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Dr Mohammed Al Thani, Dr Ahmed Al Mulla, Dr Tahir Shaltout and Feroz Moideen
By Azmat Haroon
A draft anti-tobacco law being discussed by the State Cabinet is likely to increase the number of public health inspectors, who may include non-Qataris, according to senior public health officials.
The existing law allows only Qataris in the government sector to implement the anti-tobacco law.
Apart from easing criteria for selection of inspectors, the new law, once it comes into force, may also allow non-Qataris to work as volunteers.
At present, there are 12 health inspectors working under the Supreme Council of Health (SCH), apart from 30 volunteers from different ministries.
“We prepared a memo on the case of inspectors some six months ago. The new law will be more open in the selection of inspectors and it will give them more powers,” said Dr Al Anoud bint Mohammed Al Thani, Director of Health Protection and Non-communicable Diseases at the SCH.
The new law will increase the punishment for people selling tobacco near educational institutions. Shisha joints may also be banned in residential areas and near educational institutions.
The law will be more stringent than the current one and may give shopping mall managements the right to impose fines, Dr Mohammed Al Thani, Director of the Public Health Department at the SCH, said earlier this week.
“The new law will support health inspectors to collect fines in a better way and it will also support the people who control public places,” Al Thani said.
The law is with the State Cabinet and the SCH is waiting for its approval.
Managements of shopping complexes have long expressed their inability to implement anti-smoking laws due to lack of legal authority.
The issue was taken up with the SCH by the managements of various malls nearly a year ago.
“We were discussing the issue with the Supreme Council of Health for over a year,” Feroz Moideen, General Manager of Hyatt Plaza, said.
The SCH’s anti-tobacco unit collected more than QR300,000 in fines from smokers for lighting up in public places, mostly in shopping complexes, last year.
A total of 829 persons were handed out fines in more than 1,000 raids conducted between January and November 2012.
“The new empowerment, so to speak, will be a big responsibility for mall authorities. Customers who don’t abide by security will be dealt with severely,” Moideen said.
Even though Qatar’s law number 20 of 2002 prohibits smoking in all enclosed public places, many people violate the law because of loopholes in its enforcement.
In the current set-up, inspectors are responsible for implementing the anti-tobacco law in public places, including shopping complexes and hypermarkets.
An inspector first warns offenders against smoking in public places, and fines them if they are found violating the law the second time, Dr Anoud said. The fine can range from QR200 to QR500.
The inspectors can also fine women, she added.
A dozen inspectors are not enough for a rapidly developing country like Qatar, where the population has more than doubled over the past eight years, say public health officials.
“The current number of inspectors is not enough for the country anymore,” Dr Ahmed Al Mulla, Director of the Stop Smoking Clinic at HMC, said.
In most cases, it is months before the inspectors return to raid a premises again.
“The public health inspectors rotate in the malls. They don’t visit them all the time, which is why many offenders get away with smoking here,” Moideen said.
Another issue is that many smokers do not heed warnings from security guards at shopping centres not to smoke.
“Some customers do not listen to security guards and we don’t have any power to stop them,” said Moideen.
Officials at malls as well as members of the public can request the SCH to inspect any public place where they see smokers violating the anti-tobacco law.
There has been a steady increase in the number of youngsters, particularly high school students, who are addicted to tobacco in various forms, of which the most popular is ‘sweka’ (smokeless chewing tobacco).
More than 15 percent of the preparatory and secondary school students in Qatar use chewing tobacco, which is easily available in the local market, reveals a study conducted by the Social Rehabilitation Centre and the Research and Policy Analysis Centre of the Supreme Education Council (SEC) last year.
Addiction was found to be more common among secondary school students, with 17 percent of those surveyed found to have used chewing tobacco at least once, while some said they used it regularly.
“Some youngsters want to show that they are ‘adults’ and nobody can control them,” said Dr Tahir Shaltout, Senior Consultant in Psychiatry at HMC, explaining the growing habit of smoking.
Around 30 percent of Qatari men and 1.2 percent of women use tobacco in different forms, according to SCH statistics.
These figures may be misleading, Dr Shaltout says.
“I have doubts about these figures. This seems more of a general estimate,” he said, adding that no comprehensive scientific research had been done to find out how much of the population was affected by the smoking epidemic.
Interestingly, no data is available on the number of expatriates who use tobacco.
Dr Shaltout said that in addition to a survey on the use of different forms of tobacco, there was need for more research on the diseases caused by tobacco use.
“It is difficult to detach the two issues. To get an idea about how many people are using tobacco, we also need to look at how many people are affected by it,” he said.
The Stop Smoking Clinic at HMC receives 80 to 100 new cases every month, with the patients aged 13 and above, Al Mulla said.
He said there was an emerging trend among men and women these days -- the use of smoking pipes, which are considered “fashionable”.
“The smoking pipe was very popular in the UAE, but it has also become common here over the last two years,” he said.
A growing number of shisha outlets have also increased its use, observers say.
Women use the shisha because they feel it is more socially acceptable.
“A negative attitude towards women who smoke is more widespread compared to (such an attitude towards) men. This is why most women prefer shisha as an alternative to smoking,” Dr Shaltout said.
A poll conducted by the University of Calgary-Qatar on the lifestyle and health choices made by young women revealed that smoking has become more socially acceptable.
Many experts link smoking with psychological problems such as depression, which reports say is also widespread here.
“People think smoking can help them solve their depression or other psychological problems. They come to accept such notions because of the media and films, and also when they see elders in their family smoke,” Dr Shaltout said.
Qatar was the first country in the region to adopt an anti-tobacco law, but changing social dynamics made it difficult to implement it, according to Dr Anoud.
“Ten years have passed since the law was issued. Qatar has gone through a revolution in this time period. We have more people from different nationalities, new kinds of restaurants and a mushrooming culture of malls, which is all very new,” she said.
The whole issue, therefore, is not just about smoking in malls or other enclosed spaces.
Parking lots of the majority of government and private organisations are now common smoking zones. In addition, many people smoke in their cars, mostly while driving.
“We have to narrow the places where they can smoke. But, more importantly, we have to make them realise that smoking is harmful and not a form of pleasure,” Dr Shaltout said, adding that enforcing a new law may not be enough.
The SCH recently launched fieldwork for a Global Adult Tobacco Survey that will give officials estimates about the sale and use of tobacco in the country.
More than 8,000 households will be surveyed and the statistics will reveal the approximate number of passive smokers and the estimated sales of different kinds of tobacco.
It is the first time a study will be conducted on the number of expatriates affected by the use of tobacco. The study, however, will not cover labourers and domestic workers.
The outcome of this research will help decision-makers formulate a health plan for the coming years.
“It is the responsibility of the health inspection unit and the tobacco control unit to strictly implement the anti-tobacco law,” Al Mulla said, adding that apart from stringent laws, a strong task force was needed to implement them.
A series of national anti-tobacco campaigns should also be launched, experts say.
“What we need to do is divide the younger and the older generations while campaigning. We have to relay the negative image of smoking to youngsters through audiovisual messages that match their age,” Dr Shaltout said.
As for adults, both men and women, they need to know the facts without any exaggeration, he added
Additionally, psychological and social support should be provided to smokers in smoking cessation clinics in the country.