countries to regulate tobacco. But the decree became less and less relevant because the government didn’t raise public awareness or prioritise implementa­tion.

In 2005, Nigeria signed the WHO Framework Convention on Tobacco Control. But it took until 2015 to pass a law, the National Tobacco Control Act, to implement the framework.

Nigeria’s 2015 National Tobacco Control Act regulated the interactio­n of government and industry. It also: Regulated e-cigarettes, and other tobacco products. Establishe­d the National Tobacco Control Committee (a multisecto­ral co-ordinating mechanism) and a Tobacco Control Fund.

Stipulated more stringent measures for violating the law. But the law had lots of loopholes and, three years on, it still hasn’t been implemente­d, owing to problemati­c clauses that were slipped in late in the process.

The act includes the unpreceden­ted requiremen­t that regulation­s prepared by the federal Ministry of Health must be approved by the National Assembly. This slows down the process and provides another opportunit­y for the tobacco industry to block progress.

The law also requires the Standards Organisati­on of Nigeria, a body that regulates products, to issue guidelines for regulating tobacco products.

A major problem with the organisati­on is that the tobacco industry dominates its processes: its representa­tives outnumber those from other agencies on the committee that writes the guidelines.

The Standards Organisati­on has defended this by saying it is mandated by law to include the industry. But having the tobacco industry on the committee is a serious impediment to developing effective regulation­s.

Another problem with these guidelines is that at present they cover cigarettes only. This leaves snuff, hookahs, pipes and e-cigarettes without any regulatory guidelines.

The tobacco industry in Nigeria is aware of every move the government makes even before new measures are introduced, because it has representa­tives on the regulatory committee as well as membership of the National Tobacco Control Committee.

This means the industry can mobilise against any new regulation­s. All of this is in violation of Article 5.3 of the WHO’s framework, which commits parties to insulate public health policy-making from tobacco industry interferen­ce.

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