“Before, hotel workers were uncomfortable with customers smoking tobacco indoors,” he says. “Now the hotel is cigarette smoke-free; we do not permit smoking by anyone, whether local or foreign.”

Benishangul is one of five regions recently identified by the Ethiopian Ministry of Health as having high prevalence of tobacco use, traditional tobacco smoking, access to illegal tobacco products, and khat chewing and alcohol consumption. These were among the criteria used in a new tobacco control support initiative supported by World Health Organization.

In addition to Benishangul, the regions of Afar, Gambella, Oromia, and Somali have been targeted for enforced tobacco regulation, which includes the designation and enforcement of smoke-free environments to protect the population from the harms of second-hand smoke.  

“Second-hand smoke exposure is a matter of public health,” says Heran Gerba, head of Ethiopia’s Federal Food and Drugs Authority. “Our most recent data shows that nearly one-third of adults – that’s 6.5 million people – working indoors are exposed to tobacco smoke in the workplace, and a further 8.4 million are exposed at home. Enforcing smoke-free environments is one of the major steps we are taking to protect health and promote safer environments.”

Building on lessons learned from an earlier pilot programme in Addis Ababa, Amhara, and Oromia, the initiative has trained more than 300 law enforcers, including police officers, at the regional level. Enforcement takes the form of education on the dangers of tobacco smoke, engagement of health workers, media and civil society to promote and advocate smoke-free environments, as well as surprise inspections and fines.

Additionally, the government has been raising intensive public awareness about tobacco use, the importance of protecting people from second-hand smoke exposure and promotion of quitting using regional radio and television programming in various local languages. More than 17 000 ‘No Smoking’ stickers have been distributed to public places throughout the designated regions.

The results have been encouraging so far.

In Dire Dawa City Administration, near the border of the Oromia and Somali regions, 78% of public places such as hotels, bars and restaurants as well as government workplaces were recently found to have been in full compliance. At 4.4.%, Dire Dawa’s smoking prevalence is significantly higher than the national rate of 3.7%.

According to the 2016 Global Adult Tobacco Survey, about 5% of Ethiopians, or about 3.2 million people, use tobacco products. Tobacco consumption among men is nearly eight times higher than among women.

For Tano Maure, manager of the Case Asosa Hotel in Benishangul, the benefits of enforcement go beyond physical well-being.

“The declaration of smoke-free environments is very good,” he says, noting that smoking in hotels is now illegal in his area. “Cigarette smoking causes many health, social and psychological problems for the individual and the country.

“This will help us become a more productive and nonaddictive society,” he points out.