Tobacco Free Initiative

EMR country profile

Regional Tobacco Control Profile

Tables 1- 6 reflect the summary information obtained by combining the information provided by the different responding Member States (n = 20), with respect to selected questions. Table (1) clearly shows that almost half responding nations (45 %) do not have national tobacco control programmes altogether, and one fourth (25 %) lack a multi-sectoral committee for tobacco control. Just above half the existent programmes (55 %) are actually separate / independent from other programmes, as non-communicable diseases control programmes. It also shows that for nations, which do have such programmes, they are all supervised by the MOH, and to a much lesser extent by other bodies. Among countries, which specified the personnel working in such programmes, only one third are public health professionals. It is also evident that both primary and secondary prevention are the main objectives of all existent tobacco control programmes, followed by research encouragement, implementation of legislation and protection from passive smoking rights.

Table (2) reflects the status of selected tobacco-related legislations, where it shows that most respondents (55 – 85 %) have legislations, which ban smoking in health facilities, educational facilities, public transportation, and in the media. While most responding nations (80 %) ask for health warning statements on tobacco packs, yet just above half respondents (55 %) require manufacturing specifications of cigarettes to be printed on such packs.

Table (3) shows that most responding nations ranked cardiovascular diseases as the important tobacco-related disease (health consequence), followed by chronic respiratory diseases and neoplasms. It is to be noted that percentages were calculated for each disease category, separately.

Table (4) reflects that most respondents (83 – 89 %) identified lack of human and financial resources as the most important obstacles for implementation of tobacco control activities and programmes, followed by lack of adequate studies on tobacco-related issues (61 %), lack of government commitment (56 %) and lack of a comprehensive health plan (50 %).

Table (5) clearly reflects that the high prevalence of tobacco consumption among adult (approximate mean + standard deviation = 38 + 13 %) and young (19 + 12 %) males in the responding states, but that such figures are 3.5 – 5.5 times higher than corresponding prevalence rates among females, respectively.

Table (6) shows the tobacco consumption prevalence (%) by age and sex, among respondent Member States to the current survey. It is to be noted when interpreting such table that the year of study varies in different states, from 1994 – 2000, so comparisons have to be treated with caution. Tobacco prevalence ranged from 15.5 (Oman) to 77 % (Yemen) among adult males; and 0.5 (Qatar) to 35 % (Lebanon) among adult females. Among the youth (15 – 19 years in most respondents), it ranged from 4.6 (Bahrain) to 47.4 % (Djibouti) for males; and from 0.1 (Kuwait) to 14.5 % (Jordan) for females, disregarding figures, which were reported as: “for both sexes”.

Table (1) Distribution of Responding EMR Member States, by tobacco control programme variables, EMTCP survey, 2001

Variable	No.	%	Responders
Availability of a National Tobacco Programme	11	55	N = 20
Separate Programme	6	55	N = 11
Supervision of the Programme Implementation Ministry of Health (MOH)	11	100	N = 11
Non - Governmental Organizations	3	30
World Health Organization (WHO)	2	20
Ministries, other MOH	2	20
Availability of a Written Plan	9	82	N = 11
Specialization of the Programme Personnel Public Health	6	30	N = 20 Workers
Health Education	3	15
Health Inspectors	3	15
Epidemiology	2	10
Cardiology	2	10
Oncology	2	10
General Practitioners	2	10
Objectives of the Programme Primary Prevention	11	100	N = 11
Secondary Prevention	11	100
Research Encouragement	8	73
Implementation of Legislation	8	73
Protection of Passive Smoking rights	8	73
Policy Making	5	45
Presence of a Multi-sectoral Committee for Tobacco Control	15	75	N = 20

Response rate = 59 – 94 %

Table (2) Distribution of Responding EMR Member States *, by selected tobacco control legislations, EMTCP survey, 2001

Variable	No.	%
Banning Smoking in Health Facilities	17	85
Banning Smoking in Educational Facilities	17	85
Health Warning on Cigarette Pack	16	80
Banning Smoking in Public Transport.	16	80
Banning Tobacco Advertisements in the Media	14	70
Tobacco Companies Not Allowed to Sponsor Sporting Events	12	60
Manufacturing Specification of Cigarettes	11	55
Tobacco Companies Not Allowed to Sponsor Artistic Events	11	55
Economic Procedures aiming at Tobacco Control	7	35
Punishment for Violating the laws banning Tobacco Advertisements: None Imprisonment Financial Penalty	11 6 3	55 30 15

Table (3) Rank Distribution of Responding EMR Member States. by smoking-related diseases * , EMTCP survey, 2001

Disease

Rank

No.

1- Cardiovascular

2- Chronic Respiratory Conditions

3- Neoplasm

4- Gastro – Intestinal

5- Genito-urinary

6- Addiction

100

7- Cerebro-vascular accidents (stroke)

Table (4) Distribution of EMR Member States *. by obstacles and constraints hindering the success of tobacco control activities, EMTCP survey, 2001

Constraint	No.	%
Lack of human resources, experienced in tobacco control	16	89
Lack of financial resources	15	83
Lack of adequate studies on the hazards of smoking	11	61
Lack of government commitment	10	56
Lack of comprehensive national plan	9	50

* N = 18 (response rate = 90 %)

Table (5) Distribution of EMR Member States, by mean price of cigarette pack & smoking prevalence, EMTCP survey, 2001

Variable	Mean	SD	Min.	Max
Price of Local Cigarette Pack (in $)	1.02	0.92	0.25	3.0
Prevalence among adult males	38.17	13.50	15.5	77.0
Prevalence among adult females	7.10	14.04	0.5	35.0
Prevalence among young males *	18.97	12.14	4.6	47.4
Prevalence among young females *	2.80	5.22	0.1	14.5

SD = Standard Deviation, * = excluding figures mentioned for both sexes

Table (6) Comparison of EMR Member States * with regards to tobacco consumption (%), by age and sex, EMTCP survey, 2001

Member State	Adult Male	Adult Female	Young Male	Young Female	Youth Age	Year of Study **
Bahrain	23.5	5.7	4.6	0.3	15 – 19	1998
Cyprus	38.5	7.6	6.5 (both sexes)		15 – 19	1998
Djibouti	57.5	4.7	47.4	-	15 – 19	1995
Egypt	35.0	1.6	15.0	2.0	15 – 19	1998
Iran	27.2	3.4	10.1	0.7	15 – 19	1994
Jordan	48.0	10.0	25.0	14.5	13 – 15	1999
Kuwait	29.6	1.5	12.0	0.1	15 – 19	1996
Lebanon	46.0	35.0	33.7 (both sexes)		15 – 19	1998
Morocco	34.5	1.6	-	-	-	2000
Oman	15.5	1.5	8.6 (both sexes)		15 – 19	1995
Pakistan	36.0	9.0	-	-	-	1996
Palestine	40.7	3.2	9.8 (both sexes)		15 – 19	1997
Qatar	37.0	0.5	18.0 (both sexes)		15 – 19	1999
Saudi Arabia	22.0	1.0	-	-	-	1996
Sudan	23.5	1.5	11.0	0.6	4 – 17	1999
Syria	50.6	9.9	16.0	0.8	15 – 19	1999
Tunisia	61.9	7.7	30.0	4.0	15 – 19	1997
United Arab Emirates	18.3	<1.0	18.6	-	15 – 19	1996
Yemen	77.0	29.0	-	-	-	1998

* Respondents to the EMTCP survey

** According to reports by Member States

Variable

Variable

Disease

Constraint