By Elvis Michael
Let’s be real—when most people in Africa think of health problems, they think of malaria, typhoid, or maybe high blood pressure. What you don’t hear too often? Lung cancer. Emphysema. Smoking-related heart attacks. But here’s the thing—that’s changing, and fast.
Tobacco use is creeping into the everyday lives of more and more Africans, and with it comes a wave of diseases that we’re not ready for. We’re talking about cancers, strokes, breathing problems, and heart conditions that are entirely preventable—but slowly becoming part of our future if we don’t act now.
It used to be said that Africa was “protected” from the tobacco epidemic. That’s because, compared to Western countries, smoking rates were pretty low. Many people couldn’t afford cigarettes, traditional culture frowned upon smoking, and Big Tobacco companies hadn’t yet focused their attention on the continent.
But today? The game has changed.
From street corners in Lagos to music videos in Johannesburg, cigarettes and vapes are popping up everywhere. Tobacco ads—sometimes outright, sometimes subtle—are showing up in places where young people hang out. And in many neighborhoods, kids can still walk into a kiosk and buy a stick of cigarette without anyone batting an eyelid.
The numbers are going up, and with them, so is the risk of tobacco-induced diseases that could devastate families, drain health systems, and cut lives short.
To understand what’s going on, it helps to look at what happens to people from Africa who move abroad. Recent research by Dr. Nriagu, a Nigerian-born doctor currently based in the United States, has shed some light on this.
Dr. Nriagu’s study looked at the differences in smoking between people born in the U.S. and those who were born in other countries—like Nigeria—but moved to the U.S. The results were eye-opening. When foreign-born people arrive in the U.S., they usually smoke a lot less than those born there. They’ve grown up in cultures where smoking isn’t as common, or as accepted, so they bring that attitude with them. But after spending a few years in the U.S., something starts to shift. They begin to adapt to their surroundings. And slowly, they start picking up habits—like smoking—that they didn’t have before.
This process is called acculturation. The longer you live in a new place, the more likely you are to blend into that culture. And sometimes, you end up adopting the bad habits too.
What Dr. Nriagu’s research shows us is that culture really matters when it comes to smoking. If you’re in an environment where tobacco is everywhere, where people light up like it’s nothing, and where no one talks about the risks—it’s easy to start thinking it’s normal. And once something becomes normal, it becomes a lot harder to fight.
Now think about what that means for Africa. The same shift is already happening across the continent. Smoking is no longer just something “old men” do in the village. It’s becoming trendy. It’s showing up in Nollywood films. It’s on the Instagram pages of music stars. Young people are vaping in universities, and flavored tobacco is being sold in packs that look more like candy than a deadly drug.
The tobacco industry knows exactly what it’s doing. With tighter regulations in Europe and America, they’re turning their attention to new markets—and Africa is right at the top of the list.
If we’re not careful, we could be looking at a situation where smoking becomes as common here as it once was in the West. And worse still, we could see a surge in tobacco-related diseases that our health systems simply aren’t equipped to handle.
Let’s talk about what’s at stake. Smoking is linked to a host of deadly and debilitating conditions—lung cancer, chronic bronchitis, emphysema, heart disease, stroke, mouth and throat cancers, and even complications with diabetes and tuberculosis. These aren’t distant issues anymore. The World Health Organization estimates that over 1.3 million people in Africa could die every year from tobacco-related illnesses by 2030 if nothing changes.
Part of what makes us so vulnerable is that laws around tobacco control in many African countries are either too weak or not enforced. Nigeria, for instance, has signed international agreements like the Framework Convention on Tobacco Control, which is meant to protect populations from the harms of tobacco. But in practice, enforcement is spotty. Cigarettes remain cheap. Ads are everywhere. Schools rarely educate students about the dangers of smoking. There’s little support for people who want to quit. It’s a perfect storm.
And the industry knows it. That’s why you’re seeing more investment in African markets. More subtle advertising. More products designed to appeal to young people. If the West has learned how dangerous tobacco is and started fighting back, the industry is just finding new ground to plant its roots.
There’s still hope, though. If we act now, we can stop this wave before it fully crashes over us. Stronger laws are urgently needed—laws that increase tobacco taxes, ban all advertising, and prevent underage access. But laws alone won’t be enough. People need to be informed. We need widespread public education that makes it clear: smoking isn’t stylish or harmless—it’s deadly. Parents need to talk to their kids about the risks. Teachers need to bring these conversations into classrooms. Religious leaders and influencers can play a big role too, using their platforms to send a message that health matters.
We also need to support the people who are already addicted. Quitting smoking isn’t easy, especially when it’s become part of someone’s coping mechanism for stress. But with the right support—whether that’s counseling, quitlines, or access to nicotine replacement therapy—people can and do quit every day.
The youth must be at the heart of this fight. Right now, they are the biggest targets of the tobacco industry. Everything from flavored vapes to trendy packaging is designed to get young people hooked early. If we want to protect the future of the continent, we have to protect the young people who will shape it.
Tobacco-induced diseases are like a fire slowly spreading through dry grass. We can see it. We know what’s coming. And if we don’t do something now, the fire will rage out of control. Dr. Nriagu’s research is more than just data—it’s a warning and a guide. What’s happening to African migrants abroad is starting to happen here too. If we let it continue, we’ll see a rise in illnesses and deaths that we could have prevented. But if we act now, with urgency and unity, we can turn the tide.
We don’t need to wait for the statistics to catch up. The time to act is now.
Michael writes from Abuja
