The most important way to stop the plague of smoking would be to stop the influx of new smokers, that is, mainly teenagers. When youngsters try their first cigarette, for reasons such as trying to fit in or peer pressure, most of them are not aware of the possible risk they are exposed to. Among young people, the short-term health consequences of smoking include respiratory and non-respiratory effects, addiction to nicotine, and the associated risk of other drug use. Long-term health consequences of youth smoking is reinforced by the fact that most young people who smoke regularly continue to smoke throughout adulthood.
Tobacco smoking among young people has become a burden to the country, and experts say the number of youngsters smoking is going up.
According to Rwanda Biomedical Centre (RBC), people start smoking at a young age and so that is where focus should be put when it comes to tackling and preventing the issue.
A 2013 World Health Organization (WHO) survey indicated that the overall 12.8 per cent of survey respondents declared themselves as current smokers, defined as those individuals who smoked in the past 30 days before the survey day.
A woman uses a nictonine patch.
It stated further that current smoking rate varies by background characteristics. Current smokers are recruited among adults aged 35 and above with a proportion ranging from 15.7 to 35 per cent, current smoking increases with age and men smoked more compared to women (19.2 vs. 7.1 per cent).
The Ministry of Health (MoH) is mostly focusing on minors.
According to Jean Bosco Gasherebuka, health promotion officer at WHO office for Rwanda; survey in schools in many countries sponsored by WHO is done every five years, which is known as global youth survey, targeting youth from 11 to 15 years of age.
He says it’s believed that this is the age at which most of them are influenced to start smoking.
A survey of tobacco in secondary schools carried out in 2004 jointly by the Ministry of Health and the Ministry of Education, with the support of WHO, indicated that 24 per cent of students in secondary school were smokers.
The consumption of tobacco constitutes an avoidable cause of mortality in the world. Figures provided by WHO show that there are four million deaths related to nicotine each year.
Whereas, WHO maintains that this toll is likely to increase to approximately 10 million deaths by 2030 if targeted actions are not carried out. In Africa, at least 850,000 people die annually because of nicotinism.
The consequences, he says, include respiratory diseases, oral infection, chronic ailments and cancer.
He says many deaths resulting from different cancers are related to smoking.
Gasherebuka notes that another consequence is that tobacco smoking for a long period of time makes one vulnerable to cancers that could affect any part of the body.
The Government of Rwanda has also initiated different campaigns targeting the youth and teenagers in a bid to prevent smoking among them.
Gasherebuka says teenagers are not allowed to buy cigarettes, and selling to them is prohibited by the Government of Rwanda and WHO, especially those under 18.
The youth are also encouraged to work on behavioural change, like joining clubs initiated to fight tobacco use.
Dr Edison Rwagasore, senior officer-diabetes, chronic diseases and other metabolic diseases at RBC, says there is awareness in schools at different levels to make sure young adults are aware of the consequences of smoking.
For those who already started smoking, Rwagasore says there are measures in place to help them quit, including medication.
Strategies also include not selling single sticks of cigarettes, rather, packets, making it expensive for many. They also discourage shop owners from selling cigarettes to people below the age of 18, and advising them to set up shops far away from schools.
Rwagasore says they are also developing strategic plans to curb the vice, which include multi-disciplinary approaches in tackling tobacco use since one institution alone can’t handle the problem unaided.
The partners, he says, include Ministry of Finance and Economic Planning, Ministry of Education, Ministry of Health and Ministry of Youth, among others.
Rwagasore says they have also pushed to have signs in as many places as possible, like hotels, bars and other recreational areas, to make sure they are visible to everyone.
The Government is also pushing for more non-smoking areas, people should not smoke anywhere.
“One has to move about 50 metres away from people if they want to smoke, instead of having certain areas for smokers,” he says.
Measures are also being put in place to have bigger signs of the effects of tobacco smoking on the packets.
Dr Dynamo Ndacyayisenga, the in-charge of management of alcohol and drug use disorders at RBC, says the major issue of smoking is that it contains nicotine, in that when one starts smoking, it becomes hard to stop.
When it comes to the mental health effects of tobacco, he says they mainly talk of addiction because nicotine in tobacco works with the central nervous system and through this, there are some neurons that are fixated to nicotine, leading to addiction.
Among the several patients admitted in hospitals, Ndacyayisenga says many are in for tobacco addiction.
Ndacyayisenga says there are psychotherapy sessions given to such patients.
He says there is also chewing gum known as ‘nicotine gum’ which significantly helps with withdrawal symptoms, or even eliminates them, but only if one uses them as prescribed.
He explains that this gum helps most as fast relief from irritability, mood swings, difficulty concentrating, and the urge to smoke, among other inconveniences that occur due to smoking cessation.
Rwagasore says this nicotine replacement helps victims to progressively reduce frequency of smoking and eventually, quit completely.
Although it takes time for one to quit smoking, he says it’s worth starting immediately, especially for those who have just started. The treatment, when started, he says, helps reduce the risk of developing deadly diseases.
Gasherebuka says the country is fighting hard to curb non communicable diseases (NCD); risk factors being tobacco use, alcohol consumption, poor diet and lack of physical activity.
He notes that there are many deaths that result from tobacco, making it a challenge when it comes to fighting the vice.
He advises parents who smoke not to do it around their children or in the house to prevent second-hand smoking.
When it comes to smoking or drug abuse among the youth, although there are many factors to consider, parents should take most of the blame. Creating time for minors is important, listen to their grievances and find a way forward.
Ezekiel Bizimana, youth activist
I think in schools, teachers should encourage each and every student to join clubs and help fight such vices. Alternatively, sensitising them on the consequences is also important.
Josyline Murekezi, parent
Young people should also help fight bad vices by identifying and seeking help for their colleagues or peers whom they think or suspect are engaging in unhealthy lifestyles.
Juliana Umutoni, university student
There is need to educate parents and even teachers on how to detect early signs of a young person who may be engaging in unhealthy habits. This can help prevent further complications that come with smoking and other bad conduct.
Pascal Habimana, teacher