Implementation of a indoor air ban and an advertising and sponsorship ban in Lebanon: a baseline cross-sectional study

Abstract

IntroductIon Although the majority of countries have ratified the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC), few have comprehensive smoke-free laws and compliance is not always satisfactory. In 2011, Lebanon, which has among the highest smoking rates in the Eastern Mediterranean Region, passed a comprehensive tobacco control law (Law 174). This study aimed to assess compliance with Law 174 among smokers and non-smokers in Beirut (the capital), three months after the smoking ban in closed public places and on advertisement and promotion came into effect. Methods: A population-based cross-sectional survey was conducted. Multi-stage cluster sampling identified 159 households, yielding 468 respondents aged 15-65 years of age. Data was collected face-to-face using a structured questionnaire. Weighted descriptive and bivariate analyses were performed. results: Three months after the ban came into effect in 2011, all respondents knew about Law 174. Around half witnessed other people smoking in their workplace (44.2%), in restaurants/coffee shops (52.8%) and in public transportation (60.0%) during the past months. Less than 20% witnessed any tobacco promotion/advertisements, reflecting good compliance of the advertising sector. Overall, more than half the smokers continued smoking within the workplace/closed public places. conclusIons: This study provides information on compliance to the smoking and advertising ban in Beirut. The advertising sector's compliance would hopefully decrease the tobacco industry's influence on the public. Further studies aiming at understanding the underlying factors behind the lack of compliance to the indoor smoking ban and finding effective solutions, in a politically unstable country with weak regulations like Lebanon, are crucial and can serve as an example for similar developing countries.

Effect of tobacco control policies on intention to quit smoking cigarettes: A study from Beirut, Lebanon

“…The lack of association with other policy related variables is likely a result of a weak implementation of the indoor smoking ban 14 . Literature reports that indoor smoking bans are statistically significantly associated with intention to quit smoking 21,22 .…”

“…The study was approved by the Institutional Review Board of the American University of Beirut. A full description of the data collection methods has been published elsewhere 14 . The ITC Project conceptual framework was used to develop the survey questions, thus included policy-related variables, psychosocial mediators and moderators to study the effect of tobacco control policies on smoking behavior 10 .…”

“…Although Lebanon ratified the FCTC in 2005, its first tobacco control legislation was not adopted until 2011 13 . Law 174 banned tobacco advertising and smoking in all indoor public places, prohibited the promotion and distribution of free samples of tobacco products, as well as the use of misleading elements such as ‘light’, and ‘ultra-light’ and required larger text and pictorial health warning labels on tobacco product packaging 14 . The advertising and sponsorship took effect immediately (August 2011), however, the indoor smoking ban in the hospitality sector became effective one year later (September 2012).…”

“…Similarly, a decree to mandate larger textual warnings was also issued in September 2012 but was enforced the following year. A study, assessing compliance three months after the implementation of the policy , found that overall there was good compliance with the ban by the advertising sector, however, the compliance with the indoor smoking ban was much more variable 14 . Policy and decision makers support for Law 174 has waned in the face of strong industry and hospitality sector opposition.…”

Process evaluation and challenges of implementation of a school-based waterpipe tobacco smoking prevention program for teens in Lebanon

“…However, enforcement of this policy is variable, amid the overall pro smoking social norms that persist despite passage of a more recent law, Law 174 in 2011 which includes comprehensive bans 14,15 . Education about the consequences of tobacco use is a required part of the National curriculum for all schools in Lebanon, but is not implemented comprehensively 16 .…”