Tobacco use declines – except in the Middle East and Africa


In these regions, 180-million men are predicted to be smoking by 2025, twice as many as in 2000, with experts saying taxing tobacco is still the best deterrent…

As tobacco use has steadily declined in most of the world, two large regions are bucking the trend: in the Middle East and Africa, 180-million men are predicted to be smoking by 2025 — twice as many as in 2000.

Smoking rates are rising fastest in low-and-middle-income countries in these regions, where control measures are relatively weak and tobacco is marketed mainly to men. To reverse this, governments need to more firmly confront the tobacco industry’s efforts to recruit the next generation of smokers.

In Nigeria, where smoking rates have climbed with higher incomes, retailers have begun selling cigarettes in single sticks from kiosks as close as 9m from schools. In Egypt, the number of smokers has almost doubled since 2000, to 14.4-million. Water pipes, known as shishas, are popular in cafés, where smoking restrictions don’t apply.

Public health experts already know how to crack down on such practices and give people incentives to quit, or never start, smoking: by raising tobacco taxes; requiring large graphic health warnings on cigarette packs; prohibiting smoking in restaurants and other public spaces, and banning tobacco advertising. Taxes are the most cost-effective measure because they both discourage smoking and provide a source of funding for anti-smoking campaigns and other tobacco-control efforts.

Yet few Middle Eastern and African countries have fully imposed and enforced such rules. They’ve allowed the tobacco industry too much leeway to influence policy and legitimize smoking in the public mind.

Consider the experience of SA, where tobacco taxes imposed in the early 1990s successfully lowered smoking rates. Progress has slipped in recent years, as policymakers have neglected to steadily raise the taxes. They now account for 40% of the retail price of the most popular cigarette brand — significantly below the 70% level recommended by the World Health Organisation (WHO).

One way to raise public support for tobacco control is to call out industry efforts to block or interfere with it, as government officials and civil society groups in some Asian and Pacific island nations do. (Bloomberg Philanthropies is creating a worldwide tobacco watchdog to help make more countries aware of tobacco company tactics.)

It’s essential, too, in these countries as everywhere, to monitor the tobacco industry’s use of social media to lure adolescents. Many water-pipe and e-cigarette products, as well as traditional cigarettes, have been marketed on Facebook through unpaid content, Stanford University researchers have found.

There are signs of progress, including in Nigeria, where an increase in tobacco excise taxes took effect this month. But most countries in the region have much caught up to do.

Tobacco use, as the entire world should know by now, is the single greatest preventable cause of death. Public health specialists in developed countries have spent decades learning how to fight back — and have saved lives by the millions. Countries in the Middle East and Africa simply need to follow suit.


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