Health advocacy and communication can be powerful tools to reduce tobacco use in Africa

African countries are facing a rise in tobacco use. Sub-Saharan Africa has seen the largest relative increase in the number of smokers compared to other regions and is expected to become the epicentre of the tobacco epidemic. Advocacy and communication on the health and economic impacts of tobacco are essential to mobilise and empower the public, particularly young people, and to inform and educate policy makers and other stakeholders on solutions to the global tobacco epidemic.[1].

Many African countries struggle to implement effective tobacco control policies. Health warnings on cigarette packages, smoking bans in public places, and bans on tobacco advertising in points of sale have been adopted by only about a third of sub-Saharan African countries. This situation is often exacerbated by poor enforcement and lack of controls, and heavy interference from the tobacco industry.[2].

The health and economic burden of smoking in Africa

It is projected that by 2025, there will be an estimated 84 million smokers in Africa, representing a 61.5% increase in the number of smokers since 2000. Furthermore, the youth population in the African region is expected to double by 2050, making Africa an attractive destination for the tobacco industry. However, on a continent with limited healthcare resources and limited health infrastructure, the rapid increase in tobacco consumption in the region is likely to have devastating consequences for the health system and the health of populations.

Tobacco use also represents a growing economic burden for African countries. Notwithstanding all the negative externalities of tobacco, this burden includes the cost of treating tobacco-related diseases as well as productivity losses due to illness and premature death. A recent WHO report showed that the increasing incidence of non-communicable diseases threatens the health gains made in Africa in recent years. Increasing tobacco use, alcohol consumption and consumption of processed foods are particularly responsible for the rise in non-communicable diseases.[3].

Communication and awareness raising: a component of tobacco reduction

The World Health Organization (WHO) recognizes the importance of awareness-raising and communication as strategies to promote tobacco control. Information campaigns can motivate individuals to change their behavior and communities to adopt policies to reduce tobacco use, prevent initiation of tobacco use, and limit exposure to second-hand smoke. WHO Framework Convention on Tobacco Control (FCTC) thus cites public awareness campaigns as an essential dimension of public policies to combat tobacco. Article 12 of the FCTC states that "Each Party shall endeavour to promote and enhance public awareness of tobacco control issues, using, as appropriate, all available communication tools ". In July 2022, Santé Publique France and the FCTC secretariat signed a memorandum of understanding for the creation of a knowledge hub on tobacco. This platform, bilingual in English and French, will aim to promote the transfer of knowledge between the Parties to the treaty, in particular French-speaking countries in Africa, and to the stakeholders concerned in order to strengthen the implementation of effective actions to combat tobacco in these countries, in accordance with Article 12.[4].

Prevention campaigns both build public support for strong tobacco control policies and programs. They inform the public and policy makers about the challenges of reducing tobacco-related illness and death. They also help reduce tobacco-related health disparities because they can reach different target audiences.

Health communications, particularly those on the many risks of tobacco consumption, counter the tobacco industry's promotional actions in favor of tobacco, particularly in African countries. They also attempt to address disinformation initiatives on the subject. The culture of doubt and fake news maintained by the tobacco industry remain a major obstacle to the implementation of effective anti-smoking measures in many countries.

Health communications are also relatively easy to set up; they quickly reach a large part of the population and can be disseminated via different channels, particularly in traditional media (television, radio, on billboards, in public transport, on online platforms or in the written press) or on digital channels such as social networks which are very popular with the younger generations.

Various communication campaigns have been evaluated and shown to be effective in both saving lives and saving billions of dollars in healthcare costs. In 2012, the national tobacco education campaign USA Tips From Former Smokers® cost $48 million and encouraged 100,000 smokers to quit smoking for good. This is believed to have prevented more than 17,000 premature deaths. In France, a study that evaluated the effectiveness of the “No Tobacco Month” campaign indicates that the device helped trigger 1.8 million quit attempts between 2016 and 2019.[5].

Keywords: Africa, tobacco control, prevention, awareness raising, media campaigns, Article 12, FCTC, smoking cessation

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[1] Chimezie Anyakora, Ofure Odibeli, Advocacy and health communication: A key strategy for tobacco control in Africa, Business Day, published August 15, 2023, accessed August 17, 2023

[2] Generation without tobacco, Africa: Tobacco industry interference makes it difficult to implement anti-smoking measures, published on August 5, 2023, accessed on August 17, 2023

[3] Generation without tobacco, Non-communicable diseases threaten health gains made in Africa in recent years, published on March 23, 2023, consulted on August 17, 2023

[4] Generation without tobacco, Signing of an agreement between Santé Publique France and the secretariat of the WHO Framework Convention, published July 7, 2022, accessed August 17, 2023

[5] Generation without tobacco, Tobacco-free month: use of social marketing in the fight against tobacco, published on December 23, 2021, consulted on August 17, 2023