Wednesday, July 15, 2015

The Uganda Tobacco Control Bill 2014 on verge of passage

The Uganda Tobacco Control bill (2014) is currently before the parliament of Uganda for deliberation with the press reporting, earlier this week, that a handful of legislators expressed misgivings. Actually, the story began much earlier. In 1950, a British doctor observed an increase in the number of lung cancer cases. He was curious, why the spike in lung cancers? Dr Richard Doll decided to investigate this puzzle in 20 London hospitals. What he discovered was ground-breaking. But his results would be kept from most of the world for more than 40 years. Richard Doll discovered that patients with lung cancer case had in common history of tobacco smoking. To be sure, he conducted the study again in 1954. This time following up on 40,000 British doctors who smoked. The results confirmed his earlier findings. Lung cancer was strongly linked with tobacco smoking. The mainstream world would have to wait much longer to know these results. At the time, global tobacco sales were on a high and the powerful tobacco industry would have no one spoil the party. That Uganda should spend more than four years debating whether we need a tobacco control law, in defiance of science, speaks volumes, partly, on the power of the tobacco industry in Uganda today. The UK’s University of Bath has published research results detailing how the tobacco industry in Uganda has interfered in the tobacco control legislative process since 2011. This has included peddling falsehoods that the bill bans smoking when all it does is ban smoking in public places. For the record, Kenya passed a tobacco control law in 2007 and Rwanda did the same years ago. Although tobacco control has largely been constructed as a public health matter, research we conducted in Uganda last year, with funds provided by the Bill and Melinda Gates Foundation, shows that tobacco use is also solidly a poverty issue. Ugandans in the two lowest income groups have higher tobacco use rates than those in higher income groups even when they can afford it the least. We analyzed two combined Uganda household expenditure data sets of 2009/2010 and 2010/2011 and asked a basic question. How much do poor households in Uganda spend on tobacco per week and what could this money potentially buy the household? We then looked at the prices of commodities in the Uganda Consumer Price Index of June 2010 and the potential purchases of selected alternative items with regard to food, health and education. We found that money Ugandan households spent on tobacco every week could have bought 8 litres of fresh milk or two loaves of bread. Studies done in Bangladesh show that households which spend on tobacco suffer more malnutrition than those which don’t. In the case of Uganda, we found that households’ weekly expenditure on tobacco was equivalent to the price of three and a half kilograms of maize flour during the same period. The results also showed that money spent by a parent on tobacco could buy their children a set of primary school exercise books or 21 ball-point pens. In the context of the rising epidemic of diabetes and high blood pressure in Uganda, we found that the money households spent on tobacco monthly was equivalent to a monthly dose of a standard prescription for high blood pressure or diabetes. The study also looked at the spending habits of households which use tobacco. We found that they spent less on eggs and consumed less litres of milk than the average household. These households would potentially spend 39% more on five selected food items if they didn’t spend on tobacco. There would be a 51% increase in expenditure on medical care in households which spent on tobacco. Almost 50% more wore would be spent on education if households didn’t spend on tobacco. Research has determined that the poorer a smoker is, the less cigarettes they will consume if their price is increased through government taxes. Uganda has one of the lowest tobacco taxes in East Africa. The Uganda Tobacco control bill proposes an inter-ministerial committee whose brief would include pushing for a pro-poor tobacco tax policy.

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