Secondhand Smoking, Children’s Health and Ghana’s Tobacco Control Law

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Doctors at the 37 Military Hospital in Accra have diagnosed two children with Bronchitisan inflammation of the bronchi (large and medium-sized airways) in the lungs. A total amount of Ghc6000 is needed for the treatment of the two siblings, Aku Dede Wilkins and Esi Korkor Wilkins who are aged 10 and 5 years respectively.

Bronchitis is one of those sicknesses that one suffers mostly as a result of secondhand smoking. It is a serious and costly health problem. Its symptoms include coughing up mucus, wheezing, shortness of breath, and chest discomfort, among others. Considering the environment that these children stay the fact cannot be denied that they are suffering this sickness because of the lack of enforcement of Ghana’s laws that are supposed to protect innocent children like Aku and Esi from the effects of secondhand smoking.

Aku and Esi stay with their grandmother, Eno Sisi, at La, a suburb of Accra. Aku is in class 5 while Esi is in Kindergarten 2. Eno Sisi operates a local drinking spot at La, where she also sells cigarettes in single sticks. The three share a single compartment wooden kiosk partitioned with an old curtain. The kiosk also serves as their permanent bedroom.

On daily basis, customers who visit the spot in the early hours of the morning and late afternoon get served by either of the two children who is closer to the shelves at any point in time. On a visit to the spot by this reporter on a Saturday morning we met Little Aku busy with her homework. A customer walked in for a stick of cigarette and Eno who was busy washing the children’s dirty clothes asked Aku to serve the customer who also requested a lighter for his cigarette. He sits on a wooden bench close to Aku and then started ‘enjoying’ his cigarette while Aku goes back to her homework. Not long after that another customer walked in and soon three friends have gathered at the spot, each holding a lit cigarette. They struck a conversation on the previous night’s football match. Little Esi joins her sister later and none complained about the effects of the smoke on them – they are probably used to it.

Through no fault of theirs these children are going to continue suffering this sickness until their 81 year old grandmother is able to secure enough funding to cater for their medical bills – a situation that does not look likely considering the fact that they struggle to make ends meet.

Sadly, this appears to be the situation in most communities in Ghana where good laws have been passed but simple implementation remains a challenge to the relevant authorities who have been mandated to ensure that the laws work.

Ban on Public smoking

There is a Public Health Act (Act 851) in Ghana passed in 2012. It puts a strict ban on public smoking except for “Designated Smoking Areas (DSAs)”. The law also bans tobacco advertising and sponsorship as well as the sale of tobacco products to children or by children. Act 851 clearly bars anyone from carrying out any tobacco related business around schools or homes or near children.

Act 851

Article 77 (1)(g) of the law states that A Person who “sells or offers for sale tobacco or a tobacco product to a child or exposes a child to tobacco or a tobacco product contrary

to section 65;…commits an offence and is liable on summary conviction to a fine of not

more than seven hundred and fifty penalty units or to a term of imprisonment of not more than three years or to both and in the case of a continuing offence to a further fine of ten penalty units for each day during which the offence continues”.

The Regulators

However, the Food and Drugs Authority (FDA) has consistently stated that it lacks the necessary resources to ensure that the law is effectively implemented. Despite that, officials claim they are doing their best with the limited resources at their disposal.

Olivia Boateng, who heads the Tobacco and Substances of Abuse Department at the FDA has said that the FDA is engaging the tobacco industries in Ghana over pictorial health warnings on cigarette packs and that “we have also engaged facility owners to educate them on the law as well”.

She admitted that education on the law has been on the low and that the Authority has plans to intensify public education with emphasis on the dangers associated with the use of shisha and Electronic Nicotine Delivery Systems (ENDS) which has become very common among the youth in Ghana.

Single sticks

A recent research by the African Tobacco Control Alliance (ATCA) and the Vision for Alternative Development (VALD) in ten African cities including Ghana revealed that despite the existence of regulations, cigarettes are still being sold in single sticks and is readily available, and consumed in all 10 capital cities of the research. Aggravating the problem is tobacco advertising that is usually present where single sticks are sold.

“The availability of single sticks of cigarette allows individuals with few resources, such as the youth and the poor to buy tobacco products. In addition, the fact that single sticks are widely available and promoted, underscores the fact that they are considered as normal, meanwhile smoking is a dangerous addictive behaviour that can result in death,” stated Laram Musa, the Programmes Director of VALD who is also the National Coordinator for the Ghana NCD Alliance (GhNCDA). He was speaking at a press conference last week to outdoor the result of the research.

“School children are also exposed to candy cigarettes in the form of cigarette aimed at encouraging new smokers. There was also open advertising of cigarettes by shops and hawkers near the schools despite tobacco marketing restrictions,” he stated.

Highlighting the dangers of selling tobacco in single sticks Musa said the sale of cigarettes in single sticks undermines existing effective tobacco control policies by limiting an individual’s exposure to health warning labels and lessening the impact of tobacco tax increases on cigarette packs.

He said “One of the measures to aid the achievement of the Sustainable Development Goals is tax on tobacco products, it will serve as revenue stream for government and also discourages smoking and initiation.

“Sale of single sticks undermines smokers’ efforts to quit. One study conducted in Mexico found that smokers who experience more frequent cravings to smoke because of seeing single cigarettes for sale, are less likely to intend to quit when compared to smokers who do not experience such cues or cravings,” he further stated.

He called on the relevant stake agencies including the Ministry of Health, the Ghana Health Service and the FDA to act fast on the implementation of the law so as to save the citizenry – particularly children from the harmful effects of tobacco.

“There is no reason why we cannot act now to strengthen the implementation of the FCTC in Ghana,” he asserted.


Among others, the study has recommended that stringent measures are necessary for lasting solutions to the problem of selling single sticks of cigarettes in Africa. It called upon governments to ensure that the sale of single sticks or small packs of tobacco product is prohibited by passing and enforcing appropriate legislation.

“Ensure a comprehensive ban on all forms of tobacco advertising, promotion and sponsorship and this should include any advertising or promotional materials related to single sticks.

“Consider licensing of retail vendors of tobacco products to control the sale of single sticks,” the report stated.

Source: Jeorge Wilson Kingson ||



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