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Egypt is the largest consumer of tobacco in the Arab region. Nearly 40 percent of adult men are smoking 19 billion cigarettes a year, according to recent statistics by the government. The average household spends almost $20 a month on tobacco,[link widoczny dla zalogowanych], a staggering amount in a country where nearly one-fifth of the population lives below the poverty line.
It can’t be easy when one-third of medical professionals in Egypt smoke. “Yes,[link widoczny dla zalogowanych], there are many challenges. The level of social acceptance for smoking is very high,” said El-Awa. Politically challenges persist as well. With a few exceptions, the law banning smoking is rarely enforced,[link widoczny dla zalogowanych], even inside government buildings and hospitals.
Smuggled Chinese cigarettes — without Egypt’s warning label — have also flooded the market, according to El-Sayed. “We are frustrated. The government is not totally committed to the fight on smoking,” said El-Sayed. “I think they have a lot of other problems and they think this is not something they should be focused on.”
Still,[link widoczny dla zalogowanych], the idea of a special tax on soda, similar to those on tobacco, gasoline and alcoholic beverages,[link widoczny dla zalogowanych], is attracting more interest. Advocates of a tax note that sugared beverages are the No. 1 source of calories in the American diet, representing 7 percent of the average person’s caloric intake, according to government surveys,[link widoczny dla zalogowanych], and up to 10 percent for children and teenagers.
These calories, they point out, are worse than useless — they’re empty, and contribute to a daily total that is already too high. “What you want,” says Kelly Brownell, director of Yale’s Rudd Center for Food Policy and Obesity, “is to reverse the fact that healthy food is too expensive and unhealthy food is too cheap,[link widoczny dla zalogowanych], and the soda tax is a start. Unless food marketing changes, it’s hard to believe that anything else can work.”
Advocates argue that a soda tax would reduce consumption and pay for anti-obesity campaigns. In an opinion piece in The New England Journal of Medicine last year, Dr. Brownell and Thomas R. Frieden, the director of the C.D.C. and former New York City health commissioner,[link widoczny dla zalogowanych], estimated that in New York State alone a penny-per-ounce soda tax would raise $1.2 billion annually.
Increase primacy of health over commerce in trade agreements: Successful arguments have been made that excluding tobacco from trade agreements is compatible with international law, which provides for other harmful products such as landmines to be exempted.
In addition, the World Trade Organization (WTO) has declared that human health is an important consideration and that if necessary, governments may “put aside WTO commitments” to protect human life. * Increase basic biomedical and applied tobacco control research * Increase the extent and accuracy of tobacco epidemiologic and surveillance data * Increase litigation aimed at the tobacco industry

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