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Smoking: The Plague of our Time

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Smoking: The Plague of our Time
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Dr. Ahmed Mohammed Al Mullah, Senior Consultant of Public Health & Disease Control, Head of the Smoking Cessation Clinic at Hamad Medical Corporation (HMC).

Write for Health&Life Magazine and Website

Approximately 1,000 new patients visit our clinic annually!
What many people don’t know is that one session of shisha (hookah) is equivalent to smoking around 40 cigarettes.

Tell us about the anti-smoking unit (Smoking Cessation Clinic).

It is a unit set up by Hamad Medical Corporation in 1999, and is one of the branches of the Chest Section and Internal Medicine. It offers its services to women, men and young people, and receives patients from the age of 12 and older. We also have a clinic at Hamad Hospital and Heart Hospital. We hope to expand next year in Al Wakra, Al Khor and the rest of the hospitals.

These clinics offer treatment to smokers wanting to quit, at the same time as carrying out research on smoking. They also include a special section for community awareness that is open to anyone, whether they are university or school students or other members of society.

Do you have statistics for the number of smokers, deaths and diseases caused by tobacco abuse?

Of course, smoking rate in the country is about 37 percent according to a study conducted about 7 or 8 years ago, and we will carry out another study this year to evaluate the increases or progress in reducing the number of smokers. As for the visitors of the clinic, we receive about 1,000 new patients annually, and we found that 35 percent of them had quit smoking and 25 percent more had reduced smoking intake. The rest cannot usually quit or reduce smoking, but we continue in our attempts in order to help them stop smoking.

Former officials set the ambitious deadline of eliminating smoking by the year 2000; where is Qatar in respect to this?

This is the statement of late Dr. Abdullah Albaker who sought to make Qatar a smoke-free country; but in view of reality it is difficult to eliminate smoking completely. We are trying to reduce the prevalence of smoking among adults, and at the same time reduce the number of new smokers. If we reach that goal within the next ten years, it will undoubtedly be a good achievement.
Although it is difficult to prevent people from smoking, we are trying to organize; for example there should not be smoking in workplaces and enclosed public places. Passive smoking affects smokers as well as the people around them, and now thankfully the law prohibits smoking in State ministries and workplaces.

Last year the Cultural District (Katara) announced on its Twitter account, as well as on its Director’s, Dr. Khalid Al Sulaiti, account, a ban on public shisha smoking at the Cultural District with effect from the 1st January; what is your comment?

No doubt that the step taken by Dr. Sulaiti is a good move, well calculated by Katara as it reflects the position of a state cultural icon. I hope others would follow suit, especially Souq Waqif where smoking shops have spread on a large scale. In the past, for example, in Souq Waqif there were talks of reserving half the tables for smokers and half for non-smokers, but there was no significant commitment from shop owners because of lack of enforcement. These places undoubtedly receive a lot of families and individuals are thus exposed to the dangers of smoking.

How are such decisions enforced?
We do not have authority over these entities, and we are trying as best we can. Every entity has its different circumstances, but we motivate them by increasing health awareness and intensifying awareness campaigns.

What is your role in the fight against smoking and raising awareness of the negative effects of smoking?

There are several awareness methods that we adopt, such as distributing educational literature that highlights the harmful effects of cigarette and shisha smoking. We encourage smokers to accept to stop smoking throughout the year. For example, in the beginning of the year, we had a campaign in the schools of Omar ibn al-Khattab, and we’ve also campaigned at Qatar Petroleum. Campaigns in general are ongoing in schools — independent and private — universities at the Educational City and companies in the State.

Is there cooperation between the Gulf Cooperation Council (GCC) and Qatar in the enactment of legislation and laws to combat smoking?

Yes, there is a Counter-Smoking Gulf Commission that keeps track of the Executive Office of the Ministers of Health. It is working to implement smoking ban standards, but the enactment of laws and their enforcement are up to each state, according to its sovereign law. All the Gulf States have an anti-smoking law through a commitment with the World Health Organization within the framework of the Convention to Combat Smoking. The dilemma remains in the enforcement of these laws, which vary in proportion from one country to another.

How effective are these laws?

Unfortunately in the Gulf states there has been little progress compared to European or western countries; the enforcement of laws is still timid, but it is OK compared to the past ten years, especially in workplaces and enclosed places where the “phenomenon of finding an employee smoking in front of you in his office” disappeared; so in general these things are better than before.

Why have you organized an international conference on shisha smoking only, without other types of smoking?

We have organized a conference on shisha only, because all laws and existing studies relate to smoking cigarettes only. This has caused many people to consider that shisha is not necessarily harmful, as it does not get adequate attention from decision-makers. There were no laws against shisha as we find anti-cigarette laws and others. The conference will enable researchers to present the studies and papers that show the harmful effects of smoking shisha. We also assist decision-makers until the law is well enforced. Shisha has now become a widespread epidemic, and I expect that many shisha-related diseases will appear after 10 years.

What is the difference between smoking shisha and smoking cigarettes?

Both cause a major threat to health, but shisha is a major health hazard. It is not well known by many people that one session of shisha is equivalent to smoking around 40 cigarettes, and some studies suggest much higher figures. A shisha smoker, for example, often is in a confined space surrounded by a large number of smokers for a long time, so they expose themselves to the risks of smoking and passive smoking. A smoker of shisha and cigarettes is more susceptible to smoking-related diseases.

Have many countries applied to participate to the conference?

The conference received a wide participation by all Arab countries and many European countries, America and Canada. Even states that we would never have imagined as shisha smokers, such as the Philippines, attended the conference. These countries submitted scientific papers.

What is the impact of shisha on young people?

The problem we have here is not only the health impact, but that it has become attractive especially to young university students. It holds a kind of prestige. There are also a number of young women who have become shisha smokers, which represents a great health impact on this age group. A smoker at a young age increases and accumulates the risk more than one who smokes at a late stage. A person who smokes at 15 years of age is vulnerable to greater damage and danger when he/she reaches the age of thirty. Of course we should not forget the economic damage caused by hookah for this age group. The price of shisha ranges from 10 to 70 QRs and up to 100 riyals in some stores.

Is there a relationship between shisha and drug abuse?

Smoking in general is an introduction to drug abuse; many drug users are originally smokers, unfortunately. 25 percent of them are smokers, and shisha as well as other types of smoking are an introduction to drugs and alcohol.

What about the spread of the phenomenon of tobacco chewing among students?

We hope to shed more light on the spread of this phenomenon among our students; we will intensify campaigns in this aspect. It is damaging especially for the mouth and teeth; it also contains harmful nicotine, which causes addiction.

It is said that the conference aims to examine the effects of shisha smoking on the health of smokers through presentation of the latest research and global studies. What has been achieved?

The conference is a call for participants to identify shisha smoking damage and impact on men, women and children, and some studies have shown that smoking affects even home furnishings; its effect remains glued to chairs, beds etc. Let alone when you enter a coffee shop offering shisha on a 24-hour basis. Some studies at the conference reported that the impact of shisha even affects the street where these stores are located. The proportion of pollution through the streets of Souq Waqif, for example, is very high compared to other areas where there are no smoking shops.

How does smoking harm diabetics?

Overall, smoking harms all smokers and people with diabetes already have complications; a diabetic who smokes will experience ten times more complications than a non-smoking diabetic. The most prominent complications caused by smoking are gangrene in the foot and retinal detachment in the eye. Moreover, smoking raises blood sugar levels and this is dangerous for diabetics.[1]

Is it possible that raising the price of tobacco will contribute to reducing the proportion and proliferation of smoking?

Undoubtedly it does help. In certain age groups or those with limited income, raising the price of tobacco effectively helps. In the worst-case scenario, it reduces smoking. Even the World Bank says that if cigarette prices rise by 10 percent it is offset by a decrease in the smoking rate ranging between 20-30 percent. We, for example, sell cigarettes for ten riyals, while in European countries the price of a box is 30 riyals. There is a big difference here. The higher the price of smoking materials, the fewer smokers there are. A person who smokes “two packs” will certainly reduce their consumption. In addition, some local laws restrict the sale of cigarettes. For example, we have a law that prohibits the sale of cigarettes in areas within 1,000 meters of schools. The State also prohibits tobacco advertising and promotion in the media.

How effective are awareness campaigns and outreach health camps for visitors of the Hamad Foundation on the occasion of the annual International Day of Smoking?

We organize awareness campaigns every year in late May on the occasion of the International Day of Smoking. These include awareness activities in the centers, hospitals, educational institutions and commercial complexes. They obtain a great response from individuals; they raise and intensify awareness.

Is there a plan to combat smoking?

Yes certainly, and it will involve an expansion of anti-smoking services, God willing, very soon.

Where is the Anti-Smoking Association?

It is awaiting ratification by the Cabinet and approval by the Emir. We submitted our request more than two years ago. There is no doubt that the establishment of the Association helps in reducing heavy smoking. Besides, voluntary work in this area sometimes yields more than the official work, and we have young people who are ready to work and ready with their ideas and time. We are targeting all areas of society to be partners in this association, and we hope it will be established soon.

A final word to be addressed?

It is a word for smokers in particular. I advise them to stop smoking before it’s too late. To stop smoking today is better than to wait until tomorrow… And tomorrow is better than after tomorrow. It is better for you to give up smoking soon than to give up smoking when you are forced to after being affected by smoking diseases.

And we thank you at Health and Life for making room for us in this magazine and hope you will succeed and contribute effectively to raising health awareness among members of society. 

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