Cairo Khalid Salah, 35, remembers the first day he picked the habit more than 20 years ago. "It started as a challenge from my friends, who said that smoking makes one look like a real man," Salah, a taxi driver in Cairo, recalls. "I believed them, and have been a smoker of around two packets of cigarettes a day ever since."
He said that as a taxi driver, he spends most of his smoking hours while doing his job. "I cannot quit smoking especially as I drive my taxi on traffic-clogged streets. Smoking helps me keep concentrated and calm while haggling with clients over fares," he told Gulf News. "Sometimes, clients refuse to continue their journeys with me when they see me smoking."
The habit costs Salah, a father of three, around 300 Egyptian pounds (Dh200) every month. According to a recent survey released by the World Health Organisation (WHO), an average Egyptian family spends six per cent of their monthly income on tobacco — perhaps more than on education and health.
Experts estimate that smoking in Egypt costs around 8 million pounds annually as around 85 billion cigarettes are smoked per year. Salah is one of nearly 13 million Egyptian smokers, who have been the target of a high-profile anti-smoking campaign launched over recent years.
More than two years ago, the health authorities made it obligatory for tobacco manufacturers to print an image of a sickly man living on an artificial ventilation machine, on packets of cigarettes.
But soon, the warning image became a funny public issue as the man in the picture sued the authorities for "tampering" with his features without his consent.
Last month, another controversy erupted when a new illustration was printed on tobacco products linking smoking to male impotency.
The image was considered offensive in this conservative society, and the health authorities were taken to court again.
Around 439,000 children in Egypt under the age of 15 smoke, according to the Ministry of Health. Some 74,000 of them are less than 10 years of age.
Meanwhile, WHO blames smoking for around 90 per cent of cancer cases in Egypt, a country of 80 million. Many sufferers of heart disease in the country are smokers too, said WHO.
Not eligible
In June 2007, Egypt passed a law banning smoking at work places and at health centres, schools and social clubs. A ban on underage smokers was also issued. But neither is strictly enforced.
"Egypt is still one of the cheapest countries when it comes to tobacco purchases," Mushira Khattab, Egypt's Minister of Family and Planning said. "Prices of cigarettes are available and affordable at shops and kiosks even for children," she added. Health professionals, meanwhile, blame the spread of smoking culture in Egypt on movies and wrong perceptions.
"When an actor puffs on the screen, the message received by millions of the audience is that smoking is fine," Mahmoud Chaker, a pulmonary disease specialist said. "Popular celebrities, who smoke, also help glamorise this habit for youngsters in particular."
Dr Chaker urges authorities to strictly ban smoking in movies and TV dramas.
"The tobacco industry has popularised a misleading image of smoking as being cool, attractive and rebellious. Many young people, including girls recently, start smoking with the aim of projecting a certain social image.
Disturbing facts
- 439,000: children under the age of 15 smoke
- 20%: proportion of adults over 15 who smoke
- 70%: subjected to passive smoking at home/work
Smoking rife among jobless Egyptians
The use of tobacco, which is one of the strongest cancer-causing agents, is associated with the incidence of different cancers, mainly lung cancer, according to medical studies.
In the US, lung cancer is the leading cause of cancer death among both men and women, with 90 per cent of lung cancer deaths among men and approximately 80 per cent of lung cancer deaths among women attributed to smoking.
Smoking also heightens the risk of many other types of cancer, including cancers of the throat, mouth, pancreas, kidney, bladder, and cervix.
The risks are not limited to smokers. Non-smokers exposed to smokers have the risk of developing lung cancer, say specialists. On average, smokers increase their risk of developing lung cancer between five and ten-fold compared to non-smokers. Even though lung cancer can occur in non-smokers, more than 90 per cent of all lung cancer patients are current or past smokers, they say.
"A smoker's risk of developing lung and other cancers can be reduced by quitting," said Dr Mufeed Hamed, a respiratory specialist at Qasr Al Ain Hospital in Cairo. "The risk begins to decrease immediately after quitting and continues to decline gradually each year. Moreover, the risk of developing other cancers and chronic diseases linked with smoking is also reduced," he said.
Dr Hamed attributed the increase in the numbers of smokers in Egypt to social and psychological factors. "Movies continue to glorify smoking. Popular actors are shown smoking when they contemplate a solution to a tough problem, thereby giving the false impression that tobacco is the solution."
He cited the "abysmal" failure of the authorities to promote the non-smoking culture and apply anti-smoking laws.
"Egyptians, who are gripped by economic hardships, resort to tobacco as a way of letting out their disappointment. The habit is ironically rife among the jobless young people," said Dr Hamed.
The increase in the numbers of smokers is not limited to Egypt, however.
According to a recent study in Yemen, people there smoke around 6.4 billion cigarettes per year, i.e. 317.5 million packets. "The magnitude of tobacco use can be perceived when we imagine that if cigarettes used annually are arranged in one line, they would stretch for around 508,000 kilometres," said Ahmad Hussain Al Hada, an ex-executive of the Youngsters Welfare Fund, who conducted the study.
The numbers of smokers in Yemen are among the highest in the world, according to recent studies, which estimated that around 58 per cent of men and 30 per cent of women in the country are smokers, with their total numbers exceeding 3 million. Smoking in Yemen is one of three leading causes of death including road crashes and gunfire.
