Tobacco control and prevention efforts in Ethiopia pre- and post-ratification of WHO FCTC: Current challenges and future directions
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School of Pharmacy, University of Gondar, Gondar, Ethiopia
College of Law, Dire Dawa University, Dire Dawa, Ethiopia
Daniel Asfaw Erku   

School of Pharmacy, University of Gondar, Gondar, Ethiopia
Publish date: 2019-02-22
Tob. Induc. Dis. 2019;17(February):13
Being the second most populous African country, Ethiopia represents a huge opportunity for the tobacco industry to recruit new smokers. Ethiopia signed the convention to ratify WHO Framework Convention on Tobacco Control (FCTC) in 2004 and ratified in 2014. We reviewed Ethiopia’s tobacco control legislative history pre- and post-ratification of the WHO FCTC and evaluated the level of compliance of the National Tobacco Control Directive (NTCD) with the WHO FCTC.

We reviewed Ethiopia’s tobacco legislative history, the NCTD, the National Tobacco Control Strategic Plan, and tobacco control related media stories from 2009 to 2018. The level of compliance of NTCD with WHO FCTC was compared and qualitatively analysed.

NTCD 2015 is Ethiopia’s first comprehensive tobacco control legislation, which for the most part is WHO FCTC compliant. The legislation prohibits, among other things, sale of flavoured tobacco products including menthol, sale of tobacco products to a person under the age of 18 years and bans all forms of tobacco advertising, promotion, and sponsorship. Yet, the current legislation allows smoking designated rooms in some prohibited places. Although a multi-sectoral National Tobacco Control Committee and a Strategic Plan were developed as per Article 5 of WHO FCTC, activities pertaining to the protection of such tobacco control policies from vested interests of the tobacco industry (WHO FCTC Article 5.3) are not addressed in NTCD 2015.

Major gaps in the NTCD 2015 such as allowing smoking designated rooms should be addressed in order to stop the tobacco industry from using such loopholes to interfere with national tobacco control policies and/or maintain its tobacco market. Moreover, the tobacco control policies and efforts should be institutionalized across various sectors in order to ensure implementation of the NTCD.

Authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
GBD 2015 Tobacco Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. The Lancet. 2017;389(10082):1885-1906. doi:10.1016/S0140-6736(17)30819-X
World Health Organization. Tobacco Fact sheet: WHO 2018. Accessed September 29, 2018.
Giovino GA, Mirza SA, Samet JM, et al. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. The Lancet. 2012;380(9842):668-679. doi:10.1016/s0140-6736(12)61085-x
Husain MJ, English LM, Ramanandraibe N. An overview of tobacco control and prevention policy status in Africa. Prev Med. 2016;91:S16-S22. doi:10.1016/j.ypmed.2016.02.017
Brathwaite R, Addo J, Smeeth L, Lock K. A systematic review of tobacco smoking prevalence and description of tobacco control strategies in Sub-Saharan African countries; 2007 to 2014. PloS One. 2015;10(7):e0132401.doi:10.1371/journal.pone.0132401
World Health Organization. Ethiopia-GATS-2016-Executive Summary. Accessed September 29, 2018.
Central Statistical Agency. Ethiopia Demographic and Health Survey 2012. Accessed October 12, 2018.
Defar A, Getachew T, Teklie H, et al. Tobacco use and its predictors among Ethiopian adults: A further analysis of Ethiopian NCD STEPS survey-2015. Ethiop J Health Dev. 2017;31(1):331-339.
Ashall F. Behind the smokescreen of Ethiopia’s surging tobacco production. Accessed October 1, 2018.
Japan Tobacco Inc (JT). JT Becomes Majority Shareholder of Ethiopia’s NTE. Accessed October 1, 2018.
Ashall F. Behind the smokescreen of Ethiopia’s surging tobacco production. Accessed October 12, 2018.
Ethiopian Food Medicine and Healthcare Administration and Control Authority (FMHACA). Tobacco Control Directive. https://www.tobaccocontrollaws.... Accessed September 29, 2018.
World Health Organization. WHO report on the global tobacco epidemic, 2017. Monitoring tobacco use and prevention policies. World Health Organization; 2017.
Federal Democratic Republic of Ethiopia. Proclamation 661/2009 for the Ethiopian Food, Medicine and Healthcare Administration and Control Authority (FMHACA) 2009. https://www.tobaccocontrollaws.... Accessed June, 2018.
The Federal Democratic Republic of Ethiopia. Regulation 299/2013: The Ethiopian Food, Medicine and Healthcare Administration and Control Authority and Council of Ministers 2013. https://www.tobaccocontrollaws.... Accessed October 12, 2018.
World Health Organization. WHO Framework Convention on Tobacco Control. Accessed Septmeber 1, 2018.
World Health Organization. MPOWER: a policy package to reverse the tobacco epidemic. World Health Organization; 2008.
Addis Ababa to enforce smoke ban. Accessed October 12, 2018.
Tekle TA. Ethiopian city bans smoking in public areas. Published January 12, 2015. Accessed October 12, 2018.
WHO Framework Convention on Tobacco Control. Guidelines for Implementation of Article 5.3. Accessed October 1, 2018.
Davison W. Japan Tobacco Makes $510 Million Top Bid for Ethiopia Monopoly 2016. Published May 23, 2016. Accessed September 1, 2018.
Tumwine J. Implementation of the framework convention on tobacco control in Africa: current status of legislation. International Journal of Environmental Research and Public Health. 2011;8(11):4312-4331. doi:10.3390/ijerph8114312
Egbe CO, Bialous SA, Glantz S. FCTC Implementation in Nigeria: Lessons for Low and Middle-Income Countries. Nicotine & Tobacco Research. 2018. doi:10.1093/ntr/nty069
Cains T, Cannata S, Poulos R, Ferson M, Stewart B. Designated “no smoking” areas provide from partial to no protection from environmental tobacco smoke. Tob Control. 2004;13(1):17-22. doi:10.1136/tc.2003.005488
Hogg SL, Hill SE, Collin J. State-ownership of tobacco industry: a ‘fundamental conflict of interest’ or a ‘tremendous opportunity’ for tobacco control? Tob Control. 2015;25(4):364-372. doi:10.1136/tobaccocontrol-2014-052114
Gilmore AB, Fooks G, McKee M. A review of the impacts of tobacco industry privatisation: Implications for policy. Glob Public Health. 2011;6(6):621-642. doi:10.1080/17441692.2011.595727
Ministry of Health. Ethiopia National Drug Control Master Plan 2017-2022. Accessed October 1, 2018.
Health Mo. National Strategic Action Plan (NSAP) for prevention & control of non-communicable diseases in Ethiopia 2014 – 2016. Accessed September 29, 2018.
Ministry of Health. National Cancer Control Plan 2016-2020. Accessed October 1, 2018.