Tobacco Control

Background

Nigeria is located in West Africa, home to over 170 million people. It occupies a total land mass of about 923,850km2. It is rich in oil and gas resources which account for over 90 per cent of the country’s foreign exchange earnings. Despite its oil wealth, over 54 per cent of Nigerians live below the poverty line. More than half of Nigerians live in rural areas without access to basic amenities. Nigeria’s healthcare system faces challenges of inadequate funding, malfunctioning equipment and shortage of manpower.

Nigeria boasts of an extremely vibrant political turf. With a presidential system of democracy which has a four (4) year tenure for elected officials (The President and the Legislators). Currently constituted, the country operates a multi-party system, with a robust civil society and media that actively engages governance and other stakeholders in wide ranging issues.

Nigeria as a nation continues to show great prospects economically and otherwise. Despite the imminent security challenges in the country, this has not hindered or limited socio-economic growth, with inhibited increase in the country’s Foreign Direct Investment (FDI) reinforcing its position as an investment destination not just in the sub region but on the entire continent, which led to a rebasing of the economy in 2014, effectively placing the country as the largest economy on the continent.

On the flip side, Nigeria, irrespective of its huge prospects, still remains a developing country. Although it gained independence in 1960, numerous military interregna ultimately altered the pace of development with a noticeable decline/stunted development in social, economic and political life. A sector that was amongst the worst affected during the era was definitely the country’s infrastructure and the healthcare sectors which remain in comatose. The Transparency International’s Corruption Perception Index still ranks the country as one of the most corrupt countries among the 175 countries it researched.

Nigeria’s healthcare system faces challenges of inadequate funding, malfunctioning equipment and shortage of manpower.  Most Nigerians have no access to health insurance and cannot afford the cost of good healthcare. Life expectancy is put at 45 years for males and 46 for females. This health situation is made worse by the level of tobacco-induced diseases. With the level of health care delivery, infrastructural decay and absence of a legal framework on tobacco, Nigeria does not have the capacity and capability to manage a tobacco-induced epidemic.

The impact of smoking on public health is grim. In 2006 alone, over 9,527 tobacco-related cases were recorded in Lagos State hospitals. The survey conducted in 11 hospitals run by the Lagos State Government revealed that two persons die per day due to tobacco-related illnesses. The state government estimated that it spent N216, 000 ($1,440) on each case of tobacco-related illness while the individual spends an additional N70, 000 ($467). For a country where majority of citizens live below $1 a day, this is a high cost to pay.

Nigeria have made a very strong showing during the negotiations for the Framework Convention on Tobacco Control (FCTC), it is imperative that the country is not just perceived but actually seen to be taking initiative in the full implementation of the FCTC.

Country development strategy and relevance of the proposed project

Nigeria currently has in place a strategy that is being implemented by the current government and will hopefully serve as a basis for successive governments. The Vision 20:2020 ultimate objective is the elevation and attainment of Nigeria to the world’s top 20 economies by the year 2020. Recognizing the heavy burden that citizens already bear with regard to issues that hover around the economy, health and other social factors, the government, in recent times, commenced efforts to address public health and accompanying challenges. A new Health Bill that comprehensively approaches the myriad of challenges facing the Health Sector recently got Presidential assent.

The relevance of this projects stems from the realization of the huge health burden and disposable income spent by the average Nigerian on health related and non-communicable diseases of which tobacco hugely contributes to.  This further contributes to deplorable living standards of Nigerians who are made to bear the brunt of the overall public health burden.  The project targets scaling up advocacy on the need for Nigeria to be fully compliant with the FCTC and also ensure strict implementation of Tobacco Control (TC) Law.

Partners/Funders

African Capacity Building Foundation (ACBF)

Justification for the Project

Nigeria in 2013 launched the Global Adult Tobacco Survey (GATS).  Sadly, prior to the conduct of the GATS a comprehensive evidence-based population level data was not available in the Federal Ministry of Health (FMOH) archive to show the magnitude of the tobacco epidemic. Also lacking was data from a tobacco surveillance system to document trends of tobacco use and the impact of control measures in Nigeria.

The Global Adult Tobacco Survey (GATS) therefore constitutes an essential component of a proposed comprehensive tobacco control program, as it is regarded as a global standard for the efficient and systematic monitoring of the tobacco epidemic through the tracking of tobacco control indicators. The Nigerian GATS was conducted in 2012 as a pilot project in Africa designed primarily to produce an internationally comparative data framework to study and monitor adult tobacco use in Nigeria. Findings in the GATS show that 10.0% of men, 1.1% of women and 5.6% overall accounting for 4.5 million adults currently use tobacco products in Nigeria. 7.3% of men, 0.4% of women and 3.9% overall accounting for 3.1 million adults currently smoke tobacco. 2.9% of men, 0.9% of women and 1.9% overall accounting for 1.6 million adults currently use smokeless tobacco.

In Nigeria, though prevalence data differ depending on the source and year, it is generally agreed that smoking prevalence is gradually approaching 20%. This is a huge 32 million persons.

On the face of rising use of tobacco and tobacco products, Tobacco Industry (TI) documents have shown that Nigeria has been a major target of the TI mainly because of its market size, weak tobacco control laws and favourable indicators showing that Nigeria is on the road to becoming a major economic power. For the TI therefore, Nigeria is big business.

CISLAC and other stakeholders in recent months have been working towards the speedy passage of a National Tobacco Control Law in Nigeria that is compliant with the World Health Organization’s Framework Convention on Tobacco Control (FCTC). Achievements recorded in the intervention include:

  • Mobilization of the Federal Ministry of Health to take a leadership position on TC issues resulting in the Presentation of the Executive Bill to the National Assembly.
  • Mobilization of Legislators (including key policy champions) to support the passage of the National Tobacco Control Bill (NTCB).
  • Successful advocacy visits to relevant Committees of the Senate and House of Representatives.
  • Hosting of periodic meetings with the Clerks and Deputy Clerks of the relevant Committees of the National Assembly (NASS).
  • Provision of technical support to the NASS key Committees including support to the Senate and the House of Representatives Committees on Health to hold Public Hearings on the NTCB.
  • Increased public awareness on the dangers of tobacco use, tobacco industry tactics and the need for an FCTC-Compliant NTCB.
  • Supporting Journalists under the Campaign for Tobacco Free Kids (CTFK) Fellowships Programme; this has increased media reporting on tobacco control issues in the Print and Electronic Media.

This project seeks to build on the work already undertaken in engaging the Tobacco Control Legislation process to ensure a speedy passage and presidential assent to an effective NTCB in Nigeria as well as effective implementation of the law.

Objectives of the Project

  •  To facilitate the passage of the NTCB and support relevant government agencies towards its effective implementation.
  • To build the knowledge of citizens on the legal frameworks and dangers of tobacco use in Nigeria.
  • To engage non-state actors on Tobacco Control.
  • To strengthen CISLAC’s capacity to effectively engage in tobacco control.