1. TOBACCO CONTROL IN NIGERIA Dr. Kingsley K. Akinroye Vice – President African Heart Network At African Heart Network Workshop Maputo, Mozambique Nov. 20 – 22, 2008

2. NIGERIA: GEOGRAPHY OF HEALTH Dry savannah Humid forest Mid-altitude Moist savannah

3. Nigeria- a brief profile Nigeria is home to some 140 million people It occupies a total landmass of about 923,850km2 It is rich in oil and gas resources, both account for over 90 per cent of the country’s foreign exchange Despite its oil wealth, over 54 per cent of Nigerians live below poverty line More than half of Nigerians live in rural areas without access to basic amenities Life expectancy is put at 47.2 years for males and 48.5 years for females

4. Tobacco Use and Exposure Available Resource Nigeria Demographic and Health Survey 2003 GYTS 2001 Tobacco Control Country Profiles, Second editionACS 2003 Tobacco Atlas, ACS & UICC, 2006 WHO Report on the Global Tobacco Epidemic 2008;The EMPOWER Package, WHO 2008 The WHO Global InfoBase. http://www.who.int/infobase/report.aspx http://www.who.int/infobase/report.aspx Nigerian Health Behaviour Risk Factor Surveillance Nigerian Heart Foundation 2003

5. Tobacco Use and Exposure Findings Most data are not current Most data not national in coverage Prevalence Tobacco Atlas: Adult smoking ;total 8.6%,Male15.4,female 1.7 % Youth Smoking; total 18.1, male 22 %, female 16.0 Empower: inconclusive data; currently using cigarette female 0.5,current tobacco smoking 1.0, Country Profile: Adult smoking ;total 8.9%,Male15.4,female 1.7 % Youth Smoking; total 18.1, male 22 %, female 16.0

6. Tobacco Control Stakeholders Issues Government Health is on the concurrent legislative list; Federal, State and Local Governments can legislate on tobacco control The Federal Government has demonstrated more commitment to tobacco control In 2007, the Federal Government and some states filed a suit against tobacco companies seeking some damages and public health reliefs

7. Tobacco Control Stakeholders..ctd Issues Government..ctd The Ministry of Health has concluded work on a draft National Tobacco Control Bill which will domesticate provisions of the WHO –initiated Framework Convention on Tobacco control On May 31,2008 the Federal Capital Territory declared that it would commence enforcement of the ban of Smoking in public places from June 1.

8. Tobacco Control Stakeholders..ctd Research Institutions/Researches, Nigerian Heart Foundation Ministries of Health Nigeria Cancer Society Teaching Hospitals Academics

9. Tobacco Control Stakeholders..ctd Issues, Professionals/Professional organisations Identified professionals that could play key roles in tobacco control include; include Nigeria Medical Association (NMA), National Association of Nurses and Midwives, Nigeria Bar Association (NBA Findings: Besides the NBA (Ikorodu, Lagos branch), the above professional bodies have not been very active in tobacco control.

10. Tobacco Control Stakeholders..ctd Issues, Media Nigeria has a vibrant media There are close to 20 national newspapers, about 10 magazines, close to 100 radio stations and over 40 TV stations There is a media-focused tobacco c ontrol group; Journalists Action on Tobacco and Health (JATH) and Development Strategies Nigeria (DSN) Findings: The media is a contested terrain between tobacco control activists and the tobacco industry. There have been more reports in favour of tobacco control. There is yet need for capacity building

11. TOBACCO CONTROL STAKEHOLDERS…ctd Issues, Media..ctd The tempo of activities to garner public support for anti-tobacco legislations is sustained through regular press releases and articles in national newspapers and press interviews on television, complemented by a radio magazine programme –Tobacco and You, that is used to reach masses at the grassroots on Metro FM 97.6 (Lagos), Kapital FM 92.7 (Abuja), and Pyramid FM 193.7 (Kano).

12. Tobacco Control Policies FCTC status Nigeria signed the FCTC on June 20, 2004 It ratified the treaty on October 20,2005 There are on-going efforts at domesticating the treaty by way of a National Tobacco Control Law. The draft bill is complete and will soon be going to parliament

13. Tobacco Control Policies..ctd Existing Legislation Tobacco Smoking (Control) Act ( formerly Tobacco Smoking (Control) Decree 20 of 1990, The Code of Advertising Practice (APCON),1993. APCON Resolution at its 89 th meeting held on July 11,2001, issued as a directive on January 8, 2004

14. Tobacco Control Policies..ctd Existing Legislation.. Tobacco Control Act Prohibits smoking in specified public places ( cinema, theatre or stadium; offices; public transportation; lifts; medical establishments; schools and nursery institutions. ) It requires health warnings on packs (tobacco smoking is dangerous to health or smokers are liable to die young ) Ban tobacco industry’s sponsorship of sports Requires that tar and nicotine content be stated on the packs.

15. Tobacco Control Policies..ctd Existing Legislation.. Tobacco control Act Penalty for smoking in prohibited places: “Any person who smokes tobacco contrary to the provisions of this Act shall be guilty of an offence under this Act and shall be liable on conviction to a fine of not less than N200 and not exceeding N1,000 or to imprisonment to a term of not less than one month and not exceeding two years or both such fine and imprisonment.”

16. Tobacco Control Policies..ctd Prices/Taxes The price of a pack of 20 cigarettes range between N120-N180 Sale by single stick is not prohibited, the average cost of a single stick is N5 There is 40 per cent excise duty tax on cigarette Policies like EEG extended to BAT make it possible for them to make excess profit and to make cigarette manufactured in Nigeria cheaply available in neighbouring countries Cigarette prices have been relatively stable in Nigeria

17. Tobacco Control Policies..ctd Health care cost associated with tobacco use The known statistics in this area is by the Lagos state ministry of health It States that the government spend about N286,000 on each tobacco related case and that the patient also augment that among with N70,000

18. Tobacco Control Policies..ctd Percentage of family income spent on tobacco No available data on this area There is information that a consortium based in Ilorin is working on economics of tobacco

19. D,The Tobacco Industry Over 20 brands now on sale in the open market BAT controls over 75% of the market BAT on June 17, 2003, commissioned a $150 million cigarette manufacturing plant in Ibadan BAT upgrades its Zaria factory with a $1million new GDXI machine capable of producing 7,200 sticks a minute Nigeria has become an exporter of tobacco products

20. The Tobacco Industry There is a partial ban of advertisement but the tobacco industry is exploiting loopholes like vans, posters, point of sale etc Cigarettes from parts of Asia are still smuggled into the country. Nigeria has also become an exporter of tobacco products

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23. Thank You