Health officials say they have a "golden opportunity" to head off an epidemic in tobacco use in Africa and prevent many cancer cases.
While rich nations have taken action to reduce smoking, the World Health Organization says tobacco consumption in Africa is expected to grow by than four percent a year. That's why cancer experts are holding a major conference this week in Tanzania (Nov 11– 14).
Among those attending is Dr. Thomas Glynn, Director of International Cancer Control for the American Cancer Society and acting head of the Global Smokefree Partnership.
"This is really the first time in the history of public health that we have the opportunity to prevent an epidemic…. There's no doubt tobacco is on the rise here, but it's the one continent where we are ahead of the ball at this point," he says.
Glynn says there's a "predictable pattern' unfolding in Africa showing the rise in tobacco use.
"It begins fairly mildly, particularly among the more well-to-do. Then, as time goes on and the tobacco industry begins to move in more strongly, we begin to see less well-to-do people using," he says.
He says tobacco industry advertising and industry documents indicate strong interest in the continent.
Many potential customers<!-- IMAGE -->
"There are nearly a billion people in Africa, but only about four percent of the continent is smoking right now," he says.
Cigarettes make up the vast majority of tobacco use in Africa, compared to cigars or chewing or smokeless tobacco. In south Asia, for example, smokeless tobacco is widely used.
In the United States, there are strong health warnings on cigarette packs, warning of tobacco's link to cancer or problems in pregnancy. Glynn says there are some warnings in Africa.
"It's one of the things there's a lot of attention being paid to because people are very often unaware of the dangers of tobacco use," he says.
Currently, he says, warnings on cigarette billboard advertising are written in very small letters.
While cigarettes are growing more expensive in rich nations, in part to drive down tobacco use, they're relatively cheap in Africa.
"That's one of the major issues that needs to be dealt with. We have very good economic data showing that if you do raise the price of cigarettes through taxes people will smoke less and people will be exposed to second hand smoke a good deal less, including children," he says.
Most Africans, he says, are exposed to second hand smoke on a daily basis.
"If you price low at the beginning, knowing that it's a dependence producing behavior, you're going to have people then who need to pay more as time goes on. And that's exactly the pattern we've seen," he says.
Cancer stats not easy to come by<!-- IMAGE -->
"One of the difficulties of working in Africa at the moment is in getting reliable data. There are very few cancer registries, which will be able to give us the kind of information we need about exactly what the cancer profile is in Africa,' he says.
The American Cancer Society doctor says along with increased tobacco use, cancer risks are expected to rise as Africans adopt more of a Western lifestyle. This includes being more sedentary and a change in diet.
He expects this week's meeting in Dar es Salaam to conclude that a lot more needs to be done to educate the African public and healthcare professionals about the risks of smoking.
The know-how to stop smoking
"We have just a golden opportunity here for prevention," he says.
One of the tools being used is the World Health Organization's Framework Convention on Tobacco Control. The treaty was adopted in 2003 and took effect in 2005 with 167 countries agreeing to its provisions. Glynn calls it the world's first public health treaty.
"Most countries in Africa have now ratified that treaty…. They've agreed to do certain things, which can help prevent the tobacco epidemic," he says.
These include raising taxes on tobacco, creating smoke-free environments, reducing tobacco advertising and promotion, increasing health warnings about tobacco use and making smoking cessation treatment available.<!-- IMAGE -->