Tobacco Use in Africa
Compared to the rest of the world, tobacco use in Africa is relatively low. A 2019 report from the World Health Organization (WHO) found that in 2000, the African region had a tobacco use prevalence rate of 18.5%, the lowest of any of the WHO regions.

However, as economic development in Africa continues to rise, with countries like Ethiopia and Rwanda seeing unprecedented expansion, tobacco consumption has also increased. The WHO now predicts that tobacco-related deaths are likely to double in the coming years within low and middle-income countries, many of which are in Africa.

Rising tobacco use is likely to have a detrimental effect on developing countries. The infrastructure to deal with the associated health issues is simply not in place. Facing this problem early will be crucial in giving African nations the best chance of reducing poverty and improving standards of living, along with overall health.

Targeting Emerging Economies

People commonly associate economic growth with positive changes, such as job opportunities and more money in our pockets. However, as consumers find they have more money to spend, companies are eager to market products to them. This includes the tobacco industry. In 2013, a committee of experts that the Network of African Science Academies convened found that “As the use of tobacco has declined in high-income countries, the tobacco industry has increasingly turned to low- and middle-income countries, particularly in Africa, Asia and Eastern Europe, to recruit new users.”

Tobacco manufacturers have used specific tactics to promote their products in African countries. According to a 2021 report published in the Bulletin of the World Health Organization, companies have encouraged local traders to sell individual cigarettes to attract young and low-income customers. Tobacco companies have also used promotional tactics, such as price reductions, coupons and giveaways, even though these practices are usually against the law.

Unfortunately for some African nations, as the economy has grown, the number of smokers has followed suit. For example, as the annual GDP consistently grew from 2009 to 2014 in the Democratic Republic of the Congo, tobacco use also increased.

The Burden on Health Care

Research has well documented that tobacco use causes health issues, such as cancer, stroke and lung disease. These are known as non-communicable diseases (NCDs) and case numbers are rising in Africa. This poses a problem for healthcare infrastructure. The World Economic Forum reported that most NCDs undergo treatment in large city hospitals, placing an additional burden on rural patients. Furthermore, many hospitals simply do not have the resources to treat so many cases.

Another factor to consider is the prevalence of infectious diseases, such as malaria, HIV and COVID-19. These afflictions have been a persistent burden on healthcare systems described as “fragile, fragmented, under-resourced and limited.” Increasing tobacco consumption will only exacerbate this problem.

The Effect on Poverty

Tobacco companies often cite job creation to justify their presence in developing countries. They go on to suggest that increasing taxes on tobacco products will cause people to lose their jobs.

Some developing countries indeed have tobacco-dependent economies. For example, a 2009 study found that Malawi relies on tobacco exports for 70% of its foreign earnings. However, placing more restrictions on tobacco could actually be beneficial for Malawi. It could “diversify [its] economy” and open it up to foreign aid for funding other industries.

Dr. Kenneth E. Warner made this same argument in his 1999 article, “The Economics of Tobacco: Myths and Realities,” published in Tobacco Control. Essentially, he stated that if a country is no longer dependent on the tobacco industry, this does not mean that it has no other industry to rely on. Resources can go toward developing other industries and consumers can spend their money elsewhere, generating new jobs.

The myth of economic development through tobacco is further debunked when one considers the financial burden of addiction. Studies found that rising tobacco use in Africa will exacerbate poverty. Money spent on tobacco products and the cost of treatment for associated diseases could cripple low-income families by affecting employment, not to mention the debilitating effects that these diseases cause.

Implementing Solutions

Thankfully, many African nations are taking measures to prevent their economies from becoming overly dependent on tobacco. Uganda is one of these nations. In 2015, the Ugandan government passed the National Tobacco Control Act, prohibiting tobacco sales to anyone under the age of 21. It also banned smoking in public buildings, such as schools and hospitals, and banned the advertising of tobacco products.

In recent years, media campaigns launched in Uganda, educating the public on the economic and health risks associated with tobacco use. They have also advocated for harsher taxation on tobacco products, which would generate funding for further tobacco control measures.

Another positive step is that 51 out of 54 countries in Africa have ratified the WHO Framework Convention on Tobacco Control, thereby committing to implementing policies to reduce tobacco consumption.

Tackling rising tobacco use in Africa is instrumental in reducing poverty and moving forward. Funding tobacco control measures is an important step in releasing pressure on African healthcare systems. It is time for the world to leave smoking in the past.

– Abbi Powell
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