The growth of Amman, the capital of Jordan, is visible everywhere. It is now an international business and financial hub, an arts and culture destination, and a tourism hotspot with thriving nightlife. But what we want it to be known as most of all is a model for how to clear the air of tobacco smoke.
Tobacco in Jordan starts with cigarettes. Smoking rates among men with low incomes are soaring. About 57% of men earning 100-250 Jordanian dinars a month (£110-£275) smoke regularly, and these men spend up to half of their income on cigarettes. Overall, more than half of all men in Jordan smoke cigarettes habitually, the worst rate in the Middle East.
The use of argileh, or waterpipes, has also grown significantly in Jordan, and it is not only a toxic staple of nightlife but of lunch hours and coffee breaks, even rush hour traffic. Alarmingly, many teens smoke argileh – 26.7% of young people aged 13-15, including both boys and girls – and many do not understand that the health risks are comparable with smoking cigarettes.
Additional research shows that while boys are more likely than girls to start smoking cigarettes in the seventh grade of school, girls of that age are more likely to begin to use argileh. As in many places across the world, peer pressure and family members who smoke are the primary reasons why teens in Jordan take up smoking.
All of this growth in tobacco use has taken place as we have passed smoke-free laws. The current national legislation, which is ten years old now, bans smoking in hospitals, schools, cinemas, libraries, museums, government buildings and public transport, and also gives the national minister of health the discretion to determine other places that should be free from tobacco smoke.
Implementation and enforcement, however, are the key challenges for us. Smoking is seen in many quarters as a sign of manhood, and elderly Bedouins can often be found in public spaces rolling their own cigarettes. Business owners have invested in operations that cater to this pursuit, and often decline the opportunity to help us move Jordanian culture towards a healthier, smoke-free lifestyle.
Even the legislators push back on implementation. They are often seen smoking in parliament, as are cabinet ministers at their workplaces – all in defiance of the law. Tellingly, many politicians were smoking cigarettes while voting in favour of laws that ban smoking in public spaces.
While smoking is still culturally embraced in these quarters, tobacco use is also aided by low-cost cigarettes. Our country is working hard to change this. Last year we raised taxes on cigarettes by $0.64 (50p), to $1.70 for each pack, which is roughly equal to the average tax levied by states in the US.
My administration feels that the government should live up to its responsibility and lead by example. It is our duty to exert a more determined effort to enforce the anti-smoking law, to make sure that regulations are strictly applied and enforced – and not to violate the laws we seek to uphold.
Adults in Jordan who do not consume tobacco are starting to get the message about the risks of second-hand smoke and addiction to cigarettes. Public health campaigns showing that second-hand smoke is a cause of premature birth, cancer, and cardiovascular and respiratory diseases have strengthened the resistance of these non-smokers.
The effect of our public campaigns has also been strengthened by HRH Princess Dina Mired, the new president of the Union for International Cancer Control. Her visibility – and advocacy for healthy lifestyles – provides a strong role model for young women and teenagers to emulate.
All this is to say that in Amman we have a long way to travel before we can be leaders in public health. As Jordan’s capital, we are the premier city and face of a growing nation. We have the legislative framework, the political will for enforcement, the support of the ruling family and a charismatic member as a role model, and we also have the growing reputation of a rising economic and tourism hotspot.
But we also have a culture of tobacco use that has been resistant to change – and has only strengthened its deadly grip on my people.
In which direction will Amman lead Jordan? If I as Mayor can have my way, we will head towards clean air and away from the smoky darkness of tobacco’s past.
* Yousef Shawarbeh is the mayor of Amman, one of 54 cities in the Partnership for Healthy Cities, a network supported by the World Health Organization, Bloomberg Philanthropies and Vital Strategies
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