With tobacco use in Oman forecast to rise to an alarming 33.3 per cent by 2025, the nation can’t seem to catch its collective breath when it comes to stubbing out. Alvin Thomas explores the projected impact of the new sin tax on tobacco use in the Sultanate, and the calls to action needed for a sustained shift in combating this fatal addiction
When it comes to smoking, the road to addiction begins with one puff. Inhaling in that ‘smooth’ flavour of one of the world’s leading mass-marketed carcinogens, holding it in your lungs for as long as you can, then exhaling its deadly contrails. Then doing it again and again until, one day, that routine scan you went in for doesn’t come back clear. And your doctor is sat in front of you with a look on her face that you don’t like.
Shake hands with tobacco.
It’s a cycle and a battle that many of the world’s one billion smokers go through in the grip of an addiction that continues to be, according to the World Health Organization (WHO), the world’s leading cause of preventable morbidity and mortality. And it’s an addiction that’s propped up by a billion-dollar industry with deep pockets whose marketing machine and global lobbyists make sure it’s in their financial interests that the global epidemic continues.
Addiction by the numbers
More than 6.5 trillion cigarettes are sold worldwide each year. Those numbers further translate to 18 billion packs of cigarettes sold daily.
While a glimmer of hope lies in the fact that Oman remains the country with the lowest tobacco use in the GCC, it should still be noted that penetration of tobacco users is increasing by the day, with that prevalence anticipated to increase further in the coming years.
There’s more to it than just statistics though – tobacco use in the WHO-designated Eastern Mediterranean region, which also encompasses the Sultanate, is rising at an alarming rate. The region is also one of two with the fastest growing consumers of tobacco products and where the prevalence is expected to increase 25 per cent by the year 2025, compared to a decrease in other parts of Asia, America, and Europe.
A recent report published in the Oman Medical Journal highlighted that the prevalence of tobacco use among Omani men aged ≥ 15 years-old was estimated to be 17.9 per cent in 2010. This is predicted to increase to 21.4 per cent, 26.9 per cent, and 33.3 per cent in 2015, 2020, and 2025, respectively, if tobacco control measures remain static.
While the figures may be the lowest in the region and half of the regional average of 36.8 per cent, it contrasts sharply compared to other countries in the region which have some of the highest prevalence globally, such as Iran (30.2 per cent), Lebanon (45.4 per cent), Bahrain (48.8 per cent), and Egypt (49.9 per cent).
The WHO states that tobacco kills up to half of its users, and seven million people each year. And, while more than six million of those deaths are due to direct tobacco use, worryingly, 890,000 (as per statistics revealed by the WHO in March 2018) die due to exposure to second-hand smoke.
Second-hand smoke, or secondary smoke, is defined as smoke that’s inhaled voluntarily or involuntarily by individuals from tobacco being consumed by people around them.
Speaking to Y, Dr. Suja Haneef, a specialist in pediatrics from the Burjeel Medical Centre in Azaiba says: “Second-hand smoke causes numerous health problems in infants and children, including more frequent and severe asthma attacks, respiratory infections, ear infections, and sudden infant death syndrome (SIDS).
“Smoking during pregnancy results in more than 1,000 infant deaths, annually,” she adds.
Another doctor we spoke with, who wishes to remain anonymous, sheds further light on the issue: “Second-hand smoke is a big problem that we now have to tackle. It isn’t just from cases where parents smoke around children anymore.
“I handle several cases, wherein people complain that they’re exposed to second-hand smoke from other colleagues at work or while they’re walking on the streets. There are strict laws governing smoking in public, but not much of it is enforced within the workplace. Most smokers consider their addiction a habit that may not affect others but, in reality, it does. Imagine being a worker who’s forced to be at a place where he or she has to – without any option – be exposed to the smoke.
“This is where one must take a stand and tell the individual that they’re not comfortable with smoke around them. But, because of the seniority and peer pressure, they may be forced into keeping their problem bottled in.
“Remember, when you’re being forced into second-hand smoke, you’re not the problem – they are,” he states.
Impact on health and human cost
[*Editor’s Note: Names of interviewees have been changed for privacy reasons.]
In order to understand why workplace smoking is prevalent in Oman, we spoke to several smokers who work in different companies in and around the capital.
Sumeet* a business development manager of a property firm tells Y: “I began my routine of smoking from the age of 16. But then, after the birth of my children, I stopped for a brief period. Nevertheless, the urge to light one cigarette up was running deep, so in 2015, I began smoking again.
“I’m not entirely comfortable with talking about my smoking habits, but I may smoke – on a daily basis – eight to 10 cigarettes. This is nothing compared to what I used to consume before,” he laughs.
When asked about how his non-smoking colleagues deal with his habit, he says: “Well, I have my own cabin where I’m allowed to smoke. I make sure that I light up only inside the room and not elsewhere to prevent others from being exposed to it.
He then jokes: “Of course, this has a down side. I may have to visit my colleagues desks for reports, as they may not be comfortable walking into my cabin.”
Hamed*, an Omani entrepreneur, also classifies himself as a chain-smoker. Chain-smoking is the practice of smoking several cigarettes in succession, sometimes using the ember of a finished cigarette to light the next.
He tells: “Smoking to me is a form of stress relief. It’s just like when others crack open a bottle of spirit or go to watch movies when they’re stressed. I simply take up my lighter and burn one up when the work gets to my head.
“And, in my case, since I am running the show, I may need more than just one or two cigarettes.”
Hamed confessed to smoking more than two packets of cigarettes a day. “To reduce my nicotine intake, I’ve switched to a lighter version of the cigarette I started smoking back in 2004. My family and colleagues tell me that it isn’t any healthier, but I’m here alive and kicking.
“Moreover, if I die from lung cancer or some related disease, I will happily accept it. I always take responsibility for my actions – and most smokers do,” he proudly says, before accepting that he would have benefitted from not giving into cigarettes at a young age due to pressure from his friends in college.
Strategies to stub out
To tackle this mentality towards smoking, we must understand and work towards creating awareness of the health complications caused by various carcinogenic (elements that have the potential to cause cancer) ingredients in a cigarette.
Speaking to Y, Dr. Jitendra Motavar, a specialist in Internal Medicine, at the Burjeel Medical Centre, explains: “Replacing the smoke on your face with a smile today will replace illness in your life with happiness tomorrow. Quit now.
“The true face of smoking is disease, death, and horror – not the glamour and sophistication the pushers in the tobacco industry try to portray. Smoking leaves an unseen scar; it fills your insides with toxins and tar.”
But as Dr. Haneef states, understanding this phenomenon requires education from a young age – when peer influence begins to take effect.
“Peer influence,” the doctor says, “is the most common reason that kids and teens, especially girls, start to smoke. Kids whose friends smoke are more likely to start smoking, as it gives them a sense of belonging.
“They’re a key demographic: most people who become regular smokers start smoking in their teens,” she states.
In 2005, Oman acceded to the WHO’s Framework Convention on Tobacco Control, an international treaty with numerous obligations aimed at reducing the global burden of tobacco use.
This paper documents for the first time Oman’s experience in tobacco control by providing a descriptive analysis of the evolution of tobacco control policies in relation to the country’s international obligations.
Moreover, cigarette packets in Oman also explicitly showcase images of lungs and throats affected by cancer. Another move that may soon help curb the country’s tobacco use is the newly-implemented sin tax. As its name suggests, the tax will be raised on items such as tobacco products, alcohol, junk food, soft drinks and energy drinks, sometime this month.
As per the National Tobacco Control Committee (NTCC), the excise tax levied on tobacco products will be 100 per cent – meaning that a pack of cigarettes in Oman will soon cost double. Whether this move will aid in a reduction of tobacco consumers in the Sultanate will remain to be seen.
“It’s with high hopes that the move is being made – so it’s only a matter of time before we can see the results,” says Jacob*, a sales professional based in Oman. “Smoking has become the norm in the country and, somehow, remaining a non-smoker is becoming harder and less normal by the day.”