MoH moves to enforce tobacco control law amid public smoking concerns

The Ministry of Health, in collaboration with Rwanda National Police, this week launched a crackdown on tobacco products that are not complying with the Tobacco Control Law and Orders. The targeted products are those that are non-compliant tobacco and tobacco products, both imported and locally manufactured. In its Article 24, the Tobacco Control Law and Orders states that a package of tobacco and tobacco products which does not bear warning imprints, as provided for under the same law, will be confiscated. The Government had given a 12-month grace period for tobacco manufacturers in order to stock out all products that did not comply with the law provisions. The window ended in June. The warning imprints that have to appear on every package of tobacco are, but not limited to, “Smoking kills, causes cancer, heart diseases, and other health vices such as impotence, infertility, miscarriage and stroke.” It is also provided for in the Ministerial Orders that smoking areas should be clearly demarcated and accessible only to people above 18. A statement from the Rwanda Biomedical Centre, released on Thursday, said the operation was intended to bring awareness about the harmful effects of tobacco and tobacco products use and enforcing applicable tobacco control laws in the country. “The operation seeks to compel business owners to comply with laws and regulations on tobacco control, reduce and possibly eliminate exposure to second-hand smoke, promote quitting as well as prevent smoking initiation among young persons and prevent persons under 18 from any contact with tobacco products,” the statement reads in part. The operation was conducted in Musanze, Rubavu Karongi, Rusizi, Muhanga, Huye, Kayonza and Kigali city districts (Gasabo, Kicukiro and Nyarugenge). Such crackdown will become regular, according to the statement. Passive smoking still a concern While the crackdown targets those breaching the rules on warning imprints, public smoking – leading to passive smoking – that is prohibited by the same tobacco control law is still a concern. The law says that no person shall smoke in public, workplace or in any part of a public place such as: restaurants, hotels and bars. The law, in its Article 12, requires a manager or proprietor of any of the public premises listed in Article 11 of the Law to gazette a smoking area. A smoking area in a public place must be clearly demarcated with notices in Kinyarwanda, English and French. Article 428 of the Penal Code states that any person who unlawfully smokes in public and in any other place where many people gather shall be liable to a fine of between Rwf10,000 and Rwf50,000. However, while some bars and restaurants Saturday Times visited for spot checks have signs warning against smoking, people still smoke freely. Other bars visited do not have specific smoking zones even when the owners are aware of the legal requirement. “We do not have a specific smoking area for smokers now, but we advise our clients not to smoke in public,” said Ephrem Niyitegeka, an employee with Three Kings Resto-Bar in Remera, Gasabo District. A bar attendant in Kicukiro District, who asked to remain anonymous in order to speak freely, said they do not have designated area for smokers even though they normally receive complaints from non-smokers. The attendant said they are reluctant to restrain their customers from smoking freely for fear of losing clientele. Jean-Pierre Uwayezu, from Gatsata in Gasabo District, started smoking at 18. He knows the side effects of smoking and says he is about to quit because he spends a lot on cigarette. Uwayezu normally steps aside when he wants to smoke and advises fellow smokers to respect non-smokers. “Smoking in public is not good because you spread smoke to non-smokers, it’s better to go far from others,” he said. Measures to reverse smoking trend Dr Marie-Aimé Muhimpundu, the head of non-communicable diseases division at Rwanda Biomedical Center (RBC), told Saturday Times that awareness campaigns and meetings with bars and restaurants’ owners are being conducted by the key players in the law enforcement domain to reverse the trend. Dr Muhimpundu argues that increasing taxes on tobacco and its products would greatly reduce smoking in the country. Elias Hakizimana) “One of the measures we put in place was to enact the law, mostly it is regulating everything regarding tobacco use, from production by farmers to the industry and then to individual smokers. We are discouraging people from smoking in public places and we have campaigns to educate people about the dangers of being exposed to tobacco smoke,” Dr Muhimpundu said. “We ask bar and restaurant proprietors to have designated smoking areas but I feel there is laxity in law enforcement. But non-smokers also have the right to warn smokers not to smoke near them,” she added. Muhimpundu warned that the law will soon catch up with those violating it. “It is their responsibility to set smoking zones,” she said, referring to owners of such public places as hotels, bars, and restaurants. Muhimpundu said the implementation of the tobacco control law involves many actors such the Ministry of Health, Rwanda Environment Management Authority, and Police, and every actor has their own responsibility. Early August, a meeting by key players on enforcement of the tobacco control law was held in Musanze District, where participants agreed to work together to enlighten the public on the law. The meeting was attended by different key players, including police, journalists, civil society, and the Ministry of Health. It concluded with a call on key actors to have a common understanding of the law. Tobacco smoking is dangerous to one’s health, Muhimpundu said. “Tobacco use causes various non-communicable diseases and we have some patients in Rwanda, what we have not done yet is a study about this, some of the side effects of tobacco use are like cardio-vascular diseases and cancers,” said Muhimpundu. Taxation Dr Muhimpundu said the Government has previously increased tax on tobacco and its products as part of efforts to discourage its use. According to the World Health Organisation, the number of low and middle-income countries that have implemented sufficiently high taxes on tobacco remains small, at only 9 per cent. This is unlike in countries like China, where research suggests that raising taxes on cigarettes, to account for 75 per cent of retail prices up from 40 per cent of the share of price in 2010, would avert nearly 3.5 million deaths that would otherwise be caused by cigarette smoking. Tobacco taxes are said to be cost-effective in reducing tobacco use, especially among young and poor people. Increase in tobacco prices by 10 per cent decreases consumption by about 4 per cent in high-income countries and about 5 per cent in low- and middle-income countries, according to experts. The current tax rate for imported tobacco products is 36 per cent of retail price of a pack of 20 rods and Rwf30 per pack. Tobacco use in Rwanda among men reduced from 16.1 per cent in 2010 to 10 per cent in 2015, and from 3.6 per cent to 2 per cent among women, according to WHO. WHO projects that tobacco will kill more than 175 million people worldwide between now and the year 2030. WHO’s statistics of June 2016 show that tobacco kills up to half of its users – around six million people each year. ‘Passive smoking kills’ The figures also show that more than five million of those deaths are the result of direct tobacco use, while more than 600,000 are the result of non-smokers being exposed to second-hand smoke. Second-hand smoke, according to WHO, is the smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products, such as cigarettes and water-pipes, and causes a wide range of diseases, including heart disease, lung cancer and other respiratory ailments. There are more than 4000 chemicals in tobacco smoke, of which at least 250 are known to be harmful while more than 50 are known to cause cancer, according to the WHO. Nearly 80 per cent of the more than 1 billion smokers worldwide live in low-and middle-income countries, where the burden of tobacco-related illness and death is heaviest. editorial@newtimes.co.rw ****** STATE OF SMOKING IN RWANDA According to the 2014/15 Rwanda Demographic and Health Survey (RDHS), 2 per cent of women in the country use tobacco products compared to 10 per cent of men. Among men, cigarettes (9 per cent) are the most common tobacco product used. The survey also reported that among men who smoke cigarettes, 44 per cent reported smoking between three and five cigarettes in 24 hours, 28 per cent smoked one to two cigarettes during the same span, 10 per cent smoked six-nine cigarettes while 10 per cent smoked 10 or more cigarettes daily. By province, the survey shows that men in south and east are more likely to smoke cigarettes, with 12 per cent and 11 per cent chances, respectively, than men in Kigali city and north, who have 9 per cent chances of smoking. Men in Western Province are least likely to smoke cigarettes, at 4 per cent. The survey also shows that smoking decreases with education, where only 3 per cent of men with secondary school and higher education smoke compared with 18 per cent of men with no education.

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MoH moves to enforce tobacco control law amid public smoking concerns