Little progress curbing smoking in the Arab world

Sunday 18/06/2017
No effect. A waitress walks past a No Smoking sign next to an ashtray at a café in Beirut. (AFP)

Beirut - Although it is declining worldwide, tobacco smoking remains dan­gerously prevalent in the Middle East and North Africa where awareness lev­els remain low and governments have failed to strictly address the phenomenon.
Lax tobacco regulations, the rela­tive low cost of cigarettes and the prevalence of shisha in Arab coun­tries make tobacco consumption a pressing health concern for the region.
There are no precise figures on the number of smokers in the re­gion but a recent World Health Or­ganisation (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.
On World No Tobacco Day, Re­gional Director for WHO Eastern Mediterranean Office Mahmoud Fikri raised the alarm on the de­structive effects of tobacco use, which he said not only harm human health but have corrosive effects on the environment and the economy.
“Tobacco use hinders the achievement of sustainable devel­opment,” Fikri said in a statement, “This is why we renew our call to governments to intensify their anti-tobacco use efforts.”
An estimated 7 million people die from tobacco-related causes every year across the world, including 900,000 who die from exposure to second-hand smoke, WHO said. The organisation added that 80% of tobacco use fatalities occur in low-or middle-income countries and that these countries bear 40% of the global economic cost of smok­ing from health expenditures and lost productivity, estimated at more than $1.4 trillion.
WHO called on governments to raise taxes on tobacco products, ban tobacco advertisements and channel tobacco tax money to the health and education sectors. It said combating tobacco can con­tribute to reducing poverty and hunger and boosting sustainable agriculture and economic develop­ment.
Fatma el-Awa, a regional advis­er of the Tobacco Free Initiative, which was launched in 1998 to focus international attention, re­sources and action on the tobacco epidemic, referred to a rise in the number of adults using tobacco in the Eastern Mediterranean region.
She said 42% of adults in the re­gion use tobacco and that figure was expected to reach 62% by 2025.
“This presents health care in­stitutions in the region with huge challenges because an increase in tobacco use means more disease, more fatalities and consequently more expenditure on health care,” Awa said.
When it comes to intense tobacco use, Egypt, by far the most popu­lous country in the region, is a case in point.
Egypt produces 84 billion ciga­rettes every year and the tobacco industry is an important source of income for the Egyptian Treasury, said the Tobacco Division at the Federation of Egyptian Industries, the guild of the country’s manu­facturers and factory owners. The government earns $2.4 billion from tobacco sales every year.
“This means that revenues from tobacco sales come in second place after the Suez Canal when it comes to this country’s largest sources of income,” said Ibrahim el-Embaby, the head of the section.
The country owns 55% of the Eastern Company, which has a mo­nopoly over tobacco production in Egypt. The remaining 45% of shares are owned by national banks, which are also owned by Egypt. Approxi­mately 14,000 Egyptians work in tobacco production and selling.
While much of the Arab world is plagued by tobacco consump­tion, the problem is especially dire in North Africa. Tunisia and Egypt track well above international aver­ages with 45.1% and 36.1%, respec­tively, of their adult male popula­tions smoking, state statistics from the WHO’s Tobacco Atlas, a global database on tobacco consumption.
Citizens of eastern Mediterrane­an countries pick up the habit earli­er than any other area of the world, with 21.3% of 13-15 year-old males smoking. In Tunisia, 22.2% more men suffer tobacco-related deaths than in average middle-income countries.
Anti-tobacco campaigns produce little effect. The campaigns include television ads and frightening pho­tos of people dying of tobacco use and anti-tobacco use advice on cigarette and tobacco packs. None­theless, tobacco sales never come down.
Sahar Labib, the head of the Egyptian Health Ministry’s section that fights tobacco use at the na­tional level, said the fact that laws on smoking in public places are rarely enforced raises the risk for non-smokers.
“The law imposes fines on those who smoke in public places but this is rarely enforced,” Labib said. “This increases exposure to sec­ond-hand smoke, which exacer­bates the problem.”