People all over the world are living in homes with poor indoor air quality. This can have profound health impacts. According to the World Health Organisation, 4.3 million people die prematurely every year from illnesses attributed to household air pollution. These illnesses include pneumonia, stroke, ischaemic heart disease, chronic obstructive pulmonary disease (COPD), and lung cancer. There is also evidence of links between household air pollution and low birth weight, tuberculosis, cataract, nasopharyngeal and laryngeal cancers.

Air quality is impacted by polluting sources which release gases or particles into the air. These sources include second hand tobacco smoke, combustion pollutants that mostly come from solid fuels, biological pollutants such as mould and bacteria, among others. 

Second-hand smoke (SHS) is major indoor air-quality issue that costs many lives each year. It is not only a public health issue but also a human rights issue. SHS exposure kills 600,000 non-smokers each year. This equates to 1% of the total global disease burden. Children exposed to SHS have a 50%–100% higher risk of acute respiratory illness including asthma and pneumonia, higher incidence of ear infections, and an increased likelihood of developmental disabilities and behavioural problems. Among babies in utero there is an increased risk of premature birth and low birth weight. Exposure to SHS also doubles the risk for Sudden Infant Death Syndrome.

While responding to our correspondent on ‘Indoor Air Pollution’ Dr. Gan Quan, Director at the International Union Against Tuberculosis and Lung Disease (The Union) said that, “In order to prevent exposure to second-hand smoke, smokers should not smoke inside homes or in front of non-smokers, children in this case. Particulate exposure from biomass fuels can be avoided through upgrading to more efficient fuels such as natural gas.”

“Countries like Malawi, who are not a signatory to FCTC, should realise that tobacco use is one of the main contributors to Non-Communicable Diseases (NCDs); hence controlling tobacco usage is an effective measure to curb the NCD epidemic. One piece of advice I would offer is that measures should be put into place to restrict the advertising, promotion, and sponsorship of the tobacco companies. As a tobacco-growing nation, people generally might be more sympathetic to the tobacco industry and are more likely to take tobacco advertising, promotion, and sponsorship for granted,” said Dr. Quan.

He advised that, “ The tobacco companies should be distanced from public health policy making, especially in relation to tobacco control. “The necessity is clearly outlined in Article 5.3 of the FCTC and its guidelines,” he said.

Commenting on banning public smoking, Dr. Quan said that owners of public premises would never be willing to maintain a smoke free environment in their businesses unless forced to do so because telling smokers to stop smoking or to go outside to smoke can potentially insult some customers. But the owners of public premises do have the responsibility to keep their venues safe and healthy for all who have access to them.

 “Therefore, it becomes necessary to require owners/managers of public premises to maintain a smoke free environment to protect the health of non-smokers through legal measures. On the other hand, the government also has the responsibility to ensure that its citizens live in a healthy environment through enforcement actions of the smoke free law,” said Dr. Quan.  On the need to ratify the FCTC, Dingaan Mithi, Programme Manager at the Journalists Association Against AIDS, Malawi, told CNS that Malawi should quickly accede to FCTC to show that it puts public health on the top of the agenda rather than only looking at trade and profiteering.

“It is important for Malawi to take necessary steps to curb passive smoking which has devastating consequences on people’s health. We should also remember that tobacco continues to kill a lot of people in the country, hence we cannot ignore the tobacco disease burden any longer,” he said. Mithi added that Malawi should join the rest of the world to sign the FCTC and put in place the legislation to ban public smoking, just like what Zambia and South Africa have done.

It is high time, the Malawi government realized the dangers of the tobacco industry’s interference, even though it has not signed and enacted the Framework Convention on Tobacco Control. The tobacco industry has its eyes on Africa as a potential customer, where smoking rates are low in many countries (including Malawi), which means more room for growth of the cigarette market.