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Tobacco still the leading cause of cancer

Many smokers of cigarettes, shisha and other related substances think of their habit as a fancy lifestyle, not knowing they expose themselves to cancer and other health complications. 

During this cancer month, The Observer managed to talk to health experts to explain the health implications of tobacco use, exposure and the cost of treating patients with tobacco-related illnesses.

Dr Noleb Mugisha, head of comprehensive community cancer program at the Uganda Cancer Institute, said tobacco is the most well-known cancer risk factor. The doctor said tobacco is associated with more than 20 different types of cancer - but most common in Uganda are lung, throat, bladder, and cancer of the back, of the nose, vocal cancer and cancer of the lips - high blood pressure, heart diseases, premature aging and eventual death.

Women who smoke are also at higher risk of getting cancer of the cervix.

“Nicotine is a chemical that makes people yearn for tobacco. It has the capacity of changing the DNA cells and once the DNA cells are damaged, cells start to grow out of control thus creating cancer tumours,” Mugisha said.

Tobacco also increases the risk of impotence in men because it blocks the small blood vessels that transfer blood to different parts of the body, and increases the chances of miscarriage in women or producing babies with defects. 

The cancer specialist says people who use tobacco suffer nutritional deficiencies due to loss of appetite and this makes them more vulnerable to infections and other diseases.


Tobacco farmers suffer from green leaf diseases caused by penetration of tobacco into their skin while handling the tobacco leaves. According to the American cancer society, in the United States, more than 7,300 nonsmokers die each year from lung cancer caused by secondhand smoke.

Secondhand smoke is the combination of smoke from the burning end of a cigarette and the smoke blown out by smokers. Secondhand smoking is more deadly than the firsthand smoking, according to health experts.

Richard Baguma, the coordinator of Uganda Health Communication Alliance [UHCA], says there is undebatable evidence that tobacco use and exposure causes cancer so, the public needs to be protected from the deadly use of tobacco.

“There is the law in place [Tobacco Control Act] that can be used to protect the masses and those mandated to implement the law have delayed, allowing the country to register deaths and high burden of diseases related to tobacco use and exposure,” Baguma said.

Jackson Orem, the director Uganda Cancer Institute says in 2017, it is estimated there will be 14 million new cases of cancer while eight million people will die from the disease globally. Cancer affects everyone in different ways and everyone has the power to take action to reduce the impact the cancer has.

Evidence shows that more than a third of all cancers are preventable through simple measures such as quitting smoking, eating healthy and reducing alcohol use.

“Most of the cancer cases are diagnosed in advanced stages of the disease (III/IV) which reduces individual chances of survival. At Uganda Cancer Institute, 25 per cent of the cases diagnosed with cancer are men and out of all patients diagnosed with cancer, 80 per cent die,” Orem said.

Joseph Lule is the CEO of NGO-Friends’ Crew Africa, an organization for artistes committed to creating tobacco-related disease awareness. 

“It’s unfortunate that most musicians smoke in front of their fans, subjecting them to secondhand smoke, thus risking the population to diseases like cancer,” he said. “Smoking shisha or cigarettes does not add any value to one’s vocals as most musicians think, but [send one to] an early grave.”


According to ongoing research by the ministry of Health, Uganda Cancer Institute and Makerere University on the economic costs of treating tobacco-related diseases, preliminary results show that average medical costs of the current or former smoker suffering from tobacco-related diseases is Shs 3,697,255, which is 2.28 times the annual average medical cost of non-smokers.

The cost of treating tobacco illnesses in Uganda is estimated at Shs 108.05bn and the total health cost of tobacco use including the direct cost of treatment and indirect cost due to loss of income and productivity is Shs 328.82bn.

The authors of the findings say these resources could have been diverted to more productive uses benefiting public health as well as the economy. The World Health Organization identifies tobacco as the leading cause of preventable deaths in world. If effective measures are not taken urgently, tobacco use will kill more than one billion people in the 21st century.

“Many of these occur prematurely and impact negatively on the socio-economic development of any nation. Tobacco use and exposure to secondhand smoke in non-smokers causes death to almost six million people each year among adults, of which more than 600,000 are non-smokers. The annual death toll from tobacco use is expected to rise to over eight million by the year 2030 with more than 80 per cent deaths projected to occur in low and middle-income countries,” the WHO projects.


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