Worrisome trends but also welcome moves regarding smoking in MENA
Saudi Arabia has introduced a total ban on smoking in public places and the United Arab Emirates is expected to do the same by the end of the year. These are welcome developments in an Arab world where tobacco consumption should be a major concern.
According to the Tobacco Atlas, tobacco consumption in countries of the eastern Mediterranean has increased by more than a third since 2000.
The percentage of people who smoke in the Arab world varies from 20% in Bahrain and Egypt to 31% in Tunisia, 34% in Kuwait and 35% in Lebanon. Egypt is by far the largest tobacco market in the region with 19 billion cigarettes smoked annually.
Tobacco kills tens of thousands each year in the Arab world. A recent study in Tunisia blamed smoking for 90% of lung cancer cases, 80% of acute respiratory illnesses, 75% of heart attacks and 25% of all cardiovascular-related deaths just in that North African country.
A particularly worrisome trend is the rise in smoking among children, teenagers and especially among young women. According to the World Health Organisation (WHO), the rate of tobacco consumption among school-age girls is estimated at 26.8% in Syria, 27.7% in the Palestinian territories and 54% in Lebanon.
The increase in smoking among young people is related to the fraying family structure in much of the Arab world as conditions created by war and displacement as well as by generational change make parental supervision increasingly difficult.
For young smokers, the risks are compounded. Tobacco addiction can lead to juvenile delinquency for children who cannot afford the cost of their addiction and smoking from an early age seriously increases tobacco’s long-term health risks.
Smoking among school age children and young women is associated with the popularity of water pipes (also known as hookah or shisha).
According to the WHO, 14% of young male teenagers (13-15 years old) and 9% of young female teenagers in the Eastern Mediterranean region consume water pipe tobacco and smokeless cigarettes. The popularity of shisha among Arab women is closing the previous smoking gap between men and women: Female consumption of non-tobacco smoking products (shisha and smokeless tobacco) is more than 30% in Lebanon and 20% in the UAE. More young people and women are using water pipes under the assumption that water pipe smoking is less harmful than cigarettes.
In reality, water pipe tobacco has higher nicotine levels than cigarettes and contains toxins proven to cause lung and heart disease as well as cancer. Shisha also is blamed for the transmission of viruses and respiratory diseases.
A one-hour water pipe session results in inhaling 100-200 times the volume of smoke of one cigarette.
In war-stricken areas such as Syria, according to the WHO: “Many youths, women and school-age children have taken to shisha smoking believing that it is fashionable and less harmful than cigarettes.”
Many among the millions of Syrian refugees in neighbouring countries, often unable to find work, spend much of their day smoking.
We can add to the many challenges facing the Arab world today the urgent need for smoking awareness campaigns, geared especially towards young people and including warnings over the use of water pipes to dispel the notion that it is harmless. Public health should not be ignored, even in times of war and upheaval.