The costly failure to cut smoking in the Arab world

The story of tobacco is in a way one of death and taxes. The choice is normally clear but some countries seem to weigh their options.
Sunday 17/03/2019
Palestinian vendors sell cigarettes at a shop in Gaza City. (AFP)
A scourge without borders. Palestinian vendors sell cigarettes at a shop in Gaza City. (AFP)

If tobacco addiction is the most preventable cause of death, why can’t humanity treat it as the scourge it is? A scourge without borders. Like climate change, let’s say.

Instead, certain regions of the world seem to be perceived as more equal than others when it comes to prevention from pulmonary nicotine stains.

Tobacco sales in Europe have fallen by no less than 38% during the last 20 years as a result of awareness campaigns and anti-tobacco measures. Sales seem destined to fall further. Not in Africa and the Middle East, however.

In those two regions, 180 million men are predicted to be smoking by 2025 — twice as many as in 2000. The World Health Organisation said it expects the percentage of African smokers to rise 40% in 2025 compared to the 2010 level.

Much of this catastrophic situation has to do with a lack of social awareness and political will. These factors can only necessarily lead to inadequate policies in the Arab and African regions.

A whole body of evidence points to lingering complacency. Even without scientific statistics or paid surveys, anecdotal evidence shows a depressing reality.

Incredibly false notions endure. Some young Arab would tell you smoking “clears the lungs.”

Young women cling to the notion that “light” cigarettes are feminine and not that harmful. In behaviour that harkens to the days of “You’ve come a long way, baby,” many female smokers are taking up the shisha habit.

This practice is catching up in the Maghreb the same way it swept the Levant in years past. Cancer statistics in Lebanon, Jordan and Syria have long illustrated the problem. The growing acceptability of public shisha smoking among women in the Maghreb is exposing families, including babies, to second-hand smoke.

In many parts of the Arab world, laws and regulations were passed to restrict or ban smoking but there has not been much political will to enforce them. Despite its harmful health effects and the cost incurred by the state, in terms of medical bills and sickness-related work absences, the problem is hardly perceived as a priority by most politicians.

Some short-sighted politicos would argue that young people, already frustrated by lack of jobs and opportunities, are not to be bothered by the added pressure of restrictions on cigarette sales and consumption as if letting them develop lung cancer or emphysema could improve their career potential.

There is also the perception that some governments have of economic and social stability. Decision makers tend to see the resistance of restaurant and coffee shop owners to smoking restrictions as a reason not to enforce laws on smoking. Keep them puffing, keep them happy.

There are also the geographically based marketing policies of the multinational tobacco companies. Many of these companies are based in countries steeped in the anti-tobacco culture.

Take Switzerland, for example. An investigation by the Swiss institute Public Eye has shown that cigarettes exported by Switzerland to Morocco and other African countries are “more addictive and more toxic than those sold in Switzerland or France.”

About 75% of the cigarettes produced by Swiss-based manufacturers are destined for export. For Switzerland, such exports generate comparable revenues to such flagship products as cheese and chocolate.

Research commissioned by Public Eye has shown that some tobacco brands manufactured in Switzerland and sold in Morocco contain more than 80% more nicotine than the same brands sold in Switzerland. Swiss and European lawmakers are not responsible for the health of African and Arab smokers. Their corporations can reap all the profits they can get outside their countries’ borders.

The story of tobacco is in a way one of death and taxes. The choice is normally clear but some countries seem to weigh their options. Increasing taxes on tobacco products limits the affordability and consumption of cigarettes. It, therefore, saves lives but officials in the region seem to treasure the tax revenues they get from tobacco. They fear higher prices could limit revenues or drive customers to the informal sector.

Fighting tobacco addiction should be as merit-worthy as fighting climate change. Worldwide efforts, including the adoption of international manufacturing and export regulations and the exchange of awareness-building techniques, are needed. Multinationals should have to pay for genuine tobacco prevention programs instead of the PR-motivated initiatives they now finance.

There could be blacklists established for countries and corporations that persist on flaunting the public health rules in any part of the world but, before anything else, there needs to be more political will to clean the air we breathe from cigarettes and shishas. The Arab world and Africa are no exception.