A new chapter in the country's approach to anti-tobacco legislation may be in the offing with the recent pronouncement by the recently appointed Minister of Health and Wellness Dr. Lemogang Kwape that the draft law would be headed for consideration by Parliament after completion of ongoing consultations with stakeholders.
This pronouncement, which was made by the Minister during an introductory visit by a team led by Professor Bontle Mbongwe from Botswana’s Anti Tobacco Network (ATN), has provoked optimism that Government would at long last break from what has always appeared to be the unholy influence of the notorious tobacco industry.
With preventable non-communicable chronic cardiovascular and respiratory diseases as well as mental disorders continuing to ravage the country, inflicting a heavy toll on people of all ages, causing untold misery by inflicting death, poor health, disability and poverty, the ATN welcomes the new determination of the Ministry of Health and Wellness. This would ensure that the new legislation was more aligned with domestic needs and reflecting global trends in viewing smoking as one of the greatest threats to improved livelihoods and wellbeing of all time.
The ATN’s optimism comes in the wake of a series of disappointments when different past Ministers of Health had promised but never delivered on facilitating the passing of the reviewed anti-tobacco legislation prompting suspicion that Government was siding with the tobacco industry against the country’s public health interests. Now there is renewed optimism that Government was taking the side of the people to reverse the tide that has been sweeping the country unabated for so long.
During the introductory call, Health and Wellness Minister Dr Kwape had lifted the spirits of the ATN team when he stated that his Ministry was working around the clock to take the long-awaited tobacco control Bill to parliament as soon as possible following consultation with key stakeholders. The Minister also applauded ATN as a key partner in tobacco control highlighting that his Ministry recognizes the important work that ATN does.
In the interaction with Minister Dr. Kwape, ATN’s Executive Director Professor Mbongwe called on the Ministry of Health and Wellness to adopt evidence-based smoking cessation interventions including in-patient smoking cessation programs due to their long-term and economic benefits at the individual and societal levels. She said evidence exists that hospital-based interventions are highly effective at helping patients quit, particularly when pharmacotherapy is provided along with counselling and post- discharge support.
Professor Mbongwe highlighted that more often, tobacco users in Botswana, have expressed their wish to quit, lamenting that there are currently no facilities to assist them to quit. She added that hospitalization presents smokers with an opportunity to initiate smoking cessation mainly because hospital buildings and premises are expected to be smoke-free areas and therefore can support smoking cessation.
Professor Mbongwe said research carried elsewhere has proven that the motivation for in-patient smokers to cease smoking is stronger than for the general population partly because they would be encouraged and counselled to stop smoking by clinical and non-clinical health care workers. She noted that a diagnosis with a smoking-related disease was in itself a powerful influence on the patient to quit smoking.
The ATN Executive Director used the introductory visit to Minister Dr. Kwape to solicit for financial support to train health care workers on smoking cessation and treatment
Professor Mbongwe shared some of the findings from the 2017 Global Adult Survey which showed that 18% of persons aged 15 years and older in Botswana are current smokers. “The good news from the survey was 83.9% of current tobacco smokers planned to or were thinking about quitting. The time is therefore ripe for Botswana to focus attention on assisting those who are addicted and ATN is willing to lead this initiative with the help of other partners through its Mopati program”, said Professor Mbongwe.
Professor Mbongwe said the greatest threat to tobacco control in Botswana is the tobacco industry which continues to employ a multitude of tactics to shape and influence tobacco control policy. She said the tobacco industry continues to use its economic power, lobbying and marketing machinery, to influence the government and the general public in order to propagate the sale, distribution of its deadly products, attract new users, and retain existing customers. She observed that product design, packaging, pricing, distribution, product placement, advertising, and a variety of promotional activities were deployed by the Industry to deceive target consumers especially the youth.
The tobacco industry, according to Professor Mbongwe invests huge portions of its marketing budget at the point of sale. This includes attractive display cabinets in supermarkets and convenience stores in filling stations. It is evident that as other forms of tobacco marketing are limited by public health policy successes, the industry turned to the retail environment as the primary channel to attract new smokers, keep current smokers hooked and make it harder to quit.
The ATN leader called action by Government and for Minister Dr. Kwape to expedite adoption of the long pending comprehensive tobacco control law that is fully compliant to the provisions of the Framework Convention on Tobacco Control (FCTC) which Botswana is a Party to. The law should among others prohibit all forms of tobacco advertising, promotion and sponsorship, totally ban of smoking in all enclosed public places with no exceptions to the rule in order to respect the rights of workers who work in smoking areas and to protect vulnerable groups such as pregnant women and children and to restrict the sale of tobacco products in places where children school and play through licensing. Professor Mbongwe impressed upon the Minister that just like alcohol, tobacco must be licensed.
The purpose of the introductory call was to introduce ATN as a partner in ensuring the success of the government of Botswana in tobacco control and protection of public health; to share the status of Tobacco Control in Botswana and the tobacco industry’s tricks to interfere with government efforts; to engage the Ministry on the long pending tobacco control legislation and; to discuss how the Ministry can influence civil society funding through the tobacco levy.