Tobacco Control in Saudi Arabia

Introduction

For over 50 years there has been smoking in Saudi Arabia even though the country neither grows tobacco nor manufacture cigarettes. The yearly consumption of cigarettes is 15 billion and a 40,000 tons inhalation of tobacco smoke. This costs the country approximately 600 million Saudi Riyals (close to $150 million) annually.  Studies carried out in the early 90’s indicate that most of the smokers (78%) were between the ages 21-50 years (Al-Faris 1995 p.67). The prevalence has been recorded to be higher among workers of particular professions such as army officers, and also among married and uneducated people. For this reason the country has been ranked position 23^rd in the world considering the population of smokers per capita.

The authorities have already noted that the country is facing a public health problem and calls forth for a tobacco control effort. As a predominantly Muslim country, Saudi Arabia, enjoys a lapse in smoking in the mouth of Ramadan, at least during the daylight, is free of smoke. According to the health experts the holy month of Ramadan is a perfect opportunity for the smokers to give up smoking. This is just one among the many suggestions that have been put across to address the problem of tobacco use.

A shocking Trend

The results from a survey indicate the prevalence of smoking in the country stood at 11.6%. The majority of the smokers were young to middle-aged men (Al-Faris 1995 p.47-55). This is to say that in the near future the number would have doubled. For the studies also show that smoking increased with age. With each one year of increase in age there is a 25% increase in smoking.

At least 59% of the smokers smoked not less than 20 cigarettes per day. The mean for cigarette consumption stood at 16.8 daily. A significant minority of the smokers 21% has been smoking for over 20 years while the young and the majority smokers 66% have smoked for at least a decade. The mean duration therefore is 10 years. This shocking prevalence comes despite the incomes which indicate that on average the smokers’ monthly income less 3100 Saudi Riyals compared to non-smokers 3260 Saudi Riyals. Compared to other countries cigarettes in kingdom is more expensive than in other countries. This however does not influence an individual’s decision to start smoking. Young children and those with a low income can access low cost cigarettes (Saeed 1987 p.187)

The tendency to smoke was to a great degree associated with the level of education of an individual. A higher prevalence was recorded among individuals with the lowest level of education or had simply acquired technical education. However, no matter the location of the individual, rural or urban, it did little to determine whether one was to smoke or not.

Businessmen, army officers and manual laborers had reported a higher prevalence rate of smoking than any other profession. Similarly the Easterners prove to be more prone to smoke than the Westerners.

An analysis of the research implies that gender is strongly associated with smoking. Men were 27 times more likely to smoke compared to females. The latter face a social stigma to smoke. It is even considered shameful. This is true not only in the kingdom but in many other Arab countries (UNESCWA, 2007, p17)

Anticipation of the Future

There are less data on the patterns of smoking in the kingdom. The future therefore is uncertain as there is scant national studies and follow up to monitor the problem. The long term effects of smoking lack proper documentation.

Nevertheless it has been reported that lung cancer is ranked fourth most malignant disease affecting men. The increasing prevalence will indirectly indicate that an increase in lung cancer and related illnesses in the decade to come.

Despite the high level knowledge of smoking hazards in Saudi Arabia, the smoking behavior still persists in the kingdom (Fielding and Phenow 1988 p.98). This may be due to understanding of the risks of smoking. There is still little connection between the rise in smoking and the mortality that is attributed to smoking (Pierre-Louis, Akala & Karam, 2004, p125).

Conclusion

The guidelines provided by the World Health Organization (WHO) for programs to do with tobacco control have not been adopted yet in the kingdom. These guidelines, which include media advocacy, legislative measures, fiscal measures and protective measures that guard against secondhand exposure to smoke should be implemented.

In the meantime the kingdom has not consolidated efforts and formulated a clear policy to tackle the problem on a national level. The prohibition of the promotion and advertisement of tobacco in the media and of smoking in government building is not strictly adhered to. However the government has been somewhat successful in increasing by 50% duties for the importation of tobacco.

More and more anti-smoking clinics have been established by the Saudi Smoking Control Charitable Society. Though there is still limited use of the clinics and with as little as 13% smoking cessation, there is still much to be done as most of the cases are reportedly lacking follow up.

Bibliography

Al-Faris, E, 1995, Smoking habits of secondary school boys in rural Riyadh. Public Health. Vol. 109 Issue1

Saeed, A. 1987, Smoking habits of students in College of Allied Medical Sciences, Riyadh. J R Soc Health. Vol.107 Issue 5

Fielding, J & Phenow, K. 1988 Health effects of involuntary smoking. N Engl J Med. 1 Vol. 319 Issue 22

World Health Organization (WHO) and Research for International Tobacco Control (RITC). 1999. Confronting the epidemic: a global agenda for tobacco control research. WHO and RITC, Geneva, Switzerland.

United Nations Economic and Social Commission for Western Asia, United Nations.     Commission on Sustainable Development, 2007. Compendium of social statistics          and indicators: social indicators of the Commission of Sustainable Development.     United Nations Publications.

Pierre-Louis A., Akala F. & Karam H., 2004. Public health in the Middle East and North           Africa: meeting the challenges of the twenty-first century. World Bank            Publications.