Saturday, April 7, 2012

Kampala engulfed in secondhand tobacco smoke epidemic

You enter a Kampala bar, late in the evening and the entire place is engulfed in smoke - the whole atmosphere is colored with the grey of cigarette smoke. You venture out of the bar momentarily and you smell your clothes and hair and the scent of tobacco pollutes your nose. Now, imagine how absorbent your lungs are, compared to the cotton fabric of your cloth.

Secondhand smoke, also known as passive smoking or environmental tobacco smoke, is a mixture of sidestream smoke from the burning tip of the cigarette and mainstream smoke exhaled by a smoker.

Secondhand smoke is a complex mixture of some 4,000 chemical compounds, including almost 70 known or probable human carcinogens (cancer-causing agents).

Second hand smoke kills children and adults who don’t smoke. It causes lung cancer and heart disease in people who have never smoked. Even brief exposure can damage cells in ways that set the cancer process in motion. According to the WHO, nonsmokers exposed to secondhand smoke at home or at work increase their heart disease risk by 26% to 30% and lung cancer risk by 20 to 30 percent.

“The evidence is now indisputable that secondhand smoke is an alarming public health hazard, responsible for thousands of premature deaths among nonsmokers each year”

Richard Carmona, the US Surgeon General said in 2006.

Uganda banned smoking in public places through regulations passed in 2004 by then Environment Minister Kahinda Otafire called the National Environment (control of smoking in public places) regulations.

The regulations were passed as an off shoot of a Uganda High ruling in December 2002 which declared that smoking in public places was a violation of non-smokers’ constitutional right to a clean and healthy environment.

The High court instructed NEMA to formulate a law against public smoking which was enacted in 2004 and states that: “No person shall smoke a tobacco product or a lighted cigarette in an enclosed, indoor area of a public place.”

Public places here include bars, restaurants, shopping centres and public transportation .But we all know that Ugandans make some of the best laws in the world but trail in enforcing the same very laws.

A study I recently conducted on Uganda’s compliance with the regulations on control of public smoking in in bars and restaurants in Kampala, in the wake of the ban on smoking in public, however tells a tragic public health story of thousands of people in Kampala unwittingly involved in involuntary smoking.

The majority of bars in Kampala blatantly break the law by allowing public smoking on their premises contrary to Ugandan law. In fact, of the 23 bars I sampled in Kampala, only four enforce the ban on public smoking. Ironically, even in bars and restaurants where the ‘no smoking sign’ was prominently displayed, smoking continued unabated at the premises.

The study was conducted in five areas of Kampala including in Kisementi, Kabalagala and the sampled bars including the most popular bars frequented by middle class Ugandans.

The study, made possible by the US-based Campaign for Tobacco Free-Kids, shows that the law against public smoking in Kampala remains on the books with no enforcement to speak of. With the passing out of environmental police, by the Uganda police last year one can only hope the situation will be ameliorated.

Even with the proposed 2010 Tobacco control bill having had its first reading in parliament and a Tobacco Control policy awaiting cabinet consideration, enforcement of the tobacco control law will remain critical to the health of millions of Ugandans.

Respiratory symptoms among bar workers in Scotland decreased by 26 percent after

Smoke-free legislation was implemented in 2006 and asthmatic bar workers experienced

reduced airway inflammation and reported an improved quality of life.

In Uruguay, the enforcement of a 100% some-free law has reduced hospital admissions for heart attacks by 22 percent.

Many think that as long as they don’t smoke they will escape the now scientifically proven 15 cancers associated with cigarette smoking. But sadly, it is not enough not to smoke.

No comments: