It has not been a good week for smokers. Slowly but surely like a bus crawling through traffic smoking bans are becoming the norm. The UK announced that its smoking ban in public places would come into force on the first of July 2007. France too, despite some hesitation and vacillation, announced that smoking would be banned from public places as of early next year though cafes and restaurants will have another year to make the switch. It is hard to imagine French café life without the constant hazy gray backdrop of smoke but it’s now on the cards. Even Germany, Europe’s largest tobacco market, has finally hammered out a typical Germanic compromise where smoking will be banned in restaurants, clubs, schools and government buildings but not in bars and pubs.
Saudi Arabia this week laid down the gauntlet, not at smokers but at the tobacco industry. The Ministry of Health is threatening to sue the tobacco giants if they don’t pay up in full for the cost of treating smoking-related diseases. As for banning smoking in public places, that has already been done, as well as banning tobacco advertising and the standard package of public health measures aimed at making the public understand that smoking kills. That smoking kills was graphically brought home this week by the death of Allen Carr, the anti-smoking guru. Carr, whose Easy Way to Stop Smoking helped millions all over the kick the habit, died of lung cancer despite quitting smoking 23 years ago. But had he not quit, it is likely he would have died years ago — the high price of smoking 100 cigarettes a day.
Smoking is directly responsible for one in ten deaths worldwide, that is five million deaths. Its effect is so noxious that just two or three cigarettes a day are enough to cause lung cancer. Smoking clearly kills and not just from lung cancer. In Britain alone 11,000 people die every year from other smoking-related cancers. Smoking also kills by clogging up your arteries and bringing on heart disease.
Adults have the right to make an informed choice. Smoking is not illegal and we should not treat smokers like social pariahs. That is if it wasn’t for the devastating effect of passive smoking. Smoking not only kills the smoker but also those around the smoker who breathe in second-hand smoke. What is particularly frightening is the effect of passive smoking on children. In Britain 17, 000 children under five are hospitalized each year due to passive smoking. Smoking in the same room as your child increases the risk that your child will develop respiratory problems or that your child will develop a childhood cancer or leukemia. It has also been shown to lead to learning and developmental problems.
What is also saddening is the socioeconomic cost of smoking. In one Egyptian study for instance, it was found that smokers spent 23.1 percent of the family income on tobacco. The financial burden of smoking is fine if you are rich but if you are poor or even just getting by that is a huge proportion of your annual budget that could have otherwise been spent on making life better for your family. In fact the link between poverty and smoking is becoming stronger. For one thing, it is the wealthiest nations who are kicking the habit first. This in turn has forced the tobacco industry to find new markets for its products thus channeling more and more cigarettes into poorer countries.
On the face of it Saudi Arabia is only in the minor league of smokers. The World Health Organization estimates that 19 percent of Saudi men and 8 percent of women smoke giving a mean of around 10 percent for the population as a whole. That’s the official estimate, unofficial ones put the percentage much higher at around 30 percent but this still pales compared to China, for instance, where over 300 million men smoke. In the world map of smoking habits there is a huge red blob in the center encompassing Russia, China, Mongolia, Kazakhstan and Turkey where over 60 percent of men smoke. In the Arab world Tunisia and Egypt have alarmingly high rates of smoking whilst the GCC looks comparatively healthy with smoking rates rarely exceeding 20 percent.
That is still too high though. The problem is a question of lifestyle. It’s cool to smoke. It may not be as attractive as it was just 10 years ago or even 20 years ago when smoking was openly associated with glamour and virility but it has not yet reached the stage where it has become taboo. It only takes a few iconic images to reinforce the notion that successful people smoke: Think of the paparazzi shot of Zinedine Zidane smoking on the eve of France’s world cup semi-final against Portugal, or of the trend among the Hollywood A-list for women to light up fat Cuban cigars. Those images are powerful because they are hedonistic: Smoking is pleasurable and sensual.
Pity the smoker, the joy and pleasure of smoking is so addictive that he will go to any lengths to convince himself — or herself since more and more women are taking up smoking — that his habit is not killing him and his children. The most dangerous social trend in my view is not cigarette smoking but the narghile. This is where delusion is at its highest. How often have I heard the argument that passing the smoke in water before inhaling cleans it of toxicity? Unsubstantiated nonsense, I’m afraid. Or that it is harmless because it is made of fruit and other “natural” products. Not so, on the contrary the evidence is rather damning.
According to the World Health Organization “the smoke that emerges from a water pipe contains numerous toxicants known to cause lung cancer, heart disease and other diseases.” Furthermore because smoking a water pipe is done over an extended period of time and because a relatively larger volume of smoke is normally inhaled in a single puff of a water pipe than in a puff of a cigarette, the water pipe smoker ends up inhaling a much larger volume of smoke than the typical cigarette smoker. The WHO report again: “The water pipe smoker may therefore inhale as much smoke during one session as a cigarette smoker would inhale consuming 100 or more cigarettes.”
What is true is that the water in a water pipe does absorb some of the nicotine but that may not be such good news. Because not all the nicotine is absorbed, the water pipe still delivers enough nicotine to the smoker to lead to addiction. The fact that the level of nicotine inhaled is less may conversely lead to more smoke being inhaled. Nicotine addiction leads smokers to continue to smoke until they reach their “hit” of nicotine. The result is that water pipe smokers need to smoke more and inhale more damaging smoke in order to get the same fix as a cigarette smoker. The bottom line is that smoking a narghile or a shisha is just as damaging to your health and to that of your loved ones who inhale your second-hand smoke as smoking cigarettes. Or to quote this year’s No Smoking Day slogan: “Tobacco: Deadly in any form or disguise”.
