About two months ago, I walked into a restaurant located somewhere in Lagos to pick up a bowl of Fish soup. While my soup was being prepared, I noticed a group of white folks seated in a round table and smoking cigarettes. Amidst them were two black guys and a half-caste little girl who was coughing and sneezing repeatedly. This little girl, my humble self, other customers and workers in this restaurant, were all at risk of the harmful health effects of secondhand smoking.
The smoke that comes from the burning end of a cigarette or that is expelled to the air by a smoker is referred to as Secondhand Smoke. The inhalation of secondhand smoke otherwise known as Passive Smoking is a very significant public health hazard.
About a third of the world population is exposed to the dangers of secondhand smoking and annually, thousands of deaths have been linked to this hazard. Those at particular risk are workers and people that hang out in bars and restaurants, children and pregnant women.
Secondhand Smoke contains about 4000 chemicals that are harmful to health. 69 of these chemicals are carcinogens (cancer- causing) and others are toxins that have been scientifically proven to cause various diseases in humans and even animals. They include hydrogen cyanide, carbon monoxide, formaldehyde, acetaldehyde, tar, benzene, ammonia e.t.c.
Diseases caused by these chemicals range from cancers (lung,, bladder, breast, leukaemia e.t.c), respiratory diseases(chronic bronchitis, emphysema e.t.c), coronary artery disease and stroke, to middle ear infections, sudden infant death syndrome, aggravation of asthma in children and miscarriages and stillbirths in pregnant women and erectile dysfunction in men.
There are no safe limits to exposure to secondhand smoke. Children are very vulnerable because of their poorly developed immune system. They are not only exposed at bars and restaurants, they are also exposed when they live with people that smoke. This is because the chemicals in Secondhand Smoke can stick to clothes, hair, nails, skin and even cars (for several months), and children and pregnant women can easily acquire these chemicals from a smoker.
Studies have shown that 13% of all middle ear infections in children are caused by secondhand smoking. Passive Smoking increases the risk of coronary artery disease by 30%, and also increases the risk of lung cancer and stroke. 3000 non-smokers die every year from lung cancer caused by Secondhand Smoking. Carbon monoxide in Secondhand Smoke is a known cause of growth retardation and developmental toxicity in unborn babies. Similarly, benzene causes chromosomal abnormalities in fetuses.
Since smokers are responsible for their health inspite of their knowledge of the health damaging effects of tobacco smoking, the health of non-smokers should be protected not only by the smokers but also by the law.
The World Health Organisation (WHO) through the Framework Convention on Tobacco Control (FCTC) has come out with some guidelines to help protect us from the harmful effects of Secondhand Smoking. These guidelines are part of the articles of the FCTC, which is a treaty with 168 countries (Nigeria inclusive) as signatories.
Several countries are protecting their citizens through effective legislation and enforcement of the FCTC articles to achieve 100% smoke-free public places. Top on the list of such countries are Norway, United Kingdom, Canada, Australia, USA, Italy, New Zealand e.t.c. In Africa, South Africa, Kenya, Ghana and Uganda have been able to enact smoke-free policies, though the enforcement of these policies are still relatively weak. Similarly in Nigeria, the FCT, Osun state and Lagos state have all enacted smoke-free legislation sometimes in the past, the enforcement of these legislation is extremely weak.
Generally speaking, Nigerians are still exposed to dangers of Secondhand Smoking as the Nigerian National Tobacco Bill (NTCB) is still pending in the National Assembly and yet to be passed into law.
Naturally, the Tobacco industry is opposed to the passage of this Bill and will continue to benefit tremendously from its delayed passage, all at the expense of the health of Nigerians (smokers and non-smokers).
Several arguments have been brought forward to oppose the enactment of this Bill. One of such is the issue of unemployment that could arise from an enforcement of 100% smoke-free public places. Evidence based research in countries where these laws have been enacted shows that it doesn’t portend any negative economic impact and some long-term economic gains were even noted.
Conversely, evidence shows that smoke-free legislation reduces the number of hospital admissions for heart disease. A study carried out at the University of California, USA in 2009, shows a 15% decline in heart-attack hospitalizations in the first year after smoke-free legislation was passed, and 36% after three years. A similar study also shows that women, non-smokers, and people under age 60 had the most heart attack risk reduction, with many of those benefiting being hospitality and entertainment industry workers.
Double ventilation and Designated smoking rooms are other alternatives that are suggested by the Tobacco industry. Studies have shown that all these are ineffective in reducing the harm caused by Passive Smoking, as the Secondhand Smoke sticks to surfaces and leave toxins behind for several months. Also, smoke travels from smoking sections to non-smoking sections of restaurants and bars, leaving both staff and customers unprotected. Workers at Designated Smoking rooms would still be at risk and there is no adequate ventilation system in the world that can completely remove Secondhand Smoke. The fact that people cannot see or smell secondhand smoke does not guarantee their protection against its dangers.
This brings me to the story of Heather Crowe, who suffered from Lung cancer and died in 2006, at the age of 57. She worked for several years as a Waitress in a Canadian Restaurant and was exposed to Secondhand Smoking for that long. Shortly after she was diagnosed, she pioneered a nationwide campaign against Secondhand Smoking. Today, Canadian citizens are protected from the deadly claws of Secondhand Smoking by the effective legislation and enforcement of 100% smoke-free public places.
The importance of the effective passage and enforcement of the Nigerian National Tobacco Control Bill cannot be overemphasized. We all have a role to play, our Legislators have within their hands, the power to save our generation from the scourge of the Tobacco industry. The Government has a huge responsibility in protecting our children, pregnant women, workers at bars and restaurants and the entire population from the dangers of Secondhand Smoking. The clock is ticking and more lives are being lost if no action is taken.
Dr. Olusegun Owotomo is an Independent Tobacco Control Activist Based in Lagos,Nigeria.
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