According to the World Health Organisation (WHO), more than 1.3 billion people globally use tobacco, leading to over 8 million preventable deaths annually. These deaths are often linked to cancer, cardiovascular diseases, diabetes, and respiratory illnesses. Nigeria is not exempt. The toll from tobacco-related diseases is rising and puts immense pressure on an already strained health care system, while also contributing to poverty, diminished productivity, and long-term social instability.

In 2015, Nigeria made a commendable leap forward by passing the National Tobacco Control Act (NTCA), aligned with the WHO Framework Convention on Tobacco Control (FCTC). The Act promised bold reforms, smoke-free public places, bans on tobacco advertising, sponsorship and promotion, graphic health warnings, plain packaging, and the establishment of a Tobacco Control Fund.

This was followed in 2019 by implementing regulations intended to provide enforcement clarity. However, nearly a decade later, implementation remains limited and uneven.

Despite its strengths on paper, the NTCA has been plagued by chronic underfunding and weak enforcement. In 2023, just ₦4.7 million was allocated to support the work of the National Tobacco Control Committee (NTCC). Although this increased to ₦10 million in 2024 and is projected at ₦13 million in 2025, these figures fall drastically short.

For comparison, a single statewide public health campaign in Lagos or Kano alone would exceed that amount. Public health advocates, including Corporate Accountability and Public Participation Africa (CAPPA), have called for at least ₦300 million annually to effectively implement and monitor the Act.

Without this investment, enforcement agencies such as NAFDAC, the Nigeria Security and Civil Defense Corps, and the Federal Competition and Consumer Protection Commission (FCCPC) cannot fulfill their mandate to curb illegal sales, enforce bans, or restrict marketing that targets young people.

Recent legislative proposals, particularly House Bills 47 and 1151 have also raised concerns. These bills appear to exclude modern nicotine products such as e-cigarettes, heated tobacco, and nicotine pouches from the scope of regulation. This is dangerous. Tobacco companies are increasingly shifting toward these newer products, branding them as safer alternatives despite inconclusive evidence.

The growing popularity of such products among youth is troubling. Any amendment to the NTCA must expand, not limit, Nigeria’s regulatory authority over all forms of tobacco and nicotine. As a clinician and mental health professional, I regularly see how tobacco intersects with trauma, poverty, and stress. In underserved communities, cigarettes are often used as coping mechanisms alongside alcohol or other substances.

Tobacco control policy must therefore be integrated into the broader public and behavioral health framework. Quit programs should go beyond hospital settings. They should be available in primary care centers, schools, and even correctional facilities. Behavioural interventions like cognitive behavioral therapy (CBT) and motivational interviewing can greatly improve quit rates and prevent relapse. Social workers and health professionals should be trained in trauma-informed approaches to tobacco cessation.

Public education campaigns must also be accessible and relatable. Graphic warnings are important, but not sufficient. Messages should be culturally relevant, presented in local languages, and delivered by trusted community leaders. Youth engagement is critical. Peer education and youth-led advocacy can create ripple effects that transform perceptions and reduce initiation rates among teenagers.

There are also regional and international lessons to draw from. Kenya has introduced a 2% tobacco tax to fund health education. Bangladesh has implemented a 1% health surcharge on tobacco industry profits for reinvestment in public health. Nigeria can follow suit. Regional collaborations with other tobacco control groups can help strengthen our legislation, enforcement strategies, and public education tools. These alliances allow for shared learning and coordinated responses to an industry that continues to evolve its tactics.

What Nigeria needs now is not just a well-written law, but a system of meaningful enforcement, health-centered programming, and civic engagement. The government must commit to increasing annual funding for NTCA implementation to at least ₦300 million. It must reject any legislative attempt that weakens the current protections. It must integrate cessation programs into schools and community health services. And it must place the power of education in the hands of the people, civil society groups, parents, young people, and health workers.

The National Tobacco Control Act of 2015 was a critical first step. But laws, no matter how well-crafted, will fail without sustained action. Tobacco control is about more than health, it is about dignity, justice, and economic resilience. We have the tools, the research, and the policies. What remains is the will.

Nigeria stands at a crossroads. We can either allow our progress to erode through underfunding and industry interference, or we can build a smoke-free future, one that honors the health, future, and humanity of every Nigerian.

Let us choose wisely.

Seye Omiyefa is a mental health professional, substance use prevention advocate, and tobacco control policy expert.

Views expressed by contributors are strictly personal and not of TheCable.