Lack of enforcement blamed for continued smoking

MKs were adamant in their calls to reduce the nation’s smoking rate at the Knesset Labor, Social Welfare and Health Committee meeting.

May 27, 2013 23:20
Woman smokes a cigarette

Smoking cigarette 370. (photo credit: Daniel Munoz/Reuters)

MKs and Health Ministry officials were adamant in their calls to reduce the nation’s smoking rate at the Knesset Labor, Social Welfare and Health Committee meeting on Monday by better enforcing bans in public places.

Health Minister Yael German – who made Herzliya one of the first municipalities to fight for smoking-free public places when she was mayor – presented her Smoking Report to the committee.

Ten thousand Israelis die from smoking-related causes each year and it is the largest cause of preventible deaths in the state, German told the committee members, including acting chairman Shas MK Ya’acov Margi. Nine thousand of those deaths were smokers while 1,000 were only exposed.

The rate of smokers among all Israelis is 20.6 percent, with 27.7% being men and 14.5% women. Among Jews, 19.8% of both sexes smoke, with a 23.7% among men and 15.9% of women. A total of 24.9% of Arabs smoke, with a 43.8% of men smoking compared to 6.7% of Arab women.

Urine samples of nonsmokers checked for cotinine – a chemical that represents the breakdown of nicotine in the body – showed that 33% had been exposed to significant amounts of tobacco smoke. This, said German, is evidence that enforcement of laws barring smoking in public locations and workplaces remains far from ideal.

“Without enforcement, we cannot significantly reduce smoking,” German said.

“Eight out of 10 people want to breath clean air.”

German called on the heads of local authorities to send in annual reports of the number of smoking fines served by inspectors – who nationwide primarily give parking tickets and fines against illegal food establishments and others.

The municipalities are required by law to submit these reports but many don’t.

According to figures, only 2,909 fines were given around the country in 2011.

Tel Aviv has 205 inspectors that issued 1,431 tickets. In Kiryat Ono, six inspectors fined seven people while in Migdal Haemek, five inspectors fined seven smokers.

Jerusalem’s 92 inspectors gave 443 tickets, Beersheba’s 30 inspectors handed out about 600 and Dimona’s two gave just three tickets.

Ministry director-general Prof. Ronni Gamzu said that in the 18th Knesset, a bill was presented with additional restrictions on tobacco advertising and other measures, and it will reach the 19th Knesset for its second and third readings soon. The ministry, he said, will try again to include a prohibition of smoking in sports stadiums and amphitheaters that has been voted down by a majority following tobacco company lobbying.

Gamzu related that inspectors are frustrated when they visit bars, restaurants and clubs where, at the entrance, illegal smokers inside are alerted by the guard to put their cigarettes out. Even though the premises are full of smoke, the law does not allow fines unless the cigarettes are lit, he said.

There is a decline in the number of cigarettes smoked among those who consume 21 cigarettes or over daily but the figure is stable among those who smoke up to 20 every day.

The average smoking rate among Israeli males has dropped for the first time to 24.9% below the OECD average of 25.9, but the European figures include teenagers from age 15 through adults, while Israeli figures are only men aged 21 and over.

Haim Geva-Haspil, the ministry’s official in charge of smoking reduction, said that as the rate reaches 20%, it is harder to bring about dramatic declines. His office is looking for culturally sensitive ways to get Arab men to kick the habit.

He was happy to report that the use of hookahs (water pipes or nargila) has declined due to education campaigns and the rise in the cost of the special tobacco from NIS 9 per packet to NIS 35, thanks to much-higher taxes.

In addition, fewer soldiers start smoking during military service. Nevertheless, 30.6% start in uniform while 29.3% say at discharge that they still light up.

As a result of smoking-cessation courses and prescription drugs for relieving nicotine addiction added to health services a few years ago, 25,505 people asked for help from their health providers, but the report did not say how many succeeded in quitting. One MK complained that this help is not advertised widely by the health funds, causing German and Margi to insist that the insurers do a better job.

Israelis smoked 415 million packets in 2012, with state income from taxes totaling NIS 5.3 billion, imports accounted for NIS 4.57b. and local products made NIS 744m.

The ministry said it will make the sale of electronic cigarettes, which “do not lead to smoking cessation,” illegal because scientifically, it has not been shown what they actually contain and if they are harmful to ones health. The matter will be reassessed in five years, the ministry added.

German said that the high rate of smoking in the Arab sector may account for double the rate of sudden infant death syndrome among their children.

Dr. Afu Agbaria, a physician from the Hadash Party, said that many young Arabs have easy access to self-rolled cigarettes that are not taxed, a cheaper alternative, and that they still commonly smoke hookahs. He added that the smoking rate among Arab men may be higher because of their lower socioeconomic status and higher unemployment rate although it is lowest among Arab women who live in the same conditions.

Amos Hausner, the attorney who heads the Israel National Council for the Prevention of Smoking, chided the ministry for “not spending any money on public service announcements against smoking,” even though local tobacco companies spend NIS 55m. a year to encourage lighting up. He also stated that higher tobacco taxes unfortunately do not go to the indebted public health system, but to the Treasury’s own coffers.

Kupat Holim Meuhedet said it is training 15 haredi smoking-cessation counselors to help the ultra-Orthodox to kick the habit. It noted that smoking rates are high among haredi men and that too many smoke in yeshivot, wedding halls and other places where is it forbidden.

A survey conducted for the Pfizer drug company that makes a smoking-cessation medication found that 55% of smokers "would prefer" to give up cigarettes to get NIS 1,000 more in monthly income.

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