Tobacco: a global agent of death

 

By Lumbiwe Mwanza

It is growing in popularity especially among young people in Zambia and most drinking places are synonymous with the water-pipe tobacco but some experts say a single shisha session is the same as smoking 200 cigarettes.

In the same way that some people will enjoy a cold Mosi lager or need a cigarette to keep going while they're relaxing, for Janet Zimba, 26, smoking shisha is the perfect way to unwind her evening after a hard day’s work. 

“I like to enjoy my shisha after a long day and every evening after work, I come here (shisha lounge) with my mates to relax. If I don't do it, it feels like I'm missing something,” Janet said as she puffs a rhapsody of smoke with her colleagues at Zoran cafe located at Levy shopping complex in Lusaka, Zambia’s capital. 

Shisha, also known as hookah or hubble bubble, is a glass-bottomed water pipe in which fruit-flavoured tobacco is covered with foil and roasted with charcoal. The tobacco smoke passes through a water chamber and is inhaled deeply and slowly; the fruit-flavoured tobacco tastes smooth and smells sweet, enthusiasts say, making it a pleasant and thrilling experience.

As shisha is gaining traction among the youth in Lusaka, its origins of which is disputed (some say India, while others point its roots from Turkey) is slowly decimating Zambia’s future leaders.

While some people are drawn to it for being ‘cool’ with patrons flocking to shisha parlours, experts warn that the smoke exposes someone to the highly addictive chemical including nicotine, tar, carbon monoxide and heavy metals such as arsenic and lead.

“I prefer shisha to cigarettes because I believe that the risk of tobacco is reduced since it is purified as it passes through the water,” Janet stated as her friend Melvin added, “Yeah, smoking shisha is the coolest experience one can ever have and not a health hazard as compared to dry tobacco.” 

However, the World Health Organisation (WHO) insists that shisha increases the risk of developing heart and circulatory diseases as the smoke produced contains high levels of toxic compounds including carbon monoxide, heavy metals and cancerous causing chemicals hence the shisha smoke is associated with risks of diseases such as cancer, heart and lung complications.

While most Zambian pubs are making a fortune from shisha sales which cost K120 ($6) per session, some countries such as Tanzania and Rwanda have since banned the piped tobacco within their territories.

Just like Shisha, a few minutes away from Lusaka town, is Chibolya - the most feared slum in the city where even the police or other law enforcers do not dare to tread. The notorious township is renowned as the hub for drug trafficking including the abuse of tobacco.

Trekking her way back home into the slum, Lucy Mutale walks through a bumpy track giving way to lined-up shacks covered in plastic and outside one hut, four 20-year-old boys share a joint as the smell of cannabis drifts through the township.

For Lucy, an urgent need to smoke at certain times of the day, morning or night is what she battles with daily. 

“I try to control it but it is difficult,” says Lucy who started smoking in grade eight, and by the time she was 18 years old, she smoked every day. Over time, smoking crept into every corner of her life due to addiction.

Recently, while in college and still smoking a pack of cigarettes a day - Lucy learned she was pregnant. She tried to quit, but realised that doing so only made things worse. 

Sadly, her baby was born two months early, which is a danger for all pregnant women who smoke. Her tiny baby girl spent weeks in an incubator at the University Teaching Hospital (UTH). 

“I knew that smoking was bad and I almost lost my child but I didn’t think I would have a premature baby,” Lucy lamented. 

Health experts say that every six seconds someone dies from tobacco as half of current tobacco users will eventually die from a disease associated with its use as it is the only product in the world that kills nearly 6 million people every year.

The WHO recently stressed that if current trends continue, tobacco will kill nearly 8 million people every year throughout the period leading to 2030 since most tobacco-related deaths occur in low- and middle-income countries. 

In this context, health pundits are of the view that unless counter measures are taken, tobacco will kill more than 1 billion people in the 21st century.

In Zambia, over 7,100 people die each year and 60 percent of deaths are of people under 70 years,  according to Centre for Trade Policy and Development (CTPD) research on Tobacco.

As the tobacco industry sells 6 trillion cigarettes every year, with revenues estimated to a tune of $614 billion in 2009, tobacco companies are unrelenting in their efforts to counter and undermine tobacco control initiatives and activities.

In response to the WHO Framework Convention on Tobacco Control, tobacco companies have altered their tactics by strengthening the cooperation network they have established with their allies through innovatively communicating with the media, building a network with decision-makers, and creating links with key statutory institutions.

For this reason, relevant stakeholders including Nongovernmental organisations and health care institutions need to work hand-in-hand with governments to counter tactics of tobacco multinationals aimed at undermining the implementation of the WHO’s Framework Convention on Tobacco Control in a bid to curtail the increase in tobacco consumption among the youth in Zambia.

“Government should adopt appropriate laws and measures to ban tobacco advertising, increase taxes on tobacco products and ban smoking in public places are the only ways to counter the tobacco epidemic,” said Thomas Kalaba, a second year public health student at Apex University.

Arguably, tobacco is a major problem in Zambia which affects nearly 140 lives every week, according to health statistics. The southern African country is a major tobacco producer and has ratified the WHO’s Framework Convention on Tobacco Control and has some tobacco control measures in place.

Centre for Primary Healthcare communications officer Paxina Phiri said that the more the Government drags the process for enacting the Tobacco Bill into law, the more lives will be lost and the higher health expenses will be.

Phiri lamented that despite efforts to engage the Government as to why the draft Tobacco Bill has stalled at the Ministry of Justice, no response has been given which she said raised speculation.

“As Civil society, on 17th July this year, we sent a letter requesting the Minister of Justice to explain why the draft Tobacco Control Bill has been delayed for over four months. However, to date, there is no response. So we don’t know why there is this delay but one thing for sure is that the more the Government sits on the Bill, the more people are dying and the more health expenses,” Phiri explained.

Zambia Tobacco Control Consortium (ZTCC) Vice President Webby Mwamulela reiterated that passive smoking is more harmful than first hand smoke.

And Ministry of Health Acting Chief Non-communicable Disease Officer  Enerst Kakoma said that Tobacco has remained a global agent of death as its use causes over 40 diseases, many of them fatal.

“Combustible tobacco products other than cigarettes are also associated with the same sort of chronic disease outcomes associated with cigarette smoking, such as cancer and cardiovascular disease,” Kakoma explained.

As one of the key measures to counter tactics by tobacco multinationals, CTPD programs Coordinator Natalie Kaunda noted that the commodity’s taxation is still very low hence the need to look at ways of increasing tax because when tobacco tax rates go up, tax revenue also increases which could help in economic transformation.

“The Government should significantly increase tobacco taxes from the current 37.3% of retail price to the WHO recommendation of 75% of retail price. In an effort to grow the economy, it is critical that opportunities in key economic sectors such as the agriculture sector are all identified and maximised with the view to generate more income,” Kaunda insisted.