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MENAFN - Muscat Daily - 13/05/2014
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(MENAFN - Muscat Daily) Twenty five year old Ahmed (name changed on request) gets a little embarrassed when asked how old he was when he took his first drag. ''It was a long time ago,'' he claims, without revealing too much.

''A few of my relatives managed to sneak in a stick; as children we were very curious, especially because our elders were constantly trying to warn us against smoking. So cigarettes became a cause to rebel. But the habit didn't cling to me immediately,'' he clarifies. ''I started smoking heavily only a couple of years later.''

Today, Ahmed's long tryst with the habit is slowly beginning to reflect on his health, with symptoms varying from fatigue, excessive panting when exercising and even blood pressure. The thought of being hit by something worse hasn't struck him yet. But for health experts in the sultanate, the alarming rise in the number of tobacco consumers among the youth could reveal a disturbing picture soon, especially with relation to the cancer incidents in the country, which until now have been considerably low.

According to results of the last conducted country-wide Global Youth Tobacco (GYT) Survey in 2007 released by the Ministry of Health, one in every ten Omani children between the age group of 13-15, smoked cigarettes. The numbers have only inflated in the last six years, experts believe.

Currently, cancers caused due to tobacco consumption do not figure in the five most common cancers among Omanis. But with the number of tobacco users on the rise, it wouldn't be surprising if it is declared the number one cancer-causing source soon, Dr Zahid al Mandhari, deputy director of oncology at The Royal Hospital, argues.

According to Dr Mandhari, tobacco is the single source of various cancers in the human body. ''Apart from lung cancer, tobacco use also increases the risk for cancers of the mouth, lips, nose and sinuses, larynx (voice box), pharynx (throat), oesophagus (food pipe), stomach, pancreas, kidney, bladder, uterus, cervix, colon/rectum, ovary (mucinous) and acute myeloid leukaemia,'' he states.

''Tobacco-related cancers aren't the number one in Oman because during our fathers' generation smoking was considered a taboo. Unfortunately, now the number of smokers has increased. The effects of the current lifestyle will be visible in ten years, if not more,'' he says.

Cigarettes not the only threat
Apart from the cigarette menace, the GYT survey of 2007 also highlighted another worrisome trend: The growing use of pipe, shisha and smokeless tobacco among children, with almost eight per cent of the children in the same age group (13-15) taking to water pipes, while four per cent consumed tobacco in chewable form. What was more disturbing was that 31 per cent of the children who used shisha initiated this habit before the age of ten.

The overriding concern for most doctors now is the misinformation about other tobacco products, especially shisha “ that many young kids have taken fancy to “ without realising that it poses graver health risks.

''Shisha cafs are spreading like wild fire in most Gulf countries. In fact, one could easily say that the Middle East is hit by an epidemic of shisha smoking,'' said Dr Jawad al Lawati, senior consultant and Rapporteur of National Tobacco Control Committee.

As per a World Health Organization study, a one-hour shisha smoking session amounts to smoking 200 cigarettes. ''Shisha is more dangerous because it gives a false sense of security. People think that the water acts like a purifier or filter, but it is far from it,'' says Dr Mandhari, asserting that the 200' figure is not far-fetched.

Dr Zahir Ahmed al Anqoudi, senior consultant family physician, member of the National Tobacco Control Committee and chairperson of the Oman Anti-Tobacco Society, claims that it is the period of smoking, the level of carbon monoxide, nicotine and the amount of muassal (mild tobacco) used in shishas that establishes the risks. Unlike cigarettes, smoking the pipe requires taking longer and harder drags, which increases the levels of nicotine and carcinogens entering the lungs, thus making it more harmful, experts state.

Another rage among school kids is the use of smokeless or chewable tobacco, which is still being illegally bootlegged into the sultanate despite a nationwide ban since 2011. ''We get a lot of a reports from teachers, schools and the Ministry of Education about students buying smokeless tobacco. We've been told that children are getting more and more into buying this stuff,'' Dr Lawati said.

According to Dr Anqoudi, youth generally take to smokeless tobacco because it has less of an odour and is presumed to be safer. ''But it has almost similar complications as smoking cigarettes...it also increases the risk of mouth cancers. In addition, it causes disfiguring of the mouth. Also, some producers at the local stores, as well as outside Oman add different strange materials like smashed glass to increase the absorption of nicotine by the already hardened mucosa of the mouth,'' he said, adding that this could be incredibly harmful for kids.

What can be done?
Early users of tobacco are more vulnerable to the risk of diseases, claims Dr Anqoudi, adding that only more awareness about the dangers of consuming tobacco products could change the current situation.

At the family level, he feels that parents must develop a good relationship with their children, and ''talk openly about smoking and their harmful effects'', rather than treating the issue as taboo. ''Peer pressure is a major contributor to children developing the habit...having a good relationship with your children and befriending them can have stronger influence to counter peer pressure,'' he feels.
Dr Lawati states that increasing the taxes of tobacco products may also prove to be a huge deterrent to the youth.

''Taxes on tobacco have not been raised for the last 14 years, when prices of all other goods have increased, including soft drinks, as well as other most basic items required for everyday use like oil, sugar, foodstuff etc. According to WHO, cigarette packs are cheaper in Oman, when compared to other countries for examples Sudan and Palestine. You can buy tobacco for US2.3 or less here. The same pack would be available in those countries for US8-US10. So the lack of legislation is an issue and static taxes are a concern. We are working on a national legislation, the sooner we have it, the stronger the boost to tobacco control efforts,'' he said.

Another plan, he said was to put a cautionary sticker on the shisha apparatus. ''Obviously, cafs will not like to enforce this, because that will inform the people. It is a challenge...but it should be made mandatory,'' Dr Lawati says.

If nothing else, health experts feel that such preventive measures will at least warn the youth about what they are getting into. As Dr Mandhari puts it, ''Do we wait till we see the results of our habits or rath


 






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