Africa - can a tobacco-related cancer epidemic be prevented..

November 18, 2009 - Dr Twalib Ngoma, president of the African Organisation for Research and Training in Cancer (AORTIC), says that Africa is on the brink of a smoking epidemic. "Africa is in the area of the pre-epidemic and so we should prevent the epidemic. We should not wait until there is an epidemic and then work on it. We should prevent the epidemic."

Tobacco-related cancer was one of the key topics discussed at a recent international cancer conference in Tanzania.

Among those attending is Dr. Thomas Glynn, Director of International Cancer Control for the American Cancer Society and acting head of the Global Smokefree Partnership. Glynn: "This is really the first time in the history of public health that we have the opportunity to prevent an epidemic…. There's no doubt tobacco is on the rise here, but it's the one continent where we are ahead of the ball at this point. Africa - conference on the burden of cancer, Tanzania, Africa, November 11-14, 2009)

One of the reports presented there warns that African nations are set to undergo the highest increase in the rate of tobacco use among developing countries. The report, released jointly by the American Cancer Society and the Global Smokefree Partnership, says that more than half of African countries will double tobacco use within 12 years if current trends continue. But the authors say that there is still time to do something about it.

Preventing the epidemic'.. "For the first time in history, we have the tools in hand to prevent a pandemic," says Dr Otis W Brawley, chief medical officer of the American Cancer Society. "Smoke-free public places are one example of a low-cost and extremely effective intervention that must be implemented now to protect health."

As well as Kenya, Niger also recently introduced a smoking ban in public places. Egyptian residents walk under hanged cardboard cigarettes during a 'No Smoking Day' in Cairo. Egypt is unlikely to introduce a smoking ban in public places

Mauritius also recently passed a law that the American Cancer Society says is close to meeting the Framework Convention on Tobacco Control (FCTC) standards, ranking the laws among the most robust anti-smoking measures in the world.

But the report says that many other countries have not taken any action. For some countries, introducing a smoking ban would face too much popular opposition.

While in Egypt a fatwa, or Islamic ruling, gives wives the right to divorce their smoking husbands if the smoke affects their health, there are no laws about smoking in public places yet. Since around half of the population indulge in cigarettes or water-pipes, such a measure would prove extremely unpopular.

'They lobby and lobby' to legislation on tobacco, it is difficult to enforce those laws. "We have legislation in Tanzania... but enforcement of that legislation is not easy. Tobacco companies are all too powerful.

It says the companies try to convince African governments that tobacco is important to economic activity and that raising taxes on cigarettes and implementing smoke-free laws will result in revenue and job-losses.

The organisation says that in Kenya, for example, the tobacco industry has issued a legal challenge to a strong smoke-free law passed by the parliament. And in Zambia, they say that British American Tobacco has helped to dilute proposals for a smoke-free law.

But British American Tobacco say that this accusation does not reflect reality. They say that while they were consulted on the draft bill in Zambia last year, the bill has never been finalised. They add that they support tobacco regulations in the countries they do business in as they recognise that tobacco consumption poses real risks to health. Their policy on public place smoking is that they support the creation of smoke-free areas but that a ban on all indoor smoking in work and public places goes too far.

Raising Prices.. If a consumer is addicted to tobacco, then it is possible to put prices up and they will go without lunch says Adam Spielman, Tobacco industry analyst for Citigroup. Spielman also blames advertisers who he says are hooking in Africa's younger generations. "Tobacco companies are targeting poor, developing countries in Africa. If you drive from the airports to most towns you will see a lot of billboards promoting tobacco, saying that if you smoke you are going to be successful."

The American Cancer Society agrees, saying that the tobacco industry in Africa tries to hold back legislation.

So just how important is the African market to tobacco companies? Spielman says that the African market forms around 10% or less of the profits of the biggest companies, but that this area is growing.Africa heading for 'smoking epidemic' by Helena Merriman, BBC News, 11/17/2009.