Statistics indicate that the more information one has on the health impact of smoking, they are less inclined to adopt the habit.
Starting today, cigarette packets countrywide are expected to have graphic health warnings including nauseating images that will appear next to the usual written warnings on the dangers of smoking.
The move is aimed at dissuading current and potential smokers from the harmful effects of cigarettes.
Acting director of medical services Jackson Kioko noted that more than half of the front and back of all cigarette packs should have health warnings, while the brand name will be restricted to a standard size, font and colour.
“60 per cent of current smokers thought of quitting because of health warning labels on cigarette packaging. We believe this move will dissuade even the youth from engaging in early smoking”, he noted.
Although the courts last week gave Kenyan cigarette manufacturers opposed to the graphic images a 30-day reprieve as their appeal is being heard, some of them have already rolled out the images.
Pursuant to Article 11 of the WHO Framework Convention on Tobacco Control (FCTC), the international tobacco treaty, parties to the convention must require that all packages of tobacco products carry health warnings describing the harmful effects of tobacco use or other appropriate messages which “should be 50 per cent or more of the principal display areas but shall be no less than 30 per cent of the display areas” and may be in the form of or include picture warnings.
Psychiatrist Dr Peter Njagih Kumantha.
GLOBAL COMPLIANCE
So far, 77 countries in the world have picture warnings on their cigarette packets.
Thailand has the world’s largest warnings covering 85 per cent of the back and front of packs, followed by Australia, which was the first nation to require that cigarettes be sold in plain packaging, without brand colors and logos.
In Africa, Togo has the largest warnings covering 65 per cent of the front and back. They are followed by Mauritius with 60 per cent front and 70 per cent back. Namibia, Cameroon, Ghana, Madagascar and Seychelles have an average of 50 per cent for both front and back.
The WHO FCTC guidelines reiterate that the effectiveness of health warnings increases with size. The recommendation is for more than 50 per cent coverage on the front and back. A large size means that warnings are more visible and in turn will have more impact.
The ‘Global Adult Tobacco Survey- Country Report 2014’, highlights that in Kenya, 77 per cent of current smokers are planning to or have attempted to quit. More than half of daily tobacco users attempted to quit in the last 12 months. Of those who attempted to quit, seven in 10 smokers tried to quit without assistance. For those who visited a healthcare provider in the past 12 months, three in 10 were advised to quit.
Kenya National Bureau of Statistics researcher Robert Buluma noted that majority of those who desired to quit wanted to do so because of health warning labels on cigarette packs.
“Statistics indicate that the more information one has on the health impact of smoking, they are less inclined to adopt the habit,” he said.
The survey was conducted in 2014 in 5,376 households of persons 15 years of age and above.
In Kenya, 55 per cent of all deaths from cancers of the trachea, bronchitis and lung are attributed to tobacco. According to the KDHS survey, this represents 69 per 100,000 deaths.
It normally takes an addict up to three months to treat nicotine addiction. Nairobi-based psychiatrist and addiction specialist Dr Njagih Kumantha however notes that the treatment period depends on the level of addiction.
Dr Kumantha is a former director of the Mathari Mental Hospital in Nairobi and now runs the Brightside Rehabilitation Centre in Kitisuru, Nairobi.
“Your level of addiction and your commitment to stop will determine the treatment period. Some addicts take up to a year before they can leave rehab centres.” Dr Kumantha said.
He adds that treatment is usually tailor made for a specific patient with the cut down program being best suited for chain smokers. This program helps addicts reduce the number of cigarette sticks taken in a day until one quits completely. The program runs in 10-day intervals to give the patient time to adjust.
“If for instance, you take 20 sticks in a day, in the cut down program you can reduce the number to 18 in a week until your body adjusts. After 10 days, you reduce the number again. This can go on until you reach zero sticks in a day”.
The method takes a long time and requires one to be admitted in a rehab centre to avoid a relapse.
Dr Kumantha however dismissed the use of nicotine patches or nicotine gum to counter smoking. He argues that despite the fact that replacement therapy will reduce one’s risk of exposure to lung cancer and other smoking health implications, it still does not solve the underlying problem of addiction.
He adds that nicotine addicts need to undergo behavioural counselling to develop skills they need to avoid tobacco over the long run.
“Counselling is key to recovery. This is because you need someone to be on this journey with you and discover what the underlying problem is. Depression is one of the leading contributors for cigarette smoking”. Dr Kumantha said.
The survey also highlighted the effects of second-hand smoke to unsuspecting Kenyans. It shows that adults were more exposed to second-hand tobacco smoke when visiting bars and night clubs at 86 per cent. Exposure was also high when visiting universities at 30 per cent followed by 21 per cent when visiting restaurants. Another 17 per cent of adults who worked indoors were exposed to tobacco smoke at their work place with 14 per cent of Kenyans being exposed to second-hand smoke at home with more people living in rural areas bearing the burden.
According to the Kenya Tobacco Control Act ( 2007 ), smoking is prohibited in public and work places except in designated smoking areas.
There is no safe level exposure to tobacco. Second-hand smoke recipients will bear the same disease burden as smokers.
GRIM STATISTICS
Kenya has 2.5 million adults who currently use tobacco either by smoking it or other means. Out of this number, the majority is men. One in every five men uses tobacco with more being rural men compared to those living in urban areas.
Three quarters of tobacco users use it within half an hour of waking up according to the survey. 43 per cent of them use it less than five minutes upon waking up.
The average number of cigarettes smoked per day among daily smokers is nine sticks with Kenyans on average spenapproximately Sh1,000 per month on cigarettes. The youth between 15- 24 years are the biggest spenders with some using as high as Sh2,000 per month.
“You will find that in some houses, the urge to buy cigarettes is competing with the need to buy unga (flour). Priorities change when you are an addict,” Dr Joseph Kibachio, head of NCD at the Ministry of Health said.
41 per cent of current smokers started smoking between 20-24 years while 7.5 per cent started before their fifteenth birthday.
Acting DMS Jackson Kioko also noted the need to increase taxes on tobacco products to make them unaffordable and reduce the disease burden due to use and exposure of tobacco smoke.
“In the survey, we found that 80 per cent of Kenyans favoured increasing taxes on tobacco products. I therefore urge Treasury to raise the tax on tobacco products to discourage people especially the youth from engaging in smoking”.
International Institute for Legislative Affairs CEO Emma Wanyonyi.
NO TURNING BACK
The new regulations are to fully operationalise the Tobacco Control Act of 2007. The Nairobi-based International Institute for Legislative Affairs was involved in crafting the act, and says the regulations are long overdue.
“We expect the industry to fight back or to try and delay the regulations, but there is no turning back,” says International Institute for Legislative Affairs chief executive Emma Wanyonyi.
She says tobacco use is the biggest known preventable cause of cancers and non-communicable diseases.
“If we stop tobacco use then we can save thousands of people from unnecessary sickness and death,” Wanyonyi says.