Fight against tobacco in Jordan must change course

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Jordan_Argileh

Tobacco use, both through cigarette smoking and the use of a local water pipes called shishas, is a major public health problem in Jordan.  Usage rates are extremely high among both youth 13-15 (13.6%), and adults (29%), and the impact is felt even on the nation’s infant population.  The health problems associated with both cigarette smoking and the use of a shisha are well documented.

According to the WHO’s recent study on global tobacco use (page 192), Jordan has the highest adult smoking prevalence in the Eastern Mediterranean region, and while advertising bans are considered both comprehensive and well enforced, smoke-free policies are very limited and weakly enforced.  Taxes are also high at 39% of the total cost, but despite the expense this health behavior is still widely practiced.

A quick glance at a few responses to the recent Public Health Law reveals that the problem is not just one of enforcement, but that most of the public is either under informed or unconvinced about the danger of smoking.  The only issue that comes up is about the logistics of separating smokers and non-smokers, rather than the tobacco-related health crisis.  In fact, a recent study showed that even health professionals in Jordan are given neither education about the addictive qualities of nicotine, nor training in how to educate their patients about smoking cessation.

A major change in policy must occur. For too long, the efforts in Jordan have revolved around restricting the locations of tobacco use or taxing its purchase, but the greater battle to win the hearts and minds of the population through healthcare provider education, teaching young children through school-based health education programs, and mass media campaigns must be implemented if there is to be hope of lasting change in the prevalence of tobacco consumption in Jordan.

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5 Responses to “Fight against tobacco in Jordan must change course”

  1. carriesummerterm Says:

    Actually, restricting places where people can smoke has had a huge impact on the number of smokers in the US. I’m not saying it is the only approach to take, but it has proven to be effective in combination with health education and taxation.

  2. asamarth Says:

    India has recently introduced law to ban smoking in Public places. It also penalizes people if they are caught smoking in public places and fined for the same. Introducing of pictures of ill-effects of Tobacco are very effective to reduce the consumption of smoking. I think the biggest battle is to raise public awareness on the harmful effects of tobacco and how to bring in behavioral change!

  3. eevers Says:

    I am curious to know what percentage of health care providers are still smoking in Jordan. Are the providers at least setting an example? I remember from the global tobacco control class that reductions in smoking rates usually occur in waves, with higher educated classes quitting first, followed later by others. Also, what assistance in quitting is available in Jordan? Nicotine-replacement therapy? Also, which is more prevalent, cigarettes or shishas? It would likely have a major impact on the type of intervention that is needed. If shishas are more widely used beause they are considered healthier, those claims will likely need to be addressed differently than in a campaign against big tobacco.

  4. rafielding Says:

    I would be interested to know more about the demographic that has the highest percentage of smokers. My inclination is that it is more prevalent among males (?). Perhaps no-smoking areas have been established nationwide more as a courtesy to non-smokers (predominately women and children?) rather than because tobacco smoke is seen as a public health threat. This is a great example of how targeted behavior change programs need to be developed to address the specific groups that are affected.

  5. ben Says:

    carrie: I don’t doubt that at all, but I think that trying to implement a restriction in location in isolation from other steps in an area with such a high rate of smoking is destined to be less effective.

    rafielding: The statistics by gender are very different, as female rates are close to zero and male rates are about double what is depicted above (something I omitted for brevity’s sake above). This definitely leads to issues as those in control of things are even more sympathetic to the behavior than might be thought initially.

    eevers: I don’t think even the “initial wave” has happened in Jordan yet. There is little awareness of the importance of the issue even among providers and few alternatives are widely available. Both cigarettes and shishas are used widely, but there is little knowledge that the later is as bad as the former if used a similar amount of time. Coordinated but separate campaigns would probably be needed.

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