WHO warns Tunisia of high tobacco consumption among young people

The representative of the World Health Organization (WHO) office in Tunisia, Olfa Saïdi, is concerned of the increase in tobacco consumption among Tunisian adolescents: 11.9% of adolescents aged 13 to 15 are regular tobacco consumers[1], a prevalence that rises to 14% among those aged 15 to 17 years. [2]

This worrying trend has consequences for public health. Olfa Saidi stressed the urgency of adopting stricter measures to counter this phenomenon.

Smoking and vaping in Tunisia: a major public health problem

Each year, tobacco consumption is responsible for the premature death of more than 13,200 Tunisians. More than one in six of these deaths result from exposure to second-hand smoke.[3]. According to the WHO representative, the age of initiation is particularly alarming, with some children starting as young as seven years old. Nearly 12% of young adolescents aged 13 to 15 regularly use tobacco products. Among 15-17 year olds, this prevalence is 14%. While boys continue to be more numerous in using tobacco, consumption tends to increase among young girls.

Although tobacco consumption among men has not increased significantly with 49.4% in 2018 compared to 49.8% in 2023, it still remains very high. The situation remains roughly the same as in 2018 for women, with a prevalence of 1.7% in 2018 compared to 1.9% in 2023.[4]

Moreover, according to Hatem Bouzaiene, doctor and president of the Tunisian Alliance against Tobacco, in 2023 Tunisia also faced a sharp increase in the use of electronic cigarettes among young people. According to him, more than 17% minors would use them, while the latter is supposed to be expensive and inaccessible for this age group.[5]

Tobacco-related diseases cost Tunisia 2 billion Tunisian dinars (600 million euros) each year, the equivalent of 1.81 trillion Tunisian dinars of its GDP.[6]

Laws that are very poorly respected

In 1998, Tunisia adopted legislation to regulate tobacco consumption. This law includes several important measures such as banning smoking in public places, limiting advertising of tobacco products and requiring health warnings on cigarette packages.

However, the terms of application of the text did not allow the measures to be effective. Thus, in 2008, a Tunisian study conducted among 452 health professionals revealed that 82% of smokers and 80% of non-smokers interviewed said they were aware of the existence of a smoking ban in their workplace but indicated that the majority of smokers did not respect this ban in a health setting.[7]

A 2017 report from the Tunisian Ministry highlighted the easy accessibility of tobacco products for minors. For example, among cigarette smokers aged 13 to 15, 76.1% reported having been able to buy cigarettes in the last 30 days. This accessibility to tobacco products not only facilitates the initiation of children to smoking but also contributes to keeping them addicted.[8]

Although Tunisia ratified the WHO Framework Convention on Tobacco Control (FCTC) in 2010, thereby committing to strengthening its efforts against smoking, the country is still struggling to rigorously implement existing laws, and other provisions would need to be adopted to effectively combat smoking.

Strengthening anti-smoking measures in Tunisia: recommendations and commitments from the WHO and the Assembly of People's Representatives

To stem this tobacco epidemic that persists in Tunisia and makes it one of the most affected countries in Africa, the WHO recommends in particular the application of all the provisions of the FCTC treaty. The representative of the institution particularly recommends that the country adopt and implement a total ban on the sale of tobacco to minors and that it substantially and regularly increase taxes on tobacco products. These measures are effective in preventing young people from starting to smoke, and tax increases have also been shown to encourage smokers to quit smoking.

At a session of the Social Affairs Committee of the Tunisian Assembly of People's Representatives, the problem of smoking was discussed. The discussions highlighted the need for enhanced collaboration between legislators, public health experts and civil society to define and implement these proposals effectively. The parliamentarians of the Committee committed to bringing them forward with a view to strengthening the existing legislative framework.

©Generation Without Tobacco

DT

[1] Ayedi Y, Harizi C, Skhiri A, Fakhfakh R. Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): The case for Tunisia. Tobacco Induced Diseases. 2022;20(January):7. doi:10.18332/tid/143994.

[2] Ministry of Health of Tunisia RTI International United Nations Development Programme WHO FCTC Secretariat World Health Organization, Argument for investment in the implementation of the FCTC in Tunisia, published in December 2021, consulted on July 17, 2024

[3]Ministry of Health of Tunisia RTI International United Nations Development Programme WHO FCTC Secretariat World Health Organization, Argument for investment in the implementation of the FCTC in Tunisia, published in December 2021, consulted on July 17, 2024

[4] Multiple Indicator Cluster Survey (MICS) in Tunisia, Situation of mother and child, UNICEF, published in 2023, accessed on July 18, 2024

[5] BusinessNews, Smoking: frightening figures for children and adolescents!, Business news, published June 2, 2023, accessed July 17, 2024

[6] Tunisian National Institute of Statistics, https://www.ins.tn/statistiques/115 , accessed July 18, 2024

[7] W. BEN AMAR, A. CHAKROUN, M. ZRIBI, Z. KHEMEKHEM, F. BEN JEMAA,S. MAATOUG, Anti-smoking legislative framework in Tunisia: between inadequacies and lack of application, published October 14, 2017, accessed July 17, 2024

[8] Ayedi Y, Harizi C, Skhiri A, Fakhfakh R. Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): The case for Tunisia. Tobacco Induced Diseases.