In Arab world, dangers of smoking go unrecognised, say experts

In the run-up to the “International No Tobacco Day” on Sunday, health experts and anti-smoking groups around the world launched campaigns to raise awareness about the dangers of cigarette smoking. In the Middle East, where awareness levels remain low and smoking remains dangerously prevalent, especially among the male population, the World Health Organization (WHO) emphasised the dangers involved in failing to address the phenomenon at a regional level. While political commitment across the region has risen, WHO officials say that little effort has been made to combat the smoking of cigarettes and shisha water pipes, popular in the Arab world. “In the East Mediterranean region, we still seem unable to take this message forward…to the general public in a way that has any meaningful impact,” reads a statement by WHO Regional Director Hussein Gezairy, which was delivered on Sunday. “Trends have changed, but I’m afraid it is for the worse.” Although there are no precise figures on the number of smokers in the region, a recent WHO survey revealed that smoking is more prevalent than ever in the Middle East, with shisha smoking part of the daily life for many across gender and age groups. In Egypt, the Ministry of Health is currently running an anti-tobacco campaign, issuing posters and regular information to the media on the subject. According to WHO statistics, Egypt currently runs a laboratory that works to regulate tobacco contents. Limits have also been set to regulate the maximum content of tar and nicotine in cigarettes. The limit on tar, for instance, is lower than that stipulated in Iran, but higher than in Jordan. A 1999 survey conducted by the health ministry revealed that 35 percent of the male population were smokers, compared to only 1.6 percent of women. However, more recent studies reveal that, with the spread of the use of shisha, smoking among women and young people is becoming increasingly widespread. While tobacco companies are banned from sponsoring sports and cultural events, there is no ban on the sale of tobacco below a certain age, according to the WHO. The WHO lists both a “lack of government commitment” and a “lack of financial resources” as key constraints to an effective anti-tobacco campaign. In Iraq, where smoking levels are high, no organised anti-smoking group exists. However, the health ministry is planning to approach the Cabinet to issue a decision banning smoking in all ministry buildings, health ministry spokesman Dr Qassim Allawi said on Wednesday. “We’ll start in our ministry,” said Allawi. “Then we'll ask the Cabinet to legislate a law that prohibits smoking in governmental buildings and public places.” Last month in Jordan, the Ministry of Health launched a campaign against the sale of cigarettes that fail to carry graphic health warnings. Parliament had recently endorsed a draft law that imposes hefty fines of US $3,000 on shop owners caught selling cigarettes without warnings. Another law was also passed allowing for the imprisonment of shop owners caught selling tobacco to minors. Around 3,400 cancer cases are reported annually in the kingdom, a third of which are habitual smokers, according to Bassam Hijawi, director of the ministry’s Health Promotion and Protection Department. More than half of the male population above the age of 25 are smokers, compared to 18 percent of females from the same age group. Smokers make up some 25 percent of the male population aged between 13 and 15, and 16 percent of females in the same category. In Lebanon, head of the Parliamentary Health Committee and Member of Parliament Dr Atef Majdalani told IRIN that, by the end of 2006, a draft law banning smoking in public places, selling cigarettes to minors and advertising tobacco products in public places and on television is expected to be passed into law. He added that his committee, along with other officials, were subject to heavy lobbying from tobacco companies since the draft law was proposed in 2004. Statistics for smoking in Syria make worrying reading. A study published in April by the Aleppo-based Syrian Centre for Smoking Research found that 60 percent of Syrian men and a quarter of women smoke cigarettes. That makes Syrians among the world’s heaviest smokers, with more than twice the global average for males. Equally worrying is the increasing habit among young Syrians of smoking shisha. Dr Fouad Mujallid, WHO representative in Syria, said, “We feel the number of young men and women who are smoking is increasing. But what is really surprising is the increase in smoking shisha. If this isn’t recognised, it will become a major problem.” With a widespread lack of public awareness about the causes of cancer, and with the price of cigarettes temptingly low at about US $1 a pack, many Syrians do little or nothing to protect themselves from the fatal disease. “If Syria’s Grand Mufti [the country’s highest Muslim authority] said that smoking was prohibited under Islam, I would take my box of cigarettes and throw it out the window,” said Mohammed Mogmaga, a 35-year-old taxi driver, between drags. “I smoke because I spend nine hours a day driving my taxi and there’s nothing else to do.” In 2004, Syria became one of the 121 countries to ratify the WHO Framework Convention on Tobacco Control, the first WHO global health treaty that sets out to curb tobacco consumption. The first Convention of the Parties of the Treaty met in Geneva from 6-17 February, to plan implementation of the treaty's measures. A week after the Geneva meeting, the Syrian Society for Stopping Smoking held its first meeting, attended by Health Minister Dr Maher al-Hosami, WHO Regional Director Gezairy and Dr Mujallid. The society says it aims to raise awareness about the dangers of smoking, particularly among the young. Perhaps the most practical step yet taken by the state was the announcement on 4 April that Aleppo University was to become a no-smoking area for both students and teachers. The move was welcomed, even among most university students. “It’s very good step. About 60 percent of the university's students are smoking,” said Nihad Ashkar, a student at the university’s Arabic Literature College, whose father died of lung cancer at only 39 years old thanks to a two-pack-a-day habit. “Even the girls smoke in the bathrooms.” “We have a stressful life in the Middle East,” said Dr Mouhedeen al Seaudi, director general of the state-run Nuclear Medicine Centre, which treats cancer patients. “Look at the political problems in Iraq and Lebanon, for example. I’m sure this is one of the psychological reasons behind why Syrians smoke so much.” In Yemen, meanwhile, almost 20 percent of boys and more than 10 percent of girls between 13 and 15 years of age were smokers in 2003, according to Dr Hashem Ali al-Zain, resident representative of the WHO. “And this percentage must have increased since 2003 as the number of smokers increases,” he said. Al-Zain regretted the fact that a law prohibiting smoking in public places has not yet been passed. On No Tobacco Day, said Al-Zain, only the Ministry of Health and the Yemeni Anti-Smoking Association pay much attention. “Unfortunately, on this day, smoking is not yet prohibited in governmental institutions,” he said. SA+SM+MBH+HM+LH+MAJ/AR/AM