The use of tobacco products in Egypt is widespread, with an estimated twenty percent of the population using tobacco products daily. Cigarettes are the most common form of tobacco consumption, with approximately nineteen billion cigarettes smoked annually in the country, making it the largest market in the Arab world. Inside cafes, hookah (shisha) smoking is common. Egypt is ranked as one of the top ten per capita consumers of tobacco by the World Lung Foundation. Of this twenty percent of the population estimated to use tobacco products, ninety-five percent were daily smokers. Sixteen percent smoke only cigarettes, 3.3% smoke shisha water-pipes, and 2.6% use smokeless tobacco products.
Smoking is far more common among men than women; however, the number of women smokers is on the rise. An estimated two percent of Egyptian women smoke, with most researchers believing female smoking is greatly underreported due to social taboos that push female smoking into private areas.
The trend in current smoking prevalence in the general population in Egypt shows an increase from 17% in 2000 to 24% in 2015, according to WHO trend data. This increase has been driven solely by men's smoking - 32% of men were current smokers in 2000, which increased to 48% by 2015 and is projected to increase further. Women's current smoking prevalence estimates, which started at 2% in 2000, actually showed a decline to virtually zero over the same period.
Historical Context
According to historian Relli Shechter, in the late 19th century, the cigarette emerged as a fashionable way to consume tobacco and gained popularity not only in Egypt but also globally and within the Ottoman Empire. Under British control 1882-1922, cigarettes became the preferred smoking choice in Egypt, with luxury Egyptian brands being exported worldwide, influencing global trends. It was notable for being one of the earliest non-Western producers of internationally traded manufactured goods.
Although Islam has no specific ban on smoking tobacco, several Islamic principles are cited in support of the religion-based banning of tobacco. Depending on the location and community, Islamic authorities have either deemed smoking as makruh (to be avoided) or haram (forbidden).
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Legal Framework
Law No. 52 of 1981 Concerning the Prevention of the Adverse Effects of Tobacco provides the foundation upon which subsequent tobacco legislation rests. This principal law addresses smoke-free policies; advertising, promotion and sponsorship; packaging and labeling; and penalties. Law No. 85 of 2002, Law No. 154 of 2007, Decree No. 443 of 2008, and Executive Bylaw of Law No. 52 of 1981 all amend and/or build upon the comprehensive tobacco control legislation contained in Law No. 52 of 1981. Several other laws and decrees supplement Law No. 52 of 1981 and its amending and subsequent legislation. These laws include: Law No. 137 of 1981, a labor law which established the penalties for smoking while at work or at places of work; and Law No. 4 of 1994, an environmental law addressing smoke-free policies.
Restrictions on Smoking
In Egypt, the tobacco control law prohibits smoking in the following specified public places: health and educational facilities, governmental venues, sporting and social clubs, and youth centers. Smoking is also prohibited on public transport, though these rules are not always followed.
Advertising and Promotion
Egypt prohibits many forms of tobacco advertising and promotion, specifically in all means of publicity, including newspapers, magazines, stationary or moving pictures, television, and radio. The law does not specifically ban tobacco sponsorship. However, some forms of tobacco sponsorship may be prohibited under the ban on advertising and promotion. The law does not specifically address financial contributions and other forms of sponsorship by the tobacco industry.
Packaging and Labeling
Starting August 1, 2008, cigarette labels in Egypt began requiring images of the effects of smoking: a dying man in an oxygen mask, a coughing child and a limp cigarette symbolizing impotence. The law requires two textual warnings that must be accompanied by a picture (of a heart, lung, or pregnancy) with additional relevant text. The picture and text should be rotated every six months. Health warnings are pictorial and text and must occupy 50 percent of the front and back panels of tobacco product packaging.
The law prohibits the use of the terms “light,” “low tar,” and “very low tar” on tobacco product packaging. However, the law does not prohibit the use of other misleading terms, descriptors, figures or other indicia that create an erroneous impression about the health effects of a tobacco product including a requirement that the quantity (figurative yield) of tar and nicotine be displayed on tobacco product packages.
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How do cigarettes affect the body? - Krishna Sudhir
Tobacco Industry
Tobacco cultivation is not legal in Egypt, therefore companies who produce tobacco products must rely on imported raw tobacco largely imported from India and China, as well as from Brazil, Italy, Syrian Arab Republic, and the United States of America. Egypt's tobacco industry is dominated by the Eastern Tobacco Company (ETC), the largest cigarette manufacturer in the Middle East.
Perceptions and Attitudes
In a survey conducted of Egyptian smokers, overall 97.6% believed that smoking tobacco can cause serious illness. However, belief that smoking causes specific illness varied. A significant number of smokers believe that shisha is less harmful than other forms of smoking. A national survey conducted by the Egyptian Smoking Prevention Research Institute showed that waterpipe smoking was inversely related to educational level, and that most users believed that using a waterpipe is less harmful than cigarettes.
Quitting Smoking
In a survey conducted by the World Health Organization, they found that among every day smokers, 16.6% had quit smoking. Of the people who quit smoking over the past twelve months 41.1% had made an attempt to quit and 17.9% actually proved successful in quitting. Of the current population of smokers 42.8% expressed interest in quitting smoking.
Economic Impact
The economic cost of smoking Egypt is 65,530,365,895 Egyptian pounds. Tobacco spending diverts funds from the resources that families need to rise out of poverty. Cigarette butts are the most commonly discarded pieces of waste worldwide. The tobacco industry profits significantly from producing and selling tobacco.
Vaping Regulations
In Egypt, e-cigarettes are allowed, and the legal vaping age is 18 years and older, aligning with the legal smoking age. Vaping products are legally imported, commercialsed and marketed. Although there are no legal restrictions on vaping in public places, it is recommended to observe social etiquette and avoid vaping in religious spaces.
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Since Egypt's vaping regulations are relatively new and its market is still developing, it is recommended to bring enough vaping supplies to last for the entire trip. Also, travelers should check with their airlines regarding carrying vaping products in their luggage.
Challenges and Solutions
Tobacco use continues to be an epidemic in Egypt. Government complacency in the face of the tobacco epidemic protects the tobacco industry in Egypt as the death toll grows each year. Fortunately, there are evidence-based-i.e. proven-solutions to the challenges posed by tobacco use. For several decades, governments around the world have been introducing a set of policies that address the demand for tobacco products, particularly among youth. In addition to price, change in affordability is critical. Marketing is the key avenue that tobacco companies use to reach consumers, new and old.
This study surveyed 49 senior administrative staff, 267 physicians, 254 nurses, and 109 administrative employees working in El-Kasr El-Aini Hospital in Cairo, assessing their knowledge and attitudes regarding Egypt's tobacco control laws and barriers to their effective implementation in health care facilities. The majority (>90%) of the hospital workers knew that exposure to second-hand smoke is harmful to health. Physicians and nurses had a more favorable attitude towards the smoking ban when compared to administrative employees. Overall, smoke-free policies were poorly enforced in this large teaching hospital in Cairo, Egypt.
| Category | Data |
|---|---|
| Daily Tobacco Users | Approximately 20% of the population |
| Annual Cigarette Consumption | Approximately 19 billion |
| Prevalence of Smoking Among Men (2015) | 48% |
| Economic Cost of Smoking | 65,530,365,895 Egyptian pounds |
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