Tobacco in Kenyain the African context

Data for the WHO Tobacco Control Meeting of Sub-Saharan Countries

Nairobi, October 2000

Emerging Tobacco Problem in Africa

• Disease and death caused by tobacco is an emerging problem in Africa.

• The age for smoking initiation is getting younger and younger

• In 1999, Africa smoked 4% of World cigarette consumption.

Adolescent Smoking in Africa

Males Females

Senegal (Dakar) (10-20 year old) 1989 70% 52%

Niger (15-35 years old) 1991 41% 11%

Ethiopia (18-20 years old) 1980 38% 3.4%

Benin (400 students) 1986 12% 2%

Ghana (secondary school) 1994 6% 1%

Cigarette Consumption Increasing in Kenya

Total Cigarette Sales in Kenya 1970-1999

0

1000

2000

3000

4000

5000

6000

7000

8000

1970 1980 1990 1999

Mil

lio

n s

tick

s o

f ci

gar

ette

s

Cigarette Consumption Per Capita of 15+ age group in Selected African Countries

1999(pieces of cigarettes)

20 80 111 161 196 205282 295 305 331 382 408

580 616744

1734

Gui

nea

Ethi

opia

Moz

ambi

que

Mal

awi

Gha

na

Tanz

ania

Mad

agas

car

Nig

eria

Zim

babw

e

Zam

bia

Sier

raLe

one

Ken

ya

Cot

ed'

'Ivoi

re

Cam

eroo

n

Sene

gal

Mau

ritiu

s

Smoking Prevalence by Gender for Selected Africa Countries

24%33% 36% 39% 39% 40% 42%

47%51%

60%65%

7% 8%15%

1%7%

25%

2% 4%10%

44%35%

0%

10%

20%

30%

40%

50%

60%

70%

80%Ni

geria

(90)

Swaz

iland

Zim

babw

e (9

0s)

Leso

tho

(92)

Zam

bia

Zaire

(92)

Cote

d''I

voire

(77)

Mau

ritiu

s (9

2)

Seyc

helle

s (8

9)

Gui

nea

(98)

Nam

ibia

(94)

Prev

alen

ce ra

te

Men

Women

Evidence of the Adverse Health Impact of Tobacco Use for Selected African Countries

• Botswana Lung cancer accounted for 14% male cancer deaths, 7% for females during 1985-89.

• Mali 82% of ischaemic heart disease patients, 89% of emphysema patients and 66% of lung cancer patients are smokers.

• Seychelles Tobacco related causes one-third of all deaths in men and women

• South Africa25,450 smoking related deaths were reported in 1988

• Zimbabwe Lung cancer cases increased in men from 64 in 1986 to 112 in 1992.

Changing burden of disease pattern in developing countries, 1990 and 2020

Changing burden of disease pattern in 1990

Noncommunicable diseases 38%

Injuries 15%

Communicable diseases 47%

Changing burden of disease pattern in 2020

Noncommunicable diseases 58%

Injuries 21%

Communicable diseases 21%

Smokers spend significant amounts on tobacco products

• In 1996, a smoker in Kenya who works:– in public sector spent 3.1% of annual

income on cigarettes

– in private sector spent 2.8% of annual income on cigarettes

Average Tobacco Expenditure as % of GDP Selected African Countries in 1999

0.6% 0.6%1.0%

1.3% 1.3%1.7% 1.8% 1.8% 1.9%

2.2% 2.3% 2.3%

3.2%

3.8%

Gab

on (9

8)

Zim

babw

e

Gha

na

Mal

awi

Sene

gal

Sier

raLe

one

Cote

d'Iv

oire

Zam

bia

Tanz

ania

Mau

ritiu

s

Nige

ria

Keny

a

Cam

eroo

n

Ango

la

Tobacco Control Policies tend to be weak in Countries in Africa

• ADVERTISING BAN ON SALES HEALTH BAN ON BAN TO MINORS WARNING PUBLIC PLACES

• Benin N/A No Yes Some• Botswana All media age < 16 yes Some• Burkina Faso Regulated No Yes• Cote d'Ivoire Yes but, not on TV No No Some • Ghana No Yes No No

• Kenya No No No Some• MauritiusYes 18 years No Yes• Namibia No No Yes Some• Niger Banned No No Yes• Nigeria Banned No Yes Some• South Africa Regulated Banned Yes Some• Togo Radio No No No• Uganda No No No Some• Zaire No No No Some• Zambia Media No Yes Some

Tobacco Tax Revenues (Excise+VAT) as % of Total Tax and

GDP in Kenya in 1998

43%

7%2%

0

0.1

0.2

0.3

0.4

0.5

0.6

% of excise % of total tax % of GDP

% S

har

e o

f to

bac

co t

ax

reve

nu

e

Cigarette Excise Tax Rate in Selected African Countries in 1999

10%13%15%

32%

60%

125%

171%180%

25%21%

65%70%

75%80%

90%

135%

58%

20%30%

40%

To

go

Bu

rkin

a F

aso

Mala

wi

Ch

ad

CA

R

Cam

ero

on

Nam

ibia

Nig

er

Co

te d

''Ivo

ire

Sie

rra L

eo

ne

Tan

zan

ia

Sen

eg

al

Nig

eri

a

Mali

So

uth

Afr

ica

Mad

agascar

Mo

zam

biq

ue

Co

ng

o

Eth

iop

ia

Zim

bab

we

Gu

inea

Zam

bia

Ken

ya

Gh

ana

Mau

riti

us

% o

f ex

-man

ufa

ctu

rin

g o

r re

tail

pri

ce

Choosing the Right Types of Excises

Types oftaxes

BetterQuality andMoreVariety

Under highinflation regime,generating highrevenues

Protection todomestic brandsagainstinternationalbrands

Need to setminimum pricesfor securingrevenue

Administration

Specific Yes(upgradingeffect)

No(should beadjusted by CPI)

No No Easy

Ad-Valorem

No Yes Yes(multiplier effect,higher the price,higher the taxes)

Yes(due to differentdefinition set for ad-valorem bycountries)

Not easy(not easy to definebase for advalorem)

Mauritius Tobacco Excise Tax Revenue 1993/94 and 1997/98

CPI, 1990=100

0

100

200

300

400

500

600

700

800

900

1994 1995 1996 1997 1998

No

min

al r

even

ue

(mil

lio

n

rup

ees)

0

100

200

300

400

500

600

Rea

l ta

x re

ven

ue

(mil

lio

n

rup

ees)

Nominal Tob. Excise Revenue

Real Tob. Excise Revenue

Trends in Tobacco Leaves Production and its % Change from the Previous Year in

Kenya, 1980-1997

85%

74% 14% -10% 11%-30%

42% 0%0%

0.000

5.000

10.000

15.000

20.00019

80

1985

1990

1991

1992

1993

1994

1995

1996

1997

MT

Tobacco Trade and Net Earnings (Export-Import) in Kenya 1980-1995

31141646

70327015 9087 12122

-1694

-5000

0

5000

10000

15000

20000

25000

1980 1985 1991 1992 1993 1994 1995

(100

0 U

S$)

Import Export Balance

WHY DEAL WITH TOBACCO CONTROL WHILE AFRICA FACES OTHER IMMEDIATE CHALLENGES

• TOBACCO IS AN EMERGING PROBLEM

• HEALTH CARE EXPENDITURE IS LOW IN MOST AFRICAN COUNTRIES, TOBACCO CONTROL CAN PREVENT DISEASE

• INCREASING TOBACCO TAX RATES COULD HELP TO BALANCE THE BUDGET

• AFRICA STILL HAS A CHANCE TO BE TOBACCO-FREE CONTINENT IN THE 21 ST. CENTURY