"Every country that went to partial enforcement failed to make a significant impact," says Harvard expert.
By JUDY SIEGEL-ITZKOVICHgreg connolly 311(photo credit: Courtesy)
One of the world’s leading anti-tobacco fighters, Prof. Gregory Connolly of the Harvard School of Public Health, advises Israel to abandon its policy of optional “smoking rooms” in public places and to completely bar lighting up in such locations instead.In an exclusive interview with The Jerusalem Post on Monday during his second visit to the country, the director of Harvard’s division of public health practice and a member of the scientific advisory board to the US Food and Drug Administration on the regulation of tobacco products said that the existence of smoking rooms leads around the world to violations of no-smoking laws.Just a few days ago, Tel Aviv University public health expert Dr. Leah Rosen published a study showing that owners of Tel Aviv bars and pubs consistently fail to enforce laws when they inform one another that municipal inspectors are on the prowl for violators; although full of smoke, few of them are caught with lit cigarettes in the public areas.Bars, Connolly said, function as “schools for smoking” by introducing young people to the dangerous practice. He was here to speak at a TAU symposium organized by Rosen on how to significantly reduce the current Israeli adult smoking rate of 24 percent.While the smoking rate even increased a bit here in the past year, Connolly said that he saw positive changes since his last visit four years ago. “The air in general is much cleaner, and there is no smoking in hotel lobbies and some other public places,” he said.“But Israel’s partial ban is unenforceable,” Connolly continued. “If an inspector walks into a public place and nobody’s smoking but it stinks like hell,” the law is not working. Every country in world that went to partial enforcement by allowing smoking rooms failed to make a significant impact.”In countries with a smoking culture in entertainment places that completely barred smoking such as France, Scotland, Ireland, Cyprus and Italy, violations are rare, he declared. “You have to create a social environment that supports quitting and not starting.”But governments must not only completely prohibit smoking in public places, said Connolly. “They must have serious enforcement programs and use the media to get the message across so everyone is aware of the new law. You’ll get compliance if you make the investment and prepare the population for the enforcement of the new law. Israel today is at the tipping point. Even if the health minister is a politician – as in Israel – rather than a health professional, he can be persuaded about the huge health and economic costs of smoking.”Asked about Israelis’ tendency to ignore laws and regulations, Connolly said, “That is claimed in almost every country, but if done properly, people will respect the law.”Connolly, who trained as a dentist before going into public health, also advocates banning smoking in some outdoor public places where people assemble, such on queues for transportation, and in cars where people – especially children – are being slowly poisoned without their consent.
As for smoking cessation, the Harvard expert said, “You can’t separate treatment from what society does. You can’t just give smokers a nicotine patch, give them counselling and send them to a restaurant where it is considered ‘normal’ to smoke. You have to create an atmosphere that it is wrong and dangerous to smoke.”Thanks to a law passed by the US Congress last summer, the Food and Drug Administration now has the power to regulate tobacco but not to prohibit its sale.“We will study what the tobacco companies are putting in, like sugar, licorice, menthol and chocolate that make them more desirable to smokers. They reinforce the ‘nicotine reward’ and mask the odor and bitter taste. It takes a dangerous product and makes it even more dangerous. Cigarettes labeled as ‘lite’ [now illegal in Israel] make smokers feel safer, even though they are not,” Connolly said. “Cigarettes must become less addictive. The tobacco companies figure out what additives make it easy to smoke so that more victims become addicted. Regulation by the FDA will enable the removal of such ingredients.”The FDA advisory board will set standards for tobacco products thatwill make them so undesirable to users that they will lose much oftheir market, he explained.There were 100 million deaths from smoking in the 20th century. Ifnothing is done, there will be a billion casualties in the 21st,predicted Connolly.“If we drop below a 10% smoking rate, it could be regarded as almosthaving been wiped out,” he said. The US rate is currently 22% andaround 17% or 18% for daily smokers.He believes that the rate in Israel – a country he “cares about,because Irish Catholics and Jews have a special bond” – will drop to20% in five years, and he is providing public health experts withadvice on how to reach that goal.
