A situational analysis of tobacco control in Ghana: progress, opportunities and challenges

Abstract

Tobacco use is the leading cause of preventable deaths in the world, with most of these deaths now occurring in low and middle-income countries (LMICs). Sub-Saharan Africa (SSA) is at an early stage of a tobacco epidemic and is, therefore, particularly vulnerable to rapid growth in tobacco consumption. More than a decade into the implementation of the World Health Organization’s Framework Convention on Tobacco Control (FCTC), State Parties in several countries in SSA, such as Ghana, have yet to fully fulfil their obligations. Despite early ratification of the FCTC in 2004, progress in implementing tobacco control measures in Ghana has been slow and much work remains to be done. The aim of this paper is to critically reflect on tobacco control implementation in Ghana, identify significant research priorities and make recommendations for future action to support tobacco control implementation. We emphasize the need for stronger implementation of the FCTC and its MPOWER policy package, particularly in the area of tobacco taxes, illicit trade and industry interference.

Fiscal and Public Health Impact of a Change in Tobacco Excise Taxes in Ghana

“…Currently in Ghana, policy guidelines on how to engage with the tobacco industry in protecting public health policy from influence by vested interests is limited. There is also a low level of awareness of the extent of tobacco industry interference (FCTC article 5.3) in controlling market prices (Singh et al 2020). Tobacco product importers regularly lobby to halt further increases in tobacco taxation in Ghana (Wellington 2017).…”

“…Currently all cigarettes consumed in Ghana are imported, mainly from Nigeria, after the closure of the British American Tobacco manufacturing plant in 2006. Although cigarettes remain the commonest form of tobacco used in Ghana, other forms of tobacco are also used -pipe smoking (shisha), chewing, sniffing, and smokeless tobacco (tawa), which is often used among young people (Singh et al 2020).…”

“…All rounds of the Ghana Demographic and Health Survey (GDHS) show wide gender disparity, with male smokers far outnumbering female smokers. Despite the fragmented data, the prevalence of smoking among adults (15+) is estimated at 5.4 per cent and 0.1 per cent for males and females respectively (WHO 2019), with regional and socioeconomic disparities (CRES 2014;Singh et al 2020). In particular, the northern regions and poorer sections of society have the highest prevalence rates (CRES 2014) -the prevalence rates amongst male adults in the Northern, Upper East and Upper West regions are 9.6 per cent, 10.3 per cent and 8.6 per cent respectively (GDHS 2014a).…”

“…There are few empirical studies on tobacco taxation in developing countries, compared to a vast number in developed countries (Akanonu et al 2018;Azomahou et al 2019;Singh et al 2020;Vellios et al 2018). Most of the research in this field in Ghana has focused on smoking and smoking-related determinants, the effect of the cigarette price, smoking prevalence, and general assessment of tobacco regulations in the country (Owusu-Dabo et al 2009;Nketiah-Amponsah et al 2018;Logo et al 2020).…”

Adherence to smoke-free policies in Ghana: Findings from a cross-sectional survey of hospitality venue owners and staff

“…Currently, Ghana, an LMIC in SSA, has a partial smoking ban, which prohibits smoking in enclosed public areas including hospitality venues such as restaurants, bars and nightclubs but allows for designated smoking areas (DSAs) 14 , 15 . While the overall prevalence of smoking in Ghana has been approximately 5% in adults 16 - 18 and 10% in adolescents 19 , 20 , a third of adolescents are exposed to SHS 21 . Ghana’s current SFP is faced with challenges relating to compliance and enforcement 22 .…”