Recently, Ethiopia has been coming to grips with a sweeping tobacco addiction epidemic. Unlike past years, the cigarette epidemic is not limited to adults. In fact, students and young people are starting to represent more and more of the smokers in Ethiopia. However, in response to the problem, the Ethiopian government is starting to take actions to encourage people to drop the amount of cigarettes they smoke. EBR’s Kiya Ali investigates.
Melat Girma (name changed to protect her privacy) is a 17 year old girl who started high school two years ago. She started to smoke when she was in grade 9. When she started smoking her intention was just to experience something new. Melat never thought that she would become addicted.
“I remember when I smoked for the first time. It was at a Christmas carnival,” Melat recalls. “Some of my class mates were dancing while the others were drinking and smoking. Then my friends asked me to try smoking just for fun. Initially, I was a little bit hesitant but when they encouraged me I just did it.”
Inside Melat’s school compound, there is a place called the mini forest. Since the area is surrounded by trees, students hide and smoke around the area during breaks. Although she tried to quit many times, she seems to have lost the battle. “Every morning when I get up and see my mom, who suffers from heart problems, I vow to stop smoking. I don’t want to get sick and make my mom worry.”
“In the future, I want to become a cardiologist and help my mom recover,” says Melat. However at the end of the day, she finds herself regretting smoking. “Peer pressure was my enemy,” she explains.
Various researchers and experts believe that addicted smokers like Melat are vulnerable to premature death. According to the World Health Organization (WHO), tobacco kills more people than AIDS, illegal drugs, road accidents, murder and suicide combined. Information from the WHO indicates that tobacco use is a major preventable cause of premature death and disease worldwide. Yet globally, more than seven million people die each year from tobacco related illnesses (more than six million from direct tobacco use and approximately 890,000 non-smokers from being exposed to second-hand smoke) and if current trends continue, this number is expected to increase to more than eight million a year by 2030. As per the Global Adult Tobacco Survey (GATE) conducted in 2016, in Ethiopia five percent (3.4 million) of adults use tobacco products. Among these 2.2Pct of adults smoked cigarettes daily.
In a study, Edilu Shona stresses that cigarette smoking is comparable to the Titanic sinking every 27 minutes for 25 years or the Vietnam War death toll every day for 25 years. In addition to being the major source of death, smoking tobacco has social consequences like stigma. Mainly as a result of bad breath and smells on the smoker’s clothing, it is a common phenomenon to see smokers feel a sense of social isolation.
Smoking also has economic implication. The Global Youth Tobacco Survey (GYTS) states that tobacco use is more than a health hazard; it is a challenge for sustainable development with its multifaceted consequences on the environment, trade, taxation, and social policy as well as direct and indirect health care costs.
According to the WHO, poverty and tobacco become a deadly circle by driving the poor to spend money on tobacco that is desperately needed for food, shelter, health care and education. Besides tobacco escalates health care costs of countries, reduce productivity due to illness and early death, as well as deforestation and other environmental damages.
Hussein Bedilu is a 39 year-old man who has smoked for the past seven years. He was fired from the company where he was a marketing and sales manager because of his addiction to cigarettes. “Since I was working at a freight forwarding company, I had to communicate with clients, visit customers and attend various meetings in different part of the country frequently. However since I am addicted to cigarettes, even though my colleagues criticised me, I used to smoke during our travel or coffee time. This created a bad smell and I used to feel the stigma.”
Hussein continues. “Finally after repeated advice and critiques, the management decided to fire me.” However the penalties Hussein paid don’t stop here. Although he opened a barber shop and operates his own business after he got fired, what led him to lose his job is now stealing his health. “Currently I have terrible toothaches and bronchitis. I cough repeatedly and sometimes I find it difficult to breathe properly.”On average Hussein spends ETB30 per day for tobacco consumption and smokes around 15 cigarettes every day.
According to GATE report the median amount spent on manufactured cigarettes by a current daily cigarette smoker in Ethiopia is ETB18.4. Among men who smoke cigarettes daily, one quarter smoke 5-9 cigarettes each day and six percent of daily cigarette smokers smoke 25 or more cigarettes each day.
While smoking prevalence is falling in high income countries due to restrictive legislation enforcement, in contrast it is increasing by over three percent annually in developing countries like Ethiopia. This is partly due to production increment of tobacco companies. For instance, the Ethiopian National Tobacco Enterprise increased its production of cigarettes from four billion to six billion per year by acquiring a machine at a cost of ETB145 million. Currently, the Enterprise, which exclusively targets the domestic market, has the capacity to produce 12,000 cigarettes per minute.
On the other hand, aggressive marketing by tobacco companies worsens the situation. For instance, most cigarette packs are attractive. “Packs of cigarettes like Oris and Business Royal look attractive. It is also clearly stated on the cover that they are flavored. So in order to avoid social stigma as a result of bad smells that could arise from smoking cigarettes, they became my favorite,” Solomon Mengesha, who is a smoker, says.
In addition to their attractive package, the price of the cigarettes is affordable. “Some years ago the price of Oris and Business Royal was a bit expensive. One cigarette cost as high as five birr and they were not available everywhere. However now their cost is reduced by half and they can be found everywhere,” express Solomon.
Ethiopia has ratified the Framework Convention on Tobacco Control (FCTC) on June 23, 2014. Accordingly smoking in public places, schools, health centers and advertisement, promotion and sponsorship of tobacco is prohibited. Yet, posters that imply the prohibition of smoking cigarette are not fully respected in most places in Ethiopia including cafeterias and restaurants.
The proclamation ratified in 2009 and amended in 2014 gives the Ethiopian Food, Medicine and Healthcare Administration and Control Authority (FMHACA)to regulate tobacco products and to take all acts necessary for the implementation of the FCTC. “However the law is not clear on what kind of measures the Authority should take if someone is found smoking in public places,” explains Dagim Alemayehu, a legal expert at FMHACA. “Thus we are currently working on awareness creation on the effects of smoking tobacco. And various stakeholders are discussing in order to propose legal measurements that should be taken to those people who violate the law and smoke on public places.”
As the experiencesof many countries, which managed to reduce tobacco use indicate, increasing taxes on tobacco is an effective way to reduce its consumption. For instance, Report on the Global Tobacco Epidemic published by WHO in 2015 reveal that a 10Pct increment in price of cigarettes due to taxes leads to five percent reduction in tobacco consumption. Yet, the government in Ethiopia shy away from increasing tobacco taxes. In fact, the Ethiopia among the 15 countries worldwide that levy less than 20Pct tax on the retail price of locally produced cigarettes.
Of course, especially tobacco producers argue that increasing taxation on tobacco and raising the price of cigarettes encourages informal tobacco trade, which as it is a huge problem in Ethiopia. However, studies indicate that illegal tobacco trade is not deeply connected with high taxes on cigarette. Rather, it is due to the existence of poor control, weak anti-smuggling law enforcement and corruption.
8th Year • Jan.16 – Feb.15 2019 • No. 70