What other Arab countries can learn from Saudi Arabia’s fight against tobacco
DUBAI: Tobacco use remains a serious health problem in Middle Eastern and North African countries, which have some of the highest proportions of smokers in the world.
Despite this high prevalence of tobacco use in the region, the policies put in place by the Saudi authorities appear to have led to a significant reduction in the number of smokers in the country, associated with an increase in the number of people seeking help to stop smoking.
The public health consequences of what the World Health Organization calls a “tobacco epidemic” are serious. Tobacco smoke contains over 2,500 carcinogenic chemicals and, according to WHO data, smoking eventually kills up to 50% of those who engage in the habit.
The Tobacco Atlas, a project that collects data on the problems arising from this global epidemic and the means to deal with it, estimates that more than 8.67 million people have died from tobacco-related diseases in 2019, including 1.3 million who were exposed to second-hand smoke, also known as passive smoking.
In Saudi Arabia alone, smoking is estimated to kill 70,000 people every year.
Smoking is responsible for 80-90% of lung cancer deaths and significantly increases the risk of other cancers, as well as cardiovascular, pulmonary, neurological, ocular, digestive and infectious diseases.
The often hidden economic cost of smoking, which includes medical bills for smokers and those exposed to second-hand smoke, costs many countries billions of dollars each year.
According to the Tobacco Atlas, the global economic damage caused by tobacco use in 2019 amounted to approximately $2 trillion, which is equivalent to approximately 1.8% of global gross domestic product.
A study published in the academic journal Tobacco Control in 2021 estimates that the total cost of smoking for the six Gulf Cooperation Council countries – Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates – was more than $14.3 billion in 2016 alone. Government health spending accounted for almost 75% of the cost.
Among these six countries, the economic cost of smoking was highest for Saudi Arabia, the most populous country in the GCC, where it amounted to more than $6.3 billion.
Global smoking prevalence fell from 22.7% in 2007 to 19.6% in 2019, the most recent year for which WHO data is available, according to Tobacco Atlas.
The Eastern Mediterranean region has seen a 15% decline in the proportion of the population over 15 who smoke daily since 1990. However, the number of smokers in the region has doubled since 2007 due to rapid population growth from the Middle-East. .
A growing number of young smokers creates more challenges. Although the use of electronic cigarettes and heated tobacco products – known as “vaping” – are often marketed to smokers and non-smokers as a less harmful alternative to cigarettes, they come with their own risks, in especially for teenagers and young adults.
Dr Shaikh Abdullah, a specialist in pediatrics and adolescence at King Abdulaziz Medical City in Riyadh, previously told Arab News in September 2019 that “one might be tempted to turn to e-cigarettes to facilitate transition from traditional cigarettes to quitting smoking”. at all. But smoking e-cigarettes is not advised either.
He warned that young people who vape were at risk of developing brain development delay and developing memory problems.
The Saudi Ministry of Health is working to address the challenges created by the growing popularity of vaping. He posted messages and images on Twitter and other social media platforms warning of the dangers of e-cigarettes, with slogans such as: “Flavor on the inside, color on the outside, but its truth is an electronic heart attack”.
Since the early 2000s, Saudi authorities have adopted a series of policies aimed at combating smoking. In 2003, they launched the country’s first public anti-smoking campaign.
In 2015, they banned smoking in many public places, including educational and cultural organizations and almost all workplaces. The current goal is to reduce the proportion of the population who smoke daily from 11% to 5% by 2030.
Authorities in Riyadh are not resting on their laurels, however, and plan to implement additional initiatives to further reduce the harms of smoking.
In an interview in June this year with the Saudi television channel Al-Ekhbariya, Dr Mansour Al-Qahtani, secretary general of the Saudi Anti-Tobacco Committee, said that the government intended to ban the sale of tobacco products. tobacco in supermarkets, having previously banned their sale in kiosks in 2016.
Thereafter, cigarettes will only be available for purchase in specialty stores selling tobacco products such as shisha and chewing tobacco.
The heavy taxation of tobacco products has proven to be a particularly effective tobacco control tool on which the Kingdom has relied heavily. While the Middle East as a whole lags behind other regions in imposing heavy tobacco taxes as a deterrent, a number of GCC countries have bucked this trend.
A 2021 WHO study comparing tobacco control policies around the world found that in June 2017, Saudi Arabia introduced the highest tariff on cigarettes in the GCC region: a tobacco tax. 100% excise duty.
Research has shown that Saudi policies have been successful in reducing smoking. A study published in the Eastern Mediterranean Health Journal found that the 2017 tax increase was followed by a noticeable reduction in the Kingdom’s smoking population and the number of cigarettes smoked.
A 2022 analysis published by the Annals of Saudi Medicine also found that the annual import of cigarettes fell by more than 27% from 2013 to 2019 after the tax was implemented.
Saudi Arabia and the United Arab Emirates have also imposed advertising restrictions and public smoking bans, and implemented extensive programs to help and support smokers who want to quit, according to the WHO.
The Kingdom was only the second country in the Arab world to set up national quit smoking programs and clinics, in 2011, after Bahrain, which introduced them in 2004.
In 2019, there were 542 such clinics operating across Saudi Arabia. According to official statistics, nearly 27% of people in the Kingdom who participated in programs designed to help them quit smoking successfully quit, according to a 2020 study published in the Journal of Health Informatics in Developing Countries.
Saudi Arabia also leads the Arab world in using the media to raise awareness of the harms of smoking and the warnings printed on cigarette packages.
According to a 2022 study published in the journal Tobacco Control, Saudi Arabia was the first country in the Eastern Mediterranean region to mandate the use of simple, non-visually appealing packaging on tobacco products.
The significant reduction in smoking in Saudi Arabia, following the stringent measures introduced to increase the cost of consumption and reduce demand, is not surprising and follows evidence-based policy recommendations.
A 2018 study of public health policies aimed at reducing smoking, published by the Journal of Public Health Management and Practice, found that a tax rate of at least 50% is the most effective tool to long term.
However, the Saudi government is not content to settle for the results of its existing policies. In an interview this year with the Yahla program, Al-Qahtani said: “According to studies, the most effective method of combating smoking is not volunteering or treatment (for those seeking to quit), but laws and (government) policies, and the most important among them is increasing the price. We are always trying to increase the price.
According to the latest international studies, he added, a 150% tax would be more effective. If implemented, the policy would cause the price of a pack of cigarettes to rise to around $10.50 in Saudi Arabia, the highest average price for a pack in the Arab world.