Tobacco industry supporters have cited potential hits to businesses and the economy that public smoking limits could spark. The ACS report, however, points to data showing that in fact the hospitality industry—including bars and restaurants—have not suffered under smoking bans. And, notes Gary King, a professor of behavioral health and sociology at The Pennsylvania State University in University Park, many tourists from Europe and the U.S. have come to expect smoke-free environments at their destinations.
"There are some costs associated with declines in consumption," including loss of livelihood for tobacco farmers and increased smuggling, notes Evan Blecher, a tobacco control economist with the ACS in South Africa, "although these costs are outweighed by the benefits."
Direct spending on nicotine consumption racks up some $590 million each year in Nigeria, and indirect costs such as the loss of productivity have been tallied in Kenya at about $1.2 billion.
Limiting places people can smoke is not the only way to get people to kick the habit. Blecher says that raising cigarette taxes—which boosts government income—is probably the best way to curb use.
The Framework Convention on Tobacco Control (FCTC), as part of a larger WHO treaty, went into effect in February 2005 and requires that signatory nations commit to protecting citizens from public secondhand smoke by 2012. In the 168 countries that have ratified the treaty, "it's being implemented in a checkerboard fashion," Glynn says. (Unlike many African nations, the U.S., which has passed smoke-free laws on the state and local level, has not signed the agreement.)
Even as other countries have had success instituting smoke-free laws, no one process will prove to be perfect worldwide. Passing—and enforcing—laws that curtail public tobacco use depend on each nation's specific history, legal system and popular attitudes, Glynn notes. Legal gray areas have kept lawyers and policy experts debating the finer points of many proposals, he adds.
When it comes to tobacco consumption, Africa's varied regions have disparate histories, cultures and attitudes. Although the Global Smokefree Partnership's report focuses on sub-Saharan Africa, "the problem is just as severe—if not more so—in north Africa, where tobacco use and consumption has a longer history and more established independent culture," King says. In some parts of the continent, such as the west where tobacco products have been around since the slave trade era, nicotine is often delivered via harder to measure mediums such as pipes and chewing tobacco.
Trimming tobacco use may also prove to be a paradoxical culture clash. "Smoking represents a cultural connection to the West," King says. And as more people in Africa obtain disposable incomes, more will add luxury products—such as cigarettes—to their lifestyles, he notes. Meanwhile, onlookers in the West push for rapid reversal of these potentially harmful trends, King explains, noting that many advocacy groups are pushing for changes at "ludicrous" rates. In the U.S., for example, even the existing patchwork of smoke-free laws has taken decades to enact—"nothing happened overnight," he says.
Why has Africa become the new international target for stemming the tobacco tide? "You have to look at it from the perspective of the tobacco industry," Glynn says.
Africa is home to about 12 percent of the world's population but only 4 percent of the world's tobacco users. "That makes it a battleground, but that also makes it a golden opportunity for prevention," he says.
"No one has ever accused the tobacco industry of being stupid," Glynn says, noting that they have an obligation to look out for their shareholders just like any enterprise. But, he notes, their tactics can be strident. Aside from lobbying politicians to weaken smoke-free legislation, such as by keeping some smoking areas in public places or mandating ventilation rather than complete bans, the companies have targeted their advertising to women and even children. "I have seen children wearing child-sized Marlboro T-shirts," Glynn says.
Smoking is not as prevalent among women in Africa, which is not uncommon in developing regions, says Fred Pampel, associate vice chancellor for research at the University of Colorado at Boulder, who has studied the demographics of tobacco use in Africa. But that is not necessarily for the better. "Often adoption of smoking by females lags behind males by about 10 years," he says, so "things could change quickly for the worse."
The sheer number of young people also presents both promise and potential trouble for nicotine-related health issues in Africa. As King notes: "What the tobacco industry is banking on is the reservoir of nonsmokers among the youth population."