Tobacco kills 5 700 in Malawi—global atlas

The American Cancer Society and Vital Strategies on Thursday released a public health atlas which ranks Malawi among low-income countries paying a huge cost for not replacing tobacco with smoke-free crops.

The launch of the tobacco atlas by the US health think-tanks was one of the major highlights of the World Conference on Tobacco or Health Conference underway in Cape Town, South Africa, which has brought together almost 2 000 people from about experts from about 100 countries.

The meeting seeks to unite the world to create a tobacco-free generation, but the leaf remains the largest export for the country which has not ratified the World Health Organisation (WHO) Framework Convention for Tobacco Control (FCTC).

While the country is dillydallying to sign up to the global agenda to reduce the demand and supply of tobacco, the sixth edition of the atlas shows the crop “harms the health, the treasury, and the spirit of Malawi”.

The country-specific profile reads in part: “Every year, more than 5700 of its people are killed by tobacco-caused disease. Still, more than 5000 children (10-14 years old) and 70 7000 adults (15+ years old) continue to use tobacco each day.”

This is just a glimpse of the public health crisis caused by tobacco.

According to WHO estimates, exposure to tobacco kills almost 5.1 men and 2.0 women.

Most of these 7.1 million deaths were attributable to cigarette smoking while the 884 000 were related to secondhand smoke.

Complacency in the face of the tobacco epidemic insulates the tobacco industry in the country and ensures that tobacco’s death toll will grow every year, warn the authors of the atlas.

“Every death from tobacco is preventable and every government has the power to reduce the human and economic toll of the tobacco epidemic,” said American Cancer Society vice-president Jeffrey Drope, who co-edited the atlas with Vital Strategy’s Dr Neil Shlugger.

According to Drope, reducing tobacco-related death rates starts with resisting the influence of the tobacco industry and implementing proven tobacco policies, including FCTC guidelines.

But Malawi and neighbouring Tanzania and Zambia have lagged behind when it comes to implementing WHO recommendations to monitor tobacco use, protect people from tobacco use, hike tax on tobacco products, offer support to those willing to quit as well as reducing tobacco advertising, promotion and sponsorship.

The country has no smoke-free zones, exposing non-smokers to secondhand smoke which kills 884 000 people worldwide and costs the global economy more than $2 trillion every year.

According to Vital Strategies, Africa’s fragile economies and youthful population are at a tipping point as tobacco companies are deliberately targeting countries that lack tobacco control laws to exploit farmers, government and the environment.

“The ultimate path to improved tobacco control is political will,” says Vital Strategies president Jose Luis Castro. “Strong tobacco control policies deliver a significant return on investment. The Atlas offers the best and most recent data on tobacco epidemic as a resource for governments to pursue effective strategies.”

He explained: “The answer does not lie with the industry: as the Atlas makes clear, there is a complete disconnect between the tobacco industry’s claims about the harm reduction and its actual work to grow tobacco use among vulnerable populations.

Governments must be accountable to their citizens in reducing tobacco use and improving health.”

Drope, who worked with WHO in Malawi three years ago, said tobacco-dependent countries can flourish without the nicotinic leaf if they adopt an array of crops which they can process into exportable goods.

He explained: “No single crop is going to replace tobacco in countries like Malawi and Tanzania. Mono-cropping is not going to work, but crop diversification and value-addition will bring the desired shift.

“What is happening now is that these countries are exporting 100 percent of their tobacco raw, so all the money is going abroad while governments are spending much more to contain effects of tobacco on public health, the treasury and the environment.”

The combined revenue of the world’s six largest tobacco companies in 2016 was more than USD 346 Billion, 6457 percent larger than the Gross National Income of Malawi, the researchers state.

“The industry is a powerful force that does not fear the actions of nation-states because of their extensive resources and global market power,” they write.

They urged tobacco control advocates to reach out to other communities and resources to strengthen their efforts and create change as the tobacco industry is increasingly eroding the gains made to reduce the supply and appetite for tobacco.