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"How do you package death as life, disease as health and deadly addiction as the taste of freedom and the celebration of life?" Former World Health Organization Director Gro Harlem Brundtland asked this disturbing question in 2001 in reference to the manufacture and sale of cigarettes.

For no matter which way you look at it tobacco is not a poison but a large combination of poisons for it contains over 4,000 chemicals 400 of which are known to be harmful to human health with a least 40 known to be carcinogenic or cancer causing.

As more and more evidence has piled against the use of tobacco by the individual it has also revealed that at high risk too is the non-smoker who is exposed to this second hand smoke which in effect turns him into a passive smoker.

No small wonder than that these second-hand smokers have begun hitting back and standing up for their rights, pointing out that smoking is not a self contained activity and tolerating smokers should not longer be viewed as a necessary evil at best and an irritating nuisance to be put up with at worst, but rather as a serious assault on their health as non-smokers.

It is probably with this in mind that on Saturday May 13 2006 after years of foot dragging on the issue the government banned smoking in all public places. In signing the legal notice, under the Public Health Act Cap 242 Health Minister Charity Ngilu effectively also sought to place restrictions on advertisement and importation of tobacco and its products.

She noted that Kenya being a signatory to the WHO Framework Convention on Tobacco Control (FCTC) that it finally signed last year was under an obligation to impose this ban.

This Treaty was the outcome of a resolution by the World Health Assembly on 24th May 1996 in which the Director-General of the WHO was urged to initiate the development of a Framework Convention on Tobacco Control.

Dr. Gro Harlem Brundtland, at this time the Director-General then led the establishment of a new project, the Tobacco-Free Initiative (TFI) a cabinet project reporting directly to her. The International Negotiating Body (INB) then held deliberations and negotiations on the FCTC with the resultant signing of it as a treaty on May 21, 2003 by 192 WHO member states.

It is against this background that Minister Ngilu has signed this notice and in so doing set of the furious protests which have always marked this kind attempt to restrict tobacco promotion and use.

The opening salvo’s were fired this week by Ochieng Rapuro the Associate Editor, Business of The Standard newspaper in an analysis on the op-ed page entitled "Smoking: Govt doing the right thing the wrong way" (The Standard 16 May 2006). Initially looking at the heading I was already nodding my head in agreement thinking it referred to a comment attributed to the Minister in a front page story in the People On Sunday entitled "Government bans smoking in public." (POS May 14 2006)

According to the story’s author, Health Minister Charity Ngilu had stated that "there was no great need to sensitise the public on the ban because it has been said over and over again that smoking in public places would be banned." Yet talking about banning and the actual banning are as different as chalk and cheese, for studies in other places where such bans have been imposed have consistently shown that they work better after a large scale grass-roots sensitization campaign aimed at the affected communities. For without their support it becomes very difficult for these bans to work.

Legal aspects should also all be in place for we do not want a repeat of the alcoblow breathalyzer fiasco when an alcohol consumer got the courts to effectively halt its use based on the legality (or lack of therein) in the whole exercise. A long needed assault on drunk driving therefore ground to a halt on an easily foreseeable legality.

But back to Rapuro’s article what he was actually questioning was the criteria (in this instance statistics) being used in Kenya’s case to sustain the argument for a ban. The writer believes that Ngilu’s actions are "spurious" or bogus as "the Minister has no data on the contribution of smoking on the burden of ill health in the country. This means that any action on this matter is based on assumptions that are hinged on data that is available from other countries.

"Yet as in most cases, no two situations can be identical to warrant policy replication of the type that the minister has embarked on." He goes on to explain that "though second-hand smoking is known to be harmful, research has demonstrated that the harm lies in the volume and regularity of exposure.” One therefore has to inhale this smoke over a long period to get say lung cancer.

Rapuro says that the "bottom line is that the volume of smoke that non-smokers inhale depends on the percentage of smokers in the population." In Britain and the US he continues this had to rise above 25 per cent before bans were considered yet in Kenya no figures exist. He then gives a seeming contradiction by allowing that "estimates indicate that it stands at less than eight per cent of the population."

However we do have figures from the Ministry of Health, from the National Tobacco Free Initiative, and from the National Agency for the Campaign Against Drug Abuse (NACADA) who for the last couple of years have constantly told us for example that for every shilling received as tax from the tobacco industry the government spends three in mopping up the adverse health effects of tobacco use among Kenyans.

Yet other figures paint a picture of tobacco prevalence. In a speech by the (then) Minister for Public Health Hon. Prof. Sam Ongeri during the World No Tobacco Day celebrations held in Embu Town on 8th June 2001 (the day is officially marked on May 31st but in Kenya was previously marked in the second week after Madaraka Day June 1) he gave these figures.

"In Kenya, tobacco smoking prevalence is 67% for males and 33% for females. Approximately 45% of all smokers are below the age of 20 years and the trend (of percentages) seems to be upward.

Let us also not forget that it has been decades since one could smoke in cinema theatres, buses and other public transport and in many buildings. Let us not think of the years it might take to get lung cancer, but the immediate problems of smoking near an asthmatic or a child.

The immediate respiratory problems that start to develop and often becoming full blown in days as a result of Environmental Tobacco Smoke. Let us not try to argue that there really is a case here for waiting to get ‘our own figures’. For when it comes to tobacco smoke both for the smoker and non-smoker, there can be no ifs or butts – for no matter how hard we try, how do we package death as life?

David Ogot is a freelance journalist/producer and the Programmes Director of the goinghomedotcom Trust a media NGO specializing in drug abuse awareness. A recovering alcoholic he can be reached at www.goinghomekenya.org.

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