By Tegan Insoll, LLM student International Human Rights Law,  University of Groningen, t.m.insoll student.rug.nl

Jordan recently overtook Indonesia as the country with the highest smoking rates in the world. But what exactly is happening to produce such astonishing statistics on the use of tobacco? And what must be done to turn the tide of the tobacco epidemic to protect the public health of individuals?

In 2019, Jordan reported that an overwhelming 70% of males aged 18-44 smoke.[1] Additionally, 78.8% of the Jordan population aged 18-69 are regularly exposed to second-hand smoke.[2] The prevalence is also worryingly high among youths, with 45% of all youths aged 13-15 having already tried tobacco products.[3] These figures highlight the ongoing public emergency in Jordan killing over 9,000 people every year,[4] and bring attention to the resulting human rights concerns regarding the right to health.[5]

Not only is the tobacco epidemic in Jordan negatively impacting the right to health of the population, but it is also a staggering economic expense, contributing heavily to the impediment of Jordan’s economic development. Each year, tobacco use causes an estimated JOD 1.6 billion (approx. EUR 1.84 billion) in total economic losses,[6] the equivalent of 5% of Jordan’s GDP in 2018.[7] These costs include healthcare expenditure and ‘lost productive capacities due to premature mortality, disability, and workplace smoking’. [8] The epidemic also has significant environmental impacts, due to the contribution to indoor and outdoor air pollution.

So why are Jordan’s tobacco use figures so drastically different to those in the US, Europe and Australia, where smoking has significantly reduced over the last few decades? [9] This comes down to a variety of factors, but the most outstanding distinction is the prevalence of tobacco industry interference in Jordan’s public health policy-making.[10]

Industry interference runs counter to the binding obligations of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), in particular Article 5.3 which calls on parties to establish formal mechanisms to protect against tobacco industry influence in tobacco control policies.[11] Principle 1 of the Guidelines for the Implementation of Article 5.3 FCTC expresses that there is a ‘fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests’.[12] It is clear that the Article 5.3 obligation to protect against tobacco industry influence has not been fulfilled by Jordan, as it reported in 2019 that no legislative, executive, administrative or other measures have been adopted or implemented in this regard.[13]

Not only is this situation problematic in terms of non-compliance with a binding international legal instrument, but it also conflicts with a number of individual human rights, and broader interests of public health, given the severity of tobacco use in terms of contribution to non-communicable diseases (NCDs). Tobacco use is one of the main behavioural risk factors that enhance the incidence of NCDs. Industry interference is thus responsible for perpetuating the global health problem of NCDs.

The tobacco industry in Jordan undermines effective tobacco control in a number of ways, two of which will be discussed here. Firstly, it has impeded the effective enforcement of tobacco control legislation. For example, government efforts to reduce consumer demand by raising taxes on tobacco products were essentially nullified by the tobacco industry initiating a significant price reduction to keep cigarettes affordable and maintain consumer demand.[14] Secondly, the tobacco industry in Jordan has engaged in what it claims to be ‘corporate social responsibility activities’.[15] For example, Philip Morris International, one of the largest tobacco companies operating in Jordan, has paid to refurbish schools, provided children with school bags and stationary, and run career training events for young people.[16] Whilst the tobacco industry argues that these activities are in line with their corporate social responsibility, they are in reality merely attempting to cast themselves as a positive influence on a country, and enhance their image with the public, media, and government.[17]

Not only does the tobacco industry undermine the effectiveness of tobacco control in Jordan, it also directly interferes with the governmental policy-making process. The interference mainly stems from the fact that many MPs own shares in tobacco related businesses, such as establishments that serve shisha, and other cafes and restaurants that have an economic interest in allowing smoking.[18] This blatant conflict of interest removes any chance of gathering the political will needed to thoroughly implement and enforce the FCTC.

In light of all the evidence above, there is an obvious necessity for Jordan to implement stricter measures regulating tobacco industry interference in policy-making, in order to effectively realise the right to health and adhere to the obligations of the FCTC, in particular Article 5.3. These measures must include increasing transparency, reducing conflicts of interest, reducing unnecessary interactions between government and tobacco industry, and completely removing the tobacco industry from taking part in decision-making relating to public health. Political will is required to implement these changes in practice, thus it is clear that public health advocates and NGOs play a very important role in lobbying national governments to steer health policy on the right course, as well as swaying public opinion on the harmful effects of tobacco use.