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Tuesday, 13 January 2015


"A wise king will prepare for war in the time of peace "~Horace

This truism is fitting for man’s experience with disease on this side of the divide. Right from the time man is born into this battlefield called EARTH; he is constantly in a supremacy battle with disease. The best time to engage in this inevitable war however, is the period of calm when he is at peace with his health. Medically, this period is otherwise called primary level of prevention. There are other times in the disease spectrum when man can equally fight against diseases and this includes:

*  When he is sick with disease but the toll of this can still be reversed. This is called secondary level of prevention
When he is sick with disease but the toll of this cannot be reversed, with palliation offering the best case scenario. This is called tertiary level of prevention.

These two domains belong to clinical medicine and rehabilitative medicine respectively and tend to offer little or no chance at prevention in the strict sense of the word. However, primary prevention which is the domain of public health offers the best result as far as health and disease prevention is concerned. Useful tools to achieve this are health Information, health promotion, health advocacy, health policy, behavior change and lifestyle modification like physical activity, healthy eating, tobacco and alcohol control. 

Smoking is a dysfunctional health behavior that is associated with a lot of health and health-related complications; hence there is need for us to be aware and position ourselves appropriately to win this all-important battle against indiscriminate tobacco use. It should be noted however that it is the behavior of the users that is dysfunctional and not the person, because issues have to be separated from persons. Again, this is not a stigma placing venture but a behavior change adventure! Be that as it may, why do we need to control tobacco use in our community?

Tobacco use is the single greatest preventable cause of death worldwide. It kills about 5.4Millon persons per year from lung cancer, cardio-respiratory diseases and other illnesses like mental disorder. Smokers are 25times more at risk of dying from lung cancer- a disease which is simply preventable but largely untreatable. Interestingly, second hand smokers who by CHOICE (hangs around smokers) or CIRCUMSTANCE (environment where smoking is not regulated e.g. Motor parks, Prisons, Airports) inhale the smoke from tobacco users are equally at risk of lung cancer.

Moreover, tobacco smoke contains carbon dioxide and methane which are potent greenhouse gases (GHG). Also, tobacco farming requires a lot of wood for drying and as such more trees are chopped down causing eco-system imbalance and acting synergistically with the greenhouse gases to cause climate change. This we must note however, regardless of our smoking status we all have to face the consequence of climate change. So a stitch in time saves nine!

Adaptive behavior change like quitting cigarette smoking may be difficult but it is very desirable for everyone and not just the smoker. Different mechanisms have been put forward to checkmate smoking tendencies amongst the populace and this has been conceptualized by WHO as MPOWER:

M- Monitor tobacco use and prevention policies
P- Protect people from tobacco smoke
O- Offer help to quit tobacco use
W- Warn about the dangers of tobacco use
E- Enforce bans on tobacco adverting, promotion and sponsorship
R-Raise taxes on tobacco

The Nigerian tobacco control bill has all these dimensions plus ban on sale of cigarette to minors. The benefits of this BILL is passed into LAW are immense and I think some are worthy of mention.


1.      Reduced risk of dying from lung cancer and cardiovascular diseases.
2.      Acute exacerbation of chronic respiratory diseases like Asthma, Emphysema and Bronchitis will also reduce
3.      The risk of dependence, substance abuse and the attendant mental illnesses become infinitesimal.


1.      No risk of stigmatization
2.      Healthful participation with no discrimination
3.      Some broken homes will be averted
4.      Some orphans and juvenile delinquents will be prevented
5.      Extra cost on tobacco purchase will be saved


1      Additional threat to climate change from GHG resulting from tobacco use will be removed
2      Increased deforestation from tobacco farming will be no more.
Combating tobacco use is a collective effort; we all must stand together as the negative effects leaves no one without a mark. We need to arm ourselves with sufficient health information and must be ready to change our behavior to suit the life style of a warrior. Prevention is KEY, Behavior change is CRITICAL and Tobacco control law is ALL IMPORTANT!

This sums it all:
Smoking might be pleasant; its produce leads straight to death,

However, its victim signs the contract.

They get trapped wanting to stop but the pleasure won’t let go!

When pain comes and anguish multiplies they cry for help,

Thenit will be too late as the lungs cannot be salvaged

Slowly but progressively life eases out of them.

Others watch in panic, desirous of a genuine succor

Indeed, there is no help in any other except a Tobacco Control Law.

This is it! Lets us support the passage of Tobacco Control Bill.

Charles T. Olomofe (M.B.Ch.B)

Health and Behavioral Change Advocate

@Chartol1 on twitter

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