Minister of Health report on smoking in Israel in 2015, Ministry of Health

Minister of Health report on smoking in Israel in 2015

Subjects:
Smoking prevention; Public health
Publish Date:
31/05/2016 12:00

Today, May 31, 2016, Israel and the world observed the World No Tobacco Day. The Minister of Health publishes the annual report on smoking in Israel in 2015.

The annual report provides information about:
  • Data on the smoking epidemic in the general population
  • Updated data on water pipe and cigarette smoking among youth
  • Smoking among soldiers
  • A comprehensive review of prevention activities and the great efforts jointly invested in them by the Ministries of Health, Education, Finance, IDF, HMOs and many other entities.
  • Review of legislation and enforcement activity in the field of smoking
  • Smoking cessation in Israel
  • Various economic data in relation to smoking, including state revenue from tobacco tax, national cigarette consumption and the volume of investment of the tobacco industry in encouraging and promoting cigarette smoking among young people and in general.
 

Main findings:

  • Smoking rate in Israel
    • According to the final results of the INHIS-3 survey held in 2014, the smoking rate in Israel is 19.7% among adults aged 21 years and over
    • 26% of Israeli men smoke and 13.6% of Israeli women.
    • Smoking rate among Israeli men is slightly higher than the EU overall average (24.2%), but smoking rate among Israeli women is slightly lower than the EU overall average (15.5%).
    • Smoking rate in the Arab population is 25.2% and 18.5% in the Jewish population, and age-weighted smoking rates are 22.1% for Jewish men, 15.0% for Jewish women, 43.9% for Arab men and 6.7% for Arab women.
  • Approximately 37% of non-smoker respondents reported that they are exposed to smoking (secondhand or passive smoke smoking), about 30% of the Jews and more than half of the Arabs. Places most prone to passive smoking exposure were at home (women) and at the workplace (men).
  • Youth Smoking

    • The annual report emphasizes the subject of prevention of smoking among youth, and presented updated data on youth smoking from the "Risk behaviors among youth in Israel" 2014 survey, which was sponsored and funded by the Ministry of Health.
      The survey shows that in the past decade there is a gradual decline at the rate of cigarette smoking among youth. About 8% of the students reported that they smoke at least one cigarette a week, compared to 15% in 2002.

    • Cigarettes and water pipe smoking is more prevalent in the Arab sector comparing to the Jewish sector, with boys reporting a higher rate from girls concerning cigarettes and water pipe smoking.  Water pipe smoking increases with age. Among pupils in grades 11 and 12, about 39% of boys and girls in the Jewish sector tried to smoke water pipe, and 42% of boys and girls in the Arab sector.

    • The rate of ever experiencing cigarette smoking among pupils in tenth grade is approximately 20%, slightly higher than the average among this age group in Europe, which stands at about 17%.

  • Legislation to prevent youth smoking
    • At the end of 2015 the Health Minister issued an order to amend the Supplement for the Smoking Prevention Law, stating that the entire area of an educational institution, both inside the building and in its yard, is completely prohibited for smoking, and smoking is prohibited also ten meters around school entrance, in order to minimize the exposure of students, teachers and visitors to secondhand smoke.
    • The order came into force in February 2016. Circular of the Director General of Ministry of Education on this subject was distributed to all managers of educational institutions, and the Ministry of Health invested thousands of dollars advertising the new legislation in the daily press.
    • Additional new legislation concerning smoking prevention among youth deals in establishing administrative penalties for the sale of single cigarettes or tobacco in bulk. Although this legislation is under the authority of the Ministry of Finance, the Ministry of Health was an active and important partner in its advancement.
      This enforcement does not involve indictment and criminal proceedings and is wide and fast.

      According to the amendment, sale of tobacco in violation of Section 62 (a) (3) of the Tobacco Regulations, such as sale of single cigarettes not in an unopened pack of 20 cigarettes or the sale of water pipe tobacco in bulk instead of in a 60 grams package, will result in a significant administrative fine - for cigarettes, 4000 NIS or three times the purchase tax levied on the cigarettes, whichever is higher, and for other tobacco products 15,000 NIS or three times the purchase tax levied on the tobacco products, whichever is higher.

  • The report also covers this year two important global developments regarding electronic cigarettes and uniform cigarette packs.

    •  For the first time, there is a broad agreement concerning the regulation of electronic cigarettes between the Food and Drug Administration, FDA and the European Union, to set up a mechanism for the registration, supervision and control of electronic cigarettes and their liquid filling, including obligation to report on contents and emissions, determining restrictions on sale to minors, advertising restrictions, health warnings labeling obligation, mechanism to monitor health damage or side effects following marketing and more.

    • Uniform cigarette packs are pack without any logos and brand names. The entire package is dedicated to health warnings and consumer information, except for a simple inscription indicating the cigarettes brand name.
      This policy is recommended by the World Health Organization, which declared the uniform cigarette packs a central theme in the 2016 World No Tobacco Day.

      Australia, Britain and France had enacted the legislation and set starting date for use of uniform packs. Ireland enacted but did not yet set a start date, Norway, Hungary, Slovenia, Sweden, Finland, Canada, New Zealand, Singapore, Belgium and South Africa announced the beginning of the legislation process.
      Supreme courts in Australia, Britain, France and the European Union had recently approved the legislation and thus opened the way to many countries around the world that were concerned of lawsuits from the global tobacco industry, similarly to threats and pressures exerted on the Israeli government through foreign countries.

  • In the area of enforcement, the report indicates the problems in enforcement of the Smoking Prevention Law in the local authorities and calls to examine new ways to change this situation.
  • Public expenditures on smoking
  • Israeli smokers, counting one million smokers, spent in 2015 more than 8.1 billion NIS on tobacco products, compared with a national spending of 7.6 billion NIS on dairy products in 2015. Of this amount, the state collected 6 billion NIS in taxes.
    • Tobacco companies continued to invest this year in encouraging and promoting smoking through advertising, sponsorships, direct mail and sales promotion. At least 35 million were invested this year, but as outlined in the report, there are difficulties in enforcement and obtaining the full data.
      • In 2015, the increase in people referring to smoking cessation in HMOs had stopped, and there was a 4% decrease in the number of participants in smoking cessation workshops, only 25,721 smokers out of about a million, which is only 2.5%.
        Four HMOs had conducted nationwide smoking cessation workshops with linguistic and cultural accessibility for a variety of population groups. Workshops waiting times were usually a few weeks to a few months.
      • As part of the expanding range of health services for 2015, screening for early detection of abdominal aortic aneurysm was introduced to the basket, as well as rehabilitation of patients with chronic obstructive pulmonary disease (COPD), two technologies dealing with disease often caused as a result of smoking. Thus, the basket include a "package" for all different prevention stages, from smoking prevention, early detection and treatment and rehabilitation of those sick. However, it is needed to examine how to make other technologies at every stage accessible for the benefit of smokers, to reduce morbidity and mortality from smoking.
      • The report also presents data on the rolling tobacco market and tax differences compare to regular cigarettes.
        The existing gap harm the effectiveness of tax policy as an efficient and proven tool to reduce smoking and its damages, and to prevent young people from starting to smoke, as well as cumulative revenue loss of hundreds of millions NIS to the state budget.
        The Ministry of Health recommends raising the tax on rolling tobacco to a level equivalent to regular cigarettes.
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