Kampala – To protect the public, especially those most vulnerable, from the harmful effects of tobacco, Uganda has instituted a range of regulatory measures for tobacco control and is taking steps to ensure compliance with existing legal frameworks.
In Uganda, one in ten people use tobacco daily, and exposure to second-hand smoke can cause a range of serious health effects in people who do not smoke. Children and young people are especially vulnerable, having little to no choice in their exposure. Research shows that young people are at risk, with 20% (1.7 million) of people between the ages of 13 and 15 exposed to tobacco smoke at home and 30% (2.7 million) exposed to it in enclosed public places.
The country passed the Tobacco Control Act and Regulations in 2015 and 2019, respectively. These protect the public, including children and youths, from the harmful effects of tobacco. Article 17 bans the sale of tobacco products to and by minors under the age of 21, and Article 14 bans advertising, promotion, and sponsorship by the tobacco industry and makes provision for 100% smoke-free public places.
Between 2022 and 2023, the World Health Organization (WHO) supported the Ministry of Health (MoH) in training 157 law enforcement officers and 15 national trainers from five regions to equip enforcers with skills and knowledge to ensure compliance with the law, including the ban on smoking in public places. In 2023, WHO supported MoH to conduct a compliance assessment for smoke-free environments in public places in five cities.
Many other shops in the same area where Opio’s is situated are selling tobacco products, violating the provisions of Uganda’s Tobacco Control Law that prohibit the sale of tobacco products 50 metres from places providing services to children.
“When I opened my shop in 1981, I used to sell cigarettes,” says Opio. “Though my children and I were not consuming tobacco, we were exposed to its smoke from our customers’ use. This used to affect my family’s health. We used to sneeze and cough more often.”
A decade ago, Opio decided to remove all tobacco products from his business because he wanted to protect his family’s health from second-hand smoke and educate his children on the harmful effects of tobacco consumption.
Dr Mugisha attends to health clients requesting cancer screening services at the institute. He pays particular attention to tobacco consumers as they are likely to develop cancers due to the harmful chemicals found in the tobacco products they use. For a consumer of tobacco, he will conduct mouth, throat, and lung screening, although other cancers are also a risk.
“Around 45% of all cancers of the bladder are among tobacco users,” he says. “Tobacco also increases the risk of developing cancers of the oesophagus, cervix, lungs and many more.”
Besides the risk of cancer, tobacco use and exposure to second-hand smoke can cause heart disease, stroke, reproductive health problems, sudden infant death syndrome, and asthma.
“Although cancers in children are not necessarily linked to tobacco, continuous exposure to second-hand smoke is one of the reasons why children start using tobacco,” says Paul Ebusu, Tobacco Control Officer at WHO Uganda.
In December 2023, MoH, in collaboration with district health officials, police, and the media and with financial support from WHO, conducted a five-day enforcement activity in 86 public places within five targeted cities in Uganda.
The assessment results revealed that the targeted districts registered a 53% reduction in designated smoking areas in the assessed public places visited, from 64% to 30%; a more than 30% increase in the number of places without smoking ashtrays; and a 16% increase in the number of places with no smoking signs.
“These milestones are encouraging, however, to achieve 100% compliance to a smoke-free environment, we still have more to do,” says Ebusu. “There is a need to integrate tobacco control in districts planning and programmes to improve compliance and promote sustainability.”
“Although I have never been a smoker, I was in constant contact with tobacco smokers. Often, I was exposed to cigarette and shisha smoke on official trips with colleagues or when going out to restaurants or nightclubs,” he says.
His doctor recommended that Komaketch completely avoid tobacco smoke. The ban on smoking in public places has made it easier, as well as support from people around him. "My friends and colleagues have stopped smoking in front of me. I feel safer now,” he says.
*Name changed to protect identity
Communications Officer
WHO Uganda
Email: tcheutchouae [at] who.int (tcheutchouae[at]who[dot]int)