Kampala’s silent second-hand tobacco smoke epidemic

Kampala’s silent second-hand tobacco smoke epidemic
There is need for a law to regulate usage of tobacco, especially to protect both smokers and non smokers from the adverse effects of smoking such as cancer and heart disease. Courtesy Photo.

You enter a Kampala bar late in the evening and the entire place is engulfed in smoke. The atmosphere is colored with a grey haze from cigarettes.

You venture out of the bar momentarily and smell your clothes and hair and the scent of tobacco pollutes your nose. Now imagine how absorbent your lungs are compared to the cotton fabric of your cloth.

Second-hand smoke, also known as environmental tobacco smoke, is a mixture of side stream smoke from the burning tip of the cigarette and mainstream smoke exhaled by a smoker, with some 4,000 chemical compounds, including almost 70 known or probable human carcinogens (cancer-causing agents).

Inhaling second-hand smoke, or passive smoking, kills children and adults who don’t smoke. It causes lung cancer and heart disease in people who have never smoked. Even brief exposure can damage cells in ways that set the cancer process in motion.

According to the World Health Organization (WHO), non-smokers exposed to second-hand smoke at home or at work increase their heart disease risk by 26-30% and lung cancer risk by 20-30%.

Richard Carmona, the former US Surgeon General, said in 2006: “The evidence is now indisputable that second-hand smoke is an alarming public health hazard, responsible for thousands of premature deaths among non-smokers each year.”

Smoking in public places, including bars, restaurants, shopping centers and public transportation was banned in Uganda in 2004 when the National Environment (Control of Smoking in Public Places) regulations introduced by the former Environment Minister Kahinda Otafire were passed.

This followed a high ruling in December 2002 declaring smoking in public places a violation of non-smokers’ constitutional right to a clean and healthy environment.

The Ugandan High Court instructed the National Environment Management Authority (NEMA) to formulate a law against public smoking which was enacted in 2004 and states that: “No person shall smoke a tobacco product or a lighted cigarette in an enclosed, indoor area of a public place.”

But a study I recently conducted on Uganda’s compliance with the regulations on control of public smoking in bars and restaurants in Kampala tells a tragic public health story of thousands of people in Kampala inhaling second-hand smoke.

The majority of bars in Kampala blatantly break the law by allowing public smoking on their premises. Only four of the 23 bars I sampled in Kampala enforce the ban on public smoking. Ironically, even in bars and restaurants where a ‘no smoking’ sign was prominently displayed, smoking continued unabated.

The sample of five areas of Kampala including Kisementi, Kabalagala, included the most popular bars frequented by middle class Ugandans.

The study, made possible by the US-based Campaign for Tobacco Free-Kids, suggests that the law against public smoking in Kampala remains on the books with no enforcement to speak of. With the passing out of environmental police, by the Uganda police last year one can only hope the situation will be ameliorated.

Even with the proposed 2010 Tobacco Control bill having had its first reading in parliament and a Tobacco Control policy awaiting cabinet consideration, enforcement of the tobacco control law will remain critical to the health of millions of Ugandans.

Respiratory symptoms among bar workers in Scotland decreased by 26 percent after smoke-free legislation was implemented in 2006 and asthmatic bar workers experienced reduced airway inflammation and reported an improved quality of life as a result.

In Uruguay, the enforcement of a 100% smoke-free law has reduced hospital admissions for heart attacks by 22%.

Many think that as long as they don’t smoke they will escape the now scientifically proven 15 cancers associated with cigarette smoking. But sadly, it is not enough to not smoke.

By Henry Zakumumpa