OF Tobacco, Poverty, Cultural Myths and Botswana

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Third Health Professionals Workshop

9-10 July 2013
Francistown
Cresta Thapama Hotel

Mr. John Moloi officially opening the workshop

The Anti Tobacco Network conducted a two day workshop for health workers in Francistown in collaboration with the Ministry of Health, WHO and the District Health Management Team (DHMT) on the 9-10th of July 2013 in Francistown, Cresta Thapama Hotel.


The workshop is a third in a series of workshops that started in Gaborone in late March and later on went to Maun and finally came to Francistown. Introducing the objectives Thabo Katlholo, ATN Administrative Assistant indicated that these workshops were aimed at increasing the level of awareness on tobacco and its impact on health, the economy and the environment. The workshops are also intended to familiarize the media, civil societies and health workers on the provisions of the Framework Convention on Tobacco Control (FCTC) as well as the Botswana Control of Smoking Act plus to sensitize them on the tactics used by the tobacco industry to interfere with government's efforts and initiatives to control tobacco.

Group Discussions

The other objective of the workshop was to involve the participating stakeholders in the planning of the I Dont Want To Be A Walking Billboard For The Tobacco Industry campaign which will be launched in Francistown on the 30th of August, 2013 as agreed by the workshop participants.

Workshop Highlight

Mr. Kgotlaetsile Moube listening in
during discussions

Usage of tobacco and CULTURE - Kids are given snuff to curb nose-bleeding. Participants emphasized that people burn snuff and use the smoke to "stop" the nose bleeding. Participants further cited the fact that tobacco is also used ("degwe" Ikalanga) to pay lobola in Bukalanga. Tobacco narrows blood vessels and therefore circulation becomes very poor. However, there is treatment that can be done instead of tobacco. Participants went further on to list many other examples of the "myths" that link cultural beliefs and tobacco consumption especially chewing tobacco. Dr. Bontle Mbongwe, Interim Executive Director of the Anti Tobacco Network said these cultural practices cannot be ignored but they have to be approached in such a way that it will not enrage the community. It was suggested that there is a need for a study on cultural practices and tobacco use. Health educators have to establish the cultural beliefs about smoking before they start on campaigns regarding tobacco use.

Health workers - Group
discussions

Resolution: Health workers were edged to include tobacco consumption issues on their health talks and give ATN some of those stories that link tobacco to cultural beliefs and activities.


1. Pressing Tobacco Control Issues in Ftwn
   a) Illegal products - Francistown is closer to the border
   b) Law enforcers concentrate in Francistown than in villages near the city
   c) Cultural beliefs and tobacco use

2. Activities to address this:
   a) Health education - community, school kids, parents, law enforcement officers and retailers.
   b) Dissemination IEC material that show the dangers of tobacco use
   c) Development of a comprehensive tobacco control bill in Botswana
   d) Lobby for funding for research that targets tobacco consumption and cultural beliefs

Group Discussions & Presentations

Workshop Recommendations

Formation of Anti Tobacco Committe - To develop and monitor the tobacco control plan. These should be led by the chosen committe which will spearhead these movement. Benchmarking in other towns that have carried out the campaign. The group also recommended school health fairs. The committe should coordinate with school health clubs and various other school clubs to address tobbaco consumption issues.

The workshop participants strongly felt that tobacco issues need to be addressed extensively and opened for the communities to engage in through Talk Shows (Maokaneng, Molemo-Wa-Kgang, Tsa Botsogo etc.). It was also expressed that new approaches are essential in educating our communities. The posters need to be more innovative. These new strategies should evolve with the mindsets of our people. There was also a call for training of Health Professionals on issues of Cessation.

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World No Tobacco Day, May 2013 - Maun, Botswana

Key messages - World No Tobacco Day 2013

All forms of tobacco advertising, promotion and sponsorship should be banned

Advertising bans significantly reduce the numbers of people starting and continuing to smoke. Banning tobacco advertising and sponsorship is one of the most cost-effective ways to reduce tobacco use.

The tobacco industry is constantly trying new promotional tactics using nontraditional media to exploit advertising and promotion bans

Examples include:

Ø  handing out gifts and selling branded products such as clothing, in particular targeting young people

Ø  “stealth marketing” such as engaging trendsetters to influence people in places such as cafes and nightclubs

Ø  using online and new media, such as encouraging consumer interaction to design a new pack for a cigarette brand

Ø  placement of tobacco products and brands in films and television programmes, including reality TV and soap operas

Ø  corporate social responsibility activities such as donating to charity.

Tobacco industry advertising and sponsorship target young people

About one third of youth experimentation with tobacco occurs as a result of exposure to tobacco advertising, promotion and sponsorship.

Worldwide, 78% of young people aged 13-15 years report regular exposure to some form of tobacco advertising, promotion and sponsorship.

Young people aged 13-15 years are up to five times more likely than adults to be offered free cigarettes by a representative of a tobacco company.

Most people using tobacco products start doing so before the age of 20.

A comprehensive ban of all tobacco advertising, promotion and sponsorship is required under the WHO Framework Convention on Tobacco Control (WHO FCTC)

A comprehensive ban reduces tobacco consumption regardless of a country’s income level.

WHO's report on the global tobacco epidemic 2011 shows that only 19 countries (representing just 6% of the world’s population) have reached the highest level of achievement in banning tobacco advertising, promotion and sponsorship.

Call to action

WHO urges governments to ban all forms of tobacco advertising, promotion and sponsorship as part of the full implementation of the WHO FCTC and to be mindful of tactics used by the tobacco industry to evade these laws. Legislation should be properly enforced.

Charities and community projects should never accept tobacco industry support. Tobacco companies use corporate social responsibility activities to promote themselves as good corporate citizens, normalizing tobacco use and creating goodwill in the community.

Consumers should be alert to tactics used by tobacco companies to exploit advertising and promotion bans.

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Media and NGO Workshop, Maun Lodge - 16-17th May, 2013

Comments, Discussions and Recommendations
 

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Media and NGO Workshop Maun

Maun Lodge

16-17th May 2013

Discussions and Comments

1. Thato Molosi – Poetavango: The importance of new education techniques to educate the public since it seems like the existing methods are not as effective as we would like them to be.

RESPONSE: The approach is dependent on the person you are directing the message to. If you are advising a smoker you have to assess their situation considering many factors like; their education level, their level of addiction, and gender. If you are talking to men about tobacco use you have to use different strategies like the fact that smoking has a major impact on impotence and men's reproductive health, however when the message was directed to women the might be crafted in such a way that it will make emphasis on the fact that smoking elevates aging. “Issues should not be forced into people but people should be allowed to introspect for themselves and think about issues then make an informed decision”

2. The relation between tobacco and other drugs such as marijuana and alcohol – some people use Marijuana to mask the smell of tobacco or vise vesa. Cigarettes may also act as a gateway drug for smokeless tobacco which has as devastating effects as cigarettes
   RESPONSE: Tobacco is a gateway drug for many other drugs like Marijuana, cocaine, sextacy, ecstacy and heroine. Major tertiary institutions and secondary schools are facing this huge predicament
    
3. The decentralization of the Anti Tobacco Network to other localities – Are these three workshops adequate and do they reach the different people across Botswana?
   RESPONSE: ATN believes in empowering local communities and training specialists instead of creating offices across the country. These networks of stakeholders, NGOs and health professionals that ATN is building should be equiped by the end of these training exercises, to effectively pass the messages on to their different communities.

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Health Professionals Workshop Maun, Maun Lodge

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14-15th May 2013

Discussions and Comments

1. The need to explain what tobacco is when we make presentations and to relate tobacco related issues to alcohol use since the two go hand-in hand
   1. Tobacco plant is not the same as a cigarette – because a cigarette contains more substances (7000>)
   2. Pesticides used in growing tobacco – lead, sulphur
2. The need for research on tobacco affiliated issues – It does not need to be done by university scholars, it can be done in villages and municipalities, and this workshop can be used as a baseline or reflection point in carrying out the research in clinics.
3. Why dont we ban tobacco use totally in Botswana?
4. The benefits of tobacco use -
   1. Employment - Is it a benefit?
      1. Tobacco has no benefits! - The scale between public health and trade. The bigger impact that tobacco use has in economies cannot be overlooked. A clear example is Malawi, a big tobacco producer but remains one of the poorest countries in the world. Money is channeled into health facilities to provide healthcare to or for people affected by cancers, and other non-communicable diseases caused by tobacco use.
   2. Are there any benefits of tobacco use to the smoker? - NO!!
5. What the Health professionals are doing in their respective workplaces to address the CSA
   1. More emphasis is put on alcohol than tobacco in clinics unless a patient has TB or a cough
6. The need for a Setswana version of the Control of Smoking Act (CSA)– because most people in underdeveloped rural settlements do not have a grasp on the english language
7. Smoking in public places and at the workplace sections of the CSA need to be emphasized and implemented
8. Prices of alcohol have been increased and alcohol consumption has not reduced – how will increasing taxes
   1. Tobacco is not manufactured in Botswana like alcohol therefore increases in taxes will reduce importation of tobacco into the country hence lessening consumption of tobacco in the country.
9. The need to make the CSA more accessible or make it cheap (FREE) – Extract the CSA's forestanding content and distribute IEC's for free
10. Collaborations with workplace Health and wellness committees
11. Duty of persons to protect others from smoke
    
    

    

    Mr. Thuso - Officially opening the workshop for Health Professionals

    
    

    

    Day 1 & 2 Particiants - Health Professionals in the Ngami area who attended the workshop

    1. 1. 

          Group Presentations - Staff member of Letsholathebe Memorial Hospital presenting his group's observations and understanding of the tobacco use situation in the North West district of Botswana.

          

          Maun Tribal staff member - Group Discussions concerning the Control of Smoking Act and observations of violations in the North West District

          

          Staff member of Letsholathebe Memorial Hospital, Ethel presenting her group's discussion and comments on the Control of Smoking Act.

          

          Letsholathebe Memorial Hospital's Matshediso France deliberating her group discussions on the Control of Smoking Act

          

          Participants at the Health Professionals workshop, Maun Lodge, Maun - 14-15th May 2013

          

          Participants listening attentively to the deliberations (group presentations) at the Health professionals workshop - Maun

          
          

          

          From Left to Right: Staff member of MVA Maun and an employee at the North West District Council Environmental Health office during the group discussions.

          

          Group Discussions

          
          

          

          A participant at the Health Professionals workshop, Maun Lodge, Maun - 14-15th May 2013

          
          

          

          Participants from clinic in the North West District

          
          

          

          Ethel from Letsholathebe Hospital in Maun, contributing during discussions

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Media and NGO Workshop, Maharaja Restaurant and Conference Centre, 19-20 March 2013

Courtesy of Press 24 TV http://www.press24.tv/?s=0887f467b2c16c4ad48796eece9dd716


Dr. Bontle Mbongwe presenting on the Health Effects of Tobacco Use. She said the purpose of the presentation was to:

}Introduce tobacco as a health threat

}Discuss the impact of tobacco consumption on the Millennium Development Goals

}Generate discussions toward tobacco control challenges in Botswana and come up with solutions to the Challenges

Focusing on Tobacco & Poverty Dr. Mbongwe said -

}Tobacco use is unequivocally linked with underdevelopment and poverty.

}Two-thirds of the poor nations for which data were available had male smoking rates above the average 35% prevalence rate for the developed world. (WHO2004 estimates)

}The poor are most likely to smoke.

}Tobacco use negatively affects important development objectives such as health, nutrition, employment and gender equality.

}Money spent on tobacco consumption reduces the amount of money available to spend on food, healthcare, shelter and education. 

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Media, NGO Workshop Held in Gaborone - 19-20 March 2013 at Maharaja Restaurant and Conference Centre

The Anti Tobacco Network in collaboratioon with the Ministry of Health recently held back-to-back: One for the media and NGOs and the other for Health Professionals. Target group for the first workshop was the media (15) (both public and private) and non-governmental (10) organizations who have similar interests as ATN. The second workshop targeted 30 health professionals from private and government hospitals. 

The media, NGO and health professionals’ workshops were planned to engage and bring on board the media, NGOs and health professionals as partners of ATN, MOH and WHO country office in sensitizing Batswana on the harms of tobacco and helping the government to implement the WHO Framework Convention of Tobacco Control (FCTC).

Objectives

The workshops are in line with a series of other activities funded by the ACS and aim to achieve the following objectives:

1        To familiarize the media, health professionals and NGOs on the provisions of the FCTC, the Control of Smoking Act (CSA) and the tactics used by the tobacco industry to interfere with Government’s efforts to control tobacco (Article 5.3).

2       To increase the level of awareness on tobacco control and its impact on    health, the economy and the environment.

3        To prepare for the upcoming I Don’t Want To Be a Walking Billboard (A campaign countering advertising in indirect ways by the tobacco industry.) 

WHO Country Office - Mr Moagi Gaborone opening the workshop

Dr. Bontle Mbongwe presenting on the Health Effects of Tobacco use. Dr. Mbongwe stressed out the fact that tobacco use is unequivocally linked with underdevelopment and poverty.  Two-thirds of the poor nations for which data were available had male smoking rates above the average 35% prevalence rate for the developed world. (WHO2004 estimates). The poor are most likely to smoke. Tobacco use negatively affects important development objectives such as health, nutrition, employment and gender equality. Money spent on tobacco consumption reduces the amount of money available to spend on food, healthcare, shelter and education.

FCTC Presentation made by Mr. Moagi Gaborone - WHO Botswana

Botswana Substance Abuse (BOSASNet) representative making a comment

Mr Ephraim Rapalai of the Ministry of Health Tobacco control unit making a presentation of the tobacco legislation in Botswana

Botswana Press Agency (BOPA) represenatives and Press 24 Tv representative (Holding Camera)

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ATN briefs Ministry of Health and WHO on activities ahead of 2013

ATN shares its plan to support the Ministry of Health to fast-track the development of a comprehensive tobacco legislation, to stop Tobacco Industry interference on tobacco control and to raise the level of awareness on the FCTC

From Left to right: Professor Phaladze (ATN Chair), Thabo Katlholo (ATN Admin. Asssistant),  Mr Mokgweetsinyana (Chief Health Officer-MOH), Ms. Shenaaz El-Halabi (Deputy Permanent Secretary - MOH), Mr. Rapalai (Tobacco Control - MOH)and Ms. Tabby Ramaphangela (Tobacco Control - MOH)

ATN Chair Professor Phaladze gave
an overview of the meeting.

Deputy Permanent Secretary Ms. El-Halabi
addressing the meeting

Mr Mokgweetsinyana addressing the
meeting

Mr. Thabo Katlholo
(ATN Admin assistant)

Left to Right: Mr Ephraim Rapalai (Tobacco control)
Ms Tabby Ramaphangela (Tobacco control), Mr Moahi Gaborone
(WHO country office)

 

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