Tobacco epidemic

Jordan is fortunate to be a politically stable country. The country’s human development index (HDI) of 0.745 (2014) continues to compete favourably in the region and positions Jordan at 77 out of 187 countries, above regional average.

HDI is a summary measure for assessing long-term progress in three basic dimensions of human development: a long and healthy life, access to knowledge and a decent standard of living.

However, with the current prevalence of tobacco use in the country, where nearly 45 per cent (an underestimate) of the adult population — 17 per cent men and nearly 7 per cent women — smoke, threatens to undo any health or economic gains the country enjoys relative to the region.

I have been living in Amman for nearly five months now and only rarely succeed avoiding being a victim of second-hand smoke, whether in a taxi, a mall, a barbershop or even simply walking on the street.

While Jordanians are courteous and treat foreigners with respect, this situation does not generally apply to respecting a non-smoker’s right to a tobacco-free taxi ride, while waiting in a barbershop or even at a grocery store.

While a scientific survey needs to be carried out to confirm this, anecdotal evidence indicates that the majority of taxi drivers would not bother “lighting up” without asking a passenger for permission but some would go as far as throwing a passenger off en-route before reaching destination if the passenger insists on a smoke-free ride.

Anyone can imagine the negative image this can leave on a passenger, whether a tourist, a businessperson, or anyone concerned about his/her health.

As a public health practitioner, it is also interesting to observe a good number of taxi drivers who smoke continuously coughing, clearly indicating congested chests and probably damaged lungs.

A very recent visit to the Jordan Electric Power Company, a fairly smoke-foggy place, confirms the need for Jordan to reconsider enforcement of its anti-tobacco public health and law.

From a public health and economic perspective, the toll tobacco use has on the country includes an estimated 2,200 tobacco-caused deaths per year, putting over 43,000 children and over 1.2 million adults at great risk through being exposed to involuntary or second-hand smoke (SHS), which results in inhaling higher levels (or “double polluted”) and harmful chemicals which have been linked to the cancers of the larynx, pharynx, nasal sinuses, brain, bladder, rectum, stomach and breasts.

Exposed children (who cannot and do not generally defend themselves against parental authority) could also get lymphoma, leukaemia, liver cancer and brain tumours.

SHS also affects the heart and blood vessels, increasing the risk of heart attack and stroke in non-smokers.

Children who are most affected by SHS and least able to avoid it are subjected to a number  of adverse consequences including getting sick more often; having more lung infections (such as bronchitis and pneumonia); are more likely to cough, wheeze and have shortness of breath. 

From an Islamic perspective, (and this is an area of clear contradiction between what most smokers I have spoken to believe vs. what they practise), the principles of Islam call upon people to look after their health, to avoid health hazards and risks and to raise their standards of hygiene.

The Koran has clearly called on humanity to enjoy what has been classified as “good” and refrain from what is classified as “evil”, and here is the tough test for Muslim smokers: since no one dares to classify tobacco smoking as “good”, it must be “evil” and therefore forbidden, or at least this is a conclusion many Muslim scholars have reached.

Also, the well-known Prophetic saying of “There should be neither harm nor malice” calls on a Muslim not to inflict harm either on him/herself or on fellow human beings, yet, such principle continues to be knowingly violated.

The situation in Jordan calls for serious and urgent public health protection measures, not only to protect smokers from “committing suicide”, but also to rescue non-smokers and prevent thousands of children from picking up the addictive habit.

Three urgent actions are recommended: design and implement national education and awareness campaigns targeting primary and secondary schools, with the objective of transforming children into positive change agents in their communities; plan and implement an aggressive media campaign to further educate the public and empower non-smokers by informing them of their legal rights, with posters in public facilities, taxis and shops, and with a hotline where people can call and complain or seek help; enforce applicable tobacco sales laws and, more importantly, at least double tobacco sales tax and use the revenue to fund suggested campaigns. 

The writer currently serves as a country director for Pure Hand for Mankind, a US-based non-government humanitarian charity with an office and humanitarian operations in Sanaa, Yemen. He contributed this article to The Jordan Times.