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Cameroon, set in the crook of west Africa, is one of the many African countries that, while not often in the news, have tended to be open playing fields for tobacco companies. Depending on economic factors, some of them have at times seemed like adventure playgrounds for tobacco advertisers. In the past, like so many similar developing countries, Cameroon’s frail economy, with all the immediate concerns of any low income developing country, helped ensure that tobacco control never became a dominant issue. Apart from smoking bans in healthcare facilities, and restrictions in government buildings and educational facilities, it showed nearly a full house of “not regulated” scores in surveys of tobacco control measures and infrastructure. It is therefore just the sort of country where one could expect to see some noticeable changes deriving from the World Health Organization’s Framework Convention on Tobacco Control (FCTC).
Cameroon signed the FCTC in May 2004 and ratified it less than two years later, in February 2006. Before that, smoking prevalence was low among the African population—around 36% among all adults—but higher in the country’s expatriate population, who tend to be a focus for advertising for their significantly larger incomes and their perceived status as leading the consumer good life that advertisers wanted to sell to everyone else. BAT has a third of the market, the more expensive end, and its advertising has been fairly predictable. Offers of cigarette packs with coupons offering the chance to win luxury prizes have been typical, as used by BAT as recently as this year to promote its Pall Mall brand. Other Pall Mall billboards, featuring a giant picture of the brand, have claimed, “5,000,000 people smoke one cigarette.” At around a fifth of the adult population, this would make Pall Mall significantly the most popular brand, though Benson & Hedges, Marlboro and other brand advertising was also widespread. Tobacco sports sponsorship included golf tournaments in which prizes included boxes of cigarettes, irrespective of whether the winner was a smoker.
Now, however, tobacco billboards are reported to have largely disappeared, though cigarette emblazoned umbrellas at sales booths and restaurants are still common. Tobacco manufacturers, no doubt using the hospitality trade to do their dirty work, will squeal loudly if and when the government acts to remove remaining promotional items, but that and many other measures will cost nothing to implement. Health warnings, for example, currently contain classic tobacco industry language to indicate uncertainty about smoking causing disease: printed in both French and English, they warn only that “Tobacco may be dangerous to your health.” It is to be hoped that the lengthy FCTC negotiation process made Cameroonian health officials realise that such tentative statements are no longer acceptable, and that their country can have the same sort of warnings as the international leaders by means of a simple ultimatum to the manufacturers.
While Cameroon is something of a cultural and market leader for some of its neighbours, such as Chad and the Central African Republic, the economic challenges it still faces make it unlikely to be a prime target for international tobacco companies. However, as long as people are paid to try to get citizens in any country to smoke, they will try to get round legislation. With tobacco control a relatively recent item on the agenda, countries such as this may offer instructive case histories as the process of implementing and enforcing legislation under the FCTC unfolds.