If tobacco consumption has become one of the essential issues in terms of public health on the global level, what about its situation in Lebanon? In such a country where we often offer cigarettes on a silver tray, which campaign can we launch?

Interview with Drs Zeidan KARAM and Tania ABOU NOHRA, two specialists in terms of tobacco impact on the Lebanese people’s health: Dr Zeidan KARAM (aggregate professor of the general hospitals in France and professor in Saint Joseph University Beirut, Faculty of Medicine), has been chief of cardiology in St George Hospital Beirut for 20 years. He is also the author of the book “Tobacco, the legal drug” (Le Tabac, cette drogue légale). Dr Tania ABOU NOHRA is a specialist in pediatric dentistry. She proposes new measures against tobacco consumption among the young Lebanese.

iloubnan.info: How do you define the behavior of the Lebanese toward tobacco?
Dr Zeidan KARAM: In general, the Lebanese people are not very motivated to struggle against tobacco, and “passive smoking” is far from being understood. Until today, the start we hoped for has not happened yet, but people are starting to become aware of the different dangers related to cigarettes. It is worth noting that smoking is allowed neither in hospitals nor in some banks and institutions, where it is strictly forbidden to light a cigarette.

What is the average age of first smoking experience in Lebanon?
15 or 16 years old. However, it is rare to see a cigarette between the fingers of a school student; we rather find young smokers in university campuses. On the other hand, law is not strict at this level: tobacco selling is not forbidden for underage people!

Narguileh is nowadays in the first place on our cafés menus. Is it “lighter” than the cigarette, as we often think? What about cigar?
Cigarette is more toxic than cigar. In fact, the cigar smoker swallows less smoke, and nicotine passes through his saliva. As for narguileh, it is true that a little bit of toxics remains in the water, but people must know that forty grams of the narguileh’s “head” are equal to two boxes of cigarettes!

“Tabacologie” does not exist in Lebanon. Isn’t it time to assure this education in our medicine faculties?
Certainly! “Tabacologie” is only practiced by lung specialists and some cardiologists. But office hours are reimbursed neither by social security nor by medical insurances or mutual companies.

Is there any possible campaign against tobacco in Lebanon?
Every year, may 1st is the “Anti Tobacco Day”: a little “uprising” is shown in this context, but it is not a real struggle. The tobacco price increase would not solve the problem, for in this case, the smuggling intensifies. So how do you want to protect the Lebanese from cigarettes whereas publicity is allowed everywhere: on television, in the press, and even on the highway billboards? It is worth noting that tobacco brings in 300 million dollars per year to the Lebanese State and 100 to 150 million dollars to the publicity sector!

What is the specific issue of action vis-à-vis the young smokers?
Dr Tania ABOU NOHRA: In Lebanon, we notice that the proportion of young smokers is increasing. In half of the cases, the adolescents start to smoke at the age of 15. In fact, the more smoking is early, the stronger the addiction is and the consequences are serious and irreversible. Therefore, it is important to target young smokers. Moreover, besides the bad breath and the early yellowing tooth in need of whitening, tobacco can cause grave gingival problems due to the lack of the tissues oxygenation: the gum bleeds less; the gingivitis passes unnoticed, becomes chronic, and provokes loosening, or tooth falling.

How can people struggle against smoking at a young age?
As dentists involved in the public health field, we suggest rendering access to tobacco more and more difficult, by prohibiting cigarette selling to under-16 or 18 year-old people, because tobacco industries specially target this age bracket by commercials that insist on the “cool” aspect of young smokers who identify themselves to Hollywood stars.

Therefore, it is important to limit those commercials diffusion and to launch large campaigns in order to decrease the tobacco impact. On the other hand, it is necessary to copy the occidental model by prohibiting cigarettes in public places: developing a label “enterprise without tobacco” sponsored by the Ministry of Employment and the Ministry of Health and respecting the non smokers by protecting them from passive smoking.

At the dental level, as a team of specialists, we offer free check ups to urge young people to treat themselves. Our major role is to warn infants and adolescents of the harmful tobacco consequences as well as other food habits. So contact us on: 03 370 407 and we will be there for any help!