Every May 31, the World Health Organization (WHO) and partners mark World No Tobacco Day, highlighting the risks associated with tobacco use and advocating for effective policies to reduce tobacco consumption.

The Ministry of Health through Rwanda Biomedical Centre (RBC) organized this year’s celebration under the theme, ‘Tobacco, a Threat to Health, Environment and Development’ during the Non Communicable Diseases week organized in Kigali City from 29th May to 04th June 2017. Different awareness activities were organized countrywide such as radio programs with active participation of Ministry of Health staff and civil society organizations representatives, with a wide involvement of local public and private Radios, TV, print and online medias. The last day of the NCDs campaign coincided with the monthly sports for all day, called “car free day” in Kigali City. At that occasion, messages on NCDs risk factors, namely tobacco, alcohol, unhealthy diet and physical inactivity are spread out and mass screening of blood pressure, glycaemia, BMI, eye was organized during the week campaign at a voluntary basis.

According to WHO, about 6 million people die from tobacco use every year; a figure that is predicted to grow to more than 8 million a year by 2030 without intensified actions. WHO also states that tobacco use is a threat to any person, regardless of gender, age, and culture or education background.

In Rwanda, the survey carried out on NCD Risk Factors (2012-2013) showed that adult smoking prevalence was 12.8 per cent, while on the other hand, Rwanda Demographic Survey (RDHS) conducted 2014/15 shows that prevalence of tobacco use in Rwandan population is 10% in men and 2% in women.

The Global Youth Tobacco Survey(GYTS) 2008 findings shows that tobacco use prevalence in youth is 11.5%--13.3% for boys and 9.5% for girls; cigarette smoking prevalence is 1.8%- 3% for boys and 0.9% for girls.

According to Francois Habiyaremye, the cardiovascular diseases officer at Rwanda Biomedical Centre, this calls for government to take strong actions such as strengthening the legislation in promoting smoke free environments, health warnings on cigarette packages and increasing taxes on tobacco products.

“This month, a lot of efforts will be directed to the very high burden of tobacco smoking in young people. When preventing the use of tobacco in such category, it means that we are putting more efforts in controlling its use in future generations, which is our target,” he said.

There is a need to raise more awareness about the dangers of tobacco use in general population, especially in youth, and remind everyone that it is prohibited to smoke tobacco and tobacco products (cigarettes, pipes, shisha, etc…) in public places such as workplaces, schools, hotels, bars and restaurants…  according to the Rwandan tobacco control law, said Habiyaremye. He explained that the young generation should have in mind that when processing tobacco products, tobacco companies add four thousand more chemicals which are carcinogenic.

“It’s because of these chemicals that people get addicted in a short period when they start smoking. Unfortunately, these products don’t allow one to easily quit the vice,” he said.

Habiyaremye further pointed out that the aim of the celebration was to raise awareness, especially among the youth, about the dangers of peer pressure, as well as the consequences of tobacco use.

Dr Marie Aimee Muhimpundu, the head of non-communicable diseases division at the Rwanda Biomedical Centre, stated that they are trying to control second-hand smoking, a move already supported by the law which prohibits public smoking. “Increasing taxes on tobacco products will also make it expensive for smokers and discourage those intending to indulge in the vice,” she said.

Muhimpundu said that there are health facilities already in place such as Ndera Hospital where they offer support to the addicted persons to help them quit the vice.
Another strategy, she said, is also to target young people in different fora such as schools, youth organizations and media, as well as open discussions, in order to present all this information and at the same time answer participants’ concerns.

Muhimpundu added that to reduce tobacco use by youth, the Ministry of Health should work closely with the Ministry of Education to set some rules that will ensure control of tobacco use in education facilities. “For instance, in schools, there should be a good distance between the school and shops or canteens that sell tobacco products. Also, shops that sell snacks at school should not be allowed to sell cigarettes,” she added.

Meanwhile, Habiyaremye said that tobacco use is among modifiable risk factors and tobacco related morbidity and mortality are preventable. “For most young people smoking habits might be determined early in life. Therefore, there is need of developing and implementing specific strategies targeting age group between 25 and 34 years as they are the most leading users of tobacco products,” he explained.

What the national law says

The Rwanda tobacco control law published in the Official Gazette n°14bis of 08/04/2013, under different articles has rules and regulations that are meant to guide, prevent as well as control the use of tobacco. It establishes modalities for controlling tobacco consumption and tobacco products that are manufactured in Rwanda as well as those imported so as to protect the Rwandan population. In particular, its purpose is: such regulations include preventing persons under 18 from any contact with tobacco and tobacco products, as well as to inform, educate and communicate to the public on the health, environmental, economic and social consequences.

For instance, in article 9, there are prohibited premises for selling tobacco and tobacco products. Examples of such places include all health facilities, all drugs production companies and pharmacies, children’s gardens and any other public places meant for children, schools, as well as higher institutions of learning, among others.

Furthermore, in article 11, in relation to total ban of smoking in public places, no person shall smoke in public places, workplaces, public transport, hospitals, schools, airports, recreational places, stadiums, all indoor areas including homes… The Rwandan law on tobacco control refers to   Chapter V of the penal code, article 428 about fines for persons who violate the above article and who smoke in public places. The person who smokes in a public place shall be liable to a fine of ten thousand to fifty thousand Rwandan francs.

All these and many other rules and regulations, Habiyaremye said, are there to ensure that there is prevention and control of tobacco use in the entire population.
He added that this article aims at protection of non-smokers to secondhand smoke because second-hand smoke exposure kills. Second-hand smoke harms children and adults, and the only way to fully protect nonsmokers is to eliminate smoking in all homes, worksites, and public places.

‘Tobacco is a Threat to Health, Environment and Development’. Let us all join our efforts for a world free of tobacco consumption.

For more information, please contact:

-    Mr Francois HABIYYAREMYE, Tob focal point/Ministry of Health  e-mail: hbfra2040 [at] gmail.com
-    Mr. Jean Bosco GASHEREBUKA, HPR, e-mail: gasherebukab [at] who.int