Transcript Emerging Tobacco Problem in Africa • Disease and death caused by

Tobacco in Kenya
in the African context
Data for the WHO Tobacco Control
Meeting of Sub-Saharan Countries
Nairobi, October 2000
Emerging Tobacco Problem in
Africa
Disease and death caused by tobacco is
an emerging problem in Africa.
•
• The age for smoking initiation is getting
younger and younger
• In 1999, Africa smoked 4% of World
cigarette consumption.
Adolescent Smoking in Africa
Males
Females
Senegal (Dakar) (10-20 year old) 1989
70%
52%
Niger
1991
41%
11%
Ethiopia (18-20 years old)
1980
38%
3.4%
Benin (400 students)
1986
12%
2%
Ghana (secondary school)
1994
6%
1%
(15-35 years old)
Cigarette Consumption
Increasing in Kenya
Million sticks of cigarettes
Total Cigarette Sales in Kenya
1970-1999
8000
7000
6000
5000
4000
3000
2000
1000
0
1970
1980
1990
1999
Cigarette Consumption Per Capita of 15+ age group in
Selected African Countries
1999
(pieces of cigarettes)
1734
Zimbabwe
Zambia
Sierra
Leone
Kenya
Mauritius
Nigeria
Senegal
382
Cameroon
331
580
Cote
d''Ivoire
305
408
282
295
Madagascar
Malawi
205
Tanzania
111
196
Ghana
80
Mozambique
Guinea
20
161
Ethiopia
744
616
Smoking Prevalence by Gender for Selected Africa
Countries
Men
65%
60%
44%
35%
10%
Guinea (98)
Seychelles (89)
4%
Mauritius (92)
Cote d''Ivoire (77)
Zaire (92)
Zambia
Lesotho (92)
Zimbabwe (90s)
Swaziland
50%
42%
40%
39%
39%
36%
33%
40%
25%
30% 24%
15%
20%
8%
7%
7%
10%
2%
1%
0%
51%
47%
Namibia (94)
80%
70%
60%
Nigeria (90)
Prevalence rate
Women
Evidence of the Adverse Health Impact of
Tobacco Use for Selected African Countries
• Botswana
Lung cancer accounted for 14%
male cancer deaths, 7% for females during 1985-89.
• Mali
82% of ischaemic heart disease patients,
89% of emphysema patients and 66% of lung cancer
patients are smokers.
• Seychelles
Tobacco related causes one-third of
all deaths in men and women
• South Africa
25,450 smoking related deaths
were reported in 1988
• Zimbabwe
Lung cancer cases increased in
men from 64 in 1986 to 112 in 1992.
Changing burden of disease pattern in
developing countries, 1990 and 2020
Changing burden of disease pattern in 1990
Injuries
15%
Noncommunicable
diseases
Communicable
38%
diseases
47%
Changing burden of disease pattern in 2020
Communicable
diseases
Injuries
21%
21%
Noncommunicable
diseases
58%
Smokers spend significant
amounts on tobacco products
• In 1996, a smoker in Kenya who
works:
– in public sector spent 3.1% of annual
income on cigarettes
– in private sector spent 2.8% of annual
income on cigarettes
Average Tobacco Expenditure as % of GDP
Selected African Countries in 1999
3.8%
3.2%
1.7% 1.8%
1.0%
1.8% 1.9%
2.2% 2.3% 2.3%
1.3% 1.3%
Angola
Cameroon
Kenya
Nigeria
Mauritius
Tanzania
Zambia
Cote
d'Ivoire
Sierra
Leone
Senegal
Malawi
Ghana
Zimbabwe
Gabon (98)
0.6% 0.6%
Tobacco Control Policies tend to be weak in
Countries in Africa
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ADVERTISING
BAN ON SALES
BAN
TO MINORS
Benin
N/A
No
Botswana
All media
age < 16
Burkina Faso Regulated
No
Cote d'Ivoire Yes but, not on TV No
Ghana
No
Yes
Kenya
No
No
Mauritius
Yes
18 years
Namibia
No
No
Niger
Banned
No
Nigeria
Banned
No
South Africa Regulated
Banned
Togo
Radio
No
Uganda
No
No
Zaire
No
No
Zambia
Media
No
HEALTH
WARNING
Yes
yes
Yes
No
No
No
No
Yes
No
Yes
Yes
No
No
No
Yes
BAN ON
PUBLIC PLACES
Some
Some
Some
No
Some
Yes
Some
Yes
Some
Some
No
Some
Some
Some
% Share of tobacco tax
revenue
Tobacco Tax Revenues
(Excise+VAT) as % of Total Tax and
GDP in Kenya in 1998
0.6
0.5
43%
0.4
0.3
0.2
7%
0.1
2%
0
% of excise
% of total tax
% of GDP
Mauritius
Ghana
Kenya
Zambia
Guinea
75%
Zimbabwe
70%
Ethiopia
65%
Congo
58% 60%
Mozambique
Madagascar
South Africa
Mali
32%
Nigeria
30%
Senegal
Tanzania
21% 25%
Sierra Leone
Cote d''Ivoire
Niger
Namibia
20%
Cameroon
CAR
13% 15%
Chad
Malawi
10%
Burkina Faso
Togo
% of ex-manufacturing or retail price
Cigarette Excise Tax Rate in Selected
African Countries in 1999
180%
171%
135%
125%
80%
90%
40%
Choosing the Right Types of
Excises
Better
Quality and
More
Variety
Under high
inflation regime,
generating high
revenues
Protection to
domestic brands
against
international
brands
Need to set
minimum prices
for securing
revenue
Administration
Specific
Yes
(upgrading
effect)
No
(should be
adjusted by CPI)
No
No
Easy
AdValorem
No
Yes
Yes
(multiplier effect,
higher the price,
higher the taxes)
Yes
(due to different
definition set for advalorem by
countries)
Not easy
(not easy to define
base for ad
valorem)
Types of
taxes
Mauritius Tobacco Excise Tax Revenue
1993/94 and 1997/98
CPI, 1990=100
600
800
Nominal Tob. Excise Revenue
500
700
600
400
Real Tob. Excise Revenue
500
300
400
300
200
200
100
100
0
0
1994
1995
1996
1997
1998
Real tax revenue (million
rupees)
Nominal revenue (million
rupees)
900
Trends in Tobacco Leaves Production and
its % Change from the Previous Year in
Kenya,
1980-1997
20.000
74% 14% -10% 11%
10.000
85%
42% 0%
0%
-30%
5.000
1997
1996
1995
1994
1993
1992
1991
1990
1985
0.000
1980
MT
15.000
Tobacco Trade and Net Earnings (ExportImport) in Kenya 1980-1995
25000
(1000 US$)
20000
7032
7015
9087 12122
15000
10000
5000
1646
3114
-1694
0
-5000
1980
1985
Import
1991
1992
Export
1993
1994
Balance
1995
WHY DEAL WITH TOBACCO
CONTROL WHILE AFRICA FACES
OTHER IMMEDIATE CHALLENGES
• TOBACCO IS AN EMERGING PROBLEM
• HEALTH CARE EXPENDITURE IS LOW IN MOST
AFRICAN COUNTRIES, TOBACCO CONTROL CAN
PREVENT DISEASE
• INCREASING TOBACCO TAX RATES COULD HELP
TO BALANCE THE BUDGET
• AFRICA STILL HAS A CHANCE TO BE TOBACCOFREE CONTINENT IN THE 21 ST. CENTURY