Nigeria's costly complacency and the global tobacco epidemic

Nwhator, Solomon O.

doi:10.1057/jphp.2011.58

Cited by 19 publications

(27 citation statements)

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“…The development of tobacco control policies and legislations in Nigeria have been an eventful pathway. As depicted in Table 1, the first attempt by the Nigeria government on tobacco control appeared in a 1951 revenue allocation document on licensing and controlling tobacco importation - Section 6 of the Nigeria Order in Council of 1951 [18, 21]. This policy document focused largely on the regulation of tobacco trade specifically the licensing, importation of tobacco and payment of duties [21].…”

Section: Resultsmentioning

confidence: 99%

“…Each policy document was reviewed and information aligning with these variables was extracted to populate the inventory extraction tool. Some key documents date back to Nigeria’s first tobacco policy such as the 1951 revenue allocation document on licensing and controlling tobacco importation (Section 6 of the Nigeria Order in Council of 1951) [18]. …”

Section: Methodsmentioning

confidence: 99%

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Analysis of tobacco control policies in Nigeria: historical development and application of multi-sectoral action

2018

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BackgroundTobacco use is a major risk factor for non-communicable diseases and policy formulation on tobacco is expected to engrain international guidelines. This paper describes the historical development of tobacco control policies in Nigeria, the use of multi-sectoral action in their formulation and extent to which they align with the World Health Organisation “best buy” interventions.MethodsWe adopted a descriptive case study methodology guided by the Walt and Gilson Policy Analysis Framework. Data collection comprised of document review (N = 18) identified through search of government websites and electronic databases with no date restriction and key informant interviews (N = 44) with stakeholders in public and private sectors. Data was integrated and analyzed using content analysis. Ethical approval was granted by the University of Ibadan and University College Hospital Ethics Review Committee.ResultsAlthough the agenda for development of a national tobacco control policy dates back to the 1950s, a comprehensive Framework Convention for Tobacco Control (FCTC) compliant policy was only developed in 2015, 10 years after Nigeria signed the FCTC. Lack of funding and conflict of interest (of protecting citizens from harmful effect of tobacco viz. a viz. the economic gains from the industry) are the major barriers that slowed the policy process. Current tobacco –related policies developed by the Federal Ministry of Health were formulated through strong multi-sectoral engagement and covering all the four WHO “best buy” interventions. Other policies had limited multi-sectoral engagement and “best buy” strategies. The tobacco industry was involved in the development of the Standards for Tobacco Control of 2014 contrary to the long-standing WHO guideline against engagement of the industry in policy formulation.ConclusionsNigeria has a comprehensive national policy for tobacco control which was formulated a decade after ratification of the FCTC due to constraints of funding and conflict of interest. Not all the tobacco control policies in Nigeria engrain the principles of multisectorality and best buy strategies in their formulation. There is an urgent need to address these neglected areas that may hamper tobacco control efforts in Nigeria.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Analysis of tobacco control policies in Nigeria: historical development and application of multi-sectoral action

2018

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“…Our study also shows evidence of a decrease in the prevalence of any tobacco use among men, from 12.2% reported in 2008 to 8.3% and, women from 0.6% in 2008 to 0.4% in 2013 19,22 . The available literature shows a low social acceptance of smoking behavior in women compared to men in Nigeria 25,26 . Thus, social factors may explain the low prevalence of tobacco use in women.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the use of different forms of tobacco products among Nigerian adults: Implications for tobacco control policy

Okunna¹

2018

Tob. Prev. Cessation

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INTRODUCTION This study assessed the determinants of tobacco use among adults in Nigeria, exploring associations between different types of tobacco products and gender. METHODS Study data were derived from the 2013 Nigerian Demographic and Health Survey (NDHS). The NDHS is a nationally representative household survey of 39 902 women, 17 359 men and 38 522 households. Country weighted data were collected on participants' demographic characteristics and current tobacco use by type. Weighted prevalence estimates and 95% confidence intervals (CI) were performed to examine individual sociodemographic factors and tobacco use. A multivariate logistic regression was also performed to assess the relationship between tobacco use, adjusting for sociodemographic characteristics. RESULTS Overall prevalence of any tobacco use in 2013 was 2.9% (n=1621, 95% CI: 2.8-3.0). The prevalence of any tobacco use was 8.3% (95%CI: 7.8-8.8, p<0.001) in men and 0.4% (95%CI: 0.3-0.5, p<0.001) in women. Cigarettes and snuff were the most commonly used tobacco products in men and women. Dual (smoking and smokeless tobacco products) use was associated with increased odds among men (AOR=26.1, 95%CI: 11.7-58.5, p<0.001), aged 45-59 years (AOR=5.6, 95%CI: 2.1-15.2, p<0.01) and completely/semi-illiterate (AOR=1.8, 95CI: 1.1-2.9, p<0.05). CONCLUSIONS Men and women differed in their preference of type of tobacco product and the associated risk factors. Tobacco control policies need to take these specific differences into consideration for the design and implementation of interventions aimed at addressing tobacco use. INTRODUCTIONTobacco use is the leading cause of preventable death and is responsible for about 6 million deaths each year worldwide 1,2 . The death toll is expected to rise to 8 million by 2030, if current trends continue 2 . Thus, urgent action to curb the consumption of tobacco products is imperative, particularly in developing countries were tobacco use is becoming alarmingly popular3. About 80% of the current 1.3 billion smokers live in low and middle income countries 4 . In 2010, annual tobacco-related deaths in low and middle income countries were estimated at 4.3 million, corresponding to about 25% more deaths than tuberculosis, malaria and HIV/AIDS 5 . The increasing prevalence of tobacco consumption in developing countries is associated with aggressive marketing strategies, employed by the tobacco industry, which explicitly target the youth and women 6,7 . Meanwhile, tobacco consumption, particularly cigarette smoking, is on the decline in many developed countries 1,8 , a result of successful anti-tobacco campaigns and national tobacco control policies. As a consequence, the tobacco industry has targeted new emerging markets, leading to tobacco consumption spreading across the globe 9,10 . The increase in tobacco use in developing AFFILIATION

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“…The development of tobacco control policies and legislation in Nigeria dates to its 1951 revenue allocation document on licensing and controlling tobacco importation [26]. The first significant effort at controlling tobacco use for public health benefits was the Tobacco Smoking (Control) Decree 20 of 1990 by the military government; the decree included measures for protection from second-hand smoke, health warnings and labels, and enforcing bans on advertising and promotion, but not taxation of tobacco products.…”

Section: Resultsmentioning

confidence: 99%

“…With the transition of the Nigerian government to democratic rule in year 2000, the document’s name was changed to the Tobacco (Control) Act 1990 in line with political conventions that prohibited governance through decrees in democratic dispensations; the policy content remained unchanged, however, and guided tobacco control in Nigeria for more than two decades. The Act was weak and poorly implemented [26, 27], and government actions on tobacco control were inconsistent. For instance, although the Act emphasizes reduction in tobacco use for public health, the government still supported increases in tobacco growth as when, in 2001, the Nigerian government signed a memorandum of understanding with British American Tobacco Nigeria to build potential for regional export and significantly increase the quantity and quality of locally grown tobacco [28].…”

Section: Resultsmentioning

confidence: 99%

Influence of the WHO framework convention on tobacco control on tobacco legislation and policies in sub-Saharan Africa

et al. 2018

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BackgroundThe World Health Organization’s Framework Convention on Tobacco Control, enforced in 2005, was a watershed international treaty that stipulated requirements for signatories to govern the production, sale, distribution, advertisement, and taxation of tobacco to reduce its impact on health. This paper describes the timelines, context, key actors, and strategies in the development and implementation of the treaty and describes how six sub-Saharan countries responded to its call for action on tobacco control.MethodsA multi-country policy review using case study design was conducted in Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo. All documents related to the WHO Framework Convention on Tobacco Control and individual country implementation of tobacco policies were reviewed, and key informant interviews related to the countries’ development and implementation of tobacco policies were conducted.ResultsMultiple stakeholders, including academics and activists, led a concerted effort for more than 10 years to push the WHO treaty forward despite counter-marketing from the tobacco industry. Once the treaty was enacted, Cameroon, Kenya, Nigeria, Malawi, South Africa, and Togo responded in unique ways to implement tobacco policies, with differences associated with the country’s socio-economic context, priorities of country leaders, industry presence, and choice of strategies. All the study countries except Malawi have acceded to and ratified the WHO tobacco treaty and implemented tobacco control policy.ConclusionsThe WHO Framework Convention on Tobacco Control provided an unprecedented opportunity for global action against the public health effects of tobacco including non-communicable diseases. Reviewing how six sub-Saharan countries responded to the treaty to mobilize resources and implement tobacco control policies has provided insight for how to utilise international regulations and commitments to accelerate policy impact on the prevention of non-communicable diseases.

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Nigeria's costly complacency and the global tobacco epidemic

Cited by 19 publications

References 11 publications

Analysis of tobacco control policies in Nigeria: historical development and application of multi-sectoral action

Analysis of tobacco control policies in Nigeria: historical development and application of multi-sectoral action

Assessment of the use of different forms of tobacco products among Nigerian adults: Implications for tobacco control policy

Influence of the WHO framework convention on tobacco control on tobacco legislation and policies in sub-Saharan Africa

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