The Constitutional Petition No. 46 of 2016 (British American Tobacco Uganda Limited versus Attorney General) was filed in 2016 by British American Tobacco (BAT) challenging provisions of the Tobacco Control Act in the Constitutional Court
BAT alleged that the Tobacco Control Act contravenes several provisions of the Constitution by prohibiting smoking in public places, imputes personal criminal liability on directors and management of companies, requires display of graphic health warning covering to 65%, restricts display of tobacco products at points of sale and prohibits interaction between the tobacco industry and public officials involved in the implementation of public health policies. They alleged that these restrictions contravene the freedom from discrimination, the right to property, the right to speech and expression and the economic rights of BAT
The increasing prevalence of non-communicable diseases particularly cancers, heart diseases and strokes in Uganda is one of the significant health challenges facing our country, as well as an important health priority.
The Tobacco Control Death Clock is a countdown of the number of people who die every day due to tobacco related diseases. According to the 2006 Uganda National Demographic Health Survey, up to 75% of Ugandans suffering from Non-Communicable Diseases get the diseases as a result of use of tobacco and exposure to tobacco smoke.
According to the World Health Organization (WHO), 13,000 people in Uganda die every year, making 38 people every day. The rise in rates of non-communicable diseases has been attributed to the tobacco industry
Tobacco use and the exposure to tobacco smoke is one of the most preventable causes of death and disability globally. The risk is even higher among daily tobacco users. The World Health Organization (WHO) has recommended that surveillance of major risk factors for Non Communicable Diseases to identify interventions to reduce future burden and monitor emerging patterns and trends.
In 2014 the first Uganda nation-wide NCD risk factor survey was carried out to estimate the prevalence of major Non Communicable Disease risk factors
Tobacco exposure to is one of the most preventable causes of death and disability globally. The risk of disability is even higher among daily tobacco users. In fact, compared to light smokers, heavier smokers have been shown to have an increased risk of ischemic stroke and serum lipid.
Projections indicate that between 2002 and 2030, mortality related to tobacco use and its exposure is expected to reduce by 9 % in high income countries but double from 3.4 million to 6.8 million in low and middle income countries.
The World Health Organization Global Status report on Non Communicable Diseases (NCDs) indicated that in Uganda, tobacco use was a major risk factor for NCDs which account for 25 % of all deaths in the country. Statistics from the Uganda Cancer Institute also indicate that 25 % of lung cancer patients were tobacco users and 16 %, 13.7 % and 12.6 % of oral, stomach and throat cancer patients were former tobacco users.
The WHO has recommended that surveillance of the major risk factors for NCDs such as tobacco use is imperative to predict the future burden of NCDs, identify interventions to reduce future burden and monitor emerging patterns and trends.
Currently the surveillance of tobacco use among adults in Uganda is done through Uganda Demographic and Health Surveys (UDHS) as well as the Global Adult Tobacco survey. The UDHS provides national data on demographic and health characteristics and contains one question on tobacco use. However it only reports prevalence, does not relate the prevalence to social and demographic characteristics and does not assess magnitude of risk in terms of daily tobacco use. The GATS provides information on adult tobacco use and key tobacco control indicators such as tobacco advertising, exposure to secondhand smoke and the economics of tobacco smoking but does not assess physical and biochemical outcomes. In 2014 the first nation-wide NCD risk factor survey was carried out in Uganda to estimate the prevalence of major NCD risk factors. We analyzed data from this survey to estimate the prevalence of daily tobacco use and demographic, physical and biochemical assessments associated with it.
Tobacco use remains a significant public health challenge, danger and burden in Uganda and a leading cause of Cancer and Non communicable diseases. The 2011 World Health Organization (WHO) Global status report on Non communicable diseases states that exposure to tobacco smoke remains one of the four main behavioral risk factors that contribute to Non communicable diseases. It’s important to note that Tobacco alone accounts for 6 million deaths each year and this toll comes up to 13,000 people losing their lives daily from tobacco related illnesses and diseases. These are preventable deaths we all can commit to end if only we raise awareness on tobacco control and adhere to public health policies.
Dr Noleb Mugisha, the Principal Medical Officer, Head of Comprehensive Community Cancer Program at the Uganda Cancer Institute notes that there are various diseases related to tobacco use and these have been scientifically proven like Cancer, Cardiovascular diseases, Respiratory disease, Reproductive complications, Postoperative complications,Diabetes and others.
The 2004 Surgeon General’s Report shows that Tobacco use is a major risk factor for the development of many forms of cancer and evidence is sufficient to infer a causal relationship between smoking and cancers of the lung, larynx, esophagus, pancreas, bladder, kidney, cervix and stomach. Results from the 2011 Global Youth Tobacco Survey indicate that 19.3% of young men and 15.8% of young women use tobacco. Raising awareness and education on Tobacco control in order to take action against Cancer is therefore key.
Strategies for curbing this public health crisis:
We need to create public awareness on tobacco control, adhere to and comply with the public health and tobacco control laws, and help reduce the morbidity and mortality of cancers caused by tobacco smoke through monitoring tobacco use and prevention policies, protecting people from tobacco smoke, offering help to those who want to quit smoking, warning people about the dangers of tobacco and promoting a smoke free environment.
Uganda ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) in 2007 developed in response to the globalization of the tobacco epidemic. In a bid to curb the tobacco epidemic, Uganda also enacted and passed the Tobacco Control Act 2015 aimed at controlling the demand and supply for production and consumption of tobacco products to the people. It also aims at promoting the health of persons and reducing tobacco related illnesses and deaths.
The Constitution under Article 39 guarantees the citizens right to a clean and healthy environment.It is therefore important to protect the environment from the effects of tobacco consumption and exposure to tobacco smoke.
The Public Health Act Cap 281 mandates every local authority to take all lawful, necessary, and reasonably practicable measures for preventing the occurrence of any outbreak or prevalence of infectious, communicable or preventable diseases to safeguard and promote the public health of individuals.
The Penal Code Act Cap 120 under Section 228 (f) makes it an offence for a person to dispense, supply, sell or give away any poisonous/dangerous matter in a manner so rash and negligent.
The Tobacco Control Regulations will also soon be finalized and passed by Ministry of Health.
As such, let us all join hands to make healthy lifestyle choices and avoid using tobacco and related products and educate ourselves and others to support the Tobacco Control cause through complying with the public health/tobacco control laws in place.