Half of Kenyan patients with cancer, heart diseases have tobacco problems – analysis

 

Nearly half of all patients diagnosed with cancer at Kenyan national hospitals have a history of tobacco use, a new analysis suggests.

The researchers found the same trend in patients with heart diseases, cerebrovascular illnesses (conditions that affect blood flow to the brain) and lung tuberculosis.

They assessed 2,032 patients between January and October 2022, at the Kenyatta National Hospital, Moi Teaching and Referral Hospital, Kenyatta National Hospital-Othaya Referral Hospital and Kenyatta University Teaching, Referral and Research Hospital.

Commenting on the findings, experts from the Ministry of Health recommended that all new patients with the four illnesses be screened for tobacco use and undergo cessation support as part of clinical care.

Although the link between tobacco use and the four diseases— collectively known as tobacco-related illnesses— is well known, this is the first time the burden has been quantified in Kenya.

The researchers noted that most of the patients who reported current or past tobacco use were older, which showed how tobacco devastates the body as people age.

“Since tobacco-related morbidity and mortality manifests several decades after use initiation, burden of disease would be higher in older patients,” the researchers said.

The analysis of the patients showed 45 per cent of them were ever tobacco users, six per cent were current and 39 per cent were former tobacco users.

“This is higher than the national average tobacco use in Kenya, pointing towards higher burden of use among patients with tobacco-related illnesses compared with the general population,” the researchers said.

The final report is available on the online pre-print server MedRxiv, awaiting peer review and possible publishing in a journal.

It is titled, "Prevalence and factors associated with tobacco use among patients with tobacco-related illness in four national referral hospitals of Kenya."

The authors said they are confident they captured the majority of the tobacco-related illnesses diagnosed in the country during the period under focus.

The three most common tobacco-related illnesses among the patients were oral pharyngeal cancer (36 per cent), nasopharyngeal cancer (12 per cent) and lung cancer (10 per cent). Peripheral arterial disease (PAD) was the least common TRI (2 per cent).

However, the study also had limitations. Being hospital-based, it may not be representative of the wider population. As such the findings may not be generalised to the country’s population, the authors said.

They include Dorcas Kiptui, who heads the Tobacco Control Division in the Ministry of Health. Anne Kendagor, Gladwell Gathecha, Valerian Mwenda and David Njuguna from the Ministry of Health, and Lazarus Odeny and Jane Rahedi Ong’ang’o from the Kenya Medical Research Institute.

The others are Florence Jaguga (MTRH), Beatrice Mugi (KNH),  Caroline Mithi (KUTRH),  Kennedy Okinda (KNH-Othaya), Daniel Mwai (University of Nairobi), Shukri Mohamed (APHRC), and Winnie Awuor and Rachel Kitonyo-Devotsu from the non-profit Development Gateway.

The report comes when health experts are warning that failure by the government to raise taxes on tobacco and nicotine products will hurt the poor most, since they cannot afford treatment for diseases such as cancer.

Taxes on tobacco, nicotine and alcohol will not be raised for the first time in five years, according to the Finance Bill 2023.

However, the Kenya Tobacco Control Alliance, and the legal think-tank International Institute for Legislative Affairs, told MPs this is plainly wrong.

“This omission is troubling because, as per the Ministry of Health, tobacco usage claims the lives of approximately 9,000 Kenyan users annually,” Ketca chairman Joel Gitali said.

“It is crucial for a product with such detrimental health effects to be subject to higher taxes. Taxation has been proven to be an effective tool in reducing smoking rates and ensuring tobacco duties contribute significantly to government revenues.”

He made the comments in an analysis of the Finance Bill 2023, that Ketca has presented to the National Assembly health committee.

Gitali said the affordability and easy accessibility of tobacco and alcohol products have played a significant role in enabling their widespread use, including among vulnerable populations, such as young children.

He said, “A report by the Ministry of Health in Kenya stated that tobacco and alcohol products are often sold at low prices, making them more accessible to individuals of all ages, including children.”

He said the World Health Organization recommends that taxes should constitute at least 70 per cent of the taxes on cigarettes.

Cigarettes have no benefit to a human being but it contains thousands of chemicals and 70 of them are known to cause cancer.     BY THE STAR