Christian Abayisenga started hanging out in 2015, while at high school, with friends whom he later found out were smokers — something they would do after school. It wasn’t long before he got on the bandwagon too.
“Smoking started as a way of bonding with friends, also, it made me feel cool,” he says.
The now 28-year-old says he’s “hooked” to cigarettes, a habit that he regrets because it has affected his family too.
Abayisenga is just one of many young people who started smoking because of peer pressure, and now find it difficult to quit.
Every year on 31 May ‘World No Tobacco Day’ is observed around the world, with a focus on youth as they are the biggest burden. This annual event informs the public about the dangers of tobacco use, the tobacco companies ‘ business practices, what the World Health Organization (WHO) is doing to combat the use of tobacco, and what people around the world can do to claim their right to health and healthy living and to protect future generations.
The day was celebrated around the topic ‘Protecting youth from industry manipulation and preventing them from tobacco and nicotine use’.
The day in Rwanda was marked by a growing awareness using various media platforms.
Tobacco is used today by around 1.3 billion of the world’s population. Over 80 per cent of these live in low- and middle-income countries.
According to the World Health Organization, there is an estimated $1.4 trillion of the global economic burden lost each year in health-care costs, lost productivity, fire damage, and environmental damage from cigarette litter and destructive farming practices.
Dr. Christophe W Ngendahayo, a global NCD and expert on climate change, says his commemoration keeps us awake and reflects on our responsibility to address this threat.
Tobacco is so deadly that it kills more than 8 million people each year, worldwide, of which more than 7 million are the result of direct use of tobacco while around 1.2 million are the result of exposure to second-hand smoke by non-smokers.
A 2016 study found that sub-Saharan Africa has a lower tobacco-related death burden which was possibly reflected in its traditionally lower prevalence of smoking.
Nevertheless, Ngendahayo says with an increase in the affordability of tobacco products and the aggressive marketing of the tobacco industry in Africa, smoking prevalence has already begun to increase, or is likely to increase substantially in the future.
Meanwhile, locally, the Ministry of Youth and University of Rwanda’s 2015 research found that 4.7 of young people aged 14 to 15 are dependent on nicotine.
In the world’s smoking rates, Rwanda was ranked 173 with an estimated death of 2,100 people in 2016.
Evariste Ntaganda, the Rwanda Biomedical Center (RBC) cardiovascular disease officer, says the more they are exposed to smoking at an early age, the more complex they are likely to encounter health effects.
He says exposure to tobacco affects humanity regardless of age.
“Children and youth who are exposed to second hand tobacco smoke breathe the same dangerous chemicals that smokers inhale, they’re at higher risk of getting respiratory diseases and other conditions,” he says.
Overall, around half of children regularly breathe air polluted by tobacco smoke in public places, mostly in their homes, and 65,000 die each year from diseases caused by second-hand smoke.
Ntaganda goes on to add that second hand smoke in infants and children causes numerous health problems.
These, he says, include more frequent and severe asthma attacks, respiratory infections such as pneumonia or bronchiolitis, ear infections and, among others, sudden infant death syndrome.
Smoking causes more than 1,000 infant deaths annually during pregnancy, he says.
Ngendahayo says teens and young people use tobacco because of several factors, including peer influence, as it gives them a sense of belonging, or a way to cope with stress.
“The consequences in youth are the same as in adults, with special addiction and destroyed futures due to poor education in schools,” he says.
“Because of nicotine in cigarettes, it’s addictive and harmful for youth brain development,” Ngendahayo adds.
Tobacco is a very potent risk factor for cardiovascular diseases , cancer, lung diseases and diabetes, says Ngendahayo.
Smoke brings more than 7,000 chemical substances, including tar and carbon monoxide, into contact with the tissues of the body with each inhalation, he explains.
Hundreds of the thousands, he states, are poisonous, and 70 cause cancers.
Smoke also affects the nerve endings in the nose over time, he says, causing loss of smell.
“Inside the airways and lungs, smoke increases the likelihood of infections, as well as chronic diseases like bronchitis and emphysema,” he adds.
Many of the chemicals inside cigarettes can cause dangerous mutations in the body ‘s DNA that make cancers develop, according to Ntaganda.
Smoking can also cause cancer in multiple tissues and organs, as well as damaged eyesight and weakened bones, he says.
For women, says the medic, it makes it harder for them to get pregnant and it can cause erectile dysfunction in men.
Nevertheless, Dr Dynamo Ndacyayisenga, RBC ‘s administrator of alcohol and substance use disorders, says there is a big positive upside of near-immediate and long-lasting physical benefits for those who stop smoking.
He says heart disease risks plummeting to half by the one-year anniversary of quitting, as the function of the blood vessels improves.
However, he notes that quitting smoking is not easy because some of the side effects may include anxiety and depression as a result of withdrawal from nicotine.
Luckily these effects are usually temporary.
Meanwhile, says Ndacyayisenga, replacement therapy with nicotine by gum, skin patches, lozenges, and sprays can help wean smokers off cigarettes.
“They work by stimulating nicotine receptors in the brain, thus preventing withdrawal symptoms without the addiction of other harmful chemicals,” he says.
Ndacyayisenga says group counseling and support, cognitive behavioral therapy, and exercise with moderate intensity also help smokers stay cigarette-free.
Tobacco use has increased for some young people during this Covid-19 period, according to experts.
Ngendahayo explains that if smoking is common within a household, social isolation will likely actively and passively increase the usage.
“Some see the use of tobacco as a coping mechanism for the anxiety currently being experienced,” he notes.
Dr. Edison Rwagasore, RBC’s coordinator of the Field Epidemiology and Laboratory Program, says that while raising awareness, the Ministry of Health does not separate tobacco from other drugs, instead, tobacco is seen as an illicit drug and is always classified among other harmful drugs.
Most of the interventions in place, he states, are based on prevention of early use of tobacco, to let people know about the harmful effects that smoking has.
This, he says, is done through the creation of an awareness campaign through various channels, where information is provided on how to avoid smoking.
The ministry is also collaborating with the Private Sector Federation (PSF) not to promote cigarettes, but rather to demonstrate the harmful effects on any cigarette packet.
Rwagasore says that respiratory infectious diseases are always linked to tobacco use, that’s why there is what’s called ‘community education;’ which is an outreach program that targets population groups to avoid tobacco use.
He explains that the ministry also focuses on the consumers of second hand (passive smokers) here.
Ndacyayisenga, says people are being treated who are exposed to harmful use of tobacco in health centres.
He says this is achieved by treating diseases related to tobacco, primarily tobacco addiction and other areas affected by respiratory infections.
At the tobacco addiction level, he says patients are given various techniques and medications to help with the problem.
He adds they provide a patch of nicotine and chewing gum to help fight the symptoms of withdrawal.
However, these are followed by social encouragement to focus on behavioral transformation in general, says Ndacyayisenga.
