By Esther Dhafa

Every year on 31^st May the World Health Organisation (WHO) and Global Partners celebrate the “World No Tobacco Day”, an annual campaign aimed at raising awareness on the harmful and deadly effects of tobacco use and second-hand smoke exposure, and to discourage the use of tobacco in any form.

This year, the World No Tobacco Day was celebrated under the theme “Protecting youth from industry manipulation and preventing them from Tobacco and Nicotine use”. The 2020 global campaign serves to equip young people with knowledge about the tobacco and related industries’ intentions and tactics to hook current and future generations on tobacco and nicotine products.

Tobacco use and COVID-19

This year’s commemoration came at a time when the world was facing the coronavirus pandemic. This brought forth an opportunity for countries all over the world to step up tobacco control efforts, heighten information sharing on tobacco use and COVID-19, and broaden understanding of the link between tobacco use and COVID-19 infection. It is also an opportunity to accelerate contextualised tobacco control, informed by the WHO FCTC Guidelines on the obligations of member states to counter tactics used by the tobacco industry. This is because the tobacco industry has for a long time deliberately employed strategic, aggressive and well-resourced tactics to attract people to use tobacco and nicotine products. 

According to the WHO Fact sheet/Detail on Tobacco published on 26^th July 2019, tobacco use continues to kill up to half of its users. The fact sheet adds that it kills more than eight million people each year of which more than seven million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke. 

This year, we emphasise the fact that tobacco use and smoking in particular is a risk factor for COVID-19, an infectious disease that primarily attacks the lungs. As smoking is a leading risk factor for heart disease, lung cancer, reduces immunity and makes us more susceptible to respiratory infections including pneumonia, it is also a risk for COVID-19 infection. This is especially because smokers touch their mouth and face more. A review of studies by public health experts convened by WHO on 29^th April 2020 found that smokers are more likely to develop severe cases of COVID-19, compared to non-smokers. 

Recent studies have continued to show that smokers who contract the virus are more likely to suffer severe symptoms and even die. Once a smoker has been hospitalised for COVID-19, the outcome is likely to be even worse. Smoking is detrimental to the immune system and its responsiveness to infections makes smokers more vulnerable to infectious diseases like Coronavirus. (Zhou Z Chen P Peng H are healthy smokers’ really healthy? Tob Induc Dis. 2016; 14 (November). Doi: 10.1186/s 12971-). 

There are also higher percentages of current and former smokers among patients that need ICU support, mechanical ventilation, or who have died and a higher percentage of smokers among the severe COVID-19 cases (Guan WJ, Ni ZY, Hu,Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020). Smokers are therefore more likely to have severe symptoms of COVID-19, and are more likely to be admitted to an ICU, or require mechanical ventilation or die compared to non-smokers.

Impact of the covid-19 pandemic on tobacco control implementation in Uganda

Since the start of the pandemic, tobacco control efforts have since been significantly impacted. Implementation of tobacco control measures is coordinated under the Ministry of Health (in one of the departments that tackles tobacco use, NCDs, mental health, alcohol and substance abuse), and yet the MOH’s involvement and efforts are entirely directed towards response to COVID-19 as a priority. 

The government has also continued to receive donations from tobacco industries (Leaf Tobacco and Merchandise Ltd, Meridian Tobacco Company) towards the COVID-19 National Taskforce/Response as stated in the national address by His Excellency the President on Tuesday 14^th April 2020, contrary to Section 22 of the Tobacco Control Act 2015 and the WHO FCTC. 

The Government must be weary of donations that compromise public health as it is their duty to protect the public health, laws and policies from commercial and other vested interest of the Tobacco Industry. By donating, the Tobacco Industry is trying to improve their corporate image by showing social responsibility to the population, and sending deceptive messages to the public about Tobacco industry operations and their products. Partnership with the Tobacco Industry also undermines Government’s credibility in protecting people’s health since there is a fundamental and irreconcilable conflict between the Tobacco Industry’s interests and Public Health Policy interests.

This comes at a time when Ugandans are in a lock down for over 2 months now and are at home bored, which makes many of them easily get the temptation to smoke cigarettes or related products, contrary to what the law provides.

Way forward and Conclusion:

As we commemorate the World No Tobacco Day on 31^st May 2020 and recognizing the fact that smoking could increase the risk of people contracting COVID-19 more, we call upon Government, young people, and the entire population to;

• Support implementation of the Tobacco Control Act 2015 and the WHO FCTC.
• Join hands to make healthy lifestyle choices through avoid the use of tobacco and related products 
• Educating themselves and others to support the Tobacco Control cause through complying with the tobacco control and public health measures in place

Adhering to these will help reduce the morbidity and mortality of cancers caused by tobacco smoke and COVID-19 as well.

The writer is a Programme Officer  in the Campaigns, Partnerships and Networks Programme.