With the growing adoption of Information and Communications Technologies (ICT) as the nation steps into the deployment of Fifth Generation (5G) networks, REMMY NWEKE writes on the need to review the National Tobacco Control Act of 2015 to accommodate evolution of e-Cigarettes to reduce tobacco harms in Nigeria.
Preamble:
Of late, smokeless tobacco products have been in the news, just as the electronic cigarettes continued to gain momentum, but obviously a tobacco product used by means other than smoking, which could pass for their use as chewing, sniffing, or placing the product between gum and the cheek or lip.The smokeless tobacco products, ITREALMS gathered are produced in various forms, such as chewing tobacco, snuff, snus, and could pass for dissolvable tobacco products. Smokeless tobacco products typically contain over 3000 constituents according to experts but consistent that all smokeless tobacco products contain nicotine and are therefore highly addictive.
What’s a cigarette?
Experts at VeryWellMind.com defined a cigarette, as a cylindrical roll of shredded or ground tobacco that is wrapped in paper or another substance that does not contain tobacco.They explained that to smoke a cigarette, the end is lit and the smoke is inhaled, stressing that many manufactured cigarettes also have filters on one end that are intended to trap some of the toxic chemicals contained in cigarette smoke.
Risk factor of smokeless tobacco:
Also gathered was that quitting smokeless tobacco use is as challenging as smoking cessation.
Yet, some school of thought said, smokeless tobacco is much lower on the risk continuum than combusted products but varies in risk within that class of products. For instance, low nitrosamine Swedish-type snus versus other smokeless tobacco with high nitrosamine levels.
Hence, it’s estimated the safety risk of smokeless tobacco is similar to that of electronic cigarettes. There is no safe level of smokeless tobacco use. It is correlated with a number of adverse effects such as dental disease, oral cancer, oesophagus cancer, and pancreas cancer, as well as adverse reproductive effects including stillbirth, premature birth and low birth weight.
Nitrosamine and 27 other constituents:
According to the United States Food and Drugs Administration (FDA), smokeless tobacco, though incombustible contains a mix of 4,000 chemicals, including as many as 30 or more that are linked to cancer. These chemicals include heavy metals cadmium, lead, and nickel; as well as arsenic, a chemical used in insecticides; formaldehyde, which is used in embalming fluid; and N-Nitrosonornicotine (NNN), among others. While some 13 NNN are known to cause cancer in animals and has been linked to an increase in the risk of cancer among humans.ALSO READ:
Thus, smokeless tobacco products are reportedly contained cancer-causing chemicals, even as these chemical constituents present in smokeless tobacco are carcinogenic in nature, with nitrosamine as the most prominent.
Smokeless tobacco accounts for an abundance of deaths globally with a significant proportion of them attributed to Southeast Asia. The smokeless tobacco consumption has become widespread throughout the world, with experts decrying that once addicted to nicotine from smokeless tobacco use, many people, particularly young people, expand their tobacco use by smoking cigarettes. Males were more likely than females to have tasted or used smokeless tobacco in the previous month.
Many types of e-Cigarettes:
There are many different types of e-cigarettes in use, also known as Electronic Nicotine Delivery Systems (ENDS) and sometimes Electronic Non-Nicotine Delivery Systems (ENNDS).
These systems heat a liquid to create aerosols that are inhaled by the user. These so-called e-liquids may or may not contain nicotine, often not tobacco but typically contain other additives, flavours and chemicals that could be toxic to people’s health.
Hence, e-cigarettes are the most common form of ENDS and ENNDS, but there are others, such as e-cigars and e-pipes. ENDS contain varying amounts of nicotine and harmful emissions.
According the World Health Organisation (WHO) e-cigarette emissions, therefore, typically contain nicotine and other toxic substances that are harmful to both users, and non-users who are exposed to the aerosols second-hand. Some products claiming to be nicotine-free (ENNDS) have been found to contain nicotine.
Long-term consequences on brain development:
WHO also lamented that the consumption of nicotine in children and adolescents has deleterious impacts on brain development, leading to long-term consequences for brain development and actually leading to learning and anxiety disorders.
Nicotine, WHO reported, is highly addictive and some evidence suggested that never-smoker minors who use ENDS can double their chance of starting to smoke tobacco cigarettes later in life.
“Evidence reveals that these products are harmful to health and are not safe. However, it is too early to provide a clear answer on the long-term impact of using them or being exposed to them. Some recent studies suggest that ENDS use can increase the risk of heart disease and lung disorders. Nicotine exposure in pregnant women can have similar consequences for the brain development of the fetus,” WHO warned in a recent fact sheet available to ITREALMS.
Effects on non-smokers:
In addition, ENDS use, they pointed out could expose non-smokers and bystanders to nicotine and other harmful chemicals. Maintaining that electronic delivery systems have also been linked to a number of physical injuries, including burns from explosions or malfunctions, when the products are not of the expected standard or are tampered with by users.“Accidental exposure of children to ENDS e-liquids pose serious risks as devices may leak, or children may swallow the poisonous e-liquid,” WHO experts said.
They underscored that main constituents of the solution by volume are propylene glycol, with or without glycerol, and flavouring agents.
e-Cigarettes and future adolescents:
E-cigarettes are particularly risky when used by children and adolescents. Nicotine is highly addictive and young people’s brains develop up to their mid-twenties.Whereas, ENDS use, has been discovered to increase the risk of heart disease and lung disorders, they also pose significant risks to pregnant women who use them, as they can damage the growing fetus.
Industry observers noted that advertising, marketing and promotion of ENDS has grown rapidly, through channels which rely heavily on internet and social media, as much of the marketing around these products give rise to concern about deceptive health claims, deceptive claims on cessation efficacy, and targets at youth, moreso, with the use of flavours.
WHO responses:
Noteworthy is that the scale of the human and economic tragedy that tobacco imposes remains shocking, but discovered to be preventable, if requisite steps are taken. The tobacco industry is obviously fighting to ensure the dangers of their products are concealed, but WHO on the other hand is fighting back.An instance was that in 2003, WHO Member States unanimously adopted the WHO Framework Convention on Tobacco Control (WHO FCTC). In force since 2005, it had 192 Parties covering over 90 per cent of the world’s population.
In 2007, WHO introduced a practical, cost-effective way to scale up implementation of the main demand reduction provisions of the WHO FCTC on the ground, tagged ‘MPOWER’ with some six measures. These included to; monitor tobacco use and prevention policies, protect people from tobacco use, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising, promotion and sponsorship as well as raise taxes on tobacco.
Conclusion:
In the final analysis and based on WHO’s concerns, the ENDS/ENNDS should not be promoted as a cessation aid until adequate evidence is available and the public health community could agree upon the effectiveness of those specific products.
However, where ENDS and ENNDS are not banned, WHO recommended that the products be regulated in accordance with four key objectives, namely to prevent initiation of ENDS/ENNDS by non-smokers, minors and vulnerable groups; minimize health risks for ENDS/ENNDS users and protect non-users from exposure to their emissions.
In addition, WHO canvassed for prevention from unproven health claims being made about ENDS/ENNDS; and protect tobacco control from all commercial and other vested interests related to ENDS/ENNDS, including interests of the tobacco industry.
To do better, the Federal Ministry of Health in Nigeria and stakeholders could proactively be engaged especially the youth so as to reduce the number of future cancerous effects of e-cigarettes and tobacco generally in the country.
Yes, Nigeria has since 2004 initiated a bill which was ratified in 2005 with the aim at domesticating the WHO’s Framework Convention on Tobacco Control (FCTC). Nigeria also enacted the National Tobacco Control Act (NTCA Act) 2015 to accommodate the provisions of the WHO FCTC in her domain.
Till date, Nigeria has no main policy targeted at regulating e-cigarettes, which means that the sale of e-cigarettes is not regulated; therefore, safe to say the sale of e-cigarettes is allowed.
It’s, therefore, high-time the National Tobacco Control Act of 2015 is expanded by way of review or amended to accommodate e-cigarette and its side-effects, especially on the youths.
The earlier the commencement for this proposed amendment of NTCA2015, the better for the larger Nigerian society as we look forward to what the fifth generation (5G) network brings.
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