Fighting back against tobacco industry tricks
The Eastern Mediterranean region is witnessing rising trends in tobacco use among women and adolescents and has recorded the highest smoking rates for boys among all World Health Organization regions. In some countries, smoking rates have reached 43 percent among adolescent boys (aged 13-15 years) and 20 percent among adolescent girls.
This is no coincidence. It is a calculated move by the tobacco industry to target new markets, using new forms of nicotine such as e-cigarettes and heated tobacco products to hook the next generation. The industry's cleverly marketed lies, campaigns that use packaging and a multitude of flavors — e-cigarettes are reportedly available in more than 16,000 flavors — are designed to entice the young.
In Lebanon, Jordan and Syria, tobacco use among adolescent boys now exceeds 30 percent. In every country in the region, adolescent girls now smoke more than adult women. The statistics speak for themselves, revealing the depth of the tobacco industry's reach. The message is clear: Tobacco use is not just persisting, it is evolving, adapting and aggressively infiltrating the lives of new generations.
Recognizing the growing threat, the WHO Regional Office for the Eastern Mediterranean has launched the 'Tobacco Free Initiative,' which aims to address tobacco use in these demographic groups.
The gendered health risks of tobacco use are serious. Women who smoke face increased risks of cervical cancer, osteoporosis, fertility problems and complications when using oral contraceptives. Smoking during pregnancy can lead to preterm births and developmental issues in newborns. For adolescents, early nicotine exposure can lead to a lifetime of addiction, with higher risks of chronic illness and premature death.
The initiative supports the WHO's broader strategic goals by advancing people-centered approaches to noncommunicable disease prevention. By addressing nicotine addiction early and highlighting gender and age-specific risk factors, it supports our flagship initiative on substance use. It also strengthens the Accelerated Action for the Health of Adolescents agenda, which considers tobacco control a priority intervention to address preventable mortality and morbidity among adolescents, and aligns with the Global Standards for Health Promoting Schools that advocate for safe, tobacco-free environments.
More girls and women are taking up the habit, threatening to reverse decades of progress and exposing new populations to harm.
Dr. Hanan Balkhy
The narrowing gender gap in tobacco use is of particular concern. Smoking was once a predominantly male behavior. But more girls and women are taking up the habit, threatening to reverse decades of public health progress and exposing new populations to devastating harm.
This can be reversed. The WHO Framework Convention on Tobacco Control and the MPOWER measures provide countries with a proven roadmap that includes raising tobacco taxes, banning advertising, ensuring smoke-free public spaces and offering cessation support. These policies have worked elsewhere. They can work here too.
Success will depend on leadership and collaboration. We need governments to step up and regulate emerging products by banning flavors and restricting the use of youth-oriented designs. These are not accidental trends. They are deliberately engineered entry points into addiction.
We must also engage communities. Parents, teachers and healthcare providers all play vital roles in prevention and support. Schools must become tobacco-free environments that reinforce healthy behavior. Health systems must provide age and gender-sensitive cessation services, especially for young people and women.
To meet the global target of a 30 percent reduction in tobacco use by 2030, we must act now. This epidemic among women and youth cannot be allowed to continue unchecked.
The tobacco industry is adapting fast. We must act faster.
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