Tobacco use among Nigerian women: Implications for tobacco control policy in Nigeria

Nigeria is the most populous country in Africa, with more than 160 million people, about half of which are female. Tobacco use is reported to be relatively low among Nigerian women, less than one percent. These apparently low rates provide a potentially large opportunity for the tobacco industry to increase its market share, particularly among women in Africa.

Despite the low rates of use reported among Nigerian women, there is a disparity in prevalence by sub-groups such as young girls and female sex workers; the rates reported among young girls (13-15 year olds) in some selected states in Nigeria appear to be higher than that of their older counterparts, according to the World Health Organization Global Youth Tobacco Survey (WHO GYTS) conducted in Nigeria in 2008. Compared with smoking rates among Nigerian women in the general populace (less than one percent overall), almost 10% of young girls in some of the GYTS sites had ever smoked, half of whom were current smokers.  The number of girls reported to be likely to initiate future smoking within the next year was higher than boys despite the fact that boys smoked more than girls.

It has also been documented that specific occupational groups of women i.e. female sex workers (FSW) have comparatively higher rates of use compared with average Nigerian women. One study reported that rates of cigarette smoking among brothel based FSW in Lagos state, Nigeria, to be 20.8%. This figure was twice that of Nigerian men in the general population.

The protection of women and girls from exposure to second hand smoke (SHS) is another issue of concern. This is particularly important in a country like Nigeria where the majority of the women are non-smokers, however significant proportions are exposed to the danger of tobacco smoke. A quarter of the girls in one of the states surveyed in the WHO 2008 Global youth tobacco survey reported  to SHS at home and almost half reported in public places.

Lastly, and importantly is the influence of the tobacco industry marketing on smoking initiation. Industry marketing strategies with themes of body image, fashion, and independence used in industrialized nations may increase the appeal of cigarettes and threaten women in the developing countries like Nigeria. The tobacco industry has been known to sponsor fashion shows like the popular Benson and Hedges Fashion show.

Nigeria signed the Framework Convention for Tobacco Control (FCTC) in 2004 and ratified it n 2005.  Since then, attempts to pass the Nigeria Tobacco Control Bill (NTCB) have been challenging despite several efforts by tobacco control advocates.

Highlights of the NTCB include:

  • Setting up of the National Tobacco control Committee
  • Ban on smoking in public places
  • Ban on sales to and by minors
  • Tobacco warnings (at least 50%, pictures may be prescribed by the minister)
  • Ban on promotion of tobacco products
  • Enforcement by authorized officers and the powers of such officers

The passage of the NTCB will be a major leap for tobacco control in Nigeria helping to protect Nigerians, particularly women and girls. It is recommended that efforts be intensified to prevent the uptake of smoking among women and provide programs and services to help current female smokers quit particularly in Nigeria where little or no tobacco cessation services exist.

About the Author: Oluwakemi Odukoya, MBBS, MPH, FMCPH, is a public health physician and lecturer, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos state, Nigeria.