Tobacco smoke is a health hazard. Reducing exposure to tobacco smoke in public places is a major public health goal. There is, however, considerable variation in the extent to which this goal has been achieved in different settings and societies. There is therefore a need to identify effective strategies for reducing tobacco consumption in public places such as hospital buildings, health buildings, educational institutions, libraries, and public offices. Passive smoking Secondhand smoke is the name for the sickening, poisonous smoke given off by burning tobacco - in cigarettes, roll-ups, pipes or cigars. Breathing in other people’s tobacco smoke is called ‘passive smoking’. The tobacco industry claims that smokers have a right to smoke. But non-smokers have a right to breathe clean air. The right to smoke ends where a non-smoker’s right to breathe safe air starts. Passive smoking is one of the key issues leading to smoking bans in workplaces and indoor public places, including restaurants, bars and night clubs. Current scientific evidence shows that exposure to secondhand tobacco smoke causes death, disease, and disability. Most experts believe that moderate, occasional exposure to secondhand smoke presents a small but measurable cancer risk to nonsmokers. The overall risk depends on the effective dose received over time. The risk is more significant if non-smokers spend many hours in an environment where cigarette smoke is prevalent. A study issued in 2002 by the International Agency for Research on Cancer of the World Health Organization concluded that non-smokers are exposed to the same carcinogens as active smokers. Secondhand smoke contains more than 4000 chemicals, including 69 known carcinogens like formaldehyde, lead, arsenic, benzene, radioactive polonium 210, and several well-established carcinogens have been shown by the tobacco companies’ own research to be present at higher concentrations in secondhand smoke than in primary smoke. The facts speak for themselves. But the response to this deadly problem is not on par with the impact of tobacco use on Rwandan’s health, either on the prevention or the treatment side. The government has supported the development of comprehensive plans for tobacco use prevention and control, but collective action for change remains missing. Public health must take a leadership role and demand that the health care system and public policy protect Rwandans from the dangers of tobacco use. We know what to do to prevent tobacco-related deaths, but we have failed to demand change from our government and from the health care field. Studies have demonstrated that health care providers fail to assess patients’ smoking status and advise them to quit. Firm intervention by a doctor is one of the most effective ways to encourage smokers to quit. When they smoke, we suffer Are there smokers in your workplace or at home? Then, there are good reasons for you to get them to quit, or at least stop smoking around you. If you are exposed to someone else’s cigarette smoke, you risk many health problems. You may not smoke but the second-hand smoke which you are exposed to puts you at risk of several health problems. So why do you keep quiet? If your children are exposed to passive smoking at home or in public places, you have more to worry about. Remember, passive smoking can kill. Don’t suffer in silence. We should concentrate on preventing ordinary people from having to smoke passively against their wills. If there are children present, it tends to be easier, and in places where you are the one who decides there’s also usually no problem, but then you have to make your wishes clear, not just intimate vaguely that some consideration might be nice. For those who find it hard to speak out, silent reactions can sometimes be just as effective. For example, you can move from your chair onto the floor when somebody lights up, because the air is often a little better down there. This will attract notice, and has proved to be an effective method. Smoking has become an accepted convention despite how ridiculously dangerous it is. Non-smokers must say something - do not allow yourselves to be pushed around. Smoking is anti-social; it does not have to be tolerated. We must not allow smoking to remain socially acceptable. Imagine the scenario of how the smoke is exhaled through mouths and noses, sometimes even through ears. Watch it diffuse into the room. After a while you become ‘used’ to it - it can’t be seen - that is when it is at its most dangerous. You don’t realize the sheer amount of poison lurking in the air; poison which will soon become part of your body. You are helpless - you have to inhale the smoke, and allow it to snake around your system, depositing tar onto your lungs. When it gets to this stage you have no choice. The way to stop this is to cease being ‘passive smokers’ and become active non-smokers: do not allow smokers to impose themselves with their cigarettes, to make you feel uncomfortable and smelly and put you under all manner of health risks. Making a stand, however small, will eventually make smokers listen - far more, strangely, than warning them about the astonishing health risks that they are casually undertaking. Smoking is not sociable and that it need not be tolerated. Smoking is not a ‘need’. Food and water are needs. Smoking is a short-term want. While short-term mentalities do fuel the problem, they can in fact be used as a tool for change: far more effective than spouting out statistics about the risks of various diseases years in the future, is to make a smoker stifle their craving or go elsewhere to smoke. Smokers do have the right to smoke. But the right for non-smokers not to be subject to other peoples’ smoke must take priority. It is vital that we stand up for this right, not only for our own benefit, but also for the benefit of smokers, who may well decide to question their lifestyles. In Rwanda, smoking in bars and restaurants is already banned. But the ban has not been a success at all. People continue to ignore it with impunity. Asking someone who is smoking near you not to smoke is not easy. Just let smokers know that you are not objecting to the fact that they smoke but you are asking them not to smoke near you. Be firm but polite. It is between life and death and you cannot afford to be silent. Smokers too should learn to accept situations where they are offended by nonsmokers who tell them to keep distance. Offended smokers’ sense of dignity does not outweigh nonsmokers’ right to live. Ends
