There was no smoking outside the doors of the Tel Aviv University hall during
the coffee and tea breaks – one would hardly be expected to light up while
attending the country’s first academic conference on “Tobacco or Health.” But is
a not-too-distant future when outside every conference hall, in any vehicle, on
any street or even in any home, no one smokes an achievable dream? If so, it
would be an about-face from the time when, a quarter of a century ago, I had to
suffer the constant smoke from a newsroom colleague just a meter from my
Or when, eight months pregnant, I was ejected from a Knesset
committee meeting by an MK sitting in front of me after I politely asked – twice
– if he would put out his cigarette.
Today, we are in a new era. Perhaps
we can revert beyond the time, over a century ago, when physicians stared with
amazement at a rare patient with tumor-filled, tar-encrusted, nicotine-tinted
lungs. The onus today is not only on the smoker to observe the law but on the
owner of the premises to enforce it.
The right of the citizen to breathe
clean air is a given, while even the government has realized that slashing the
costs of treating victims of tobacco offsets losses in tax income.
adult smoking rate has dropped from 45 percent a generation or two ago to 20.6%,
and a target of 10% doesn’t seem imaginary anymore.
It is inevitable that
“the days of organized tobacco around the world are numbered” as exemplified by
the declaration of the government of New Zealand, which will be completely-smoke
free by 2025 along with a growing number of other countries, said long-time
smoking-prevention lawyer Amos Hausner, the head of the Israel Council for the
Prevention of Smoking, who personally masterminded most of the country’s
Hausner, the son of Gideon Hausner – Israel’s late
attorney-general and prosecutor of Nazi arch-murderer Adolf Eichmann – referred
to the phrase “banality of evil.” He said that this phrase was wrongfully used
in connection with the Nazis, but could however be used to describe an industry
that knowingly kills half its customers, amounting to some 5.7 million people a
“Unlike the Nazis, who were motivated by hate, anti-Semitism and
vicious racism, the tobacco companies are motivated by greed,” he said. They
continue to make and market them aggressively. In addition to suing the
conglomerates for the damage they caused, it is also appropriate that companies
and individuals be tried for “homicide,” said Hausner.
Just as pre-Civil
War America never dreamed slavery would be abolished within a few years, he
continued in his TAU address, “we are in the midst of an irreversible process
that will lead to the termination of organized tobacco. The environment will be
tobacco-free. This is what people all over the world want.”
working to make smoking history in this country,” said conference initiator
Leah Rosen of the department of health promotion at TAU’s Sackler
Faculty of Medicine’s School of Public Health. But the country’s decisionmakers
may not know what the public wants. She and her colleagues conducted a survey in
2010 not only on what Israelis want by way of smoking legislation but also what
decisionmakers think the people want.
“If they read the [Hebrew] papers,
they may think the people don’t care about secondhand [sidestream] smoke. The
newspapers published negative publicity about recent anti-smoking legislation,”
By contrast, it should be noted that The Jerusalem Post has for
many years refused to accept tobacco advertising; in the Hebrew press,
dependency on this advertising unavoidably affects the scope and the nature of
the coverage of the smoking issue.
Rosen asked both decisionmakers and a
randomized sample of adults whether they favored or opposed prohibiting smoking
in lobbies and stairways of apartment buildings, private cars with child
passengers, the entrances to healthcare facilities, train platforms, bars and
pubs, open areas on college campuses, beaches, outdoor pools and the
The vast majority of Israelis (including many smokers) favored
smoking bans outside medical facilities, in vehicles carrying children and even
at bars and pubs. Eighty percent wanted their apartment buildings’ common areas
smoke-free. The figure was lower for college campuses (where such prohibitions
are growing in the US). But in every case, policymakers underestimated the
public desire for smoke-free environments, said Rosen.
Association director-general Miri Ziv, who has been with the organization for
the past 30 years, said that even though enforcement of laws is still
inadequate, “we were among the first 10 countries in the world to pass
legislation against smoking in public places. We have attained tangible
achievements, but we still have to eradicate smoking.”
HE IS a practicing
Catholic of Irish origin, but Prof. Gregory Connolly – a leading Harvard
University School of Public Health observer of the tobacco industry and how to
minimize smoking – finds himself visiting Israel regularly to give advice.
Originally a dentist, Connolly worked for years as head of the Massachusetts
Tobacco Control Program, cutting the number of smokers by a third and tobacco
consumption by a half.
Every year, over five million people around the
globe are killed by tobacco, he said. If significant action is not taken, the
figure could rise to eight million by 2030, and even a billion people in the
whole 21st century, as the conglomerates shift their merchandising to the Third
World, which is too weak to fight back.
“Today, four large tobacco
companies control 90 percent of the world’s tobacco sales.
It’s hard for
governments to deal with them,” Connolly said, “as they have a lot of power.
They have bought into other industries...
My pension fund at Harvard is
heavily invested in Philip Morris, the world’s largest tobacco company. One
year’s tobacco profit is equal to the gross domestic product of a trillion
people at the poverty line.”
While Israel’s Dubek company used to rule
the local market, this has changed, with Philip Morris now number one in this
country, Connally revealed.
“Israeli smokers are controlled by foreign
industry. The money goes to the US, Britain, China and Japan. Whoever owns
Marlboro Country control the lungs of young people around the
Philip Morris, he continued, “targets young people and women,
producing a pellet that the customer crushes to release menthol; it is claimed
to be ‘lighter,’ as it is easier to inhale. Customers are hooked on tobacco more
easily. This type of cigarette is marketed in Israel and all over Western Europe
Marlboro Gold cigarettes are sold with an image of being “good
and safe.” Marlboro Black, with heavy nicotine content, are handed out outside
military bases inducting new draftees. Cheap L&Ms are sold in Russia, with
immigrants to Israel bringing them along. Smokers in countries with strict
nosmoking laws that have to rush outside for their “smoking breaks” are lured by
short, high-nicotine cigarettes that give them their nicotine fix quickly,
The Harvard expert added that tobacco companies file
complaints against limitations that “hurt company freedom” and “compromise
intellectual property.” The World Trade Organization, which coordinates the
rules of trade between nations, pushes for lower tariffs, he said, “and WTO
boards decide things even though they have very little expertise. Tobacco
companies complain to the WTO, and under bilateral treaties, try to prevent
enactment of national tobacco control policies.”
Connolly added that
while Philip Morris earned $54 million last year from its tobacco sales in
Israel, the country spent billions of shekels to treat victims of
tobacco-related diseases. The direct and indirect expenses to Israel reach NIS
48 per pack compared to the NIS 17 per pack that the companies earn.
average tobacco company, he continued, earns as much as NIS 10,000 for each
Israeli smoker from the time he first lights up until he dies from smoking its
“Israel has sovereignty. Fight for it. Don’t let large
multinational corporations that devalue human life determine your health
policies. There is no silver bullet, but raise tobacco taxes and save lives.
Prohibit smoking throughout schools,” advised Connolly.
“Kids must not
see their teachers smoke.
They’re a bad example.”
has been known for its high smoking rates, especially among men, and with
alarmingly increasing rates among women. But two years ago, the country
implemented legislation to bar smoking in public places. Prof. Costas
Christophi, an expert in epidemiology and occupational health at the Cyprus
University of Technology (who also teaches at Connolly’s School of Public Health
at Harvard) came to the Tel Aviv conference to describe progress.
studies compared particulate matter associated with secondhand smoking,
affecting employees in hotels and restaurants before and after the
implementation of laws – and found a dramatic improvement.
that smoke-free legislation, when enforced, is highly effective in improving the
air quality. You need a strong political will, with active enforcement of the
authorities and public support of the laws.
Even in nations with high
smoking prevalence, laws can be effectively implemented and have no negative
effect on accommodation, food and beverage services,” the Cypriot
Cotinine – a chemical in urine, blood and saliva that
indicates exposure to nicotine – was tested in the urine of Israeli adults in a
study headed by Health Ministry chief toxicologist Dr. Tamar Berman. Her team
found that the cotinine levels of non-smokers was significant, even though they
they themselves did not light up. The conclusion was that secondhand smoking was
a serious threat, making it clear that laws to protect non-smokers were very
Facebook and other social networks, said Haim Geva-Haspil, in
charge of the ministry’s health education and promotion effort for the the
struggle against smoking, is rife with smoking subjects – both negative and
positive. The tobacco companies use them to market their products and promote
games, parties and raffles. But the other side, usually not those in the
establishment, use it so fight smoking, especially by complaining about
violations of no-smoking laws and demanding enforcement by the
With new laws, tobacco promotion will be barred from Israeli
websites, the ministry official said, but foreign sites cannot be touched. The
ministry official promised to set up a website to accept complaints related to
smoking violations and even giving locations via GPS so establishments are
Ministry director-general Prof. Ronni Gamzu said: “We are in a
battle. We have to be more sophisticated and determined.”
that the ministry’s handling of smoking issues was not always adequate, as its
failure to push through vigorous changes via the Allon Gillon committee to
reduce smoking; despite commitments to the highest court, it never even produced
its promised report of recommendations.
Cigarette vending machines will
finally be banned in 2014 (as implementation was postponed for two years under
pressure from owners); laws will be interpreted more broadly to increase
restrictions. Gamzu said that after moving from director of Ichilov Hospital to
his current post two years ago, he had no idea how difficult tobacco lobbying
was to overcome.
“Tobacco advertising in the [Hebrew] newspapers
constitutes more than 2% of their advertising income. I tell them to advertise
other things instead. We won’t give up. Forcing tobacco companies to use only
plain packets without logos will come too.
But we can’t do it alone. We
need help from the four health funds and others.”