Tobacco control in the context of the COVID-19 pandemic in Uganda: a policy implementation review

BACKGROUND: The COVID-19 pandemic has caused more than 900,000 deaths globally. The risk of mortality is higher for people with pre-existing conditions such as cancers, respiratory and cardiovascular diseases and diabetes for which tobacco use is a known risk factor. We conducted a study to explore how efforts to address the COVID-19 pandemic in Uganda have been integrated with tobacco control policies to generate evidence to inform policy decisions about the public health response in general and tobacco control interventions in particular. METHODS: We conducted a desk based review of ‘grey’ literature data sources (i.e. data that were not included in peer reviewed journals) with information about tobacco and COVID-19 in Uganda. Data were also obtained from stakeholders involved tobacco control via an online survey and telephone interviews. FINDINGS: A total of 136 data sources were identified, of which 107 were eligible for data extraction. The online stakeholder consultation involved invitations to 61 participants of whom 33 (54%) took part via the online survey while 5 (8.2%) opted for telephone interviews. In the context of the COVID-19 prevention interventions, social media can be a powerful platform for communicating anti-tobacco messages such as the vulnerability of tobacco users to COVID-19 and the exacerbated disease severity among COVID-19 patients with history of tobacco use. Two thirds (n=20, 65%) of survey respondents expected a tobacco tax increase to address health, economic and wider policy impacts of the COVID-19 crisis. CONCLUSIONS: Advocacy should be conducted for taxation of tobacco products to reduce consumption and generate revenue to support public health investments. Public health institutions involved in the COVID-19 response should reject donations from the tobacco industry and its allies as is stipulated in the Framework Convention on Tobacco Control and the Uganda Tobacco Control Act 2015. The COVID-19 pandemic also offers an opportunity to promote tobacco cessation and strengthening tobacco control policy implementation by recognizing the role of tobacco use in exacerbating COVID-19 health outcomes.