The use of social media, entertainment content and online sales platforms are making tobacco control and related enforcement of its law increasingly challenging, the Acting Director of the Tobacco and Substances of Abuse Directorate of the Food and Drugs Authority (FDA), Dr Martin Kusi, has said.

According to him, promotion of tobacco and other nicotine products through these communication channels have presented fresh challenges that requires stakeholders to come up with new ways to identify and document possible violations.

Dr Kusi, expressed the concerns at a two-day training workshop for journalists and Civil Society Organisations (CSOs) in Accra on Tuesday under the Tobacco Policy Action Fund for Africa Project, initiated by Management Sciences for Health.

The workshop was aimed at strengthening the capacity of the participants to monitor emerging forms of tobacco promotion and gather information that could support enforcement of Ghana’s tobacco control laws.

The workshop was occasioned by the growing popularity of substances including Shisha and other nicotine products among the youth despite the efforts to curb its use.

Dr Kusi stressed that information gathered through monitoring activities needed to be properly documented and channeled through the appropriate reporting and referral mechanisms to facilitate enforcement.

He, therefore urged journalists and CSOs to strengthen their capacity to identify tobacco related promotional content and report suspected violations, particularly in digital spaces where such material could reach large audiences.

The Country Representative of the World Health Organisation (WHO), Dr Joana Ansong, said the training was particularly important as Ghana’s tobacco control landscape changes with the emergence of shisha, electronic cigarettes, vapes and other novel nicotine products.

Gladly, she explained that Ghana’s national smoking prevalence was relatively as low as 4.8 per cent but that, she added should not lead to complacency.

That notwithstanding, she stated that some regions including the Upper West Region recorded significantly higher rates approaching 10 per cent.

Dr Ansong said there was a growing appeal for shisha among young people, young adults and females, particularly because of its attractive flavours.

She also drew attention to electronic cigarettes and vapes designed in forms resembling cartoon characters, toys, school supplies and other everyday objects, saying such designs could appeal particularly to young people.

Dr Ansong said tobacco use remained one of the leading preventable causes of death globally, with about 1.2 billion people using tobacco worldwide and about seven million people dying annually from tobacco related causes.

She further noted that tobacco use contributed significantly to cardiovascular diseases, stroke, chronic respiratory diseases and more than 20 types of cancers, while about 1.6 million deaths annually resulted from exposure to second hand smoke.

Ghana’s tobacco control framework is anchored in the Public Health Act, 2012 (Act 851) and the Tobacco Control Regulations, 2016 (L.I. 2247), which prohibit tobacco advertising, promotion and sponsorship.

By Stephanie Birikorang

The root causes: It is never just one reason

My years of counselling at CPAC show me abandonment is rarely an act of malice. It is the tragic endpoint of seven overwhelming distresses:

Psychology

1. Severe maternal mental illness —The hidden emergency

a) Clinical Postpartum Depression (PPD): This is far beyond “baby blues.” It is a severe mood disorder that can appear weeks to months after birth. Due to a massive drop in hormones, extreme sleep deprivation, and emotional exhaustion, the mother feels deep sadness, worthlessness, and complete emotional numbness towards her baby. Picture: A new mother sits by her bed all day, staring blankly. Her baby cries for hours, but she cannot lift her hands to carry the baby. She whispers, “This baby would be better off without me.” She does not hate the baby; she feels she has completely failed as a mother.

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b) Peripartum Psychosis (Postpartum Psychosis): This is a psychiatric emergency. Rare but extremely dangerous, appearing suddenly within the first 2-3 weeks after delivery. The mother completely loses touch with reality. She hears commanding voices telling her to abandon the baby, or believes the baby is possessed by an evil spirit or is a “spirit child” who will bring a curse. Picture: A mother genuinely believes she heard a voice saying, “Leave this child at the crossroads at midnight or your family will die.” She abandons the baby not out of hatred, but because her broken mind believes she is obeying a higher spiritual order to save her family.

c) Pre-existing untreated Schizophrenia: This is a chronic, severe mental disorder that existed before the pregnancy. The stress of pregnancy and labour shatters her fragile coping. She suffers from paranoid delusions — believing people want to poison her and the baby — flat affect (zero facial expression), and grossly disorganised thinking, making it impossible to plan how to feed or clean a baby. Picture: A young woman whose family called her illness “spiritual attack” instead of taking her for medication wanders away after delivery, completely forgetting she even gave birth, leaving the infant behind.

2. Extreme socio-economic deprivation: For many girls in some parts of Ghana such as Kasoa, Madina, or Bekwai, poverty is not a statistic; it is a daily panic. No money for antenatal care, no money for hospital delivery, no money for baby diapers or formula. When a mother cannot feed herself, the thought of feeding another mouth feels impossible. Some mothers say, “I left her where someone richer would find her, because I could not watch her starve to death in my hands.” It is a distorted act of survival.

Geographic Reference

3. Intense societal stigma and shame: In Ghana, pregnancy outside marriage, teenage pregnancy, or pregnancy from rape can bring extreme family rejection. The girl is called “spoilt,” beaten, banned from church, or sacked from school. The fear of bringing shame to the family name is heavier than the fear of police. So she hides the pregnancy for 9 months, delivers alone, and abandons in secret to protect her family’s “honour.”

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4. Paternal abandonment — The Man Who Ran Away: Behind almost every abandoned baby is a man who vanished. He says, “It is not mine,” or “Abort it,” and switches off his phone. The mother is left utterly isolated — no emotional, financial, or social support. She is criminalised alone, but the abandonment started with him. Psychological research shows paternal denial is one of the strongest predictors of maternal panic and newborn abandonment. 

5. Substance abuse disorders: Alcohol, tramadol, and other drug addiction impair the brain’s executive functioning — the ability to plan, judge consequences, and process emotions. A mother struggling with addiction may give birth in a highly intoxicated or withdrawal state, unable to comprehend the needs of the newborn, leading to neglect and eventual abandonment.

6. The spirit child cultural phenomenon and superstition: In some remote pockets of Northern Ghana and even in few parts of Central and Ashanti regions, public health research shows babies born with congenital deformities, severe disabilities, or whose mothers die in childbirth are branded as “spirit children” or cursed. In extreme instances, families, under cultural pressure, mandate that such babies be exposed or abandoned at shrines or bushes. This is not mental illness, but a harmful cultural belief system that still kills.

The invisible wounds

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On the baby: Risk of death from hypothermia, sepsis, and infection. Survivors suffer Anaclitic Depression and Failure to Thrive due to lack of touch. As adults, they battle Reactive Attachment Disorder, chronic mistrust, and identity crisis — “Why did my mother leave me in a dustbin?”

Babies & Toddlers

On the mother: Lifelong hidden grief, intense guilt, chronic PTSD, depression, and elevated suicide risk. A prison cell does not heal this.

On the nation: Overburdened orphanages like Osu Children’s Home, draining health budgets, and overworked Social Welfare officers.

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