The third edition of the World Health Organization WHO report on trends in prevalence of tobacco use says tobacco kills and sickens millions of people every year. Around 8 million people died from a tobacco-related disease in 2017. According to the report, the number of annual deaths can be expected to keep growing even after rates of tobacco use start to decline, because tobacco-related diseases take time to become apparent.
A global commitment to reversing the tobacco epidemic was made in 2003 when member states of the World Health Organization adopted the WHO Framework Convention on Tobacco Control, which lays out specific, evidence-based actions that all parties to the convention should take to effectively reduce demand for tobacco. World Health Organisation says in 2000, around a third, or 33.3% of the global population both sexes combined and aged 15 years and older, were current users of some form of tobacco.
By 2015, this rate had declined to about a quarter, or 24.9 per cent of the global population. Assuming that current efforts in tobacco control are maintained in all countries, the rate is projected to decline further to around a fifth (20.9%) of the global population by 2025. It was further shared that in the same year 2000, around half of men aged 15 years and older were current users of some form of tobacco. By 2015, the proportion of men using tobacco had declined to 40.3%.
By 2025, the rate is projected to decline to 35.1 per cent. Around one in six women or 16.7 per cent aged 15 years and older were current users of some form of tobacco. In 2015, the proportion of women using tobacco had declined to under one in ten. By 2025, the report says the rate will decline to 6.7%. In 2000, according to WHO report, the proportion of males using any form of tobacco was three times the proportion of users among women. By 2015 the rate for males was more than four times the rate of females.
By 2025, the rate for males is expected to be five times the rate of females. The 2025 target set under the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases 2013-2020 specified that countries should strive to achieve a 30 per cent reduction in tobacco use prevalence using 2010 level as baseline. This translates to a maximum total tobacco use prevalence rate of 19.1 per cent for the total population aged 15 years and older, 30.2 per cent for males and 8.0 per cent for females.
The trend analyses undertaken for this report indicate that the reduction target will not be met for males but will likely be met for females. The projected 2025 prevalence rate of 35.1 per cent for males would be short of the target by an absolute 4.9 per cent. The projected 2025 prevalence rate of 8.0 per cent for females would exceed the target by 1.3 per cent.
Overall, the report indicated that the global target for the total population will fall short of meeting the overall global target of 19.1 per cent by 1.8 per cent. Instead of achieving the 30% relative reduction globally called for in the NCD target, the relative reduction likely to be achieved based on current efforts is 23.4 per cent (18.8 per cent and 41.2 per cent for males and females respectively)
Further, the report noted that there has been a steady decline in any tobacco use for both males and females in each age group over the observed period 2000-2015. The age-specific rates are projected to continue declining to 2025 for both males and females. The age-specific rates peak at age group 45-54 for men and, for women, at age group 55-64 in some years and 65-74 in others. The report said the absolute prevalence levels have been consistently higher for males than those for females in each age group.
Among young people aged 15-24 globally; the average rate of tobacco use has declined from 22.6 per cent in the year 2000 to 17.0 per cent in 2015. The rate in 2025 is projected to be 14.2 per cent. Among men in the age group 15-24, the report stressed that tobacco use has declined from 35.3% in the year 2000 to 27.6 per cent in 2015. The rate in 2025 is projected to be 23.6%. Among women in this age group, the 2000 rate of 9.3% reduced to 5.6% by 2015, and is projected to continue downwards to 4.2% by 2025.
The age-standardized tobacco use prevalence rates are declining in all WHO regions, the report claims. In the year 2000, it is estimated that the South-East Asia region had total tobacco use rates at around 47%. This was the highest average rate of any WHO region. The lowest average rate was estimated to be 18.5% in the African region. These two regions have continued to be the regions with highest and lowest average rates respectively, but the gap between them have narrowed and are expected to keep narrowing to 2025. The South-East Asia region is tracking towards an average prevalence rate in 2025 of 25.1 per cent and the African region is tracking towards 11.2 per cent.
Focusing on the period 2010-2025- the period of interest for monitoring reduction targets under the WHO Global Action Plan for Prevention and Control of Non-Communicable Diseases 2013-2020- the only WHO region expected to achieve a 30 per cent relative reduction in prevalence of current tobacco use by 2025 is the Americas region.
The average rate of current tobacco use in Americas region is expected to fall from around 23% in 2010 to 15% in 2025, assuming tobacco control efforts in Americas region countries are maintained at current levels. Western Pacific is the region expected to experience the least decline in the average prevalence rate- a relative reduction of around 12% between 2010 and 2025. The other region with a relatively slow rate of decline is the European region, currently tracking towards an 18% relative reduction between 2010 and 2025.
According to this report, in 2000, the highest average prevalence rates among males were in the South-East Asian region (62.5%), followed by the Western Pacific region (55.6%). The trend in these two regions crossed over in 2014 and the Western Pacific region is now projected to have the highest rates among males in 2025, averaging 46.4%. The South-East Asian region average is projected to reach 42.9%.
The report said the Eastern Mediterranean and European regions are in the middle ground, with very similar prevalence levels and trends among men in all years, from 46-47% in 2000 to 30-31% in 2025. The African region is the region with the lowest average rates for males, and is projected to remain lower than other regions until 2025, when the rates for the Americas region to around the same level (20.4%).
Among males, only countries in the Americas region will collectively achieve a 30% relative reduction in the average prevalence by 2025, the report said. All other regions except the Western Pacific region are on track to reduce male prevalence rates between 19% and 22%. Western Pacific region countries are likely to achieve close to a 10% reduction between 2010 and 2025.
Botswana Accountancy College (BAC) last week held its 2022 graduation where 727 students graduated after spending the last two years of their academic studies navigating through the effects of the Covid-19 pandemic.
It is said that during the pandemic, BAC provided students with laptops, tablets and data sim cards to facilitate virtual learning and blended learning. The Acting Minister of Education and Skills Development at the ceremony, Wilhemina Makwnja noted that the students managed to create connections and build bridges to reach their ultimate goals, therefore their graduation is not only testimony of their strength and resilience, but it also demonstrates their commitment to excel by facing the challenges they encountered head on to break through the barriers and focused on their success.
âI trust that the graduates will build onto these qualities and competencies as they venture into the industry to impart their skills in the various sectors of the economy,â said Makwinja. She also shared that she strongly believes that the graduates will become agents of change and that they will take advantage of the spectrum of opportunities available in the market both locally and internationally.
Living in an era of digital economies, e-commerce, fin-tech and many other new eco-systems that have been created as the world continues to evolve, it is said to be inevitable that we all need to be steadfast and adapt to the rapid changes experienced before the pandemic. âAs part of the transformation agenda, the Ministry of Entrepreneurship has been established with a mandate to drive development of sustainable industries and trade, and this can be achieved through âaccelerated transformative investments in Botswanaâ,â said Makwinja.
She further noted it is through the Ministry that youth entrepreneurship projects will be supported including administration of the Youth Development Fund that facilitates funding commercialization of various youth projects. âThere are other Government incentives in Agriculture which are aimed at supporting Batswana farmers with commercialization of their produce to supply both the local market and exporting to other markets,â added Makwinja.
The BAC Executive Director, Serty Leburu on the other hand enunciated that it was important to recognise that the past years they have gone through a lot of changes and mostly life defining moments as the school lost some valuable staff members and students during the Covid-19 pandemic. âThe environment within which we operate has been changing rapidly and as an institution we have to constantly come up with some interventions and pivot ourselves in order to rise to the test and adapt,â said Leburu.
Leburu also renowned that they were also launching the BAC 2022-2027 Institutional Strategy focusing on key areas for Teaching and Learning, Research, Innovation and Entrepreneurship, Transition to University Status and Internationalization, Asset Mobilisation and Optimization as well as Student and Staff experience. âIt is our ambition to continue to expand into other markets to provide access to our programs through partnerships and collaborations with both local and international private and public entities,â added Leburu
In addition to this, she reflected that research, innovation, and consultancy are some of the areas they are making strides to develop and grow in partnership with various stakeholders. Through the schools there are projects that are being worked on at various levels. âAs BAC we continue to work with the industry and our partners, we assess the market to identify training and development needs to capacitate employees to meet the demands of the new and evolving economies,â concluded Leburu.
African Scientists and Experts Call for the adoption of a Harm Reduction in approach in Public Health Strategies and Tobacco Control. Media have a critical role to play in accelerating Harm Reduction efforts by informing and sensitizing cigarette smokers on the availability and benefits of alternative, potentially lower risk products to cigarretes. Traditional cessation and smoking prevention norms are not the only ways that smokers who cannot or donâtâ want to quit can make healthier choices that cause less harm to themselves and those around them.
This was said during the 2nd Harm Reduction Exchange conference for African journalists held in Nairobi, Kenya on the 1st of December 2022. Speaking at the Harm Reduction Exchange Conference, Integra Africa Principal Dr. Tendai Mhizha emphasized the role that journalists and media houses should play in handling misinformation and disinformation in tobacco harm reduction discourse that is actually perpetuating the death and disease caused by people continuing to smoke combustible cigarettes. âThere has been a lot of disinformation surrounding the topic of nicotine and the alleged negative effects that e-cigarettes have on public health.
This has led to policies that disfavour risk reduces products and narratives that completely deny their benefits. The media have the difficult responsibility to curb the scourge of disinformation and misinformation on harm reduction just like on other socio-political stances that are prescriptive and do not uphold consumersâ right to healthier lifestyle choices,â Dr Mhizha said.
The Harm Reduction Exchange cast a spotlight on alternative ways to reduce harm among tobacco smokers. Held under the theme Harm Reduction: Making a difference in Africa, the conference focused on the progress being made through harm reduction strategies in all fields related to public health such as drug and alcohol abuse, excessive sugar consumption, skin lightening and other addictive and behavioral practices. A wide array of harm reduction strategies and initiatives that are deployed towards reducing unnecessary deaths through non-communicable diseases were presented and discussed.
It applies to areas where there is a need to reduce the harm associated with a practice or consumption of a substance that is overused in society leading to increased morbidity and mortality. âInnovative Harm Reduction initiatives will help to keep more Africans alive. Tobacco Harm Reduction initiatives, including the use of popular e-cigarettes, nicotine patches and chewing gums, have continued to generate a lot of misunderstanding in both the public health community and in the media. However, there is evidence that the use of potentially less harmful alternatives than cigarettes for those who are not willing or cannot give up smoking with currently approved methods may be a solution, not necessarily the best for everyone but by far better than continuous smoking.
Tobacco Harm Reduction was introduced to mitigate the damage caused by cigarette smokingâthe most dangerous form of tobacco use, and the leading cause of preventable diseases, including cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease. âNicotine has an addictive potential but plays a minor role in smoking-related morbidity and mortality. Across the world, there is growing interest among experts in novel approaches towards tobacco control and there is an ongoing discussion that reducing the negative effects of smoking can be also achieved by tobacco harm reduction,â Dr. Kgosi Letlape, an ophthalmologist and President of Africa Medical Association and the president of the Association of Medical Councils of Africa, said.
Tobacco cessation is a key factor in the prevention of cardiovascular diseases and cancer. Abstinence from tobacco smoking is one of the primary goals for health promotion and management globally but it is unachievable in a huge amount of cases. This task remains unaccomplished despite extensive public campaigns on the health dangers of tobacco smoking. Thus, the development of novel strategies to reduce smoking is imperative. Moreover, the use of innovations in smoking products has been currently adopted by several smokers to reduce the health risks of smoking.
âThe Harm Reduction approach prevents drug-related deaths and overdose fatalities and is the only way out for addicts. In the same way these alternative technologies can reduce tobacco harm and accelerate the journey to a smoke-free world as they reduce exposure to toxicants,â Bernice Apondi, A Policy Manager at Voices of Community Action and Leadership Kenya (VOCAL-Kenya), said.
During the Harm Reduction Exchange, journalists drawn from Southern, West and East African countries, including: Nigeria, Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Eswatini, Tanzania, Uganda, South Africa, Zambia, and Zimbabwe debated and set forth several resolutions in regards to the present and future as well as the challenges and progress made in Harm Reduction,and science-led regulation.
The Harm Reduction Exchange brought together high-level policy makers, physicians, scientists and health policy experts with media stakeholders from Africa in a lively mix of speeches, presentations, and panel discussions. The key note speakers included Prof Abdoul Aziz Kasse, Ms Bernice Opondi, Joseph Magero, Jonathan Fell, Chimwemwe Ngoma, Clive Bates, Dr. Kgosi Letlape, Dr. Vivian Manyeki and Dr. Tendai Mhizha.
Over 2,000 civil servants in the public sector have been interdicted for a variety of reasons, the majority of which are criminal in nature.
According to reports, some officers have been under interdiction for more than two years because such matters are still being investigated. Information reachingÂ WeekendPostÂ shows that local government, particularly councils, has the highest number of suspended officers.
In its annual report, the Directorate on Corruption and Economic Crime (DCEC) revealed that councils lead in corrupt activities throughout the country, and dozens of council employees are being investigated for alleged corrupt activities. It is also reported that disciplined forces, including the Botswana Defence Force (BDF), police, and prisons, and the Directorate of Intelligence and Security (DIS) have suspended a significant number of officers.
The Ministry of Education and Skills Development has also recorded a good number of teachers who have implicated in love relationships with students, while some are accused of impregnating students both in primary and secondary school. Regional education officers have been tasked to investigate such matters and are believed to be far from completion as some students are dragging their feet in assisting the investigations to be completed.
This year, Mmadinare Senior Secondary reportedly had the highest number of pregnancies, especially among form five students who were later forcibly expelled from school. Responding to this publicationâs queries, Permanent Secretary to the Office of the President Emma Peloetletse said, âas you might be aware, I am currently addressing public servants across the length and breadth of our beautiful republic. Due to your detailed enquiry, I am not able to respond within your schedule,â she said.
She said some of the issues raised need verification of facts, some are still under investigation while some are still before the courts of law.
Meanwhile, it is close to six months since the Police Commissioner Keabetwe Makgophe, Director General of the Directorate on Corruption and Economic Crime (DCEC) Tymon Katlholo and the Deputy Director of the DIS Tefo Kgothane were suspended from their official duties on various charges.
Efforts to solicit comment from trade unions were futile at the time of going to press.
Some suspended officers who opted for anonymity claimed that they have close to two years while on suspension. One stated that the investigations that led him to be suspended have not been completed.
âIt is heartbreaking that at this time the investigations have not been completed,â he toldÂ WeekendPost, adding that âwhen a person is suspended, they get their salary fully without fail until the matter is resolvedâ.
Makgophe, Katlholo and Kgothane are the three most high-ranking government officials that are under interdiction.