Tobacco (21) Do people understand the harms of using tobacco products? (5) The role of governments

28 February, 2023

Hello Neil,

Thank you for this mail and your content. [ ]

Current smoking rates among adults may be decreasing in Northern and Western Europe, North America and the Western Pacific regions, where considerable measures have been implemented to tackle tobacco smoking. But it is not the case in the Middle East, Asia and Africa where the habit has actually increased, including in sub-Saharan Africa, by as much as 57% between 1990 and 2009, with prevalence as high as 37.7% among men in Sierra Leone.

In Nigeria, one in ten Nigerians still smokes daily, even though Nigeria ratified the convention agreement in 2005, and in 2015 signed into law the National Tobacco Control (NTC) Act that regulates all aspects of tobacco control including advertising, packaging, and smoke-free areas, Following the 2003 World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) As the most populous country in Africa, Nigeria is a leading tobacco market in the continent, with over 18 billion cigarettes sold annually costing Nigerians over US$ 931 million by some reports.

The oxygen fueling this increase in smoking are many including economic growth (Nigeria has the biggest economy in Africa), improved socio-economic status, rapid migration, and increased cigarette affordability, and paradoxically increasing unemployment, poverty and demographic change towards the youths. There is need for comprehensive measures and strict anti-tobacco laws targeting tobacco production and marketing

Therefore, no matter how comprehensive the measures and how strict anti-tobacco laws that are made, to control and eliminate smoking they are hampered by the ironic ambivalence of Government. The public cannot trust Government because it continues to license tobacco companies and collects huge taxes from them especially as it increases the retail sale prices.

It is also common place to see very highly placed Government officials, even Presidents and prime Ministers encouraging tobacco production and marketing. The greatest and most effective way to achieve any measure of tobacco control and cessation of smoking is for Governments everywhere to match words with action. Governments double-speak on tobacco smoking is a key obstacle to achieving its objective of control. It cannot continue to tell the population that tobacco smoking is bad for them, but yet continue to encourage tobacco production and sale and collecting huge taxes from the producers and sellers. If smoking has no known benefit to human beings, and endangers public health so much, both of which are known facts, why can’t it be banned in all ramifications, especially production and open sales.

Joseph Ana

Prof Joseph Ana

Lead Senior Fellow/ medical consultant.

Center for Clinical Governance Research & Patient Safety (ACCGR&PS) @ HRI GLOBAL

P: +234 (0) 8063600642


8 Amaku Street, State Housing, Calabar, Nigeria.

HIFA profile: Joseph Ana is the Lead Senior Fellow/Medical Consultant at the Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria, established by HRI Global (former HRIWA). He is a member of the World Health Organisation’s Technical Advisory Group on Integrated Care in primary, emergency, operative, and critical care (TAG-IC2). As the Cross River State Commissioner for Health, he led the introduction of the Homegrown Quality Tool, the 12-Pillar Clinical Governance Programme, in Nigeria (2004-2008). For sustainability, he established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria. His main interest is in whole health sector and system strengthening in Lower, Low and Middle Income Countries (LLMICs). He has written six books on the 12-Pillar Clinical Governance programme, suitable for LLMICs, including the TOOLS for Implementation. He served as Chairman of the Nigerian Medical Association’s Standing Committee on Clinical Governance (2012-2022), and he won the Nigeria Medical Association’s Award of Excellence on three consecutive occasions for the innovation. He served as Chairman, Quality & Performance, of the Technical Working Group for the implementation of the Nigeria Health Act 2014. He is member, National Tertiary Health Institutions Standards Committee of the Federal Ministry of Health. He is the pioneer Secretary General/Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers. ( Email: info AT and jneana AT