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BackgroundNigeria is a significant tobacco market and influential country in Africa. Nigeria ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005. We reviewed Nigeria's tobacco control legislation since 2000 and compliance of the National Tobacco Control Act (NTCA) 2015 with the FCTC.MethodsWe reviewed the National Tobacco Control Bills 2011 (proposed by legislature) and 2014 (proposed by Executive), the NTCA 2015, and media stories on tobacco control from 2008 to 2017.ResultsThe NTCA, despite being more comprehensive than Nigeria's first Tobacco Smoking (Control) law of 1990, maintained provisions promoted by the tobacco industry, for example: allowing designated smoking areas in hospitality venues, higher educational institutions, and transportation venues; a loophole in the advertising restrictions allowing communications with consenting adults; and having the Manufacturers Association of Nigeria (MAN) (which includes tobacco companies) on the National Tobacco Control Committee charged with working with the Ministry of Health to implement the law. The industry is also directly involved with the Standards Organisation of Nigeria (SON) in preparing regulations on cigarette constituents and emissions. In an unprecedented step globally, the law requires that implementing regulations be approved by the National Assembly, giving the industry another opportunity to weaken this law further by lobbying the legislators to favor the industry. As of January 2018, the law was still not being enforced.ConclusionThe NTCA can be strengthened through implementation guidelines still being developed. The industry should be prevented from interfering with through MAN and SON, as required by FCTC Article 5.3.ImplicationsThe tobacco industry works to block Framework Convention on Tobacco Control implementation even after a country ratifies the treaty. The Nigerian case illustrates that it is essential for health authorities to remain vigilant and ensure that the tobacco industry does not play a decision-making role in the process of tobacco legislation and regulation either directly or indirectly. The unprecedented step of requiring approval of implementing regulations for the Nigerian law should not be allowed to become a precedent in other countries.

IntroductionNigeria ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005. Tobacco control advocates in Nigeria achieved some success in countering tobacco industry interference to implement the FCTC.MethodsWe triangulated interviews with key informants from local and international organisations who worked in Nigeria with documentation of the legislative process and Nigerian newspaper articles. Data were analysed and interpreted using the Policy Dystopia Model and WHO categories of tobacco industry interference that had been developed mostly based on experience in high-income countries.ResultsAs in high-income countries, the tobacco industry continued to oppose tobacco control policies after Nigeria ratified the FCTC, including weakening Nigeria's 2015 National Tobacco Control Act. Both tobacco control advocates and industry used discursive (argument-based) and instrumental (activity-based) strategies. The industry argued self-regulation and the economic importance of tobacco. They exploited legislative procedures, used front groups and third parties to push for pro-industry changes. Advocates, with help from international organisations, mobilised prominent Nigerians and the public. Advocates pre-empted and countered the industry through traditional and social media, monitoring and exposing tobacco industry activities, and by actively engaging lawmakers and citizens during the legislative process.ConclusionThe Policy Dystopia Model and WHO categories of industry interference provide a helpful framework for understanding tobacco control debates in low/middle-income countries (LMICs) as in high-income countries. One difference in LMIC is the important role of international tobacco control advocates in supporting national tobacco control advocates. This partnership is important in pushing for FCTC-compliant legislation and countering industry activities in LMIC.

BackgroundNigeria plays important economic and political roles in Africa and is a significant market for the tobacco industry. This study describes the tobacco industry's efforts to block Nigeria's early tobacco control attempts, especially the Tobacco Smoking (Control) Decree 20 of 1990, and efforts to strengthen the Decree in 1995.MethodAnalysis of documents from the Truth Tobacco Documents Library and other Internet resources related to Nigeria's Decree 20 and earlier tobacco control efforts.ResultsThe World Conferences on Smoking and Health and World Health Organization in the late 1970s spurred the Nigerian government to take steps towards tobacco regulation. In response, the tobacco industry lobbied government ministries, used front groups and its trade group, the Tobacco Advisory Council of Nigeria, to block and weaken government efforts. The industry obtained a draft of Decree 20 two years before it was enacted, considered the Decree anti-business and proposed language that led to the passage of a weaker Decree in 1990. It also attempted to influence a potential review of the Decree in 1995.ConclusionDecree 20 was a strong law for its time, but was weakened due to tobacco industry interference. Nigeria ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2005, and enacted a comprehensive National Tobacco Control Act (NTCA) in May 2015. Lessons learned from Decree 20's experience should be applied to protect NTCA 2015, and in compliance with WHO FCTC Article 5.3 which require parties to protect tobacco control policies from tobacco industry interference.ImplicationsThis is the first detailed account of tobacco industry interference with tobacco legislation in Africa. The emergence of tobacco control in Nigeria threatened the tobacco industry, which believed that success in Nigeria would have a "domino effect" in Africa. The industry used lobbying and front groups to successfully block and weaken Nigeria's tobacco control, especially the Tobacco Smoking (Control) Decree 20 of 1990 and efforts to strengthen it in 1995. Nigeria and other African countries must learn from this history to protect tobacco control policies from the tobacco industry's vested interests and vigorously implement Article 5.3 of the WHO FCTC.

Cigarette smoking has widely received the attention of international and local health bodies. Efforts are being made towards curbing smoking prevalence globally with a view to reduce the health, economic and social effects of smoking in the society. While some developed countries are recording success in this effort mainly through stringent tobacco control policies and educating the public, Nigeria is yet to actively key into the WHO-Framework Convention on Tobacco Control (WHO-FCTC) which she signed in June 28 2004 ("Nigeria: Report card on the WHO-FCTC," n.d.). With the stalling of the process of formulating a viable tobacco control policy in Nigeria through politics and politicking, it is important that other strategies which will help in reducing smoking prevalence especially among the youth be explored. This article looks at the psychosocial risk influences for smoking among Nigerian youth with a view to inform educational and psychosocial interventions that can help to reduce smoking uptake by the youth.

Background/Objectives: Tobacco smoking is a cause of premature death and illness globally. This study examined the prevalence and factors associated with tobacco smoking among South African adults according to sex, education, and employment status among socio-demographic subgroups. Methods: Data were obtained from the 2021 South African Global Adult Tobacco Survey (a nationally representative household survey using a multi-stage stratified cluster random sampling design). The 6311 participants were aged 15+ years. Descriptive statistics, chi-square tests, and multiple logistic regression analysis were used to investigate relationships between current smoking and socio-demographic variables. Results: Smoking prevalence was 25.8% (n = 1573) (41.2% among men, 11.5% among women; 29.9% among working individuals, 23.1% among non-working individuals). The multiple logistic regression results showed that males aged 45–64 were twice as likely to be currently smoking than males aged 15–24. Coloured (of mixed race) males were twice as likely to smoke as Black African males. Males with secondary/post-secondary education were less likely to smoke compared to males with no education. Coloured females were seven times and White females were almost five times more likely to smoke than Black African females. Females with post-secondary education were less likely to smoke than those with no formal education. Females earning an income were more likely to smoke compared to those with no income. Non-working participants aged 25–44 and 45–64 were more likely to smoke compared to those aged 15–24 years. Working and non-working Coloured and working White individuals were three times more likely to smoke than working or non-working Black Africans. Conclusion: Groups with higher identified smoking prevalence may indicate where smoking cessation interventions should be targeted to reduce national smoking prevalence. [ABSTRACT FROM AUTHOR]

We utilized Global Adult Tobacco Survey data to examine singlestick purchases and related demographic characteristics in 10 African countries (Botswana, Cameroon, Ethiopia, Kenya, Nigeria, Mauritania, Senegal, South Africa, Uganda and Tanzania). Results show the weighted percentages and prevalence ratios with predicted marginal means to evaluate significant differences between groups (P  < 0.05). The prevalence of singlestick purchases among the 10 African countries ranged from 48.4% in South Africa to 92.0% in Tanzania. Across countries, the incidence of singlestick purchases was higher in urban areas than rural areas in Kenya; among those aged 15–24 years versus those aged 45 years and older in Botswana, Ethiopia, Mauritania, Nigeria and South Africa; and among those aged 25–44 years versus those aged 45 years and older in Botswana, South Africa and Tanzania. The incidence in Botswana was higher among adults with no formal or primary education than among those with secondary or higher education. In South Africa, the incidence was higher among adults in the middle or lower wealth index than among those in the high or highest wealth index. The findings suggest opportunities for strengthening efforts to prevent singlestick purchases through effective legislation and enforcement in line with Article 16 of the World Health Organization Framework Convention on Tobacco Control. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) estimates that smoking kills more than 8 million people every year. While the WHO African Region has the lowest smoking prevalence of all WHO regions [...]

Introduction and Aims: Alcohol use is among the leading risk factors for premature death and morbidity in South Africa. This study sought to identify factors associated with drinking behaviour in on‐ and off‐licensed premises (typical occasion quantity and frequency) among adults in the City of Tshwane, South Africa. Design and Methods: A household survey was conducted in 2014, using a multi‐stage stratified cluster random sampling design. Participants comprised 982 adults (65% males) aged 18–65 years. Factors explored included socio‐demographic variables and situational variables at on‐ and off‐licensed premises. Multiple logistic regression analysis was performed to predict drinking behaviour at on‐ and off‐licensed premises. Results: The majority of the participants consumed alcohol in off‐licensed premises (64% vs. 36%). However, participants who consumed alcohol at on‐licensed premises were more likely to drink more alcohol and more frequently (weekly). Additionally, participants who consumed alcohol in above‐average sized containers were more likely to consume six or more drinks and drink weekly. Being of high socio‐economic status was associated with drinking weekly at off‐licensed premises, while being less educated was associated with a significantly higher frequency of drinking at on‐licensed premises. Discussion and Conclusions: Interventions to reduce alcohol use should target specific drinking behaviour at on‐ and off‐licensed premises, for example, regulating the availability of alcohol in big‐sized containers and the need for cutting down on quantity of alcohol and frequency of drinking for South African males who drink at on‐ and off‐licensed premises. [ABSTRACT FROM AUTHOR]

INTRODUCTION To inform policy making under the proposed The Control of Tobacco and Electronic Delivery Systems Bill, we compared annual costs of using e-cigarettes versus cigarettes, and estimated revenue from e-cigarette taxation. METHODS We extracted e-cigarette retail prices from 231 South African e-cigarette vendor websites. We compared annual costs associated with daily cigarette smoking (self-reports from daily smokers in the 2018 South African Social Attitudes Survey, SASAS) versus daily e-cigarette use (based on cumulative costs of consumables plus device costs). We estimated revenue from excise tax if e-cigarettes were taxed at 75% (the rate proposed by the government) and 37.5% (half of the government's proposal as a hypothetical scenario) of the cigarette excise rate. We applied the different rates to e-cigarette consumption in 2018 SASAS and projected for 2021. RESULTS Mean annual cost associated with daily use was ZAR 6693 (US$460.32, based on an exchange rate of about 69 US$ to 1000 ZAR) for manufactured cigarettes; for e-cigarettes, this ranged from ZAR 8574.69/year (with price minimizing strategies) to ZAR 19780.83/year (retail products exclusively). Expected revenue from e-cigarette excise tax at 75% of the cigarette tax rate was up to ZAR 2.20 billion (95% CI: 0.96-3.44). If taxed at 37.5% of the cigarette tax rate -- half of the government's proposed rate -- the projected revenue was up to ZAR 1.10 billion (95% CI: 0.48-1.72). Of the projected revenue from e-cigarette excise tax at 75% of the cigarette rate, the portion attributable to hardware (device and batteries) was 61% (ZAR 1.35 billion), while the portion attributable to e-liquid was 39% (ZAR 0.86 billion). CONCLUSIONS Calculated daily costs were higher for e-cigarettes than cigarettes. We recommend an e-cigarette excise tax. The government's proposed tax rate may reduce youth e-cigarette access, while allowing adult smokers wishing to switch exclusively to e-cigarettes to reduce their tobacco-related harm. [ABSTRACT FROM AUTHOR]

Tobacco use is the single largest preventable cause of death globally. For years, the tobacco industry sought to create a tobacco product that is less controversial than conventional cigarettes. Electronic cigarettes were created out of the supposed need to supply consumers of tobacco products with a less harmful tobacco product. The question remains, is it really less harmful for consumers of traditional cigarettes and other tobacco products to switch to electronic cigarettes? This article takes a closer look at the overall harm in relation to benefits of using electronic cigarettes for the individual and public health and the unintended negative consequences the introduction of electronic cigarette has had on overall public health. Given the evidence that the use of electronic cigarettes is a gateway to the use of other tobacco products especially among adolescents, we view electronic cigarettes as having the potential to cause a rebound of the tobacco use glut which the global public health community has been succeeding in reversing. We therefore support the World Health Organization's suggestion that electronic cigarettes should be regulated as other tobacco products since there is, as yet, no harmless tobacco product. In the same vein, we view the new Tobacco Products and Electronic Delivery Systems Bill seeking to regulate electronic cigarettes in South Africa as other tobacco products as a step in the right direction. [ABSTRACT FROM AUTHOR]

INTRODUCTION Shisha which was formally popular mostly in the Eastern Mediterranean region is now gaining popularity globally and has become a trending tobacco product in Nigeria. The increasing popularity of shisha is possibly driven by the attractive flavours and the misperception that it is safer than traditional cigarettes. Since the media plays a significant influence on public awareness, perception and understanding of various issues, this study sought to explore the coverage of shisha use by five national newspapers in Nigeria. METHODS Five newspapers were selected based on their website traffic (online readership). The software NVIVO 12 was used to organise the content of the articles into themes. RESULTS Between 2014 and 2018, we found 30 relevant publications about shisha. Some newspaper articles reported that shisha smoking was gaining popularity among youths, especially in tertiary institutions across the country. Similarly, some misconceptions about the safety of smoking shisha among shisha users was reported. Addiction to shisha was also reported as being so common that many shisha users were no longer satisfied with just visiting nightclubs and shisha cafes but now own the shisha paraphernalia. There were also reports that the tobacco in shisha was in some instances being replaced or mixed with other hard drugs like marijuana. Subtle advertisement of shisha lounges, which is a violation of the Nigeria National Tobacco Control Act, was also observed. CONCLUSIONS There is a need for increased sensitization of the public through the media on the dangers of shisha smoking and other tobacco product use. There is also a need for a national survey to determine the prevalence of shisha use in Nigeria. [ABSTRACT FROM AUTHOR]