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Tobacco images inappropriate, gruesome…and a bit of a joke

The numbers speak for themselves: With approximately 40 percent of the male population smoking an average of 19 billion cigarettes annually, Egypt is hands down the largest consumer of tobacco in the Arab region.

In an effort to shed this dubious honor, the Ministry of Health enforced a law in 2008 requiring all cigarette packs sold in Egypt to carry graphic warnings depicting the hazards of smoking.

The (often gruesome) images are printed on both the front and back of every cigarette pack–regardless of brand or popularity–and cover half of each side. These graphic warnings are updated every six months with a new image designed specifically to instill fear in the ailing hearts of smokers all over the country. But two years on, what effect has this slideshow of diseased organs and suffering children had on Egypt’s population of smokers?

When Al-Masry Al-Youm posed the question above to a group of adolescents huddled around a Nasr City street corner, the answer came on a wave of derisive laughter and a puff of smoke. "You mean this picture," asks 21-year-old Moussa, pulling a pack of Marlboro Reds out of his pocket and holding it up to show the image of a limp cigarette printed on its front.

Of the five images printed to date, the one that has undoubtedly had the strongest effect on smokers, particularly younger ones, has been the limp cigarette–a not-so-subtle promise of impotence, or as the written warning puts it, "marital strife." Frustratingly, this effect seems to be closer to "amusement" than anything resembling genuine concern.

"That stuff doesn’t really happen," Moussa reassures Al-Masry Al-Youm after pocketing his pack and plucking his cigarette from between his lips. "At least not from smoking. It’s all made up, just to scare you."

Whether this is denial or sheer ignorance, it seems to be working for Moussa, his tobacco-enthusiast friends and, apparently, most smokers. From cab drivers to college students, kids in the street, and even a doctor–not on a single occasion did any of Al-Masry Al-Youm’s interviewees admit to being bothered enough by any of the images to seriously consider kicking the habit.

"We all know about the negative consequences of smoking. We’ve always known–how could you not?" asks Ibrahim Metwaly, a cab driver who has been a smoker for 40 of his 52 years. "That’s the problem. The pictures don’t tell you anything new, they just depress you. And depression isn’t good for you, either. Depression can also cause marital strife."

"If we [smokers] could quit, we’d quit. But that’s why it’s called an addiction," he sighs. "It’s not like I was sitting here waiting for a picture of a limp cigarette."

"Besides," Metwaly adds after silently puffing on his cigarette for a few moments. "It’s not right for [the government] to print pictures like [the limp cigarette] on cigarette packs. Excuse my saying this, but we’re a Muslim country, and it’s just inappropriate."

While it may be inappropriate to some, the impotent cigarette is only one of five circulated images. Yet, the first three–depicting, respectively, a frail-looking man in a hospital bed, a child covering his mouth and nose from second-hand smoke, and an unconvincing illustration of a baby in its womb–have also seemingly failed to register, at least in the intended way.

After studying the three images shown to them by Al-Masry Al-Youm, 22-year-old Yasser Talaat turns to his friends and, pointing to the image of the child suffering from second-hand smoke, says, "If the smoke’s bothering this kid so much, he should go outside and play soccer. The fresh air will do him good." When Al-Masry Al-Youm points out that Cairo is hardly the best place for those seeking fresh air, Talaat excitedly replies, "That’s right! The government should fix its own pollution problems before telling us to worry about our [lungs]."

"When microbuses stop polluting the air," he says, coming to a conclusion after a lengthy discussion, "I’ll stop smoking."

However, even the government seems to have little faith in that ever happening, as evidenced by the increasingly disturbing nature of the images: the fifth and most recent graphic warning, in circulation for the past two months, is a close-up of some unfortunate soul’s cancer-ridden gums.

"All the images before this one were a joke," says 28-year-old Mina Magdy, who has been smoking since high school. "You couldn’t really take them seriously. But this one freaks me out."

"They [the images] are definitely getting more disturbing," agrees Amira N. (who doesn’t find the limp cigarette inappropriate). "I feel like the next image will be of a man with a bullet-hole in his head," the 31-year-old smiles. "It’ll say, ‘Smoking leads to suicide'.”

For its part, the Ministry of Health knows it still has a tough job ahead of it. "Our biggest challenge is to change people’s behavior," says Sahar Labib, director of the ministry’s Tobacco Control department. "Of course, this is extremely difficult."

In order to successfully change people’s behavior, Labib explains her department has been primarily focusing on raising awareness towards the hazards of smoking, as well as "our right to breathe pure air." Labib also believes in the effectiveness of the graphic warnings–which are modified from "international designs" by a team of ministry-employed artists, before being passed on to a supervisory committee and then, of course, the Minister of Health for final approval. "The image of the child protecting himself from second-hand smoke is the most effective," Labib asserts. "Especially on parents who smoke."

When asked about this particular point, cab driver Ibrahim Metwaly replies, with a hint of guilt, "I try not to. I used to smoke around my children. Now, I try not to smoke around anyone. I’m free to harm myself as much as I want, but why harm others?"

"Of course," he adds, "my children are all grown up now."

With years of irreparable damage already behind them, Labib and the employees of her department are striving toward a cleaner, healthier future–a hope shared by Metwaly. However, while the Tobacco Control department’s solution includes banning smoking in public places and improved cessation clinics, Metwaly’s is far simpler, even if the logic is a little hard to follow.

"If the government wants people to stop smoking," he says, reaching over to accept a cigarette from Al-Masry Al-Youm, "then they should just ban cigarettes and legalize hashish."

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