SEATTLE, Washington — In Egypt, more than 40,300 children light a cigarette and smoke every day. Moreover, approximately 33 million people in Egypt, or a third of Egypt’s 100 million people, survive on less than $1.45 each day. While the two circumstances may not seem to relate, tobacco use in Egypt is disproportionately affecting impoverished communities’ health, safety and financial security—perhaps to a greater extent than what appears on the surface.
Smoking Health Problems in Egypt
Smoking is a severe health problem in Egypt. Despite the enactment of numerous prevention policies, from banning tobacco usage in all indoor public places to implementing anti-tobacco advertising, Egypt continues to grapple with more than 61,200 tobacco-related deaths every year. The tobacco-related death rate is exceptionally high among men, with an estimated 957 Egyptian men dying each week from tobacco use, according to the 2016 Tobacco Atlas.
Although the percentage of youth using tobacco products (13.6%) is lower than adults (20.9%), the Campaign for Tobacco-Free Kids underscores a high exposure to second-hand smoke as just one reason for promoting anti-smoking legislation. In Egypt, approximately 60.7% of adults and 55.2% of youth are exposed to second-hand smoke in enclosed public spaces, despite outlawing tobacco usage in such places.
How Smoking is Affecting Impoverished Communities
According to a 2018 World Health Organization report on the epidemiology of tobacco use in Egypt, men of lower socioeconomic status are more likely to use tobacco products. In such lower-income households in Egypt, more than 10% of household expenditures are for purchasing cigarettes and other forms of tobacco. With the national poverty line set at $1.45 of daily income, tobacco use in Egypt can leave families with little spare money for necessities, and even less for addiction treatments and therapies.
Moreover, according to the Narconon Drug and Rehabilitation Center outside of downtown Cairo, accessibility to addiction treatment centers is curtailed by Egypt’s scattered rehabilitation facilities. Without proper means to obtain nicotine addiction treatment, impoverished communities face increased malnutrition and the premature emergence of chronic diseases.
Preventing Tobacco Use in Egypt
Fortunately, advancements in curbing tobacco use in Egypt have taken into account disadvantaged communities’ accessibility to treating addictions. In 2013, the WHO established the MPOWER program in collaboration with the Egyptian government, an initiative seeking to monitor tobacco prevention policies, research costs of tobacco use in Egypt and promote anti-smoking legislation and awareness. Furthermore, the government has enacted a strict 77.9% taxation on cigarettes’ retail price and has provided at least one nicotine replacement therapy (NRT) or smoking cessation service free of charge.
Yet, while strategies for preventing tobacco use in Egypt have improved in recent years, advancements to mental healthcare accessibility have proceeded at a somewhat slower pace. According to a 2015 report by the World Bank, mental health services make up only 2% of the government health budget, despite the beneficial effects of pharmacological and psychological treatment on cessation.
Improving Healthcare in Impoverished Communities
Nevertheless, community healthcare in rural communities is on the rise. In 2014, the Scarabaeus Foundation for Sustainable Development (TSF) was founded, a nonprofit organization seeking to improve marginalized communities’ lives through research, training and advocacy. Currently, the organization emphasizes mental health through its multilingual Online Mental Health Portal, which provides resources, treatment options and educational materials to those struggling with tobacco use in Egypt and other mental health concerns.
Such advancement comes at a particularly critical time in the country’s and the world’s history. To date, there have been more than 100,228 confirmed cases of COVID-19 in Egypt and 5,560 deaths. Moreover, the progression of the virus has been particularly severe for smokers, compared to non-smokers. According to the WHO’s research convention in late April, smoking is reported to have increased the severity of COVID-19 infections due to decreased lung capacity.
While no research has emerged to confirm smokers’ higher risk of contracting COVID-19 at this time, one thing is sure: Smoking’s assault on the lungs is not favorable for COVID-19 recovery. According to the WHO, as Egypt continues to combat the pandemic, ensuring the implementation of anti-smoking policies and addiction treatment options will be essential to smoking cessation. With increases in mental healthcare accessibility for impoverished communities, tobacco use in Egypt is expected to decrease and, consequently, the severity of COVID-19 cases.