E-cigarettes: A New Demon to Face – by Dr. Larissa Al-Uar

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Dr. Larissa Al-Uar
Tobacco Free Jordan

Eight years ago, as a group of working mothers that decided to start Tobacco Free Jor-dan, we had no idea that our job will only become more and more challenging. With a very clear goal in mind to protect our children from second hand smoke and prevent them from becoming future nicotine addicts, we simply demanded the implementation of the Jordanian Health Law 47/2008 that tackles indoor smoking, sales to minors, and tobacco advertisement.

During our journey we learned that our government was amongst the first countries to sign and ratify (2004) the Framework Convention for Tobacco Control, better known as the FCTC. Our country can even boast to have had anti-tobacco laws and regulations in place as early as the 1970s, amended the law in 2008 and increased the fines in 2017, and the result? Far from satisfactory!

We have taken it upon ourselves to work as a grassroots movement, talking to children as young as four years old on the harms and exposure to second-hand smoke.

A Harsh Reality

Over the years, certain incidents stuck, as in they were never forgotten. For instance, a first grader in a remote village told me he smokes because it’s cheap. Another one told me that his grandad taught him how to smoke, to become a “man!” Little girls explained they take shisha puffs, “as mom and her friends light them up at home or at cafes.” As the laws became tougher in the civilized world, we started to suffer more from the pres-sure of the tobacco industry.

From Cigarettes to Shisha

During the lectures, the points raised by children and teenagers alike, changed over the years, indicating a change in what was available to them. Cigarettes became old news and the interest in shisha increased. The most important and incorrect point raised by adults and children alike was that shisha is not smoking. They think that molasses doesn’t contain tobacco and argued that it is basically a blend of fruit and honey!

When the Amman Municipality decided to ban shisha in restaurants in 2014, the uproar that resulted showed how influential the industry actually is. So as a result, the ban wasn’t implemented. Today, both licensed and unlicensed cafes and restaurants exist, with children as customers, or as part of the 62% helpless young passive smokers, sit-ting there with their addicted parents.

A New Herbal Nicotine: Midwakh

Then the topic of Midwakh appeared. A mother once called me because she found a “small pipe like device and a bottle with some green herbal stuff, like tea” in her 15-year-old son’s drawer. There was a regional anti-tobacco meeting going on at the same time, and I took this seemingly new device to the experts, to discover that it is common in the Gulf region. They explained that the “shredded herbs” were tobacco with nicotine concentrations that are about eight times stronger than regular tobacco!

Taking the device with me to school lectures, I discovered something else. Children as young as 12 years old know what it is, explained its use to me, while the academic staff, like myself, had no clue that this existed. “When my friend and I go on Fridays to play cards and smoke shisha at the cafe, we see older kids smoking it. Not us, we didn’t try it,” tells me a 13-year-old, not seeing anything wrong in admitting spending his weekend smoking shisha at the cafe less than 50 meters away from his school. It is no wonder that we have the highest percentage of boys smoking in the EMRO, 33.9% (2014 GYS), as well as the highest ever smoking in youth, a staggering 45%!

When the product started to appear on cafe menus and in vicinity of the university, the Ministry of Health took action and the product was banned from the market, but we still find it sold under the table to the youth.

E-cigarettes and Vapes: A New Dangerous Trends

Just few months ago, I drove past three 12-year old boys, sharing a vape and proudly informing me that because smoking is unhealthy, they decided to use the vape, which is made of fruit and water. They bought it from a tobacco supply shop, and they pass it around as they can’t afford to buy one for each. This sight has become more and more common.

Large devices are being replaced by smaller, more discreet ones, where students can easily smoke discreetly in classrooms. Children have also been caught selling them to their peers, and as my teenage children tell me, everyone is vaping.

A Battle to Face

The battle is hard. Headlines appear in local newspapers claiming that e-cigarettes are “95% less harmful than smoking cigarettes,” cardiologists appearing on local television stations recommending it, radio shows interviewing people who say they smoke much less since they started vaping, Facebook users lashing out, with hundreds of comments piling up when anyone posts something against vaping; and thousands of people following “illegal” vape shops advertising and selling their “illegal “products. I just wonder, where is our youth heading? When the industry itself, admits that there is no proof that e-cigarettes help smokers quit and that dual use leads to stronger nicotine addiction, what will the outcome of legalization be? When experts expect that the number of male smokers will reach 85% by 2025, what future will Jordan have if anti-tobacco laws are not implemented?

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