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Tag: smoking

  • The teenage marijuana smoking epidemic

    The teenage marijuana smoking epidemic

    With the rate at which teenagers in Lagos are smoking Indian Hemp as if it is a candy, and going out of fashion, stakeholders are at a crossroad on how best to handle the helpless situation reports Sina Fadare & Medinat Kanabe

    They are helpless, homeless, hopeless and perhaps do not know the implications of their actions.  They are smoking marijuana, popularly called Indian hemp, igbo, eja or kukuye on a 24-hours basis as if their lives depend on it. They are products of broken homes and carefree parents who care less about where, when and how they are surviving.  They live their lives on the streets and under the bridges. During the day, they are noticeable at major bus stops and parks across Lagos and other states. And these are aside those permanently operating under the bridge at Oshodi towards the Ilupeju end. Often, you can identify them by their tell-tale unkempt looks, wrapped weed in between their fingers, thick smokes unfurling and melting into the atmosphere, and of course the nauseating odour. Welcome to the little world of teenage hemp smokers,

    As early as 5 am, their day starts. They are on the streets, snatching bags, phones and money. Investigation by The Nation revealed that they rarely sleep, preferring to occupy themselves with smoking Indian hemp almost throughout the night. And they’re freshly out of the cradle, their ages ranging between 12 -16 years.

    “How can they sleep, when throughout the day they are smoking Indian hemp? Definitely sleep will elude them and that is why they are ready-made recruits for buglers and armed robbers,” a newspaper vendor under the bridge, who knew virtually all of them, due to years of interacting with them lamented.

    We also discovered that some of them have turned under the bridge to their homes. Their clothes could be seen littering the base of the bridge, while those recently washed hung on the barbed wire, supposedly used as demarcation by the authorities to discourage people from making the place a bypass.

    A repeat visit to the place on weekends confirmed that the kids actually live under the bridge. Some of them could be seen washing few of pieces of cloths, while others naturally busied themselves with their pastimes, hemp smoking. It did not matter that it was just 6:30 in the morning. We also discovered that they are threats to commuters who trooped to the popular bus terminus to take early bus rides to Lagos Island and other cities and towns outside the state. At one time or the other, a good number of them have fallen prey to these urchins, losing bags, phones and other belongings in the process.

    After the morning rush of passengers, some of them move to the garage adjacent their abode to begin a long session of dice and card games, using money, wrist watches and sometimes shoes, most of which were stolen,  to bet. During this time, the big white stick never leaves their fingers. They just can’t seem to have enough of the illicit weed.

    How teenagers between the ages of 11 to 15 years of age could become hemp addicts in the glare of the ever busy Oshodi, with so many people troop in droves on a per minute basis beats the imagination and raises cause for concern.  More worrisome is the fact that a police station sits just about 10 meters from this spot.

    This team of The Nation was however dazed to discover that this trend cuts across the major bus parks and bus stops across the Lagos metropolis. From Fadeyi to Mushin to Bariga; right across to Somolu, Ketu, Pen Cinema, Abbatoir, Mile 12, Olodana Oto Apapa,  Agege, Ajelogo, Agric Ikorodu, Agbole area of Ikotun, Itire, Ojuelegba, Obalende; the story is the same. And so it is official, hordes of teenagers, who should be in school or at vocational training, preparing themselves for a meaningful future, are smoking away their future with impunity.

    At Agege area of the state, a middle age man, who identified himself as Baba Kabiru, said he almost fainted the day he learnt that his son who was in primary six was smoking Indian hemp.

    He said the poor boy learnt to smoke the weed during his regular trips to the Quranic lesson, which he used to attend after school hours. “Some of the bad boys were living in the same building that is housing the evening class and were using these innocent children as errand boys whenever their master was not around. Gradually my son and some others were inducted into smoking. I got to know one day when my wallet was missing. In the confusion of searching everywhere, l checked his school bag where l saw two raps of Indian hemp.”

    Baba Kabiru who disclosed that he was unable to sleep that night said upon investigation he learnt that they have a group and they have been involved for a while. “l had to change his school and move away from the environment because l was too shocked to see my son, a primary school pupil smoking Indian hemp. The experience is still strange to me.” He lamented.

    The entrance of Our Lady Lourdes Girls Primary School on Clegg Street in Surulere area of Lagos is another notorious joint that harbours hemp-smoking kids. On a daily bases, immediately the school closes for the day, these kids take charge and smoke marijuana till the wee hours of the day.

    Again, the Area  ‘C’ Police Division  is very close to the school compound, but somehow, they seem to be content with looking elsewhere, whilst this atrocity go on.

    Speaking to The Nation on condition of anonymity, a police officer from the command said most of the parents of these kids are within the vicinity, but unfortunately they cannot put them under control, adding that “there is little the police can do because some of these kids are under-age and cannot be put behind bars.”

    As a panacea, he challenged the government to wake up to its responsibility and send these kids to rehabilitation homes, where they can learn different vocations to make useful to themselves and society later in life.

    At Obalende, another kid hemp smoking rendezvous assailed our reporter. Here we gathered that weed smoking, particularly among the teenagers, is like a carnival. A middle-aged woman, Labake Ilori who sells assorted wines in the area questioned this reporter’s naivety, asking if he was new in Lagos not to know that smoking of Indian hemp in the vicinity by the teenagers is a daily occurrence.

    “Are you new in Lagos? All these kids are chain hemp smokers, virtually from morning till late into the night. Some of them don’t have anywhere to go; therefore they live on the streets and sleep in most of the kiosks. Occasionally the police come here to raid them, but after few days you see them again,” she explained.

    She lamented that at the dawn or night, they become uncontrollable and there is nothing they cannot steal. “You can see all of us are very careful and keep our money inside our inner purse otherwise they can do anything.”

    Candidates for nuthouse

    If the kid hemp smokers are potential recruits into the world of crime, they are also potential patients at psychiatric homes. The question thus arises; why are they left to waste away their future under the bridges and at bus terminals, when their parents, government officials and even the police could have kept them in check?

    Lagos State Police Public Relation Officer, Mr.  Nwosu Kenneth said that the police in the State are doing everything within its power to arrest the situation.

    He pointed out that Oshodi area of the state is a peculiar terrain that remains a concern to the police authority, adding that “when we arrest people we know are underage and cannot really be arrested under the criminal justice system, we take them to juvenile homes for care because some of them get involved in it because of lack of care.”

    He said the police in partnership with the National Union of Road Transport Workers, NURTW and the government of Lagos State are trying to mop up the area in order to save the future of the kids. “Most of the kids you see there are not from a home; they are on their own, fending for themselves; so they are vulnerable and easily lured into these things. We do clean up there about twice a week. We rescue these kids because they cannot be arrested. If you have information about how we can get the kids, so they can be rescued, it will be much appreciated.”

    Kenneth however regrets that the kids keep returning to the dark areas, despite being rescued on a daily basis. He ascribed this to the fact that these are places where they earn their living, albeit illegitimately.

    Speaking in the same vein, Head of Public Affairs of National Drug Law Enforcement Agency, NDLEA, Mr.  Ofoyeju Mitchell said kids get involved in marijuana due to their ignorance of the consequences of the drug.

    Mitchell while speaking to The Nation in his office noted that “some are so carried away by the type of peer groups they keep that they don’t even know when get involved.  If they are unfortunate to have friends who are involved, they are likely to succumb to pressure by their peers to try it out.”

    According to Mitchell most of the kids do not have what you can call a home; therefore they are ready-made tools for such a gamble. “Lack of good upbringing also leads to it because when children are not properly cared for, it affects. You don’t know their friends or what they do; when they keep late nights, nobody asks where they are coming from. And children being what they are, like to experiment, even when they know that government have said the drug abuse is bad. They want to experiment and have a taste of that much-talked-about euphoric pleasurable feeling, forgetting that the feeling is addictive.”

    He lamented that these kids are products of broken homes, who possibly have nobody to lean on for survival and therefore take solace in bad peer groups. “There are children that don’t even know where they are from or where their parents are. We have counseled some that we expect them to go back home, but they can’t because of one reason or the other. Some live under the bridge in Lagos but their parents are in Osogbo.  And when they are on the streets, they are exposed to all forms of abuses because they don’t have guidance.”

    Mitchell pointed out that the NDLEA has put up a lot of enlightenment programmes to assist them. “We have introduced drug free clubs in schools. The club builds capacity among the children. They have their NGO. We  talk to them and give them  fliers, and whenever they are having programmes like debate or seminar within their school, they invite us as patrons to come and present talks and we believe that by involving them in anti-drug abuse programme, it will help to inculcate a drug free lifestyle in them, and it is working.”

    Mitchell said that in as much as the agency wants these kids off the street, it has its limitations. “We have challenges of accommodation for them. After we counsel them, we can give them money to go back to their various homes around the country, but there is no proper follow-up or monitoring to know if they actually went home.

    “There are some others that after the counseling process, they go back home but because of lack of follow-up we re-admit them again. We expect that their parents would take over after they complete the process. Some say that nobody cared for them after getting home, but their friends came and they followed them and started taking the substance again.”

    He argued that the daunting challenge at hand is that all hands must be on deck to monitor these kids, particularly by their parents who have greater responsibility towards them before they turn to social menace.

    “We have raided Oshodi, Obalende and some other notorious spots in Lagos and we do that on regular bases, but we cannot do it alone. Parents must be involved; NGOs, civil society groups, opinion leaders, traditional rulers, individuals. We have a dedicated phone line on our website that people use but we also advise other people to use it. I cannot know what is happening in your area even though we have people who go out to raid notorious places.” He said.

    Reacting to the allegation that the government of Lagos State is not doing enough to take these kids off the streets, a deputy director at the ministry of Environment, Lagos State, who spoke to The Nation on condition of anonymity said the government is trying to do its best but challenged parents not to give birth to children they cannot take care of, lest they become social deviants.

    According to him the government in conjunction with relevant security agencies raids these notorious dark spots, but the kids are always back there after “escaping from our custody at juvenile homes.”

    He lamented that the government is busy about electioneering at the moment and most of these kids have been conscripted into pasting posters, especially at night; therefore he said “To have a meaningful programme for them will be after this election palaver.”

  • Smoking – good reasons to quit

    Smoking – good reasons to quit

    There is the need to legislate on passive smoking for smokers  to quit;  if not for his own health, but for the family. OYEYEMI GBENGA-MUSTAPHA writes.

    When Idayat, a 28-year old sewing mistress got married to 30 year old Segun Ikuomola, a commercial driver that smokes, she looked forward to a happy matrimonial experience. But barely two years into the marriage, with her losing four pregnancies, one still birth and the last pregnancy ending in low birth weight baby, was she fed up. Yet gynecologists at the private hospital she enrolled in said she had no problem with reproduction, her husband as well.

     

    Her mother in-law then suggested she moved her case to the public hospital. Idayat complied and registered with the Lagos University Teaching Hospital (LUTH), Idi Araba, Lagos.

    During one of the ante-natal clinics, she listened to a seminar on roles environment plays on health, especially fumes and smokes.

    After the talk she found audience with the nurses who gave the talk. And narrated her past experiences. Her file was fished out and she was referred to a Consultant (name withheld).

    After many interactions with the Consultant, it was established there was a link between her miscarriages, premature births and low birth weight babies.

    Idayat was shocked that her husband’s habit of smoking had caused her these much anguish. But she was not to be blamed. She did not know nor her husband that there are health risks for expectant mothers and foetus who are exposed to passive smoking.

    She was not the only woman who had been at the receiving end of effects of passive smoking. Mrs Ngozi Okafor, a 32 year old receptionist had lost two children to same passive smoking. Her two children died as a result of increased risk of sudden unexpected death in infants (SUDI), sudden infant death syndrome (SIDS) and fatal sleep accidents.

    Passive smoking means breathing in other people’s tobacco smoke. Exhaled smoke is called exhaled mainstream smoke. The smoke drifting from a lit cigarette is called side stream smoke.

    Second-hand smoke (SHS) is a common indoor pollutant in the home, making passive smoking a serious health risk for both those who smoke and those who do not. Children are particularly at risk of serious health effects from second-hand smoke. In Victoria, US, it is illegal to smoke in cars carrying children who are under 18 years of age and in enclosed workplaces. But Nigeria has no such law. Though smoking in public places is restricted by the Federal Government, only Lagos State has passed a law to illegalize smoking in public places.

    According to a Consultant Public Health physician, Department of Community Health and Primary Care, College of Medicine CMUL), University of Lagos, Idi Araba, Dr kemi Odukoya, SHS, also known as passive or environmental tobacco smoke (ETS), is a combination of main stream smoke that is exhaled by smokers and side stream smoke given off by the burning end of a cigarette, cigar, or pipe. “SHS is a mixture of air-diluted side-stream smoke from the burning tip of the cigarette, and exhaled mainstream smoke that has been initially inhaled and then exhaled by the smoker.  The proportions of side-stream and exhaled mainstream smoke can differ but side-stream smoke is usually the larger constituent. An open window doesn’t provide enough protection against the chemicals found in second-hand smoke. These chemicals linger long after the smoke has disappeared, and can be absorbed by carpets, furnishings and walls in the home, increasing your risk of exposure.

    “Harmful particles in mainstream smoke include tar (itself composed of many chemicals), N-Nitrosamines, benzene, benzoicpyrene, dioxins and heavy metals including chromium, lead and cadmium. Harmful gases include carbon monoxide, ammonia, sulphur-dioxide, dimethylnitrosamine, formaldehyde, hydrogen cyanide and acrolein,” said Dr Odukoya.

    According to Dr Odukoya, SHS is a serious health hazard, approximately causing close to 50,000 deaths per year, globally.  “It can cause a wide range of adverse health effects, including lung cancer, respiratory infections and asthma.  Nonsmokers exposed to secondhand smoke at work are at increased risk for adverse health effects. SHS exposure causes disease and premature death in children and adults who do not smoke. There is need for the government at all levels to pass a law to save mothers and children from the evil effects of passive smoke.”

    Facts

    Intrigued to find out how expectant Nigerian women are affected by passive smoke, a researcher at LUTH, Mrs Grace E.  Oyekan, decided to carry out an investigation.

    Titled: “Second hand tobacco smoke exposure among pregnant women: Knowledge, attitude and associated factors in patients attending Ante-natal clinic in Lagos University Teaching Hospital (LUTH)”, she established that there is urgent need for the government to save expectant mothers and their babies from the harmful effects of SHS because, “based on my study I found out that the pregnant women’ knowledge of second hand smoke was 19.3 per cent good. About the attitude, 50.3 per cent had positive attitude while 49.7 per cent had negative attitude. I also found out that among the respondents 29.4 per cent were exposed at home while 32.7 per cent were exposed at other places other than their homes, these percentages of the respondents that exposed were significant enough as there is no safe level of exposure to SHS. I recommend as a matter of urgency that health talk should be done at the ante-natal clinics nationwide to inform the pregnant women about the dangers associated with second hand smoke. There should be the passage of tobacco smoke free law in homes, and Passage of tobacco smoke free law in public places, as was done in Austria.”

    Other sources equally affirmed that globally, SHS is a serious health hazard causing close to 50,000 deaths per year; approximately 3,400 deaths from lung cancer and 22,700 to 69,600 deaths from heart disease each year.  It can cause a wide range of adverse health effects, including lung cancer, respiratory infections and asthma. Nonsmokers exposed to secondhand smoke at work are at increased risk for adverse health effects. SHS exposure causes disease and premature death in children and adults who do not smoke.

    SHS is especially harmful to young children. It is responsible for between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalisations in the United States annually. Secondhand smoke exposure may cause buildup of fluid in the middle ear, resulting in 790,000 physician office visits per year and it can also aggravate symptoms in about 1,000,000 children with asthma.

    Mrs Oyekan (1)Mrs Oyekan, an operative theatre nurse found out that SHS harms not only the mother-to-be, but her unborn child as well. It increases both her and her baby’s risk of developing lung cancer, heart disease, emphysema, allergies, asthma, and other health problems.  “When a pregnant woman is exposed to secondhand smoke, the nicotine she inhales is passed on to her unborn baby and as such they have a higher rate of miscarriages and stillbirths as well as have an increased risk of low birth weight infants. The children born also have greater risk of sudden infant death syndrome (SIDS) and decreased lung function.

    “Nicotine in the blood of a pregnant woman exposed to second-hand smoke can decrease the blood flow to the unborn baby. This can affect the unborn baby’s heart, lungs, digestive system and central nervous system. Carbon -monoxide in smoke can affect the baby’s growth and may lead to low birth weight. Exposure to cigarette smoke in utero whether via maternal smoking or maternal exposure to secondhand smoking is associated with a number of adverse pregnancy outcomes. It is a source of severe oxidative stress in the unborn child and can have detrimental effects on the fetal growth, neurodevelopment, neuro behaviour as well as cardiovascular regulation that predispose the fetus to a number of adverse health outcomes.”

    On the effects on the foetus, Mrs Oyekan said:  “SHS harms not only the mother-to-be, but her unborn child as well. It increases both her and her baby’s risk of developing lung cancer, heart disease, emphysema, allergies, asthma, and other health problems.  When a pregnant woman is exposed to secondhand smoke, the nicotine she inhales is passed on to her unborn baby and as such they have a higher rate of miscarriages and stillbirths as well as have an increased risk of low birth weight infants. The children born also have greater risk of sudden infant death syndrome (SIDS) and decreased lung function.”

    Further damages

    The Consultant, Dr Odukoya said men are not the only source of passive smoke, ‘some women smoke too. Maternal tobacco use is also likely to expose infants and children to SHS and serves as a role model for children’s use of tobacco. Intervening during pregnancy is also important because of the health risks to the woman who potentially has many years of remaining life. For cigarette smoking, these health risks include lung and other cancers, coronary heart disease and stroke, and chronic obstructive pulmonary disease; health risks from smokeless tobacco products include oral and pancreatic cancer.”

    Mrs Oyekan said, “Active maternal smoking during pregnancy can increase the risk of a range of conditions, including impairment of fetal growth and development. However non-smoking mothers who are exposed to SHS may also risk similar effects on fetal and reproductive health, although the risk is smaller than that of smoking mothers. A foreign research indicates that almost 19,000 babies exposed to passive smoke during gestation are born with low birth weight each year in the UK. Latest figures from Scotland suggest an annual decline in the numbers of mothers reporting smoking at first booking and first visit, though the percentage of women recorded as ‘not known’ has increased. 18.8 per cent of women were active smokers at booking (first antenatal appointment); a decrease of nine per cent on 2005 figures. Maternal smoking rates at first visit from a health visitor were 18.1 per cent for the same period (a fall from 22.2 per cent in 2005). Though not conclusive, some studies have argued that maternal passive smoking may reduce fertility, increase fetal and perinatal mortality and increase the risk of some congenital abnormalities.”

    Further facts

    The researcher said: “Mothers’ avoidance behavior of SHS plays a critical role in the exposure of children to SHS. If mothers do not take adequate precautions to avoid exposure to such SHS hazards, they and their children may be susceptible to a series of negative health effects. Of the 585 non-smoking adults in a study done in two cities in Nigeria, 38.8 per cent had regular exposure to SHS; mostly, in public places (24.4 per cent). More men were exposed at public places when compared with women (27.0 per cent versus 19.5 per cent).  The strongest factor associated with exposure to SHS in women was having a smoking spouse [prevalence rate (PR) ratio-7.76; 95 per cent confidence interval (CI), 3.08-9.42]; and in men, it was lack of home smoking restriction (PR ratio-6.35; 95 per cent CI, 4.51-8.93). Among men, SHS exposure at any location was associated with lack of secondary school education, residing in slum apartment (house with many households), living with a smoking family member (non-spouse), lack of home smoking restriction, and alcohol intake.  Among women, SHS exposure at any location was associated with having a smoking spouse, residing in slum apartment and lack of home smoking restriction. Seventy-two percent of respondents were aware of the harmful effects of SHS on their health.”

    It is of concern to Dr Odukoya that children of smoking parents are not taken into cognizance on the effects on them and the Government is seemingly doing nothing to prevent the children, because the home is a predominant location for smoking, children are exposed to tobacco smoke as they go about their daily lives, i.e. while eating, playing and even sleeping.

    “The exposure at home may be added to exposure at school and in vehicles. Consequently, in a country like ours, children cannot avoid inhaling tobacco smoke. Data on the exposure of children to secondhand tobacco smoke are limited. In perhaps the most comprehensive cross-sectional study to date, researchers examined exposure to secondhand tobacco smoke in 17, 448 children aged one to 10 years in the USA. Exposure varied considerably according to socio-economic status- 41 per cent of children of lower socio-economic status experienced daily exposure to secondhand tobacco smoke in their home, whereas only 21 per cent of children of higher socioeconomic status were exposed daily.

    “People who have never smoked who live with people who do smoke are at increased risk of a range of tobacco-related diseases and other health risks, including: increase in the risk of heart disease. There is consistent evidence that people who do not smoke, who live in a smoky household, have higher risks of coronary heart disease than those who do not.  Passive smoking makes the blood more ‘sticky’ and likely to clot, thereby leading to increased risk of various health conditions, including heart attack and stroke. There is evidence that passive smoking can cause levels of antioxidant vitamins in the blood to reduce.”

    The Consultant said just 30 minutes of exposure to SHS can affect how your blood vessels regulate blood flow, to a similar degree to that seen in people who smoke. “Long-term exposure to passive smoking may lead to the development of atherosclerosis (narrowing of the arteries). People who do not smoke who suffer long-term exposure to second-hand smoke have a 20 to 30 per cent higher risk of developing lung cancer. There is increasing evidence that passive smoking can increase the risk of stroke, nasal sinus cancer, throat cancer, breast cancer, long- and short-term respiratory symptoms, loss of lung function, and chronic obstructive pulmonary disease among people who do not smoke,” she stated.

    Call to action/ Recommendations

    The 2010 publication of the National Institute for Health and Clinical Excellence (NICE) titled, “Quitting smoking in pregnancy and child birth” guidance aimed at stopping smoking in pregnancy and following childbirth recommended that midwives should identify pregnant women who smoke through discussion and the use of CO tests to assess their exposure to tobacco smoke. This would help identify levels of exposure through both active and passive smoking.  The NICE guidance also recommended that partners and other smokers in the household should be offered help to stop smoking, as well as information and advice on the risks of passive smoking on the mother and baby.

    Smoking among fathers is another concern of particular interest, as the women and young children who live with them are especially vulnerable to SHS at home. Smoke-free legislation has been effective in protecting both non-smoking adults and children in public places. In July 2007, the “promote smoking control” law, which included the aim of preventing second-hand smoke in public places, was introduced in Taiwan. However, as of 2009 such Taiwanese governmental legislative protection had not been enforceable in private homes, which is still the primary source of SHS exposure for women and children.

    Special Adviser to the Lagos State Governor on Public Health, Dr Yewande Adeshina had also advocated the need for Nigerians to cultivate the healthy habit of not smoking actively or passively, in order to reduce the incidence of preventable diseases.

    Adeshina opined that tobacco smoking is an unhealthy habit with every puff taken, about 4,000 dangerous chemicals and 400 compounds such as tar, carbon monoxide and the highly addictive nicotine are released into the bloodstream. “When there are children in a house where someone smokes, they are seriously affected leading to the development of asthma. In school, such children do less well in reading and mathematics. The list of these problems caused by tobacco is almost endless, staying away from the habit could prevent all these problems’’.

    The Special Adviser advised Nigerians to shun the advertising gimmicks of tobacco producers which often advertised their products by presenting people who took tobacco in the adverts with the image of successful personalities as if it was tobacco that took them to such height just. She urged them to shun concerts and parties that have been supported by the tobacco industry.

    Adeshina admonished tobacco industry on the need to intensify their efforts in changing the perception of people especially the unsuspecting and impressionable youth who are easily influenced to cultivate smoking habit.

    These findings justify the urgent need for the government to take action on the passage of the National Tobacco Control Bill. Tobacco is the bedrock of SHS, and its use in Nigeria is projected to have devastating consequences, even on unborn innocent babies. For Civil organisations and non governmental organisations (NGO) to have pushed for the passage of the National Tobacco Control Bill is an indication of the seriousness of the situation and the government should not lag in initiating a legislative process to combat this social ill, by passage of the bill.

    These findings by the researcher, and the consultant justify the urgent need for the government to take action on the passage of the National Tobacco Control Bill (NTCB). Tobacco is the bedrock of SHS, and its use in Nigeria is projected to have devastating consequences, even on unborn innocent babies, paediatrics, and women.  In fact everybody. For Civil organisations and non governmental organisations (NGO) to have pushed for the passage of the National Tobacco Control Bill (NTCB) is an indication of the seriousness of the situation and the government should not lag in initiating a legislative process to combat this social ill, by passage of the bill.

     

     

  • The battle against smoking

    The battle against smoking

    The Lagos State government recently joined other governments that have legislated on tobacco control but the challenges about stopping people lighting up is not yet over, writes Joe Agbro Jr.

    JUST last week at one of my favourite haunts around Mushin, Lagos, I noticed an innocuous sign posted on the wall. The sign simply reads ‘No Smoking’. It was, however, loud in meaning. It was the fall-out of the recent enactment of the state government’s anti-tobacco smoking law.

    Going by the law, smoking is prohibited in designated non-smoking areas and public places such as museums, public toilets, libraries, nurseries, day care centres, offices, schools, restaurants, parks, and in public transportation in the state. Others are private vehicles where there are more than one persons, school buses, factories, restaurants and cinemas, theatres, amusement parks or any other place used by members of the public as conference centres and exhibitions halls.

    First time offenders may get up to three months in jail and pay a fine of N10, 000, while repeat offenders may be fined N50, 000 or face six years in jail. The law also reserves a fine of N15, 000 or six months imprisonment for smokers who smoke around minors or anyone below 18 years old.

     

    From gold to dust

    Tobacco smoking, once glamorous across the world, has seen many bans and restrictions. Unlike before the millennial, it is no longer cool to smoke and many governments across the world are legislating against tobacco smoking. Across Lagos, especially in the ghettoes, smoking is a favourite pastime, often engaged in publicly.

    And as expected, mixed reactions have trailed the law. Jide Fabiyi, who has wanted to quit smoking, welcomed the law. “I like the law,” he said. It would definitely make me reduce smoking.”

    Ironically a woman who operates a bar and even sells cigarettes around Ikeja said it was a good law. “I think it is good,” she said. “People that want to kill themselves can continue but it is not good for other people that don’t smoke. Since we heard about the law, I tell my customers not to light cigarettes anymore but they complain that they cannot enjoy their drinks without smoking and so they enter inside.”

    Though the law permits public places such as restaurants to designate a well-ventilated area not more than 10% of the property size as smoking area, the reality is that many places where smokers hang around are cramped and already strained for space.

    No doubt, the law will stem the rate of smoking, something, Akinbode Oluwafemi of Environmental Rights Action/Friends of the Earth Nigeria, (ERA/FoEN) wants. “We want to completely remove the environment that induces our children to smoke,” he said. “We want to completely remove every business incentive that makes it possible for tobacco companies to continually to relocate to Nigeria and sell cigarettes to us at very cheap prices.”

    And against the Lagos example, Oluwafemi believes the advocacy is gathering momentum. “Very soon,” he said, “I can guarantee you’ll see more movements in the other (state) assemblies. It is becoming like a movement.”

    This movement is catching on, even though it may be at a slow pace. There are still about one billion smokers worldwide today. And in Nigeria, there has been some struggle to restrict the foothold of tobacco, but commercial activities of the big tobacco producers and old habits of smokers still kept the cigarettes burning. Many who grew up in the 90s would remember the glitz and glamour associated with cigarettes in terms of advertisement and promotions. It was hype. But the wave of condemnation has stifled their growth. Nowadays, even when exercising their Corporate Social Responsibility (CSR), the level of visibility is reduced.

    Tobacco farmers also foresee a drought in their business following a fervent bid in tobacco control. The chairman of Nigeria Independent Tobacco Farmers Association, Rasheed Bakare recently said: “We learnt that the government is taking steps toward tobacco control. For us, tobacco farming is our mainstay. If tobacco is banned, our communities will suffer. Our people will be jobless.”

     

    Implementation

    Though the anti-smoking law is here to stay, some people worry enforcement may be compromised even though the Lagos State Environmental Protection Agency (LASEPA) has been charged to enforce the law. But of course, other law enforcement agencies like the police, KAI, including individuals have powers to arrest.

    The president of the Nigerian Medical Association (NMA), Dr. Osahon Enabulele, also worries over “the implementation of the law given the sub-optimal levels of public awareness and health education on the dangers associated with tobacco smoking.”

    But while he worries about awareness and health dangers, some people worry that some law enforcement officials may see the law as a way of fleecing violators of the law.

    According to a smoker, Kazeem who usually hangs out around the Lagos State Abattoir at Agege, a policeman threatened to make sure he (Kazeem) is arrested for smoking.

    “I know he is joking,” Kazeem said. “But I know police would use it (the law) to raid people.”

    Another smoker, Seun Fajana, said while the law is good, it may not be effectively enforced. “I wonder why the price of cigarettes is not just increased,” he said. “The high price alone can discourage many people from smoking instead of a law that won’t work.”

    According to Governor Fashola, the law was made to protect human lives. He said, “I have read a lot of comments about the possibility of enforcing the laws. But our commitment to public health and public safety is stronger than that.”

    Smoking kills

    It has been scientifically proven that tobacco smoking is harmful. And many smokers know that. What is widely unknown is really how harmful it is. A 2009 survey in China revealed that less than half (38%) of smokers knew that smoking causes coronary heart disease and only 27% knew that it causes stroke. The level of ignorance among Nigerian smokers is unknown. Yet, smoking affects nearly all the organs in the body, causing all sorts of diseases and ailments. According to the World Health Organization (WHO) tobacco kills nearly six million people each year. ‘Unless urgent action is taken,’ WHO says, ‘the annual death toll could rise to more than eight million by 2030.’

    Out of this number, 600, 000 deaths are a result of non-smokers being exposed to second-hand smoke. And one of the areas the anti-smoking law addresses is to protect non-smokers from the effects of second-hand smoke, the smoke that fills enclosed spaces when people burn tobacco products. WHO documents that second-hand smoke causes more than 600,000 premature deaths per year.

    In adults, second-hand smoke causes cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death. In pregnant women, it causes low birth weight. WHO also discloses that almost half of children breathe air polluted by tobacco smoke in public places.

    According to scientists, tobacco smoke contains about 250 harmful chemicals, of which 50 are carcinogenic. Surely, these are good reasons to discourage tobacco smoking.

    While quitting tobacco smoking is difficult, for people wanting to stop smoking cigarettes, there are less harmful alternatives sticking nicotine patches, chewing nicotine gum, and ‘vaping’ on e-cigarettes. However, these are not popular in these parts. And NMA is concerned about the “absence of cigarette smoking withdrawal programs” should more people decide to give up smoking.

    According to WHO, nearly 80% of the world’s one billion smokers live in developing countries. And the present challenge is for these countries to stem the smoking tide, something the Lagos State government has done with the anti-tobacco smoking law.

     

  • Why pregnant women should avoid smoking

    Why pregnant women should avoid smoking

    If your health isn’t enough to encourage you quit smoking, then the health of your baby should be. Smoking while pregnant increases the possibility of stillbirth, miscarriage and low birth weight – especially in teens and young adults.

    Teens and young women have the highest reported smoking prevalence, and it’s only getting worse. The problem is kids experiment with tobacco and it often turns into a lifelong habit. Nearly 90 per cent of adults say they started smoking by the age of 18.

    This is a reflection of aggressive tobacco industry marketing to girls. Tobacco companies advertise in magazines, market their brands through direct mail and adverts, promote their products in convenience stores and coerce youth through Internet websites and social media sites.

    They fail to mention that tobacco smoke contains more than 7,000 chemicals and at least 60 cancer-causing compounds. Two compounds are especially hazardous to a mother and child: highly addictive nicotine and carbon monoxide.

    Pregnant women often have intensified desires for cigarettes due to increases in their metabolism. The addictive effect is very strong and often proves extra difficult to cut cravings.

    However, according to a new study, a brisk walk has been shown to temporarily reduce the effects of nicotine. Exercise was known to interrupt nicotine cravings for men and women, but it was still unclear for expecting young mothers.

    “This was the first time we have been able to replicate the findings with pregnant smokers,” said Harry Prapavessis, director of the Exercise and Health Psychology Laboratory at Western University in Ontario, who led the research.

     

    As little as 15 to 20 minutes of walking at a mild to moderate pace was found to ward off cravings. Additional benefits included less irritability, restlessness, tension and other withdrawal symptoms.

    There’s no safe amount of smoking for pregnant women of any age, the more you smoke, the worse the outcomes for your baby. This is not true for exercise; it’s good for you and your baby.

    Exercise can prevent excess weight gain during pregnancy, prevent gestational diabetes and lower the risk of birth complications. Being more fit can also help with pregnancy-related aches and pains, which makes labour and recovery a bit easier.

    Even if you don’t quit, regular exercise is still beneficial to you and your child. When you exercise, your lungs and blood vessels expand which increases circulation of oxygenated blood throughout you and your baby’s body.

    Regular exercise during pregnancy has been proven to reduce stress, improve sleep and prevent depression as well. Just don’t exercise too close to bedtime, or you may be too energized to fall asleep and experience insomnia.

    Barring certain pregnancy related risk factors, pregnant women can continue to exercise throughout their pregnancy, right up until delivery. Isometric, or contract and relax exercises are recommended for expecting moms to improve core strength and support pelvic ligament laxity, particularly during late pregnancy.

    Remember to check with your doctor before starting a new exercise programme, especially if you have any health concerns.

     

    Couillard is an international health columnist that works in collaboration with the World Health Organization’s goals of disease prevention and control. Views do not necessarily reflect endorsement.

    Email: drcorycouillard@gmail.com

    Facebook: Dr Cory Couillard

    Twitter: DrCoryCouillard

     

  • Can you hide smoking from life insurance companies?

    Can you hide smoking from life insurance companies?

    How much smoking does it take to be considered a “smoker,” and what if you fudged your answer about smoking on your life insurance application?

    Life insurance companies want an accurate picture of activities that could affect your longevity. Questions about whether you’ve used nicotine in the past few years go along with questions about whether you pilot a private plane or plan to travel to dangerous countries.

    Who is considered a nicotine user?

    Life insurance companies generally use three broad rate classifications for pricing policies: standard, preferred or preferred plus. Then there are the rates for nicotine users, who pay significantly higher premiums within their classes. The definition of a “nicotine user” is someone who uses any form of nicotine delivery, including cigarettes, cigars, chewing tobacco, a nicotine patch and nicotine gum. The look back period will vary by insurer. Some will judge you to be a nicotine user if you’ve used a nicotine product in the past five years.

    Many life insurance companies will allow the “celebratory” or “occasional” cigar smoker to still qualify for non-smoking rates. Insurers generally define “occasional” as smoking 12 cigars or less per year. Of course, the urine sample you provide for your life insurance medical exam must be nicotine-free, too.

    If you’re a regular smoker, it’s not a good idea to lie on your application in order to escape detection to get a lower rate.

    If you’ve lied on your application about nicotine use and then nicotine turns up in your medical exam tests, you’ll be issued your policy at the smoking rate.

    Look at the worst case scenario. Say you die of a heart attack and it comes to light that you’ve been a smoker all your life. The insurance company could justifiably deny the claim. That’s not a position in which you want to put your beneficiaries. It’s better to pay the extra premium and know your beneficiaries will eventually collect the benefit.

    Perhaps you’ve made an application and don’t like the nicotine rate you’ve been given. Don’t try to apply with a different company and lie to get nonsmoker rates; your previous medical exam results will sit in a database operated by MIB Group for seven years. When the insurer checks your new application against the MIB database, which is used to detect fraud, your history will be revealed.

     

    •Tips by insure.com

  • ‘Smoking will kill 1 billion people this century’

    A new study finds smokers who quit before the age of 40 can live almost as long as people who never smoked.

    Researchers at the University of Toronto report quitting smoking before turning 40 gives back almost all of the 10 years that smoking generally cuts off a person’s life span.

    But that does not mean smoking is safe up until age 40. The study’s lead researcher – Prabhat Jha, a University of Toronto professor and head of the Centre for Global Health Research at St. Michael’s Hospital – said former smokers still have a greater risk of dying sooner than lifetime non-smokers.

    “Now it’s not true that the best thing to do is to smoke until 40 and quit. Because if you do that, you still have at least 20 percent higher risk of dying if you have quit smoking by age 40,” said Jha. “Now that’s much lower than the risk of continuing to smoke, but it’s still quite significant. In contrast, those that quit by age 30 basically are close to never-smoker rates, meaning they get almost all of that full decade of life back. So the key message is not that it’s safe to smoke until age 40 and quit. The key message is: Don’t smoke, and if you do smoke, quit as early as possible.”

    The researchers also found that women’s risks of dying from smoking-related causes were 50 percent higher than what studies in the 1980s found. This most recent study looked at health and death records in the United States, but Jha said the findings can be applied worldwide.

    “What smoking does is multiply the background rates of disease in any population upward. What this study adds, along with actually about three more recent studies, is that, that upward multiplication, if you will, of the risks is about threefold,” Jha said. “So this suggests worldwide the risks are probably going to be as extreme. Basically, what we found is if women smoke like men, they die like men. And similarly if Indians smoke like Americans, they are going to die like Americans. If Chinese smoke like Americans, they are going to die like Americans.”

    Jha said just five countries – Brazil, China, Russia, Indonesia and India – are home to about half of the world’s estimated 1.3 billion smokers. If the current trends continue, his report said smoking will kill about 1 billion people in the 21st century, a dramatic increase from 100 million in the 20th century.

  • How smoking affects your health

    THERE are no physical reasons to start smoking. The body doesn’t need tobacco the way it needs food, water, sleep, and exercise. And many of the chemicals in cigarettes, like nicotine and cyanide, are actually poisons that can kill in high enough doses.

    The body is smart. It goes on the defense when it’s being poisoned. First-time smokers often feel pain or burning in the throat and lungs, and some people feel sick or even throw up the first few times they try tobacco.

    The consequences of this poisoning happen gradually. Over the long term, smoking leads people to develop health problems like heart disease, stroke, emphysema (breakdown of lung tissue), and many types of cancer including lung, throat, stomach, and bladder cancer. People who smoke also have an increased risk of infections like bronchitis and pneumonia.

    These diseases limit a person’s ability to be normally active, and they can be fatal. In the United States, smoking is responsible for about 1 out of 5 deaths.

    Smokers not only develop wrinkles and yellow teeth, they also lose bone density, which increases their risk of osteoporosis (pronounced: ahs-tee-o-puh-row-sus), a condition that causes older people to become bent over and their bones to break more easily. Smokers also tend to be less active than nonsmokers because smoking affects lung power.

    Smoking can also cause fertility problems and can impact sexual health in both men and women. Girls who are on the pill or other hormone-based methods of birth control (like the patch or the ring) increase their risk of serious health problems, such as heart attacks, if they smoke.

    The consequences of smoking may seem very far off, but long-term health problems aren’t the only hazard of smoking. Nicotine and the other toxins in cigarettes, cigars, and pipes can affect a person’s body quickly, which means that teen smokers experience many of these problems:

    Bad skin. Because smoking restricts blood vessels, it can prevent oxygen and nutrients from getting to the skin which is why smokers often appear pale and unhealthy. Studies have also linked smoking to an increased risk of getting a type of skin rash called psoriasis.

    Bad breath. Cigarettes leave smokers with a condition called halitosis, or persistent bad breath.

    Bad-smelling clothes and hair. The smell of stale smoke tends to linger not just on people’s clothing, but on their hair, furniture, and cars. And it’s often hard to get the smell of smoke out.

    Reduced athletic performance. People who smoke usually can’t compete with nonsmoking peers because the physical effects of smoking (like rapid heartbeat, decreased circulation, and shortness of breath) impair sports performance.

    Greater risk of injury and slower healing time. Smoking affects the body’s ability to produce collagen, so common sports injuries, such as damage to tendons and ligaments, will heal more slowly in smokers than nonsmokers.

    Increased risk of illness. Studies show that smokers get more colds, flu, bronchitis, and pneumonia than nonsmokers. And people with certain health conditions, like asthma, become more sick if they smoke (and often if they’re just around people who smoke). Because teens who smoke as a way to manage weight often light up instead of eating, their bodies also lack the nutrients they need to grow, develop, and fight off illness properly.