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WHO
Collaborative Programme
Substance
abuse
Back
Situation Analysis:
Tobacco use and control in Lebanon is quite a complex issue.
Tobacco use seems to be quite prevalent, as suggested by the various studies conducted over the past few years. In fact According to a study done by the A.U.B in conjunction with the UNICEF, WHO, Ministries of Health and Education on students aged 15-18 years (1997), revealed the distribution of smoking status as follows:
- Median age of smoking = 14 years
- 40% of them smoked (including those who tried one cigarette only)
- 46% of the smokers were males compared to 35% females. 6% of the males and 3.5% of the females do smoke regularly. In addition, 2% of the males and 0.1% of the females did smoke more than 20 cigarettes a day. In another study done by Baddoura et al (1997), it showed that Lebanon has one of the highest rates of smokers in the region. 53.6% of adults are smokers; with the proportion of male smokers at 60% while that of females is at 47%.
In the last few years, the Ministry of Health passed several legislation such as mandatory display of the health-warning message of tobacco advertising on the media channels (i.e. TV, radio, and print media), prohibitions of smoking in hospitals.
" Regarding the anti -tobacco measures and legislation, there is the ministerial decision number 1/213 issued on 2/3/93 and law number 394/95 issued on 12/1/95, which prohibits smoking in the hospitals, infirmaries, pharmacies, theaters, public transport services, health clubs, and all schools, universities and in the elevators.
" As for the Law number 394/95, it is an amendment of the decree number 101/83 issued on 16/9/83, and consists of six items evolving around smoking hazards, stressing the necessity of label warning on all smoking packages including cigarettes and cigars and controlling the smoking advertisement through the media: "The ministry of health warns you that tobacco use leads to dangerous and deadly diseases".
Moreover, the tobacco-lobby in the country is very strong, spending, according to a 1998 study, a minimum of 100 Million US Dollars per year on advertising. Smoking in the workplace is very common with more than 80% of smokers reporting that they smoke regularly while at work.
The civil society, through active NGOs and some private institutions have attempted some actions that remained shy.
Attempts at issuing a law prohibiting advertisement for tobacco use has failed, due to the strong lobby of the profit making media companies
In view of the importance of the problem from a public health perspective, the MOH, in line with the recommendations of WHO, established a National Program for Tobacco Control in 1998 and a part-time manager was recruited for this purpose. Except for sporadic media activities (concentrated mainly around the World Tobacco Day), no clear strategy has been developed; the Tobacco Control program remained also without a defined plan of action in 2001, another manager was recruited on full time basis.
Implemented activities:
-Increase taxes
In April 1999, as part of government measures to raise revenue, taxes on tobacco were sharply increased - to 138 percent from 54 percent.
Legislation
Moreover, there has been a major step in the legislation toward banning all tobacco advertisements in Lebanon. A law was circulated by the Minister of Health to the Ministers Council to ban all types of Tobacco advertisements on all local TV stations, radios, and all print media. Unfortunately, the Council of Ministers disagreed with this legislation due to the economic laws that faces the country. Setting a law on total ban of publicity on smoking on all means of media is needed. This plan requires follow-up, support and lobbying. Working on a law that would be more acceptable to face the smoking publicity is urgently needed. The law would include special taxes on all profits from smoking publicity to be used in the no smoking campaign
Surveillance
Lebanon was included in few international surveys. As for the Global Health Professional Tobacco Survey, Lebanon has been selected in addition to 10 other countries in the world. This survey will monitor tobacco use, assess behaviors in providing cessation support to patients, and to assess knowledge of health effects of tobacco among health professionals
Communication
Lebanon has been chosen to be among 14 countries world wide to participate in the Don't be Duped Campaign. It is a two-year United Nations Foundation sponsored project on media and NGO/advocacy for policy change.
In progress activities
- Global Youth Tobacco Survey (GYTS):
It is a school-based sample design to produce representative data for students aged 13-15; has been developed by WHO and CDC to track tobacco use among youth across countries using a common methodology and core questionnaire.
- Workshop on how to fight smoking prevalence in the Community. The key figures are; school principals, city mayors, regional medical officers, religious figures, journalists, women organizations, and other NGOs.
- Training of Trainers Workshop for Smoking Cessation Based on the Freedom from Smoking Group Counseling Program developed by the American Lung Association
- Media advocacy campaigns program.
CONSTRAINTS
Political and economical pressure
Objectives
Prevention: Preventing tobacco use among young people, and pregnant women.
Cessation: Persuading and helping smokers to stop using tobacco products.
Protection: Protecting the community by reducing exposure to second hand smoke.
Demoralization: Community education about the marketing strategies and tactics of the tobacco industry and the effects the industry's products have on the health on community in order that social attitudes are consistent with the hazardous, addictive nature of tobacco and industry products.
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