COMMENT: Tobacco worse than terrorism

Uganda should learn from the Kenyan court and get tough on one of the leading causes of preventable deaths

By David Kabanda

Tobacco is a leading cause of preventable death globally. Its consumption is associated with increased risk of several cancers, including lung, larynx, oesophagus, oral cavity and pharynx, bladder, pancreas, kidney, liver, stomach, bowel, cervix, leukaemia, and ovarian cancers. Tobacco smoking caused an estimated (27%) of all cancer deaths in 2015. Tobacco (both active smoking and environmental tobacco smoke) causes almost a fifth (19%) of all cancer cases each year. Yet tobacco is the single most preventable cause of death in the world.

After realising this pandemic, the WHO adopted the World Health Organisation Framework Convention on Tobacco Control (WHO FCTC) treaty in 2003 to “protect and present future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke”. It enacted a set of universal standards stating the dangers of tobacco and limiting its use in all forms worldwide. The treaty’s provisions include rules that govern the production, sale, distribution, advertisement, and taxation of tobacco. FCTC standards are, however, minimum requirements, and signatories are encouraged to be more stringent in regulating tobacco than the treaty requires them to be.

Kenya signed and ratified the WHO FCTC treaty in 2004, and the Guidelines for the implementation of the Convention. Meanwhile Uganda signed the WHO FCTC on March 5, 2004 and ratified it on June 20, 2007 in accordance with article 123 of The Constitution, section 3(b) (ii) of the ratification of treaties Act and Article 35 of the World Health Organisation’s constitution. But Kenya appears to be moving far ahead of Uganda in the anti-tobacco fight.

When the British American Tobacco’s Kenyan subsidiary in 2015 filed a High Court civil suit claiming that Kenya’s Tobacco Control Regulations are unconstitutional, the court ruled in favour of health. The tobacco industry appealed and lost again. The courts upheld nearly all elements of the regulations, which are designed to implement the Tobacco Control Act, including, a 2% annual contribution by the tobacco industry to help fund tobacco control education, research, and cessation. Regulations include graphic health warnings, ingredient disclosure, smoke-free environments in streets, walkways, verandas adjacent to public places, disclosure of annual tobacco sales and other industry disclosures, and regulations limiting interaction between the tobacco industry and public health officials.

The court’s decision allowed the government of Kenya to move forward with implementing a law that will help protect Kenyans from the devastating consequences of tobacco use.  Included in Kenya’s Tobacco Control Regulations are requirements for picture-based health warnings and strengthened protections against second-hand smoke. The regulations also require tobacco companies to pay an annual fee into a designated tobacco control fund. These same provisions are in the Uganda Tobacco Control Act of 2015. In the said Act the introductory and the preamble sections elucidate the objectives of the Act which among others is to fulfill Uganda’s obligation under the treaty. There is, therefore, nothing that is barring Uganda from implementing the WHO Convention.