Editor's Notes: 12,000 reasons not to light up

We're talking about an addictive drug that kills many users and those who come into proximity with it.

By
May 31, 2007 21:52

People stood and stared in shock. One or two even applauded. The policeman, embarrassed, shrugged and murmured, almost apologetically, "Look, that's the law." The scene was the Jerusalem Central Bus Station and the young man in blue had confronted two shoppers with cigarettes in their mouths. "You're not allowed to smoke here," he told them. The pair didn't say anything in response, but their expressions amounted to a defiant: Do us a favor, haven't you got terrorists to catch? So the cop told them to stub out the cigarettes there and then or he'd slap them with a fine. Confronted with the financial threat, they complied with alacrity, to the amazement of the rest of us. Israel's annual statistics for fatalities from smoking are nothing short of horrifying. Twenty-five percent of the population smokes - a figure that has remained stable in recent years, while such percentages are declining in many other countries - and the toll is estimated at 10,000 to 12,000 deaths a year. These are numbers that dwarf the terrorism casualties, not to mention the relentless traffic-death totals, that so rightly exercise us. And included in those figures are an estimated 1,500 annual fatalities who aren't even smoking themselves - innocent victims of other people's addiction and selfishness. Year by year, evidence accumulates of the extent of passive smoking's impact. One new study now suggests that the unborn child of a mother exposed to other people's smoke is more prone to suffer from Attention Deficit Hyperactive Disorder (ADHD). (My thanks to our health reporter, Judy Siegel-Itzkovich, for this and much of the other factual information in this article.) As in so many areas, it's not a lack of legislation that is to blame for this continuing blight but, rather, an absence of enforcement. Since the early 1980s, Israel has boasted increasingly stringent laws outlawing smoking in public places. The problem is that nobody has done much to implement them. The onus was initially placed on the police force but, with the best will in the world, the police are under-staffed and over-burdened as it is. The obvious, and intended, alternative has been for local municipalities to take the lead. After all, it was fondly imagined by legislators, City Halls would have every interest in hiring teams of inspectors, doling out fines at hundreds of shekels a time to public-smoking offenders, because the stream of revenue would swell municipal coffers. But it hasn't turned out that way. Ra'anana, where the local government is evidently genuinely committed to smoke-free workplaces and public areas, is an exception to the wider rule, which has seen City Halls nationwide demanding that the Treasury allocate additional funding to pay for the inspectors. But the Treasury has no intention of doing any such thing. And so, with existing municipal inspectors merrily ticketing illegally parked cars whose owners are nowhere in sight, but proving unwilling to risk confrontation with fuming smokers, the legislation remains largely unenforced. It might not say so publicly, but the truth is that the Treasury is quite comfortable with the current situation. After all, almost three-quarters of the price of a pack of cigarettes constitutes vital tax revenue. A drastic antismoking drive would threaten this influx. For the Treasury to pay for new inspectors would thus be to shoot itself in the foot twice over - putting out extra cash of its own to impose a ban that would reduce its income. The Treasury also rather likes the current level of cigarette tax, fearing that to increase it further would be to discourage smoking, and thus, again, to cut revenues. WE ALL have our little addictions, I hear many of you say. Israel is a stressful society. Why go campaigning against a habit that plainly helps so many Israelis get through the day? Well, yes, we do all indeed have our coping mechanisms - in my case, for instance, an overdeveloped fondness for chocolate as comfort food. But we're talking about a drug here, an addictive drug that kills many of its users and those who come into proximity with them. Evidently, 75% of Israelis have found other ways of shedding or coping with stress. Evidently too, as the smokers among you will testify, many cigarette addicts would love to quit, and would welcome efficient, public-funded frameworks to help them kick the habit. They need support and guidance. And at terrible cost to themselves and to the rest of the public, they are not getting it. The Treasury, again, has been resolute in not using tax revenues from cigarettes to finance antismoking advertising or courses. But why not bring in the private sector? Why not privatize the public ban? Issue a tender and, with the appropriate supervision and appeals recourse, have private inspectors on duty in malls and other public places, and responding to 1-800 calls, issuing fines - with some of the money collected being mandated for allocation to stop-smoking campaigns and courses. To her credit, Knesset Speaker Dalia Itzik's heart is in the right place on this. Defying the skeptics who said it couldn't be done, she's restricted her colleagues' habit to enclosed areas in the Knesset cafeterias. The corridors of power, as a consequence, no longer reek. The IDF, which unlike many city councils also takes the legislation seriously, has managed to bring down smoking levels, too, so that a dire statistic - which saw fully twice as many young Israeli women smoking by the end of their army service as at its start - no longer applies. Too many other dire statistics, by contrast, show no sign of improvement - including one released by the Israel Cancer Association to coincide with Thursday's World No-Smoking Day that shows no fewer than four in 10 children in grades 7-11 smoke nargilot (tobacco water pipes), which have somehow garnered an unfounded reputation as being a nondangerous alternative to cigarettes. Israel's various antismoking lobbyists this week expressed their dismay, and worse, at Health Minister Ya'acov Ben-Yizri's ostensible disinclination to tackle the issue effectively. Among the host of measures they want introduced are an increase in cigarette tax, a ban on smoking in cars (so that drivers can keep both hands on the wheel, and reduce the passive smoking impact on their passengers), the closing even of designated smoking areas in public places and a ban on cigarette vending machines. Ben-Yizri, a smoker himself for the past 60 years, has spoken in the past of a determination to at least have the vending machines removed from spots near schools; his critics say even that has yet to happen. The minister is also weighing an absolute ban on smoking - with no designated closed smoking areas - in all Health Ministry buildings, hospitals included. He made this declaration at an antismoking conference earlier this week. The only reasonable response is one of abject horror - to the fact that, as things stand, people are explicitly allowed to smoke in certain parts of hospitals. IF ALL of the above information on the largest preventable cause of death and its thousands of annual Israeli victims has failed to stir you, then just maybe, like that pair of smokers in the Jerusalem bus station, a greater awareness of how it hits us all in the pocket will make the difference. Another of the antismoking lobby proposals is for a requirement that tobacco firms allocate funds to pay for the medical treatment of the victims of their merchandise. At present, all of us, smokers and nonsmokers alike, are covering the incalculably vast sums of money spent on such treatments out of our health taxes. Just think of the money we'd all save if the tobacco firms were footing those bills instead. In the meantime, a few enterprising Israeli individuals have recently discovered a way to get some of that money back. Working through the small claims courts, they've created a precedent whereby they can sue restaurants that don't either ban smoking outright or limit it to a separate designated area. The courts have been prepared to impose fines of up to NIS 2,500 and to accept the compelling cumulative evidence on the impact of passive smoking, so that a complainant, in order to prevail, need only assert before the court that his or her health has been endangered by the restaurant's smoking-tolerant policies. You might want to think about this the next time somebody else's cigarette fumes waft your way. Like the policeman said, "That's the law."


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