(photo credit: INGIMAGE / ASAP)
Many of the estimated 550,000 to 710,000 Israeli smokers who will die prematurely from smoking could be saved if the government fully carries out the World Health Organization Framework Convention for Tobacco Control (FCTC) that Israel ratified in August 2005, according to a new study just published in the Israel Journal of Health Policy Research.
The study was carried out by Dr. Laura (Leah) Rosen of the Health Promotion school of Tel Aviv University’s Sackler Faculty of Medicine; oncology Prof. David T. Levy of Georgetown University Medical Center in Washington; Dr. David B. Abrams of Johns Hopkins University’s Bloomberg School of Public Health in Baltimore and of Georgetown University; and Levy’s son Jefrey Levy, a research assistant.
They based their findings on the 2014 Israel National Health Interview Survey population data from the Israel Central Bureau of Statistics. There are 1.1 million current Israeli smokers.
They made their estimates based on existing knowledge that between 50% and 65% of smokers will die prematurely from smoking.
“Within 40 years, complete implementation” of the FCTC recommendations is projected to reduce smoking prevalence among current smokers by 34% and avert between 188,000 and 245,000 deaths among current smokers.
Among the recommendations is that the government fully implement the raising of tobacco taxes, fully enforce smoke-free-air laws, restrict the marketing of tobacco products and limit media campaigns for the products. Each of these will “reduce smoking by about 5% within five years. Improved cessation treatment and health warnings each have smaller effects in the next five years, but their effects grow rapidly over time,” they stated.
Complete implementation of the strategies has the potential to substantially reduce smoking prevalence and avert tens of thousands of premature deaths due to smoking, they noted. “Additional benefits are also expected from reduced morbidity, reduced initiation among nonsmokers and reduction in exposure of nonsmokers to tobacco smoke.” At present, an estimated 8,000 smokers die from their habit, and some 2,000 nonsmokers who are exposed to tobacco smoke die in an average year.
The WHO set a voluntary target of a 30% reduction in smoking rates by 2025 as part of its global non- communicable disease agenda. It seeks to: “Monitor tobacco use and prevention policies, protect people from tobacco smoke; offer help to quit tobacco use; warn about the dangers of tobacco; enforce bans on tobacco advertising, ramping up promotion and sponsorship; and raise taxes on tobacco.”
But even though Israel ratified the agreement over a decade ago, the Health Ministry has not seen to it that municipalities adequately enforce no-smoking laws. They have not handed out NIS 1,000 fines per cigarette in certain zones. The ministry also has not required graphic warnings on large sections of cigarette packets and allows the selling of duty-free tobacco at airports.
“There are fines for violations on establishment owners and patrons, but they are inconsistently enforced. When citizen complaints are registered, investigations are launched but are, likewise, inconsistent in scope and regularity,” the authors wrote.
On the issue of advertising, Israel has banned national TV and radio advertisements and issues fines for violating this ban. But there are no such bans on magazines and newspapers ads, billboards and outdoor advertising, point-of-sale advertising, and Internet ads (The Jerusalem Post voluntarily stopped doing this decades ago).
With regard to indirect advertising, Israel has bans on free distribution in mail or through other means, appearance of tobacco brands on TV and/or film (product placement) and fines for violating these bans, but does not ban promotional discounts, non-tobacco goods or services identified with tobacco brand names, brand names of non-tobacco goods or services used for tobacco products and sponsored events, the researchers stated. There is also no requirement to present prescribed anti-tobacco ads before, during, or after the broadcasting of visual entertainment.
Age adjusted estimates of smoking by Jewish males (23%), Jewish females (14%), Arab males (48%), Arab females (6%) “are not addressed, due to a lack of sufficient information to distinguish differences in relative risks and differences in policy effects among these populations,” they continued.
The Health Ministry did not respond to a request for comment.