Smoking Control in Africa: Problems and Prospects

Prospects for the development of smoking control policies and programmes in Africa are reviewed. With life expectancy throughout much of Africa often remaining below the peak age range for smoking-caused deaths and the presence of widespread major causes of death and disease from malnutrition and infection dominating illness patterns, arguments for smoking control must be based on wider criteria than those of health that underscore control policies in developed countries. While the burden of smoking-caused disease in Africa may be currently low by international standards, rapid rises in smoking prevalence suggest a ‘coming epidemic’. It is argued that, with the exception of a handful of nations for whom tobacco is a major industry and currency earner, four factors - concern for this ‘coming epidemic’, the way in which household expenditure on tobacco in marginal survival situations competes with that for food, the drain on hard currency caused by deficit balances of trade in tobacco and the environmental impact of the industry-are likely to set the future agenda for those advocating the adoption of tobacco control policies.