Environmentally, tobacco smoke is a health hazard. Reducing exposure to tobacco smoke in public places is a widespread public health goal.

There is, however, considerable variation in the extent to which this goal has been achieved in different settings and societies.

There is therefore a need to identify effective strategies for reducing tobacco consumption in public places which include auditoriums, hospital buildings, health buildings, educational institutions, libraries, court buildings, public office and public conveyances.

Passive smoking

Second hand smoke is the name for the sickening, poisonous smoke given off by burning tobacco - in cigarettes, roll-ups, pipes or cigars. Breathing in other people’s tobacco smoke is called ‘passive smoking’.

The tobacco industry claims that smokers have a right to smoke. But non-smokers have a right to breathe clean air. The right to smoke ends where a non-smoker’s right to breathe safe air starts.

Passive smoking is one of the key issues leading to smoking bans in workplaces and indoor public places, including restaurants bars and night clubs. Passive smoking is the involuntary inhalation of smoke from tobacco products.

It occurs when tobacco smoke permeates any environment, causing inhalation by all people within that environment. Such smoke is called secondhand smoke or environmental tobacco smoke.

Current scientific evidence shows that exposure to secondhand tobacco smoke causes death, disease, and disability. Most experts believe that moderate, occasional exposure to secondhand smoke presents a small but measurable cancer risk to nonsmokers.

The overall risk depends on the effective dose received over time. The risk is more significant if non-smokers spend many hours in an environment where cigarette smoke is prevalent.

A study issued in 2002 by the International Agency for Research on Cancer of the World Health Organization concluded that non-smokers are exposed to the same carcinogens as active smokers.

Side stream smoke contains more than 4000 chemicals, including 69 known carcinogens such as formaldehyde, lead, arsenic, benzene, and radioactive polonium 210, and several well-established carcinogens have been shown by the tobacco companies’ own research to be present at higher concentrations in side stream smoke than in mainstream smoke.

Although the facts speak for themselves, the response to this epidemic of death and suffering is not at par with the impact of tobacco use on Rwanda’s health, either on the prevention or the treatment side.

Where is the concerted effort of government commensurate with the death, disability, and suffering that tobacco causes?

The government has supported the development of comprehensive plans for tobacco use prevention and control and it has supported the development of a scientific basis for action, yet collective action and a collective voice calling for sweeping change are missing.

Public health must take a leadership role and demand that the health care system and public policy protect Rwandans from the consequences of tobacco use.

We know what to do to prevent tobacco-related deaths, but we have failed to demand systemic change from our government and from our colleagues in the health care field. We have let our voices be silenced.

We must speak out to prevent needless suffering. Studies have demonstrated that health care providers fail to assess patients’ smoking status and advise them to quit, yet a brief intervention by a doctor is one of the most effective methods of increasing use of cessation services.

We must confront the social inequities of tobacco use and its burden of death and disease. We must communicate a sense of urgency and engage all the people in the battle against tobacco use.

We must demand scientifically sound programs and policies that will help us build a society where young people reject tobacco and where anyone who does use tobacco can quit. Our future demands so.

When they smoke, we suffer

Are there smokers in your workplace or at home? Then, there are good reasons for you to get them to quit, or at least stop smoking around you.

If you are exposed to someone else’s cigarette smoke, you risk having many health problems. You may not smoke but the second-hand smoke which you are exposed to puts you at risk of several health problems.

So why do you keep quite? If your children are exposed to passive smoking at home or in public places, you have more to worry about. Why do you shut your mouth?

Remember, passive smoking can kill. Don’t suffer in silence.
People who smoke are not governed by reason even smokers normally agree on this point. Perhaps that’s why tackling the problem with reasonable arguments don’t get us far.

So let professional health workers take care of direct smoke cessation. We others should concentrate on preventing ordinary people from having to smoke passively against their wills.

We have to believe that smoking is enjoyable for smokers, so we cannot expect to meet with any understanding regarding how disagreeable it can be for others. Only those who are bothered by smoking can understand that!

Make sure you’re not misunderstood If smokers get the impression that you are trying to get them to stop smoking, you may not fare too well, and you will have to try somehow or other to get them to understand that you just want them to smoke somewhere else.

If there are children present, it tends to be easier, and in places where you are the one who decides there’s also usually no problem, but then you have to make your wishes clear, not just intimate vaguely that some consideration might be nice.

For those who find it hard to speak out, silent reactions can sometimes be just as effective. For example, you can move from your chair onto the floor when somebody lights up, because the air is often a little better down there. This will attract notice, and has proved to be effective after just a few repetitions.

Smoking is addictive

Smoking is a big problem that is never given the proper status of a ‘current issue’. The facts about smoking, in particular the risks to health, are well known and publicized, yet the problem remains. Cigarettes are nasty, evil little things.

They are addictive. The helplessly agitated, ratty smoker will go to extraordinary lengths in order to get a cigarette in to their system. Then we have the dreaded question: ‘do you mind if I smoke?’

This question is loaded. This person wants to smoke and they want to do it there and then. If you respond with anything but ‘no, go ahead’ then you are giving the wrong answer and that is why you comply.

Herein lies the problem: things become accepted and conventions form, irrespective of how wrong they are; ironically, perhaps, out of habit. But this should not to be the case with smoking where the consequences are potentially lethal.

Non-smokers must say something - do not allow yourselves to be pushed around; you do not have to suffer in silence. Smoking is anti-social; it does not have to be tolerated. We must - through thought and through action - change things; we must not allow smoking to remain socially acceptable.

Imagine the scenario of how the smoke is exhaled through mouths and noses, sometimes even through ears. Watch it diffuse into the room. After a while you become ‘used’ to it - it can’t be seen - that is when it is at its most dangerous.

You don’t realize the sheer amount of poison lurking in the air; poison which will soon become part of your body - only it doesn’t ever seem to come back out again, does it?

You are helpless - you have to inhale the smoke, and allow it to snake around your system, depositing tar onto your lungs. When it gets to this stage you have no choice.

The way to stop this is to cease being ‘passive smokers’ and become active non-smokers: do not allow smokers to impose themselves with their cigarettes, to make you feel uncomfortable and smelly and put you under all manner of health risks.

Making a stand, however small, will make smokers listen - far more, strangely, than warning them about the astonishing health risks that they are casually undertaking. Smoking is not sociable and that it need not be tolerated.

A harder line must be taken. Smoking is not a ‘need’. Food and water are ‘needs’. Smoking is a short-term want. It is one of the most poignant manifestations of the prevailing societal attitude that demands instant and constant gratification.

Asking ‘do you mind if I smoke?’ is an improvement on how things were; but given that a person’s response may rarely correspond with their thoughts or feelings, asking for ‘permission’ is essentially a token means for the smoker to justify smoking around others.

The change that is needed must fight against this and create a status quo where the true, honest and properly informed choices of everyone have equal purchase.

And while short-term’s mentalities do fuel the problem, they can in fact be used as a tool for this change: far more effective than spouting out statistics about the risks of various diseases years in the future, is to make a smoker stifle their craving or go elsewhere to smoke.

The consequences are serious and real for everyone. We all must think about smoking; give common sense consideration to the facts; reflect on how we feel we someone smokes around us; think about the times when, against our will, we have ‘put up’ with someone smoking around us.

And through this process of thought, it will be possible to justify and sustain the taking of action; to say ‘yes I do mind actually’. Smokers do have the right to smoke. But the right for non-smokers not to be subject to other peoples’ smoke must take priority.

It is vital that we stand up for this right, not only for our own benefit, but also for the benefit of smokers, who may well decide to question their lifestyles.

We live in a country where smoking in bars and restaurants, etc is already banned, how is the ban enforced where you are? But the ban has not been a success at all and people continue to be silent about It.!

Asking someone who is smoking near you not to smoke is not easy. Let smokers know that you are not objecting to the fact that they smoke but you are asking them not to smoke near you.

Be firm but polite. It is between life and death and you cannot afford to be silent. Smokers too should learn to accept situations where they are offended by non smokers who tell them to keep distance. The too offend many non smokers and their rights do not over weigh the latter’s.

Ends