Assessing Tobacco Control Strategies in Turkey

This article discusses research by Nazmi Bilir, Coordinator of Tobacco Control Research at the Ankara, Turkey based Hacettepe Public Health Foundation on behaviours and attitudes toward smoking in Turkey. The first survey, completed in 1996, was based on 2,500 interviews with teachers, doctors, journalists, politicians, athletes, and students living in the Ankara area. Initial reactions to Law 4027, the anti-smoking legislation passed by the Turkish Parliament that same year, were also investigated. Law 4027 prohibits tobacco advertising and selling cigarettes to minors, and bans smoking in public buildings and on public transport. A second research phase, launched in 1998, extended the survey process to a national scale, with 40 interviewers visiting 34 of Turkey's 858 municipal districts. The survey group was also expanded to include commercial drivers, police officers, and religious leaders. Two sets of cross-sectional surveys, performed one year apart, collected data to monitor changes in the habits and attitudes of the different employment groups. Reaction to the anti-smoking law was also measured in more depth.

According to the article, preliminary results showed that with the exception of police and commercial drivers (whose overall smoking rates increased by 4% each to 64 and 74% respectively between 1998 and 1999), smoking rates have either stayed constant or declined. One of the most surprising discoveries was the decline in smoking among children. Among women only 24% describe themselves as smokers, roughly the same number as in 1996. The first survey found that working women are more likely to smoke than mothers, most of whom were homemakers. The research pointed to a relationship between gaining social status, economic power, and smoking in women.

Print and broadcast media were also monitored to analyse how the anti-smoking message was being reported. The research found that that journalists - who have one of the highest smoking rates (63%) - prefer to write stories that deal with the health effects of smoking, rather than articles that attack the tobacco industry. The researchers also found that although banned from advertising their product, the tobacco industry skirts the law by announcing price changes in regular news articles. Tobacco companies have also lobbied parliamentarians to allow them to sponsor sporting and cultural events.

The report states that researchers will use the results to further publicise anti-smoking, and to recommend ways that the Turkish Parliament can strengthen the existing law. One of the team's goals is to convince physicians to raise awareness of the dangers of smoking with their patients.