Development & Aid, Headlines, Health, Latin America & the Caribbean

HEALTH-CUBA: Tobacco a Harmful Addiction with a Long Tradition

Patricia Grogg

HAVANA, Jul 6 2004 (IPS) - In Cuba, where the Taino Indians had tobacco in hand as they received Christopher Columbus, thousands of people die of lung cancer every year, and there is a high percentage of smokers despite government anti-smoking campaigns.

Tobacco is a key part of Cuba’s national history. The pre-Columbus indigenous inhabitants of this Caribbean island were keen on smoking for the pleasure that supposedly brought them closer to the gods.

But today tobacco consumption has become a national problem.

According to official figures, cancer is the second leading cause of death in Cuba, with 25,000 new cases reported each year, and around 14,000 deaths – 5,000 related to tobacco use.

In 2002, the Cuban government reported that 2,780 men and 1,279 women died of lung cancer. Experts have long been using state-run TV and radio broadcasts to urge Cubans to lead healthy lifestyles.

The annual increase in lung cancer death rates in Cuba is higher among women (2.3 percent) than among men (1.0 percent), which is attributed to the growing number of women smokers while there has been a decline in the number of men smokers.

Studies by the National Hygiene and Epidemiology Institute and polls by the Cuban media confirm that men smoke more than women do, but that the gap between them is beginning to close.

The government’s anti-smoking campaigns highlight some startling data, such as the argument that each cigarette reduces life expectancy by nine minutes and that smokers on average live 15 years less than non-smokers.

The government effort to fight tobacco use also points to the harm it causes the economy, domestic life and the country as a whole because it implies higher medical spending, and work absenteeism resulting from tobacco-related illness.

Four thousand toxic substances have been identified in cigarette smoke, and a pack-a-day smoker inhales that smoke an estimated 70,000 times a year, according to sources from the Havana’s Superior Institute of Medical Sciences.

Each inhalation exposes the mucous membranes of the mouth, nose, pharynx and trachea to some toxins, while others are absorbed by the blood or dissolved in saliva and ingested.

The latest survey published in Cuba about tobacco use dates to 2001. It said there were 2,047,714 smokers on the island, home to over 11 million people. The 2001 figure represented 31.9 percent of adults, compared to 36.8 percent in 1995.

Although the percentage of adult smokers has declined, more and more people are becoming addicted to smoking before their 20th birthday.

”Smoking is one of the few pleasures I can enjoy at any moment. It accompanies me and revitalises me when I am feeling most tired,” Orestes García, 29, who began smoking with his friends at age 14, told IPS.

In a study conducted in Havana amongst students ages 13 to 15, the percentage of respondents who said they had smoked at least once was 29.9 percent.

”It is well known that imitation plays an important role in tobacco addiction in Cuba. Imitation and so-called social contagion is the main reason people begin smoking,” doctor Nery Suárez told a recent press conference.

”Parents do not serve as the primary pattern for imitation in Cuba. It is teachers and friends,” said Suárez, researcher for the National School of Public Health, a post-graduate academic institution.

The first ongoing nationwide programme to discourage smoking began in 1988. Cuban health officials had previously launched a campaign in 1985 when the trend of increased tobacco use was discovered.

Since the 1970s, packages of cigarettes and other tobacco products sold in Cuba have included health warnings and information.

In Cuba it is illegal to sell tobacco to anyone under age 16. It is prohibited to smoke in schools, and employees and patients throughout the national health system are not allowed to smoke in any of the system’s facilities.

”Everything is well laid out, very detailed, but violations of the rules abound, and people smoke without much thought for who might be next to them,” says Laura María, head of communications at a post office.

”If you complain, you end up looking like someone without a sense of humour,” she said.

There are 242 ”detox” centres throughout Cuba to help people overcome their addictions, according to the government, which over the past six weeks has rolled out new campaigns against smoking and in defence of smoke-free areas.

On May 29, the Fidel Castro government signed the Framework Convention on Tobacco Control, of the World Health Organisation (WHO), which aims to curb the harm caused by consumption of tobacco products.

The convention establishes rules on advertising, promotion and sponsorship by tobacco companies, and advocates increased taxes and prices for tobacco products, among other things. According to the WHO, there are 1.3 billion smokers in the world.

Although 60 percent of cigarette addicts in Cuba say they want to quit, 40 percent would need professional help to do so, and just three percent would be able to quit on their own, say health authorities.

Among the treatments used by those who want to quit smoking are psychotherapy, herbal therapy, natural and traditional medicine and acupuncture, as well as replacement approaches, such as nicotine patches.

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