World No Tobacco Day 2022 in the Middle East: The Rise of E-cigarettes and Vaping
A man passes by an anti-tobacco graffiti painted on a wall in Sanaa, Yemen, May 30, 2019. World No Tobacco Day is observed every year on May 31. (Xinhua/Mohammed Mohammed) (Xinhua/Mohammed Mohammed via Getty Images)

World No Tobacco Day 2022 in the Middle East: The Rise of E-cigarettes and Vaping

Countries in the Middle East continue to exhibit some of the highest rates of tobacco use across the globe

Tuesday marks the 2022 World No Tobacco Day, 34 years since the inauguration of the event by the World Health Organization (WHO) in 1988.

This year’s World No Tobacco Day aims to demonstrate the detrimental impact of the tobacco industry on the environment, with WHO revealing that every year, the industry fells 600 million trees, raises global temperatures through the emission of 84 million tons of CO2, and uses 22 billion tons of water.

According to figures released by the World Bank, the Middle East and North Africa have seen a steady decline in tobacco consumption since 2000, with 23.3% of adults using the product in 2000, 20.8% in 2010, and 19.2% in 2020.

However, countries in the Middle East continue to exhibit some of the highest rates of tobacco use across the globe, with 38.2% of Lebanese and 34.8% of Jordanian adults using tobacco in 2020.

Several anti-tobacco nongovernmental organizations are continuing to campaign against these unsustainable figures. The Tobacco Free Initiative in Lebanon is among those groups fighting to cultivate a nonsmoking culture.

Nadine Kayrouz El Krab, president of Tobacco Free Initiative in Lebanon and winner of the 2008 World No Tobacco Day award, told The Media Line that governmental inaction is the greatest barrier to reducing tobacco consumption.

Tobacco Free Initiative was one of the foremost advocates in lobbying for Lebanon’s Law No. 174, which aimed to ban smoking in public places, prohibit tobacco advertising, promotion, and sponsorship, and increase the size of mandated warning labels. El Krab lamented, however, that “it had started to be applied very well during the first months, but then after a few months, since the government itself doesn’t abide and doesn’t enforce the law properly, then people are smoking everywhere.”

While Law No. 174 continues to be implemented in malls and hospitals, alongside select establishments, El Krab noted, “in governmental organizations, restaurants, and cafés, Law No. 174 is totally unapplied.”

Similarly, a committee established by the Lebanese government in partnership with Tobacco Free Initiative was supposed to implement follow-up legislation, such as mandating pictorial warnings on the backs of cigarette packs.

Yet as El Krab explained, “It never happened because we tried several times to propose these amendments, and no follow-up was done by the government.”

Israel is another Middle Eastern nation with unsustainably high levels of tobacco consumption, with 21.2% of adults consuming tobacco products in 2020.

While smoking is currently banned in most public spaces, advertising prohibited, and plain packaging with warning labels mandated as of January 2020, consumption remains high.

Shira Kislev, founder of the nonprofit organization Smoke Free Israel, told The Media Line that while tobacco use by adults has decreased over the last few years, there has been a startling rise in teenage smoking since 2019.

“So, we can see that in four years, according to our research, we doubled the rate of teenagers who smoke every day, from 4.7% to 9.7%,” she said.

Kislev attributed this alarming phenomenon to the rise in electronic cigarettes (e-cigarettes) and vaping devices. “We can see, like in most modern countries, problems with the youth, the teenagers, because of e-cigarettes.”

In Israel, e-cigarettes are treated as a tobacco product, so the regulation of e-cigarettes and regular cigarettes is the same. Nevertheless, as Kislev pointed out, the marketing of e-cigarettes via social media is difficult to regulate, despite the prohibition on official advertising.

“But the problem is, although we have a law banning all the advertising, we have a problem with social media and advertising by celebrities and influencers, and that’s a much more difficult area to enforce,” she explained.

Concern over the rise in tobacco and nicotine consumption among teenagers was reiterated by El Krab, who posited that e-cigarette use was supplanting the hookah, or narghile, among Lebanese youths.

“Apart from the cigarette, there has been a curse that was really very dramatic among youths, it’s the narghile, what we call the water pipe, and we had done some statistics, and something like 35% of the young people, aged between 12 and 14, were smoking the water pipe because it was very trendy and social,” she said.

However, El Krab also noted that e-cigarettes were gradually replacing the hookah. In a joint investigation with the American University of Beirut, the Tobacco Free Initiative discovered that around 40% of teenagers in Lebanon are using vaping devices.

In 2020, Health Ministry Director-General Nachman Ash recognized the distressing prevalence of smoking in Israel, with data for the year 2020 showing no decline in the number of smokers across the country.

In part, this was attributed to inexpensive e-cigarettes which are easily purchased by young people.

“Currently these cigarettes enjoy a tax-free status that makes them cheap and accessible and consequently attractive for teenagers, although they are just as harmful and addictive,” he said.

However, after Smoking Free Israel brought a case against the Finance and Health ministries, challenging the finance minister’s refusal to impose taxes on e-cigarettes, the law was altered.

As of January 2022, an order was ratified by the Knesset Finance Committee to tax e-cigarette refill liquid, e-cigarette cartridges, and disposable e-cigarettes. Moreover, one-time use e-cigarettes in Israel are now subject to a massive tax of 360% of the common wholesale price.

As the campaign against teenage usage of e-cigarettes and vaping devices continues, organizations like Smoke Free Israel and Lebanon’s Tobacco Free Initiative seek to implement further measures.

Kislev told The Media Line that her organization is continuing to attempt to limit the number of businesses that are licensed to sell e-cigarettes, and to have all the companies which are involved in selling tobacco products signed up to a registry, so the industry can be better-regulated and more efficiently managed.

El Krab explained that her organization is persisting in its bid to raise awareness among school- and university students of the harmful effects of vaping. Next Saturday, they are hosting a conference on World No Tobacco Day, in collaboration with WHO, to discuss how consumption of both tobacco and e-cigarettes could be further curtailed.

Aron Rosenthal is a student at the University of Edinburgh and an intern in The Media Line’s Press and Policy Student Program.

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