BY S KWAGALA: Tobacco addiction continues to plague millions globally, with Uganda bearing its share of the burden. The harmful effects of nicotine, as highlighted by the World Health Organization (WHO), are a well-documented public health crisis. Despite numerous campaigns urging smokers to quit, many remain trapped in the grip of addiction. Advocates argue that the introduction of safer nicotine products could alleviate the health burden on these individuals, offering them a path to reduced harm.
Nicotine, the primary addictive substance in tobacco, is responsible for a myriad of health issues. According to the WHO, nicotine can cause increased heart rate, high blood pressure, and is linked to the development of various cancers. The WHO’s research underscores the danger, reporting that smoking-related diseases claim more than eight million lives annually worldwide, with low- and middle-income countries like Uganda bearing a disproportionate share of this mortality.
In Uganda, the health burden of nicotine consumption is staggering. With increasing rates of tobacco-related illnesses, the healthcare system is under strain, and families are left grappling with the emotional and financial toll of these diseases. Despite the health warnings, some individuals are simply unable to quit. Addiction is a complex issue, often exacerbated by circumstances beyond an individual’s control.
Joshua Omonuk, Researcher and Secretary of Tobacco Harm Reduction Uganda (THR-Uganda), shared his insights: “There is no statistically significant effect the level of awareness of the harms of tobacco has on the ability to quit smoking. In both surveys, over 80% of the smokers have failed to quit despite the awareness of the harms of smoking. The awareness of the change in law has had no significant effect on the use of combustion cigarettes. The change in law has been of benefit to non-smokers but detrimental to those that smoke. To the smoker, the need for pleasure is stronger than the fear of death, and this is very worrying.”
Omonuk mentioned this in reference to results from a survey on smoking conducted in Lira and Bukedea between 2022 to 2023. The same survey conducted in Lira indicated that 86.2% persons had never used safe nicotine products while in Bukedea 80%, putting the larger population of smokers and non-smokers at risk.
In September 2015, President Yoweri Kaguta Museveni assented to The Tobacco Control Act, a landmark legislation that prohibits smoking in public places, workplaces, and means of public transport. The Act also imposes strict penalties, with offenders facing a fine not exceeding ten currency points or imprisonment for a term not exceeding five months, or both. This law was aimed at reducing public exposure to secondhand smoke and curbing tobacco use. However, its impact on smokers themselves has been mixed.
Emong Nathan, a smoker from Bukedea, shared his personal struggle with tobacco addiction. He recounted how he was introduced to smoking through friends he moved with. Initially, he resisted, but eventually, he succumbed to the habit. When the ban on smoking was introduced, Nathan faced significant stigma, to the point where he would lock himself up in a latrine to smoke. This isolation and frustration led him to seek help from medical workers, whose only advice was to quit. However, as an addict, he struggled to quit completely, facing severe withdrawal challenges.
Later on, through the intervention of THR-Uganda, Nathan went through rehabilitation and was gradually supported in overcoming his urges. Today, he proudly shares that he has been clean for eight months.
Many of those suffering from nicotine addiction, like Nathan, were introduced to tobacco at a young age, often through innocuous acts such as purchasing cigarettes for adults. These early exposures can lead to a lifelong struggle with addiction. Despite this, current laws in Uganda place a blanket ban on safer nicotine alternatives, which some argue is unfair and overlooks the reality that no one chooses to become addicted.
The survey indicated that 89.9% of smokers in Lira started during childhood.
Advocates for Tobacco Harm Reduction argue that safer nicotine products, such as e-cigarettes and nicotine patches, could play a crucial role in reducing the health risks for those unable to quit. These alternatives are designed to deliver nicotine without the harmful toxins found in traditional cigarettes. By adopting a harm reduction approach, the health burden on tobacco addicts can be significantly lightened, offering them a chance at a healthier life.
The ongoing debate highlights the need for a more compassionate approach to tobacco addiction, one that considers the plight of those who are victims of circumstance. A reconsideration of the law could pave the way for safer nicotine products, providing a lifeline to those trapped in addiction’s grasp.