American University of Beirut

K2P Center urges implementation of Law 174 to control the smoking and coronavirus pandemics

​​​​​World No Tobacco Day (WNTD) is observed on May 31. As this day approaches, Knowledge to Policy (K2P) Center at the Faculty of Health Sciences at the American University of Beirut (AUB) has launched a Rapid Response document “Prompting Government Action for Tobacco Control in Lebanon during COVID-19 Pandemic”​. The launch took place at a press conference on Tuesday, May 19, 2020 at the AUB. The document includes immediate government measures to reduce smoking amid this health crisis, in addition to a long-term road map, to enforce Law 174 and eliminate conflicts of interest between tobacco industry and their allies at the expense of public health. These measures involve all concerned ministries, namely the Ministry of Public Health, the Ministry of Economy and Trade, the Ministry of Justice, the Ministry of Interior and Municipalities, the​ Ministry of Tourism, the Ministry of Transport, and the Ministry of Information, to form multi-sector executive forces and specialists to re-instate the laws, their value, and importance in securing public welfare. 

This conference was held in the framework​ of the gradual easing of lockdown, and the Ministry of the Interior issuing a memorandum concerning the opening and closing of institutions, including restaurants, citizens will gradually return to restaurants and cafes under conditions, the most important of which is NOT PROVIDING nargileh to customers, due to its role in increasing infection with the novel coronavirus, COVID-19. 

​But what about the post-COVID-19 period and the phase following the end of the General Mobilization?

Law 174 “Tobacco Control and Regulation of Tobacco Products’ Manufacturing, Packaging and Advertising” was ratified in 2011 and came into effect in 2012. With this question about post-COVID-19 and post-general mobilization period, the annulment of the application of some provisions of Law 174 is now in focus. Law 174 was met with many vicious campaigns by some who preferred their own profit to public welfare, specifically for the prohibition of smoking in closed public places. In addition, the $1 million donation to the Lebanese government by the Régie Libanaise (the Lebanese Tobacco and Tunbac Monopoly Department) for the purchase of ventilators and to repatriate students in financial difficulties outside Lebanon is a clear violation of Article 5.3 of the WHO Framework Convention for Tobacco Control (WHO FCTC), signed by Lebanon in 2005. 

Conference participants were Dr. Rima Nakkash, co-director of the K2P Center and Associate Profesor at the FHS'  Department of ​Health Promotion and Community Health; MP. Assem Araji, cardiologist and chief of the Parliamentary Health Committee; Rana Saleh, advocacy and evidence leas specialist at the K2P Center; Dr. Imad Bou Akl, pulmonary medicine and pulmonary blood hypertension specialist at AUBMC; and Mrs. Rania Baroud, media professional and advocate for Law 174. Dr. Bou Akl explained the relationship between smoking and the increased risk of sustaining serious complications among COVID-19 patients who are smokers, as well as increasing the risk of infection through reduced immunity, increased vulnerability to respiratory infection, repeated face-hands contacts, and through sharing various parts of the nargileh (water chamber, tube, plastic mouth piece) which disregards the principle of social distancing.​

In her turn, Dr. ​​Nakkash stated that today we are looking at an ideal opportunity to support coordination between the ministries and concerned sectors and to implement the general mobilization measures, and we therefore ask to take advantage of the successes achieved throughout this period to deduce how best to efficiently implement Law 174 and with all its clauses. She also stressed the need to prevent tobacco manufacturers and their allies from interfering in the decision-making process and to reject any funding from them as it is illegal, as well as controlling competing commercial and other vested interests in the midst of the COVID-19 response and beyond, in accordance with Article 5.3 of the WHO FCTC.

Saleh asserted that despite the implementation of many of Law 174's provisions, the application of the ban on smoking in closed public places remains very weak, given the limited political will of successive governments, the low levels of coordination between responsible authorities, the conflicts of private interest, and the interference by tobacco industry and their allies in the process of making such decisions. She pointed out: "Tobacco products in Lebanon are still very available at affordable prices, easily accessible wherever our young people go. How long would private interest prevail over the public interest? How long will some entities remain above the law?”

​Mrs. Baroud said that for more than a decade, civil society has contributed to supporting the tobacco and smoking control agenda, and they are continuing to do so. She called for the government's commitment to resisting COVID-19 by reintroducing the implementation of Law 174 as an integral part of efforts to combat coronavirus and with similar commitment.

​Mr. Araji asserted the Parliamentary Health Committee full commitment to take all necessary measures to support this cause. He stressed that the committee has examined several laws that will reduce the smoking pandemic in Lebanon, and that today is the ideal time to reconsider how to implement Law 174 to reduce the risk of smoking.

In the end, it was emphasized that despite all the consequences of COVID-19, this period is the perfect time to quit smoking and re-implement Law 174, as public health legislation and policies have shown national and global importance.

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