Smoking is unfortunately a very widespread habit all over the Middle East and Jordan is no exception. People light up almost everywhere. Airports, shops, malls, restaurants, taxis, offices – you name it, people are smoking there. “No smoking” signs are routinely ignored by smokers across the Kingdom. I have seen people smoking in gas stations, hospital corridors, and horrifically have even witnessed pregnant women puffing away with little regard to the dangers they are exposing their unborn children to.
Statistics show us that the prevalence of smoking is extremely high, with as many as 29% of Jordanians smoking tobacco and 9.3% smoking argeelah. This includes 14% of children in the 13-15 age bracket. In addition, it is shockingly estimated that as many as 60% of Jordanian children are exposed to second-hand smoke. Not only is this a serious health risk that affects their mental and physical development, but it means they are more likely to become smokers in the future. So this vicious cycle continues as indicators tell us there is an rise in smoking and smoking-related diseases afflicting the country.
Dr. Feras Hawari is the chief of pulmonary and critical care and director of the Cancer Control Office at the King Hussein Cancer Centre, which treats over 3500 new cancer patients every year. He has reported that smoking is responsible for over 25% of the cancer cases in Jordan, as well as the majority of chronic diseases including cardiovascular and respiratory complaints.
As Dr. Hawari presented figures showing that approximately 8,300 cancer cases are expected to be diagnosed in 2012, double the number currently diagnosed every year, he warned The Jordan Times that ‘if no action is taken to combat smoking, we will end up with a disaster on our hands.’
We live in a time where there is no excuse for ignorance over the dangers of smoking. Smoking is one of the leading causes of preventable deaths in the world and medical studies have proven that smoking is directly responsible for a number of ailments: ranging from various cancers, heart attacks, chronic obstructive pulmonary diseases such as emphysema, erectile dysfunction and birth defects.
Despite this knowledge, figures show that tobacco consumption in Jordan is on the rise with household spending on tobacco products jumping from JD352.3 million in 2008, to JD480 million in 2010. The indirect cost of smoking, in terms of health care for tobacco-related illnesses, today stands at JD500 million a year according to the Ministry of Health.
Not only are smokers responsible for causing the immediate damage to their own bodies but they are also to be held accountable for the damage their passive smoke inflicts on those around them. These people, through no choice of their own are routinely exposed to secondhand smoke in Jordan with little opportunity to escape the toxic fumes of cigarettes, cigars and argeelah.
Despite the introduction of the Public Health Law in 2009, which prohibited smoking in public places, anti-smoking rules are generally flouted en masse. A process of gradual implementation of the law, seeking to change people’s attitudes before a blanket ban is put in place, has so far been largely ineffective.
The law stipulates that any person caught smoking in a public place is subject to between one week and one month imprisonment or a JD15-JD25 fine. The same penalties apply to those who sell cigarettes to minors. Despite the introduction of this legislation such penalties are rarely, if ever, imposed.
There are further measures are in place to encourage smokers to kick the habit, such as the presence of a ‘quit smoking clinic’ in Amman and the training of doctors in Irbid and Karak, with a view towards opening further such clinics by the end of the year. It has also been announced that anti-tobacco pictorials, illustrating the dangers of smoking, would be appearing on cigarette pack from next January onwards.
The introduction of legislation and other such measures is encouraging, but more needs to be done during a critical period of healthcare growth in Jordan. The severity of the smoking problem in Jordan is compounded by the fact that the Public Health Law is routinely ignored on a widespread scale. The prevailing attitude in Jordan is that smokers have the right to smoke indoors and cultural norms indicate that people are reluctant to ask smokers to put out their cigarettes, in fear of seeming impolite.
Another problem in discouraging smokers by enforcing the law may lie with healthcare providers (of whom 34% smoke themselves) and other people in authority; it is not uncommon to see government officials setting a bad example by smoking in public and on camera in televised indoor meetings.
Organisations such as the Jordan Anti-Smoking Society, Global Bridges Healthcare Alliance and Women Against Indoor Smoking in Jordan, are all praise-worthy groups focused on implementing the much disregarded 2009 law, as well as deterring young people from starting smoking in the first place. However, much more needs to be done, not only in efforts to implement the law but also to change popular opinion on smoking in Jordan. Otherwise we are only heading further down an already disastrous path in the scenario of healthcare in Jordan.