1. Water pipe time for prevention Hedaya Alhaj

2. "public health is a social issue“- Dr Lee, Director-general of the WHO TOBACCO USE IS A SOCIAL PROPLEM. It requires real change in social beliefs and.social norms RELIGION IS A PUBLIC HEALTH TOOL Religion has worked successfully in this regard. Religious message therefore must be activated whenever possible and used as needed.

3. Ex. EMRO has been working with the leaders of Christian churches and Islamic institutions to endorse and support tobacco control through religious messages since the 80’s of the last century.

4. Egypt: STUDYING THE IMPACT OF THE FATWA DISTRIBUTION 2 years after the Fatwa distribution; the Department of Community Medicine, Ain Shams University, studied the impact of the Fatwa distribution. The study focused on Mosques’ attendants in five major cities in Egypt : 1. Cairo 2. Giza 3. Alexandria 4. Ismailia 5. Beni Sweif

5. Results Among all Individualse Among 3635 surveyed, 2836 believed in the Fatwa, 39% of them were smokers. Among smokers who believed in the Fatwa, following the Fatwa distribution they reported: 68% intended to stop smoking. 61% tried to stop smoking. 60% actually reducing the number of cigarettes they smoked. 69% would try to convince a friend to quit. Regarding the decision on whether to stop selling tobacco products: Among 1523 shop-owners surveyed: 1210 owners (79.4%) believed in the Fatwa, 27 owners (1.8% ) did not, and 286 owners

6. Reasons why a smoker would want to quit smoking the water pipe : \The majority of students (89% Egypt; 88% Lebanon, 93% Kuwait) wanted to quit smoking the water pipe to maintain their health.About two thirds of the study sample (63%, 66%,and 71%, respectively) in the three countries wanted to quit smoking because of medical problems. Only approximately 75% of the Kuwaiti students and 23.5% of the Lebanese, compared to 85%of Egyptians, wanted to quit smoking because it is against their religious beliefs. Most of the students in the three countries (66.2% Egypt, 72% Kuwait, 61% Lebanon) wanted to quit smoking to avoid discomfort for people nearby. More than three quarters of the Egyptian and Kuwaiti students (81% and 78%, respectively) cited complying with the cultural norm that it is not acceptable for women to smoke the water pipe.

7. Water Pipe Prevention Academics NGOs Media Governments

8. Governments : Strong Political Commitment Presidential, Ministerial leadership Multinational agreements

9. Lebanon  Ministry of Health warning: smoking is a main cause for dangerous and deadly diseases  Health warning: smoking is major cause of dangerous diseases and kills Syria  Smoking may cause serious problems to your health Palestine  Scientific studies proved that smoking causes addiction—Ministry of Health  Warning: smoking cigarettes harms your children and people around you  Warning: smoking cigarettes causes ageing of the skin South Africa  Danger! Smoking causes heart disease ()  Smoking is a major cause of heart attacks strokes and blood vessel diseases. Quitting smoking reduces your risk of heart diseases for more information call (011)720

10. Academics : Ongoing research Evolving Tobacco preventive and Control strategies Tobacco Burden and Outcome measurement

11. Non-Governmental Organizations (NGOs) Continuous Strong Advocacy Real-time surveillance Internet organization tools

12. Media Support and human resources Political reach/ change Norms Multinational collaboration o TV Ads Australia

13. Emphasis : Non-smokers rights to a smoke-free environment In addition to Awareness issues Radio talks by experts, with youth contests for prizes based on their knowledge of the right answers Development of songs, drama, and TV spots for use by national media A satellite TV show was arranged with a famous youth religious leader (Amr Khaled), who spoke on passive smoking

14. WHO suggested methods to regulate and reduce the use of Water pipe: Water pipe and water pipe tobacco should be subjected to the same regulation as ciggerates. Water pipe and water pipe tobacco should include strong health warnings. Claims of harm reduction and safety should be prohibited. Misleading labelling.such as ‘contains 0 mg tar’ should be prohibited. Water pipes should be prohibited in public places such as cigarettes. Education of health professionals is needed about the risk of water pipe,including high potential levels of second hand exposure : children, pregnant and others.