
When Turkish Prime Minister Recep Tayyip Erdogan addressed a meeting of the National Tobacco Control Programme in December 2007, he didn't mince words. "Struggling against the use of tobacco products has become as important as our counter-terrorism struggle," he told an audience assembled in the lobby of Ankara's Sheraton Hotel. Those products, he said, "are literally murdering our future generations". As a non-smoker Erdogan was, at the time, in the minority of Turkish men. According to a government survey of tobacco use conducted in 2006, some 33% of adults were daily smokers, including just over half of all men and approximately 16% of women aged 18 and over. In a Gallup poll conducted in 100 countries the following year, two out of three Turkish men said they had lit up the day before they were surveyed, as did one out of three women. That was, Gallup said, "by far the highest incidence reported". It also confirmed a stereotype common to countries across Europe: that to smoke heavily was "to smoke like a Turk". [ILLUSTRATION OMITTED] Three weeks later, the prime minister signed into law a ban on smoking in all enclosed public spaces. The first tobacco control law in Turkey had been signed in 1996, and in 2004 the Turkish parliament ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), committing it to a set of obligations, explained Toker Erguder, tobacco control programme manager at WHO's country office in Turkey. A special unit was then established in the Ministry of Health, charged with rolling out a national tobacco control programme and action plan. In 2008, more tobacco control legislation was passed, which made indoor spaces 100% smoke-free, including the hospitality sector. This meant it had some of the most stringent tobacco control measures in the world, alongside countries such as Ireland and the United Kingdom of Great Britain and Northern Ireland. Toker says: "A key success of the policy on tobacco control is the whole-of-government approach lead by Erdogan and strong intersectoral collaboration by the health minister, Recep Akdag, to combat the tobacco epidemic. And the head of parliament's health commission, Cevdet Erdol, was instrumental to the preparation and adoption of the tobacco control laws." Passing legislation is one thing. Enforcing it is often quite another. And for all the promise of sweeping change, many doubted the law would have an impact on a smoking culture as strong as Turkey's. Now, nearly three years after the ban went into effect, Turks and tourists alike express amazement at its widespread acceptance and the degree to which patrons of restaurants and bars have abided by the new rules. "I would never have imagined that they could implement the ban as well as they have," says Sarp Ucak, an equity trader with Citibank in Istanbul, home to most of Turkey's 16 million smokers, out of a population of almost 74 million. "I don't really like this government, but I have to congratulate them. There are still some restaurants and bars that don't obey, but only very few. And now many of my friends are quitting." Ucak is, too, he says. "I'm trying again. I want to quit." "It not only brought down the consumption rate, but it also changed public opinion", says Elif Dagli, chair of the National Coalition on Tobacco or Health, a civil society group formed in 1995 to lobby for the country's first anti-tobacco law and one of the prime movers in generating support for the FCTC. "It was like changing--not the 'climate', that's too mild," she says. "It was like changing the religion. And it was amazing; everybody said it would be protested, but then everybody started quitting." [ILLUSTRATION OMITTED] Turkey's transformation didn't occur overnight. Indeed, even after the ban was passed, a battle that had begun nearly twenty years ago--between industry and activists--continued apace. …
Public aspects of medicine, RA1-1270
Public aspects of medicine, RA1-1270
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