American University of Beirut

K2P COVID-19 Series on “Combatting effects of tobacco during COVID-19 crisis”: When two pandemics collide.

​​Lebanon will gradually exit lockdown based on the circular issued by the Ministry of the Interior. As such, citizens will gradually start to return to restaurants and cafes, which are required to operate under multiple conditions, the most important of which is not providing waterpipe to patrons given its role in increasing infection with COVID-19.
However, what about the post-COVID-19 period? What should citizens consider after the end of the general mobilization? Why should this circular that is inspired from Law 174 (Lebanon's Tobacco control Law- ratified in 2011) still be applicable even after the end of the COVID-19 pandemic?

Open Letter: Continue to implement the decision to ban the Shisha in public places​ (LAW 174)​


Given that World No Tobacco Day falls on May 31, the Knowledge to Policy (K2P) Center at the Faculty of Health Sciences at the American University of Beirut, launched a new Rapid Response from the K2P COVID-19 Series Initiative​ on “Prompting Government Action for Tobacco Control in Lebanon during COVID-19 Pandemic". The document was launched at a press conference on Tuesday, May 19, 2020.

The press conference aimed at supporting the Lebanese government with evidence-based immediate actions to re-implement Law 174, and reinforce its 3rd chapter on banning smoking in closed public places. The conference also argued eliminating conflicts of interest among tobacco industry and their allies at the expense of public health. This stems from the $1 million donation to the Lebanese government by the Régie Libanaise (the Lebanese Tobacco and Tumbac Monopoly Department), for the purchase of ventilators and to repatriate students facing financial difficulties outside Lebanon, which comprises a clear violation of Article 5.3 of the WHO Framework Convention for Tobacco Control (WHO FCTC) signed by Lebanon in 2005.  The press conference convened Dr. Rima Nakkash, Associate Director of the K2P Center and coordinator of the AUB Tobacco Control Research Group, Ms. Rana Saleh, Advocacy and Evidence Lead Specialist at K2P Center, Member of Parliament Assem Araji, Head of the Health Parliamentary Committee, Dr. Imad Bou Akl, pulmonary medicine and pulmonary blood hypertension specialist at AUBMC; and Mrs. Rania Baroud, media professional and advocate for Law 174.

Watch the full Press Conference here​​

​“As Tobacco control advocates, and health specialists, we never thought we would be fighting two pandemics at the same time, one that is novel (COVID-19) while we have struggled with the other for more than seven decades (tobacco)". With these words Dr. Nakkash opened the conference, and launched the K2P Rapid Response that encompasses the best available evidence on this topic. 

Given the mounting evidence linking tobacco to a higher risk of COVID-19 infection and complications, Dr. Bou Akl, explained how, smoking reduces immunity and increases the risk of infection with the new coronavirus, through repeated contact with the face and hands, and through the sharing of various parts of the nargileh and ignoring the principle of social distancing.


Moreover, Ms. Saleh, asked: “how long will some groups remain above the law?" hinting to tobacco companies and allies and their conflicting interests with public health. While Mrs. Baroud, emphasized the role of civil society in supporting the implementation of Law 174 in 2012, and called for the reinforcement of Law 174 as an integral part of the government's anti-Covid-19 efforts. MP Araji, from a legislative point of view, supported and committed to dedicating all efforts needed within the Parliamentarian Health Committee to re-activate Law 174, as he highlighted the large burden of tobacco-related health expenditures on the Lebanese economy.


Finally, immediate actions from the K2P Rapid Response were shared in preparation for a long-term roadmap to fully re-implement Law 174 requiring mutli-sectoral legislative and executive collaboration:

  • Strengthen and continue enforcing the Memo 48/أ.م/2020 long after the General Mobilization and expand it to include all types of tobacco use to comply with the articles of Law 174.
  • Enforce Law 174, with all its dimensions, and capitalize on the successes made in monitoring and enforcement throughout the General Mobilization phase and extrapolate to enforce Law 174.
  • Promote and strengthen current smoking cessation programs available in some healthcare facilities and primary healthcare centers to support tobacco control efforts in times of COVID19
  • Leverage on the efforts of support teams active in the General Mobilization and those monitoring public facilities such as MOPH teams that assess food quality, MOET Consumer Protection teams, Tourism police, internal security forces and municipality police to enforce Law 174.
  • Capitalize on the current role of municipalities in the General Mobilization and coordinate with them to support in the enforcement of Law 174 through monitoring the public places within the municipality jurisdiction.
  • Ensure swift penal provisions for violators of Law 174 and the ministerial memo by the Ministry of Justice
  • Ensure a multi-sectorial coordinated effort between the different responsible sectors and ministries for effective tobacco control amid COVID19
  • Prevent tobacco industry and allies' interference in the decision-making process and funding, ban tobacco-related corporate social responsibility along with controlling commercial and other vested interests in COVID19 response as per article 5.3 of the WHO FCTC
  • Develop a data collection system that properly records data on the smoking history of patients with COVID19 and promote data sharing to conduct further research
  • Raise awareness on the harms of tobacco use, home-smoking and second-hand smoke and increased risk of COVID19 infection through media campaigns and community awareness in municipalities and primary healthcare centers.

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