Why Govt is right in banning of Shisha

By Steven Kabwama Ndugwa

On the July 28, 2015, Parliament of Uganda passed the Tobacco Control Bill 2014. This was after almost a month of debating and more than a year since it was tabled in the Uganda Gazette.

 Part VI, clause 15 has provisions for the sale and display of tobacco and tobacco products. Clause 15 subsection 2 states that a person shall not import, manufacture, distribute, possess, sell or offer for sale or bring into the country (b) a water pipe tobacco delivery system, including the water pipe device, the water pipe tobacco product or other substances to be used in the water pipe delivery system.

One of the products that fit the description of a “water pipe delivery system including the water pipe device or the water-pipe tobacco product” is that popularly known as Shisha. Shisha is a glass bottomed water pipe in which fruit-flavoured tobacco is covered with foil and roasted with charcoal.

The typical fruit flavours include apple, grape, guava, lemon and mint. Shisha has recently gained social acceptance in many bars and restaurants around Kampala, especially among the youth. Unlike cigarettes, the flavours added to tobacco smoke make it aromatic and more tolerable, which explains why it is more socially acceptable compared to cigarette smoke. Contrary to what many may presume, smoking shisha is no less harmful and addictive compared to smoking cigarettes.

In fact, research has shown that a shisha smoking session of one hour is equivalent to smoking 100 cigarettes. Also, one has to smoke two cigarettes in order to inhale a litre of tobacco smoke. However a shisha smoker inhales six times in order to breath in the same litre of tobacco smoke.

Research has unequivocally established the association between tobacco smoking and lung cancer. But besides lung cancer, smoking shisha would increase one’s risks to cancers such as cancer of the blood, throat, mouth, kidneys, cervix and pancreas.

Given the fact that almost two in every 10 Ugandan male teenagers have smoked some form of tobacco, the banning of the importation, manufacture, distribution, possession and sale of any product related to the smoking of Shisha is a welcome development in public health policy and public health promotion.

The bill further stipulates that anyone found using shisha will be liable on conviction to a fine not less than sh2m or imprisonment for a term not less than one year or both. Once assented to by the President, these punitive measures should be prohibitive enough to limit the access to and use of tobacco through shisha. The legislation will also aid in the control of use of other substances such as marijuana that are sometimes mixed with the tobacco before it is smoked.

The challenge of good policies in Uganda has been poor implementation. For example the failure of the Tobacco control act of 2004 could be attributed to the fact that personnel in charge of enforcement were not trained and the legislation was not disseminated to the public and concerned stakeholders.

The impact of the Tobacco control Bill 2014 on reducing tobacco use will depend on sensitisation of enforcers such as the Police, municipal laws (like KCCA enforcers), health implementation staff at the ministry of health as well as local administration police in local governments.

The legislation should also be disseminated to stakeholders with a role to play in tobacco control such as school administrations and local governments at municipality and district levels.

The writer is a Fellow with MakSPH-CDC-MoH Public Health Fellowship Programme