Aurora Goodwill Ambassadors arrived in Armenia as part of the Aurora Humanitarian Initiative. Derek Yach, the President of the Foundation for a Smoke-free World, fights against smoking for decades and is one of the best international experts in this field. In an interview with Sona Aghbalyan on the First public television channel, he talks about the effective means of combating smoking.
Welcome to Armenia, Mr. Yach. Our Minister of Health has launched the campaign "Smoke-free Armenia", but it faced many problems and society didn’t accept that. As president of the Smoke-free Foundation, what advice would you give to our society?
First of all, I think the smoking rate among men in this country has come down, but it can increase again. We must prevent it by applying common methods. Hospitals and clinics have to participate as well. Physicians must talk more about the harm of smoking. If the physicians don’t speak up, there will be no success. Second, we need to reduce the volume of local production and encourage the use of e-cigarettes, as the UK government did. Of course, there may be worries that this is not good for smokers, and this solution may not seem perfect to them, but it does reduce the risk of lung cancer and heart diseases. As for women, I saw the statue of Botero's "Smoking Woman" and I hope she will be the only female smoker in Armenia. But, unfortunately, I saw many young women in hookah bars and cafes, and many were just starting to smoke. We need to understand how to deal with the problem of female smokers, otherwise the success that has been achieved in the fight against male smoking can fail because of female smoking. And third, I had here in Armenia many technological and scientific meetings and I saw the progress of innovation technology. It should be applied in the fight against smoking. Currently science and technology tap on many aspects of our life, and the world, as well as Armenia, has to drive science to address the smoking epidemic.
Do you think the increase in cigarette prices can somehow help to solve the problem?
This is the case everywhere: if the cigarette price goes up, the smoking rates go down or at least slow down among youth. So yes, raising taxes and cigarette prices is one of the most important factors. But attention should also be paid to the reduction of the trade volume to make sure it does not have a negative impact.
Your advice was to use innovative technology. What actions did you take?
I think that even a regular smartphone can help to reduce the smoking rate. It can monitor one’s behavior through programs and applications even without visiting the hospital and seeing the doctor. Then take less harmful alternatives should be used, such as an e-cigarette. If we combine these two, I suspect it will bring the smoking rates, particularly in man down fast.
For 30 years maybe you faced many problems with cigarette producers. How have you been able to come to an agreement?
If you do not overcome the obstacles, you will not make any progress. You have to keep moving. Of course, tobacco companies are creating problems: they oppose taxes, warnings, and many other things, but there are also innovative elements in the tobacco industry. They are also looking ahead, trying to cut down on the production of combustible cigarettes, replace them with e-cigarettes or similar products. We need to think not about how to oppose manufacturers, but about how many people believe that any type of nicotine is harmful: that is actually not true.
Does it mean that e-cigarettes are not a solution as well?
They can be a solution for the smokers, and not for the non-smokers. If you are smoking for 20 years, switching to an e-cigarette will certainly reduce your exposure to toxic emissions. But that can only be part of the whole package in fight against smoke. We should focus not on what people use, but on what our goal is, and our goal is to prevent cancer and heart disease.
Have you ever smoked?
No, I haven't, but unfortunately my friends and my family members do.
Please, tell us about your results of struggling against smoking for thirty years, and how you see the smoke-free world in the future? Or do you see that future, and for what time period?
I have spent ten years at the World Health Organization. Most of my work has been dedicated to the Framework Convention of tobacco control which is relatively successful. In many countries around the world, smoking has declined. Now my fear is that the rate is falling. Another result is that we also focus on youth. We need to realize that today's smoker can smoke for another three, four, five decades if we don’t help him. Smokers are not fools: they realize their interests. We need to work with them to find better solutions so they stop smoking which is for the people around them not to be exposed to the smoke as well.
Tell us about the situation in your country.
I live in the United States but I was born in South Africa. So I can present two cases. There has been a lot of progress in South Africa over the last few decades, mainly due to tax policy. The situation in the United States is very good. Only 20% of the population are smokers, with 4-5% among youth. That's a great indicator. The problem is that working with smokers is difficult. They mostly have mental health problems, are either the poorest or neglected by society.
How we should help our society? How to convince them smoking is harmful?
I believe the majority of people realize that smoking is not a good thing to do.
Here in Armenia, we have a huge problem, because when the bill was introduced, the public did not accept it.
The thirty-forty years experience shows that only one thing can make a big difference in the fight against smoking: there would only be a success if the physicians talk to each other. If they do not appear on television, talk to their visitors, meet with government members, if they remain silent, smoking will continue. If doctors are engaged, smoking rates will decrease. The best thing that happened in the United States and the United Kingdom about fifty years ago was that doctors combined their reports. I do not know if Armenian doctors have prepared such large reports. Taxes and high prices can be long-term solutions, but if you want to address the problem thoroughly, doctors need to play a greater role.