Although public health experts see a clear relationship between smoking tobacco and life-threatening diseases, the Zambian tobacco industry continues to emphasise its contribution to the country’s economy.

By Brian Moonga, Lusaka

Zambian public health experts say the rate of tobacco related disease is on the rise. About 30% of men and 2% of women in Zambia smoke, according to the 2007 Zambia Demographic and Health Survey. The survey was conducted by the Institute of Economic and Social Research of the University of Zambia.

“Smoking is a risk factor for TB-infection and for the development of pulmonary TB,” says Dr Peter Chungulo, a Lusaka-based TB control programme specialist. Zambia had the 10th highest incidence of the disease in the world in 2008, according to the United States Agency for International Development.

According to the latest figures from the World Health Organization (WHO) there has been a slight reduction in new TB cases, from 553 per 100,000 people in 2006 to 506 per 100,000 in 2007. “But we see more asthma attacks, bronchitis and poor TB recoveries, even in children who don’t smoke themselves, but whose parents do,” says Dr Fastone Goma, a tobacco researcher.

Chain smoker
John Kalunga, a 26-year-old carpenter, is currently undergoing TB treatment in Kanyama compound, a township west of Lusaka. About a year ago, Kalunga was a chain smoker, puffing away at over 20 cigarettes a day, before he discovered that he had TB. “It was very hard for me to quit, until I got very sick and I found out I had lung TB,” Kalunga says. “The doctor told me that the drugs I am on right now will never go well with smoking.”

Cervical cancer
According to Professor Groesbeck Parham, a gynecological cancer surgeon at Lusaka’s University Teaching Hospital, smoking is a key cause of cervical cancer. “Tobacco can trigger cervical cancer by weakening the immune system which results from a loss of essential immune cells,” Parham says. Zambia’s rate of cervical cancer is extremely high, with an incidence rate second only to Tanzania and the sixth highest prevalence rate in the world.

Tobacco industry in denial
But the Zambian tobacco industry doesn’t acknoweldge the increase in the number of tobacco-related deaths. It produces 120 million kilograms of tobacco per annum, 60% of which is produced by peasant farmers, earning the country 75 million euros a year. “Yes, tobacco contains 4,000 chemicals, some of which are known to be carcinogenic, but the same chemicals are found in food like cake,” says Knox Mbazima of the Tobacco Association of Zambia.

Zambia is one of 180 countries that signed the WHO’s Framework Convention on Tobacco Control (FCTC), which seeks to tighten the noose around the necks of tobacco companies due to the severe health risks caused by smoking.

Mbazima: “Zambia signed the FCTC because it’s a member country of the World Health Organisation, but the tobacco industry contributes to the economy of the country.”

Smoking ban
Anti-tobacco activists like Brenda Chitindi of the Tobacco Free Association of Zambia want tighter regulation of the tobacco industry.“The government isn’t all that tough on tobacco companies because of the taxes it receives from the industry. But that attitude constitutes a great danger to public health,” says Chitindi.

In 2008, Zambia passed a law banning smoking in public. A 1992 law already prohibited smoking in certain places. But many African governments have dismissed calls by the World Health Organisation to control tobacco. Last year the Common Market for East and Southern Africa asked its members to reject the Framework Convention on Tobacco Control.