Royal declaration to make Mecca and Medina smoke-free
In 2001, on World No Tobacco Day, the Late King Fahd announced that Mecca and Medina would become smoke-free cities. This directive, although not a formal law, has a similar force within the Kingdom of Saudi Arabia. Saudi Arabia subsequently signed the FCTC in 2004. Since then it has adopted a religiously-inspired policy approach to strengthening tobacco control. Working within this faith-based paradigm, a National Tobacco Control Programme that focuses on primary prevention and supporting tobacco cessation has been adopted. National legislation also bans smoking in health and educational facilities and on public transport. In practice, however, apart from in Mecca and Medina, few cities in the Saudi Kingdom implement the legislation.
The faith-based approach that underpins Saudi tobacco control policy reflects the Islamic perspective and rulings of leading religious figures. This has been central to the impetus and the justification for a focus on tobacco control and smoke-free initiatives in Mecca and Medina. The cities are Islam's two most sacred places.
Fact file: Mecca and Medina
Population: 1.7m, 1.3m
A distinctive feature of the approach adopted in Mecca and Medina was its focus on targeting and restricting tobacco sales as the way to progress a smoke-free agenda.
An array of implementation steps and activities were carried out to achieve the Royal initiative of a tobacco-free Mecca and Medina. They include:
- Banning tobacco smoking around the two Holy Mosques in Mecca and Medina.
- Banning tobacco sales within city limits and beyond city limits, prohibiting sales in all food stores and in the neighbourhood of mosques and schools.
- Prohibiting waterpipe smoking in cafes and restaurants within residential areas and near mosques, schools and wedding halls.
- Extensive campaigns to raise awareness about the hazards of smoking and the tobacco control policy in the cities amongst the public and city visitors.
- Within the smoke-free areas of the cities surrounding the Mosques, there is very little smoking now and most of the visitors know that it is a smoke-free city and that they should not smoke around the Mosque.
- In other public spaces, such as restaurants, smoking has continued, though limiting tobacco sales combined with an increased awareness that smoking within the holy cities does not constitute “good behaviour”, means that it has reduced.
- In Mecca, in 2008, an assessment of the policy found that 75% of stores had complied with the requirement not to sell tobacco. Fines were issued to the remainder of the shops.
- Squeezing the availability of tobacco from retail outlets has stimulated a black market and pushed up the price of tobacco.
- The role of the King in instigating the smoke-free agenda was crucial to ensuring the agenda was adopted and progressed. Equally, the appointment of key people on the committees able to push the agenda forward was a significant asset.
- The Fatwas and opinions of religious leaders and scholars provided important support, motivation and justification for the tobacco control actions adopted.
- The tactics of WHO (Eastern Mediterranean Regional Office) were influential, especially in contributing to international meetings of respected religious scholars, disseminating their outcomes to public and health authorities in the region, and publishing Fatwas at the appropriate time.
- However, without a comprehensive smoke-free legal framework, local administrations are constrained by limited powers and reluctant to push for making all public and workspaces smoke-free.