For decades, smoking has been on the rise, causing more than 100 million deaths in the 20th century alone and creating health and other costs of about $ 1,500 billion a year that hamper global growth. According to a report by global health policy organization Vital Strategies and the University of Illinois at Chicago in the latest edition of the Tobacco Atlas, the era of big tobacco is coming to an end: there is a clear decline in global smoking levels to 19.6% in 2019. 22.6% in 2007
However, the figures show a plan to turn tobacco back into a growing industry, focusing on Africa.
Global progress against the “tobacco epidemic” is due to the great decline, especially in nations that have raised tobacco taxes, restricted marketing, organized heavy public information campaigns and banned smoking in many public places. Our research shows that the decline in smoking in Africa is small, and the prevalence of adults increased in 10 countries on the continent between 1990 and 2019.
Quick guide
A common condition
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The human number of non-communicable diseases (NCDs) is huge and growing. These diseases kill approximately 41 million of the 56 million people who die each year – three-quarters of them in the developing world.
NCDs are just that; unlike, say, a virus, you can’t catch them. Instead, they are caused by a combination of genetic, physiological, environmental and behavioral factors. The main types are cancer, chronic respiratory diseases, diabetes and cardiovascular diseases – heart attacks and strokes. Approximately 80% are preventable and all are on the rise, spreading relentlessly around the world as aging and lifestyle driven by economic growth and urbanization make unhealthy a global phenomenon.
NCDs, once considered diseases of the rich, now have power over the poor. Disease, disability and death are ideally designed to create and perpetuate inequality – and if you are poor, you are less likely to be accurately diagnosed or treated.
The investment in tackling these common and chronic conditions, which kill 71% of us, is incredibly low, while the costs to families, economies and communities are incredibly high.
In low-income countries, NCDs – usually slow and disabling diseases – see that some of the money needed is invested or donated. The focus remains on the threat of communicable diseases, but cancer mortality has long outpaced deaths from malaria, tuberculosis and HIV / AIDS combined.
Frequent Illness is a new Guardian series reporting on NCDs in the developing world: their prevalence, solutions, causes and consequences, telling the stories of people living with these illnesses.
Tracy McVeigh, editor
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According to a study by the University of Bath, a partner in tobacco industry oversight, Stop Tobacco Organizations and Products (Stop): parts of a world where growth opportunities are largely limitless … Nowhere is this underutilized perspective as ripe as Africa. TTCs are expanding in African countries, where, with the exception of South Africa, the tobacco market grew by almost 70% in the 1990s and the first decade of the 21st century.
Taxation is the most effective way to control tobacco use, but Africa is doing poorly in this area. The Tobacconomics cigarette tax indicator scores nations on a scale of 0 to 5, with 5 showing the best performance. Compared to leaders such as New Zealand or Ecuador (4.63), which are making rapid progress, countries such as Kenya (0.88), Zimbabwe (1.38), Chad and the Central African Republic (both 0.75) show that tobacco is lightly taxed in most of the continent.
Less than 2% of all development aid goes to non-communicable disease prevention, and the figure is even darker for Africa
Cheap cigarettes suit international multinational tobacco companies. As profits suffocate in the West, big tobacco has taken root in African communities, and especially in their young people, as incubators for new deadly initiatives. The African Tobacco Center announced in 2016 that shops and carts selling cigarettes along with sweets were operating near schools in Cameroon and Burkina Faso. The Tobacco Atlas provides clear data on the industry’s global focus on youth, finding that smoking rates among 13- to 15-year-olds are rising in 63 countries.
Ironically, maintaining affordable cigarettes for the poor is used by industry lobbyists as an argument against taxation. However, he ignores the fact that these groups are more price sensitive and the health, social and economic benefits of higher taxes – fewer people who start smoking and quit more – accumulate much more for these groups. The positive impact can also be enhanced by governments that use tobacco tax revenues to benefit these same groups, such as support programs to help people quit smoking.
Another argument for the industry is that tobacco growing in many eastern and southern African countries is an important part of the economy. The tobacco industry has lobbied governments to delay action for fear of hurting farmers, but the tobacco atlas has identified recent research showing that most tobacco growers are poorer and governments would better serve them by helping them move to more profitable ones. cultures.
We cannot allow Africa to be the ashtray of the world. Governments must act now to raise tobacco taxes at least to the levels recommended by the World Health Organization, restrict marketing to young people, create policies that control access to tobacco products and protect policymaking from tobacco industry interference. . The continent’s smoking rate is still relatively low, and the tobacco epidemic that has already plagued the United States and Europe will inevitably break out in Africa if we act now to protect the next generation.
African economies remain vulnerable; the remnants of colonialism are still in play. We can work together to ensure that global corporations based in high-income countries do not profit from lower-income countries at the cost of their people’s health. Less than 2% of all development aid is for the prevention of non-communicable diseases, and the figure is even darker for Africa – a gap leading to preventable premature deaths and increased costs, leaving the population more vulnerable to health shocks. like Covid. Financial and technical assistance for tobacco control must be readily available to protect one billion people in Africa from being the next market for growth.
It is encouraging to see the impact of tobacco declining around the world, but this edition of the tobacco atlas reveals an industry that is working hard to make Africa the new frontier for smoking. A concerted effort will be needed to implement established tobacco control measures to counter powerful multinational companies that want to profit at the expense of human health. As high-income countries act to ensure a tobacco-free future, we must use these same policies to prevent tomorrow’s health crises in Africa.
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