World No Tobacco Day brought with it a flurry of anti-smoking activity from the Middle East’s health ministries. Is the region finally serious about kicking the habit, or is there still a lighter at the end of the tunnel?
Smoking, say experts, is on the decline in developed countries. By 2010, world tobacco demand will have peaked, according to a report by the United Nations Food and Agriculture Organisation (FAO).
So far, so good – global efforts to reduce smoking are patently making an impact. But unfortunately for the Middle East, its nations are considered to be developing, rather than developed. And in developing countries, tobacco consumption is still very much on the rise.
In the Middle East we make it very easy and affordable to smoke.
Nevertheless, on May 31 the region played its part in encouraging smoking cessation. The legal age for smokers to buy and consume tobacco products was raised to 20 in the United Arab Emirates.
Saudi Arabia implemented a ban on all TV advertising of cigarettes. Bahrain’s Health Ministry put its weight behind a of smoking cessation clinics to mark the occasion.
Even Qatar put up an anti-smoking stand in a mall for three days. Whether this will be enough to stand in the way of big tobacco is a moot point – it won’t be: similar, sustained campaigns in the West took years before bearing fruit.
What’s more important for now is whether or not 2008 will mark the region’s genuine acceptance of the need for aggressive anti-smoking tactics; whether beneath the veneer of publicity, governments are truly serious about curbing the region’s growing addiction to smoking.
The young lungs
Health ministries are not helped by the fact that gathering smoking data in the Middle East can be like grasping at dirty air. Yet if anyone’s figures are to be believed, it would be the World Health Organisation’s (WHO).
The WHO lists Yemen as leading the region in the prevalence of smoking among adult males, at 60% – compared to 48% in Jordan, 46% in Lebanon and an impressively low 18.3% in the UAE.
A closer look at the UAE’s statistics, however, reveals that the emirates face the same problem as the rest of the region – their smokers are getting younger and the future burden on the healthcare system is increasing dramatically.
The WHO’s numbers claim that in the UAE, 42% of 17-year-old males smoke, while, staggeringly, 24.3% of boys aged between 13 and 15 years have also developed the habit.
An independent survey of students in the country found that 40% of those polled had their first cigarette before the age of 13.
The theme of 2008’s World No Tobacco Day was a ‘Tobacco-Free Youth’. The accompanying literature warns legislators how the tobacco industry targets the young through advertising, promotion and sponsorship tactics.
Whether or not direct advertising and marketing is responsible for the Middle East’s latest generation of smokers, it seems clear by its previous actions that the tobacco industry does.
No smoke without power
The first volume of the WHO Regional Office for the Eastern Mediterranean’s report on the “tactics and strategies used by the tobacco industry…in the countries of the GCC specifically, to promote [smoking]”, entitled Voice of Truth, makes for demoralising reading.The report cites tobacco industry documents as proof that the Middle East Tobacco Association (META), which is still a listed company in the UAE’s Jebel Ali Free Zone, “enlisted prominent political figures in the Middle East to provide information and lobby for them, including… the Secretary-General of the GCC Health Ministers who was also the Kuwaiti Under-Secretary for Health”.
There’s no harm in aiming for the top, it would seem.
The report continues to explain how META hired Middle East Marketing & Communications (now known as Memac Ogilvy) to cultivate key media figures and “allocate special effort to counter false claims on World product marketing practices of multinational tobacco manufacturers in developing countries”.
Features with such titles as ‘Smoking Out the Facts’ were planted in regional papers, including the UAE’s broadsheet Khaleej Times, in an attempt to cast doubt on the health impact of smoking, claims the report.
The paper also points to some rather uncomfortable relationships between prominent figures in the GCC and their roles as distributors for tobacco companies such as Philip Morris.
The blame game
Undeniably, the Middle East and its media have moved on since then. Just last year Saudi Arabia was tabling a US$2.7 billion lawsuit seeking damages from international tobacco companies over the cost of treating tobacco-related illnesses.
The UAE recently announced plans to double the price of cigarettes every two years, which certainly sounds impressive.
But when a pack of cigarettes are 10 times cheaper than in the United Kingdom, and the cost of living is roughly the same (if not higher), then smokers still have a fair amount of wheezing room before the moves hits their wallets.
In a previous interview with Medical Times, Dr Juma Bilal Fairouz, director of the department of disease control at the UAE’s Ministry of Health, urged GCC governments to ignore pursuing action through the courts, or making token policy gestures, and take a decisive stand against smoking.
“If Saudi Arabia wants to address the issue of smoking-related diseases, going after the cigarette companies will not achieve this,” he said.
“Here in the Middle East we make it very easy and affordable to smoke – it’s an economic issue and we will only get to the bottom of it if we stop importing cigarettes.”
The Middle East is hardly unique. Tobacco is a huge industry and smoking cessation is a complex economic equation for governments. China is the world’s biggest smoking nation, for example, but it also accounts for 35% of global tobacco production.
But if Saudi Arabia’s cost concerns prove anything, it is that the region is starting to bear the consequences of a soft stance on smoking. It isn’t enough to resist being openly complicit with big tobacco.
The Middle East needs to take bold strides towards smoking cessation, including enforcing a blanket ban on advertising, as suggested by the WHO. Anything less and the Middle East might want to consider in just what way it is developing.
References
1 ‘Projections of tobacco production, consumption and trade to the year 2010’, Food and Agriculture Organisation of the United Nations, 2004.
2 ‘Voice of Truth: Volume 1’, World Health Organisation, Regional Office for the Eastern Mediterranean, 2001.
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