Strengthening tobacco control in West Africa: How CRES is leading the charge
ccording to the World Health Organisation (WHO), tobacco kills more than 7 million people each year, 80% of them in low- and middle-income countries. The huge health, social and economic impacts associated with it have prompted calls for stricter regulation, especially in Africa where warning bells over a tobacco epidemic have been sounding for years.
In Senegal, Consortium pour la Recherche Économique et Sociale (CRES) has been spearheading research on tobacco control for more than a decade. Ahead of World No Tobacco Day, the Africa Portal spoke to the think tank's director, Dr Abdoulaye Diagne, about CRES's ongoing efforts to strengthen tobacco control in the region.
What prompted CRES to engage in tobacco control research?
In 2006 CRES quickly realised that something had to be done to curb tobacco consumption in West African countries because the health, economic and social consequences of smoking could hinder their development.It was necessary to act fast, especially since Africa, with its huge markets and weak or non-existent tobacco regulation, was the new El Dorado of the tobacco industry.
A situational analysis of smoking in Africa (ASTA) carried out in 12 African countries in 2009/2010 found that there was an absence of national information on tobacco taxation, no research on the situation on the taxation of tobacco products in Africa, and a lack of synergy between research, advocacy to influence legislative and policy decision-making in tobacco control. All these considerations led us to focus on tobacco control in West Africa, starting with a research-action project aimed at contributing to the improvement of public policies on tobacco.
Tell us about the project.
We launched a multidisciplinary project in Touba, the second largest city after Dakar, which is also home to one of the largest religious communities. Since the 1970s, smoking was banned in Touba by religious authorities but without any legal enforcement, offenders could not be prosecuted or fined. From 2009 onward, CRES worked closely with the community to develop a proposal that would provide a legal basis for the ban. We assembled a team of lawyers and activists to draft a proposed Bill on the production, consumption and distribution of tobacco, which would also provide a legal basis for the prohibition of smoking in certain areas such as Touba.
CRES worked closely with the Ministry of Health and helped build a strong alliance of civil society organisations in Senegal (called LISTAB), which led an advocacy and lobbying campaign at a national level. The Bill was adopted by Parliament and signed into law in March 2014.
It was the first of its kind for West Africa, and since then, CRES and Touba have continued to partner and co-operate on joint anti-tobacco activities.
What is the significance of this law?
Senegal ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005, but did not have a tobacco control law that complied with it until this one was adopted in 2014.
This legislation represents great progress for Senegal and is one of the strongest in Africa. First, it addresses second-hand smoking issues by prohibiting smoking in public areas. It also protects young people, who are provenly more vulnerable to tobacco use, by banning the sale of tobacco products around the schools. The law makes cigarettes less affordable to poor and vulnerable people, as the sale of cigarettes per unit is forbidden. Senegal's religious cities will also be protected as the local authorities now have the right to officially impose fines on offenders. Other provisions include a ban on all tobacco advertising and sponsorship, and sanctions for those who violate it. While fully enforcing the law remains a challenge, it is undoubtedly an important achievement.
What research has CRES undertaken in the region?
Pursuing the same objective of curbing tobacco usage through stronger policies, CRES extended the scope of its research on tobacco taxation to the Economic Community of West African States (ECOWAS).
Raising taxes on tobacco is widely considered to be the most effective way of limiting tobacco consumption. However, previous studies related to tobacco control in Africa, if any, were limited to the national level only.
During 2012, CRES conducted research on tobacco taxation in each of the 15 ECOWAS countries to provide policymakers with a regional overview, and to address the lack of updated and accurate data on tobacco in the region.
The CRES team presented the research at a regional conference in 2012. We discussed the results with high-level policy makers from national governments, ECOWAS and the West African Economic and Monitory Union (WAEMU). In 2014, we submitted an advocacy document gathering all the scientific evidence available for tobacco tax reform, and drafted a proposal for a new ECOWAS regional tobacco taxation directive. It was officially adopted with minor revisions by the ECOWAS Council of Ministries in December 2017. WAEMU has started the same process of adopting a new regional regulation on tobacco taxation.
You received an award from the WHO for your work on tobacco control in 2014. Why is this field of research so important to you?
All studies on tobacco are unanimous about the fact that tobacco-related diseases have a huge negative impact, not only on people’s health but also the entire economy of a country (loss of productivity, health care costs, etc). The burden is particularly high on young and vulnerable people. As a think tank, CRES aims to have an effective impact on Senegalese and African people’s lives through better public policy. A stronger tobacco policy will have a positive impact on the well-being of populations by reducing the prevalence of morbidity, mortality and public health expenditure due to smoking-related illnesses and deaths.
What is next on CRES's research agenda?
The adoption of the ECOWAS regional directive is a great achievement but the battle is not yet won. There is still a long way to go before it is effectively enforced by all 15 member states. In 2016, we started Phase II of our regional tobacco tax program. We are pursuing with efforts to provide decision makers with more evidence and contribute to the adoption of national tobacco taxation regulation that will raise the price of tobacco so that the consumption of cigarettes will decrease. Our research currently focuses on:
- the optimal tax system to be adopted to achieve an effective impact on the health of populations without reducing tax revenues;
- the estimation of illicit tobacco trade in Senegal;
- the estimation of health costs induced by tobacco-related disease in Senegal; and
- the updating of 7 country profiles related to tobacco.
View publications from Consortium pour la Recherche Économique (CRES) here.
(Main image: A picture taken on 26 August 2017 in Dakar shows a pack of cigarettes bearing the text 'Smoking results in a slow and painful death' to warn of the dangers of tobacco consumption. – Seyllou/AFP/Getty Images)