In the face of consistent opposition from the tobacco industry, Uganda is standing firm on its successful eight-year long ban on the sale of electronic cigarettes (e-cigarettes), says World Health Organization (WHO) Country Representative Dr Yonas Tegegn Woldemariam.

The Tobacco Control Act, 2015 sought to effectively remove this globally popular tobacco alternative to smoking cigarettes from public life. Current evidence indicates that using e-cigarettes is dangerous, especially for young people and people who have never smoked. This is especially significant, says Dr. Yonas, for a country in which over 15% of boys and 13% of girls aged 13 to 15 start smoking every year. 

Electronic cigarettes are battery-operated devices that emit a vaporized solution to inhale. These include e-hookahs, vaporizer cigarettes, vapes, and vape pens. They contain nicotine and other harmful contents such as acetaldehyde that causes cancer, acrolein - a weed killer that can lead to irreversible lung damage, and diacetyl, a chemical linked to bronchiolitis.

“Despite Uganda’s high and increasing burden of non-communicable diseases morbidity and mortality rates, one in ten people still smoke cigarettes daily, making the practice an ongoing and dire public health threat. This justifies the Tobacco Control Act and all the other government initiatives to regulate products, including e-cigarettes,” Dr. Yonas emphasizes.

Uganda is one of the 35 countries globally where e-cigarettes are banned. The law bans the importation, manufacture, distribution, processing, sale, offer for sale of e-cigarettes, including nicotine- and non-nicotine containing liquids among other substances.

As opposed to the tobacco industry’s claim that e-cigarettes are less harmful with potential to help smokers quit, people who switch from traditional cigarettes to e-products put off getting medical help or trying proven tools that can help with quitting and this delays or even prevents a person from quitting smoking. A 2016 study reported in the Lancet journal found that people who use or have used e-cigarettes are less likely to stop smoking.

The tobacco life cycle is an overwhelmingly polluting and damaging process, with severe environmental consequences, including deforestation, the use of fossil fuels and the dumping of waste products into the natural environment including non-biodegradable butts – millions of kilograms of which are discarded every year. Tobacco is estimated to kill 204 Ugandans every week.

As part of efforts to restrict its use, the government included the ban on the sale of e-cigarettes in the Tobacco Control Act, 2015. Even though legal consequences aren’t optimally enforced, it is encouraging to see that there are now comparatively fewer people smoking in public. 

According to WHO’s Tobacco Epidemic Report of 2019, cigarettes became less affordable between 2008 and 2018 in Uganda. Other gains in tobacco control in the country include a ban on direct advertising, promotion and sponsorship, and an increase in tobacco taxation by 39.9%

A 2019 legal challenge to the Constitutional Court by the British American Tobacco Uganda, which has a near-monopoly on Uganda’s tobacco industry was foiled when the Constitutional Court upheld the 2015 Tobacco Control Act as constitutional, dismissing the tobacco company’s petition.

Mable Kukunda, Advocacy and Networking Officer at the Uganda National Health Consumers' Organization says the ban on e-cigarettes in Uganda is yet to have a significant impact on people's health.

“There's been diminutive evidence of enforcement or prosecution of offenders, and many tobacco control actors have limited knowledge about e-cigarettes, a further complication to enforcement the ban. The ban on e-cigarettes needs to be implemented concurrently with other proven strategies in tobacco control, such as tax measures and close monitoring of the industry,” says Kukunda.

Ms Kukunda suggests that full implementation of the ban can save young people from harmful innovations such as e-cigarettes and the tobacco industry’s subtle marketing strategies.

Uganda is a signatory to the WHO Framework Convention on Tobacco Control, which provides countries with evidence-based strategies to address the tobacco epidemic in their national contexts. Research conducted as part of Uganda’s 2014 Global Adult Tobacco Survey revealed strong support for anti-tobacco measures. Nine of every ten adult respondents favored both an increase in taxes on tobacco products, and a complete ban on tobacco advertising (88.2% and 89.3% respectively).

WHO continues to support the Ministry of Health Tobacco control initiatives, including sensitizing communities about the negative impacts of tobacco consumption on health and the environment, and encouraging local farmers to plant food rather than tobacco.

Other areas support by WHO are research, training of enforcement officers and laboratory personnel, surveillance including the global adult tobacco survey, the school health survey, the global tobacco youth survey, the noncommunicable diseases risk factor survey.