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According to a report titled ?Health care costs attributable to smoking induced cardiovascular diseases in Tanzania,? the total costs of smoking in the country is 118.7 million US dollars per year.

?Most of the patients appear to be elderly males and the amount spent on patients aged 40 years and above constitute 68 per cent of the total expenditure.

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This group may have been smoking for many years and this is likely to prolong recovery, increase health care costs, accelerate mortality and decrease life expectation,? one of the authors of the report, University of Dar es Salaam Professor of Economics and Statistics, Asmerom Kidane, said.

Prof Kidane said in the report that with an estimated cardiovascular prevalence of 2 per cent and having a severely limited access to health care centres as cited by the World Bank in 2012, there is every reason to believe that the prevalence is an underestimate.

Tanzania has insufficient and outdated health facilities, with per capita income of 609 US dollars per year, a figure that is ten times lower than that of China, the report further said.

Prof Kidane said that other reasons for the underestimation includes the fact that many Tanzanian smokers belong to the low income group and are less likely to have access to referral clinics, thus there may be serious under reporting.

?Other smoke related diseases such as cancer, hip fracture and gum diseases are not considered. The loss in earnings due to higher mortality (low life expectation) is also not accounted for.

Most importantly, the negative health effects of passive smoking are not included. The latter is likely to be high within a household setting where the mean household size is more than five individuals,? the report read in part.

Another author of the report from the Department of Economics at the University of Dar es Salaam, Dr Aloyce Hepelwa, said that comparing the mean monthly income between non-smoking and ever-smoking cardiovascular patients; the results reveal that the mean income of non- smoking patients as being 138.2 US dollars; while for ever-smoking patients is 110.2 US Dollars ? a difference of 25.4 per cent.

Dr Hepelwa said that about 29 per cent of non-smoking cardiovascular patients appear to be insured; the corresponding value for ever-smoking patients is only 23 per cent; implying that the burden of health care cost is high among ever-smokers.

?Policy makers in Tanzania ought to introduce policies and guidelines to decrease the prevalence of ever-smoking in Tanzania. This will help reduce the cost of smoking related diseases,? Dr Hepelwa said in the report.

An Economics PHD student at the University of Dar es Salaam, Ernest Tingum Ngeh also an author of the report cited that export earning from tobacco was 252.6 million US dollars, according to the Tanzania Revenue Authority (TRA) report of 2013, which constitutes to 40 per cent of total export earnings from traditional crops.

Mr Ngeh said that with regards to cigarette smoking, the overall smoking prevalence rate is 12.4 per cent for males, 8.8 per cent for females and 10.6 overall according to the WHO in 2009 and that the overall estimate increases to 20.5 per cent when the reference population is limited to adults between 15 and 60 years.

In 2007 the government ratified the WHO?s Framework Convention on Tobacco Control (FCTC). However, implementing the convention guidelines appear to be lagging. The report utilised a 2014 survey conducted among cardiovascular patients at the cardiovascular ward of Muhumbili referral and teaching hospital in Dar es Salaam.

A total of 123 patients were interviewed over a period of two months where 59 patients were outpatients and 64 were inpatients. Enumerators included two medical doctors, a nurse and two postgraduate students.

The results showed 46.6 per cent of the outpatients as being males; the corresponding value for inpatients is 56.3 per cent.

The per cent of males aged 40 years and above (the age range when tobacco related diseases are at their peak) is 66.1 per cent for outpatients and 57.8 per cent for inpatients.

Other findings are that compared to inpatients, outpatients seem to have smaller household size, a higher monthly income and greater insurance coverage and that the per cent of ever-smokers (current and past smokers) among the cardiovascular patients as being 28.8 per cent for outpatients and 21.9 per cent for inpatients.

By MASEMBE TAMBWE, Tanzania Daily News

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