Tobacco and Drug Use in Africa: Advances and Setbacks
By Lydia Nobert, Sokona Sy, Serge Bataliack
Overview of tobacco and drug use in the Region
Reducing tobacco and drug use is vital to improving public health, as these habits have significant effects on individuals, families, and communities.
The World Health Organization has been working tirelessly with other partners to decrease the prevalence of tobacco and drug use. In 2020 tobacco use prevalence among individuals aged 15 years and older in the African Region was 10.3%. Moreover, there has been a 15% decrease in tobacco use prevalence in 2010 to 10% in 2020, which is a significant achievement. However, trends in African Region shows that tobacco use among girls has increased. Presently, 13 million women use tobacco products and 22 000 women die every year from tobacco-related diseases.
In 2019, drug use disorders caused 2,703 deaths in the African Region, with 2,222 men (82%) and 481 women (18%) being affected. Opioid use disorders accounted for 73% of the total. Furthermore, 4.129 million individuals were living with drug use disorders in 2019, with 1.345 million new cases recorded in the same year. These statistics are alarming, and there is a pressing need to take action to reduce tobacco and drug use. Recent data in the African Region shows countries leading in tobacco use among female aged 15 years and above are Madagascar (11.1), Comoros (9.2), Botswana (6.9), Rwanda (6.4), and South Africa (6), while the countries with high rate of tobacco use among male aged 15 years older are Lesotho (42.4), Algeria (41.1), Madagascar (40.7), Mauritius (36.3), South Africa (33.7) and Seychelles (33.1).
Indeed, more work needs to be done to reach the Sustainable Development Goal (SDG) target of reducing tobacco use prevalence to 30% by 2030. As per the recent iAHO fact sheet on tobacco, the African Region is on track to achieve the SDG target with 8.9% being the projected value by 2025 which is equal to a reduction of about 34% as compared to 2010. Tobacco use remains the major cause of preventable deaths worldwide, and the African Region is not an exception.
Risk factors associated with tobacco use
Tobacco use poses several risk factors to individuals and communities. Some of the risk factors associated with tobacco use in the African Region include:
• Health risks: Tobacco usage is a leading cause of avoidable deaths worldwide, and it relates to several health dangers such as lung cancer, heart disease, stroke, and respiratory illnesses. These health risks are prevalent in the African region, where access to healthcare services is often limited, and health systems are under-resourced.
• Economic risks: Tobacco use can have significant economic impacts on individuals and communities. For example, tobacco use can lead to increased healthcare costs and lost productivity due to illness and premature death.
• Social risks: Likewise, tobacco have impacts on individuals and communities as it can lead to social isolation, discrimination, and stigma.
• Environmental risks: Tobacco cultivation and production can have significant environmental impacts, including deforestation, soil degradation, and water pollution.
• Youth and vulnerable populations: young people and vulnerable populations, such as women and low-income individuals, are at a higher risk of tobacco use in the African region. This is due to several factors, including targeted marketing by the tobacco industry, social norms around tobacco use, and lack of access to education and information on the health risks of tobacco use.
WHO and countries response on tobacco eradication
WHO has made several efforts in supporting countries on reducing the demand of tobacco products. The introduction of the “MPOWER” package in 2007 that comprises of six measures that countries can implement. Each measure reflects at least one provision of the WHO Framework Convention on Tobacco Control. Several African countries have made efforts on adopting the MPOWER package, Mauritania introduced its first tobacco control legislation in 2018. In 2020, Botswana prohibited the importation and sale of tobacco and tobacco related products. South Africa banned tobacco sale temporarily under a general ban of non-essential product during the country pandemic response. Uganda improved the legislation in 2018 but it was yet at the best practices in 2020.
Moreover, African countries (Mauritania, Niger, Nigeria, Ethiopia, and Gambia) joined on the graphic health warnings on tobacco packaging. One of the most effective ways to combat tobacco use is to implement strong tobacco control policies. In recent years, many African countries have taken steps to do just that.
For example, in 2019, Chad adopted a decree to prevent tobacco industries. The African Union supported Uganda in 2012 in developing national strategic plan for tobacco control. On the other hand, South Africa was supported by WHO FCTC secretariate in establishment of African center for tobacco industry monitoring and policy research. All these efforts help African countries implement the WHO's Framework Convention on Tobacco Control (FCTC). In the African Region, 44 countries have ratified or acceded to the WHO Framework Convention on Tobacco Control. Strengthening the implementation of the convention is one of the big challenges for countries in the African Region.
Establishing a full-time national coordinating mechanism with a designed national focal point and a national multisectoral steering committee.
Building capacity for the development of national action plan and comprehensive tobacco control policy and legislation reflecting the different provisions of the WHO FCTC such as protection from tobacco smoke, support for cessation programmes, warning about the dangers of tobacco, bans on tobacco advertising and promotion and raising taxes on tobacco products.
Learn more on tobacco
WHO report on the global tobacco epidemic 2021
iAHO Tobacco regional factsheet
Tobacco control and the sustainable development goals
The Atlas of Africa statistics 2022 full report
National center for chronic diseases prevention and health promotion
Tobacco control in Africa