In 2005, Israel ratified the WHO Framework Convention on Tobacco Control (WHO FCTC). In the ensuing years the smoking rate, which had been about 45% in the early 1980s, fell to under 20%.Sounds good, right? Not so fast. A recent Health Ministry report indicated a rise in smoking rates to 22.5%, ranking Israel 28th out of 35 countries in Europe, which has the highest rate of smoking in any region in the world.Dr. Leah Rosen, chairwoman of Tel Aviv University’s Health Promotion Department, said such a rise was unheard of in the developed world once measures had been put in place to reduce smoking. “We have broken that trend,” she said.So, what’s changed in Israel that has contributed to an increase in smoking rates, which have contributed directly to the deaths of 8,000 to 9,000, including 800 non-smokers exposed to secondhand smoke? One glaring clue is the recent announcement by Finance Minister Moshe Kahlon that he would not raise the tax on loose tobacco (a.k.a. rolling tobacco) to bring it in line with ready-made cigarettes, against furious objections from representatives of the Israel Cancer Association, who had asked him to increase tobacco taxes. His rationale: He had vowed not to raise taxes and would not make an exception for rolling tobacco, which costs 43% less than packed cigarettes.Anyone with a calculator in the Finance Ministry could work out that this constitutes a loss in tax revenue over the past four years of more than a billion shekels. Additionally, a vast body of studies has shown that for every rise in the price of tobacco there is a corresponding number of smokers who stop. (Ironically, by not making tobacco more expensive the public coffers lose out because it costs many billions of shekels a year to treat patients for tobacco-related diseases.) The converse is also true: Sales of loose tobacco have grown since 2013 and now stand at a whopping 25% of all tobacco sales. It is therefore not surprising that with a cheaper alternative to prepared cigarettes, smoking rates have risen concomitantly. In another development, Israel is one of the first countries in the world to market socalled “smokeless,” “safer” iQOS cigarettes (which heat tobacco as opposed to burning it), manufactured by that paragon of “good health promotion,” the world’s largest tobacco company Philip Morris Ltd. Despite being banned in the US and other countries while the product is being investigated by the Food and Drug Administration (FDA), Health Minister Ya’acov Litzman accepted it with open arms.While Israelis are being used as “guinea pigs” by the above-mentioned tobacco giant, whose overarching goal is profit-making and not promoting good health, some experts believe iQOS cigarettes will ultimately be rejected by the FDA because they are more addictive than regular cigarettes.Attorney Amos Hausner, chairman of the Israel Council for the Prevention of Smoking and Israel’s foremost anti-smoking crusader, maintains that Israel’s health officials never wholeheartedly embraced the WHO FCTC. Smoking rooms are still allowed in most public places around the country in violation of the convention, and the ministry doesn’t spend money on public anti-smoking campaigns.In addition, Litzman strongly opposes putting graphic images – dirty teeth or lungs – on all tobacco packets or selling cigarettes in uniform packages without graphics. He claims they are “not aesthetic” and even suggested cigarette packets in Israel carry “pictures of Jerusalem.”What is not aesthetic, dear minister, is the sight of real-life patients wasting away and dying horribly of heart disease and cancers related to the effects of smoking.Another contravention of the convention is the permitting of tobacco advertising and promotion of tobacco products in Israel. Instead of barring tobacco ads, Litzman has proposed that every such ad be accompanied by an anti-smoking one. Hadassah Magazine is the only publication in Israel today that does not allow advertising of any tobacco products.One bright spot on the horizon is the decision by IDF Chief of Staff Lt.-Gen. Gadi Eisenkot that the military will eventually become free of tobacco, even though it will mean a significant loss of income to military units as they receive 25% of proceeds from cigarette sales on bases.This year, when sales contracts expire, open bases whose soldiers go home daily will no longer sell tobacco. In the meantime, a minimal number of locations allowing smoking will be publicized, though smoking will be prohibited in all military vehicles. Studies show that soldiers who smoke shoot less accurately, endangering their own safety and that of others. Currently, 37% of soldiers smoke at discharge.I salute you, Chief of Staff Eisenkot! May the ban happen speedily in our days and may others follow your example.