Dubai Antismoking Campaigns: Effectiveness Evaluation Research Paper

Executive Summary

Countries around the world have embarked on major antismoking campaigns to try and resolve major health risks caused by tobacco use, as well as help millions of people affected by passive smoking. Cigarette smoking has been found to cause one in every ten deaths among adults, making it the number one preventable cause of death worldwide. The World Health Organization argues that tobacco use is responsible for decimating half of its users. As such, many countries, including the United Arab Emirates, have undertaken massive antismoking campaigns as a spontaneous reaction to the many health risks brought about by tobacco use in the country. Dubai is one city where smoking bans have been implemented to check the situation.

The health officials around the city were concerned about the high incidences of coronary heart disease as well as lung-related infections. Cigarette smoking was viewed as the number one cause of these diseases. In respect of the developments, stakeholders kick-started the antismoking campaigns in May last year hoping to reverse the health worries. The Ministry of Health, the Dubai Naturalization and Residency Department, and Nicotinell have all been credited with the antismoking campaigns. The strategies for antismoking campaigns were targeted at all public places, minors under the age of 20 years, eating joints, and marketing strategies used to enforce the ban. Health experts in Dubai intensified the antismoking campaigns in the city owing to its commercial importance as well as its dense population. There were valid concerns about passive smoking and how it affected other people unknowingly in public offices, beaches, restaurants, among other public places.

From May 31, 2007, stakeholders have been involved in implementing the anti-smoking bans in three phases, ending in December 2007. This research aims at evaluating the effectiveness of the antismoking bans by analyzing the core areas and individuals affected by the ban. Of particular concern is to evaluate the effectiveness of the smoking bans in public places, workplaces, health clubs, hair salons, internet cafes, educational establishments, food courts, and the strategies being employed to minors under the age of 20 years to help them out of the problems posed by tobacco use. This study would also evaluate the various marketing strategies used by stakeholders to sell the antismoking campaigns to the population.

Literature review

Introduction

The war against tobacco use has reached a fever pitch in major countries around the world. Governments around the world, from the richest to the poorest have embarked on vigorous anti-smoking campaigns aimed at creating awareness of the dangers brought by tobacco use. Tobacco use has often been blamed for bringing more woes to mankind than the mere feel-good effect that tobacco products purport to offer to users. According to Ahmed (2007), cigarette smoking causes one in every ten deaths among adults, making it the number one preventable cause of death worldwide. According to available figures, tobacco use was responsible for around 5.4 million deaths in 2005 alone. Put another way, tobacco causes the death of one person every six seconds. By 2030, the death rate would have surpassed eight million individuals per year (Kader & Bardsley, 2007). According to the World Health Organization (WHO), tobacco kills half of its users. This, therefore, means that around 650 million of the globe’s 1.3 billion tobacco users would be killed by tobacco. Such shocking statistics have led the world health body to announce the commemoration of the World No Tobacco Day to underline the grievous dangers brought about by tobacco use, especially to the young generation.

It is under this backdrop that countries around the world have embarked on extensive antismoking campaigns to try and reverse the extensive damage that has been occasioned by tobacco use (Sabera, Aljandy, & Za’Za’, 2004). The United Arab Emirates is one of the countries where antismoking campaigns have earnestly taken root. The campaigns are widely perceived as a spontaneous reaction to the many health risks brought about by tobacco use in the country. The number of individuals developing coronary heart disease is on the increase in the UAE. According to Landais (2008), around “1, 381 individuals died of cardiovascular diseases in 2000, a disease that is directly associated with tobacco use.” Apart from cardiovascular diseases, health experts in the country found that cigarette smoking was responsible for almost 80 percent of lung-related infections among adults. Diseases like Emphysema, Peripheral artery disease, and Bronchitis have become more common among smokers in the country. In 2005, health experts also warned that tobacco use was directly responsible for high incidences of osteoporosis, stomach ulcers, and infant deaths reported in the country (Hassan, 2007).

Concerned about such statistics, health officials in conjunction with other stakeholders kick-started major antismoking campaigns in the whole country, and especially in cities that attract millions of visitors annually. Dubai is one such city where the campaigns have indeed being intensified owing to the city’s importance as a tourist and business hub. According to Brown and Kissinger (2007), the Ministry of Health, the Dubai Naturalization and Residency Department, and Nicotinell have all been credited with the antismoking campaigns. The fight against smoking has been intensified across all sectors in Dubai from public offices to private shopping malls. The effectiveness of the campaigns can be measured through a careful analysis of each of the sectors that have been targeted by the antismoking campaigns. The strategies for antismoking campaigns were targeted at all public places, minors under the age of 20 years, eating joints, and marketing strategies used to enforce the ban (Kader, & Bardsley, 2007).

Origins of Dubai smoking problem

As already mentioned elsewhere, Dubai has the double pride of being a commercial as well as a business destination. It is the most densely populated city of the UAE and is one of the seven known emirates. It is located on the Arabian Peninsula, along the southern coast of the Persian Gulf (Hassan, 2007). According to a 2006 Census conducted by the Statistics Centre of Dubai, the total population of Dubai was 1,422,000, with 349,000 being females and 1,073,000 being males (Rahimi, 2007). Due to its dense population and its commercial importance, health experts intensified their antismoking campaigns in the city. This was necessitated by valid concerns about passive smoking and how it affected other people unknowingly in public offices, beaches, restaurants, among other public places. Health officials hoped to communicate the message that smoking was socially unacceptable as it was destroying the lives of city residents.

The May 31 2007 regulations by Dubai health officials, Dubai municipality, and other stakeholders involved agreed to implement smoking bans on schools, colleges, and government buildings as the initial step towards stubbing out smoking around the renowned tourism and trade hub by the end of 2009 (Kader & Bardsley, 2007). The Dubai Municipality had indeed hired the services of renowned celebrities, including artists, singers, and film stars to jumpstart the antismoking ban.

The second phase of the antismoking campaigns was unveiled in September, last year. Subsequently, the third phase, which included a blanket ban on smoking in health clubs, hair salons, internet cafes, educational establishments, food courts, and offices, was effected in November 2007. Cafes, restaurants, and shopping malls were required to designate smoking corners or lounges in their premises that must comply with set prerequisites such as smoke absorbers and proper ventilation (Landais, 2008). According to the smoking bans, people below the age of 20 years were to be denied access to the set smoking lounges. The Dubai municipality was charged with the responsibility of implementing the ban to reduce the high incidences of cigarette-related diseases as well as reduce the number of smokers. Whether the bans have been successful one year down the line remains a matter of evaluation. The best approach to analyze the successes (or failures) would be to analyze the various sectors that were directly affected by the ban. Antismoking campaigns were targeted at minors under the age of 20 years, workplaces, public places, educational facilities, restaurants, and shopping malls.

Minors under 20 years

Available research shows that minors below the age of 20 years are increasingly becoming hooked to the habit of cigarette smoking. According to WHO, tobacco smoking inflicts maximum damage in this age group as their bodies are hardly developed to cope with the effects of numerous chemicals found in tobacco (Kader & Bardsley, 2007). For this reason, Dubai Municipality in conjunction with the relevant government agencies hiked the prices of cigarettes to make them out of reach to this age group. Dr. Wedad Al Maidoor, an official with the Ministry of Health in the Head of Smoking Cessation Committee, argued that “minors were more affected by fluctuations in price of tobacco products and therefore were bound to be affected by the ban.” (Hassan, 2007)

Due to various media campaigns depicting tobacco users as cool and macho, this category of people has been hit hardest by the health risks brought about by cigarette smoking. This age group has been known to follow media advertisements blindly, and therefore bear the brunt of cigarette advertisements (Brown & Kissinger, 2007). This is the initial reason why Dubai health and local government officials resulted in massive advertisement campaigns against cigarette use. They have used television commercials, Radio, posters, and billboards to specifically target minors under 20 years old, and spread the message that tobacco use is no longer a cool idea. Media advertisement campaigns have been known to influence the perceptions and behavior of people on various products. Edgar Watson Howe once remarked that “doing business without advertising is like winking a girl in the dark: you know what you are doing, but nobody else does.” However, cigarette advertising had brought untold suffering to minors under the age of 20 as it directly influences their choice to smoke. One year down the line, has antismoking media campaigns influenced the change of attitudes on tobacco among members of this age group? This can effectively be evaluated through engaging the minors in a discussion about their perception and attitudes towards tobacco use, and how various media campaigns have influenced their stand on tobacco use.

Smoking regulations in public places

The antismoking regulations in malls, salons, restaurants, cinemas and other open places within Dubai were implemented in the second and third phases of the campaign. According to Dubai Municipality, shopping malls were specifically targeted by the antismoking campaigns to enhance public health as well as protect the health of non-smokers, especially the elderly people and children. According to Hassan (2007), smokers value shopping malls and supermarkets as their preferred places to puff away from a cigarette. Many people were being affected in the shopping malls through passive smoking. Initially, those who smoked in the shopping malls were asked to leave but were later subjected to a fine for not observing the smoking ban on shopping malls.

According to Hassan (2007), this strategy has worked effectively well due to the media campaigns it received. As a result, the proportion of individuals subjected to passive smoking has greatly reduced. However, some seasoned smokers have resisted the ban on smoking in shopping malls by lighting them in the malls. Those who resist the ban have been arrested by mall security staff and handed over to Dubai Police or Dubai Municipality inspectors for appropriate prosecution (Rahimi, 2007). According to the laid down procedures, shopping malls were required to set some indoor designated smoking places to serve the needs of smokers.

Workplace smoking regulations

According to WHO, some 200,000 individuals perish every year due to passive smoking at their places of work. Numerous individuals who have never smoked in their lifetimes die of illnesses caused by passive tobacco smoking at their places of work. Going by the WHO statistics, many workers in the Middle East are smokers, with half of the adult males assuming the roles of active smokers (Landais, 2008). This shocking revelation necessitated Dubai health officials to consider employing a blanket ban on cigarette smoking in all public working places. On their conviction, 31 percent of smokers in the Middle East agree to the fact that cigarette smoking causes them to be less productive in their workplaces compared to their workmates. Almost 50 percent of employers agree to that revelation (Hassan, 2007). According to the Global Workplace Survey, a typical smoker uses 8-10 cigarette sticks per day, translating to an average of half an hour in lost manpower per worker on daily basis. When calculated on a yearly scale, one smoking worker loses over 17 days in lost productivity per year. Lost man-hours, coupled with a high number of diseases brought about by passive smoking in the workplace made public workplaces to be included as a target area for the proposed ban (Sabera, AlJandaly, & Za’za’, 2004).

Passive smoking in the workplace has also contributed to the increase of diseases and death brought about by tobacco use. In the United States, passive smoking is said to kill 38,000 non-smokers every year (Brown & Kissinger, 2007). The majority of these people are directly affected while in their places of work. In Dubai, tobacco use had increased the costs incurred by the government in taking care of individuals affected by passive smoke exposure. According to available statistics, the costs of employer liability insurance have increased in working places due to the non-enforcement of smoke-free regulations. To this end, Dubai Municipality sought to introduce smoke-free policies in the workplace as the most effective method of preventing injury from passive smoke. Whether workplace regulations have been effective one year down the line is a matter of evaluation. Critics have argued that workers have continued to smoke in their workplaces unperturbed by the regulations.

Antismoking Marketing strategies

Ever since the smoking bans were implemented, the Dubai Municipal has undertaken numerous advertising campaigns to educate people on the dangers of tobacco use. According to Lee and Johnson (1999), there are various mechanisms for advertising, which include billboards, banners at sporting events, internet websites, and newspapers, logos on clothing, radio spots, magazines, and television commercials. Posters, newspapers, radio, and television were overly used by the Ministry of Health and Local government officials to educate the citizens about the health risks that cigarette smoking posed to them (Hassan, 2007).

Posters depicting the message that tobacco use was no longer considered as cool were hanged in open places to stress the message home. In Dubai, there existed two forms of cigarette advertising; on one hand, were the cigarette manufacturers who advertised in the media for their products to gain the market, and on the other hand, were the antismoking campaigners advertising their message on the health risks involved in tobacco use. According to Sissors, Baron, and Ephron (2002), advertising is viewed as the paid, non-personal promotion of an idea, cause, service, or product by a previously identified sponsor attempting to persuade or inform a particular target audience. One year down the line, have the antismoking campaigns been marketed to cause a tangible change in people’s attitudes and perceptions towards tobacco use? This revelation is a matter of evaluation.

Research problem

This research aims at evaluating the effectiveness of Dubai antismoking campaigns since their introduction in May of 2007. The antismoking enforcement targeted public places, shopping malls, educational institutions, minors under 20 years, salons, and other amenities viewed as public by the law. The objective was to protect the public health of citizens while at the same time making sure that more people quit the habit. Many man-hours were being lost as workers indulged in cigarette smoking at the expense of work, while tobacco-related diseases were killing people by their thousands. One year down the line, has the antismoking bans being necessitated by the Ministry of Health, Dubai Municipality, and other stakeholders borne any fruits in checking tobacco use? This research is therefore aimed at evaluating the effectiveness of Dubai antismoking campaigns in the fight against tobacco use.

Study aims and objectives

This study aims at exploring the successes and failures of Dubai antismoking bans during the one year that they have been in existence. At the same time, the findings generated by this study would be applied in the formulation of effective remedies that could be used to reinforce the smoking bans in their efforts to reduce cigarette smoking. Specific objectives include:

1. The evaluation of the effectiveness of antismoking campaigns in all public places. Such places include public working places, restaurants, shopping malls, schools, and salons.
2. The effectiveness of the various marketing strategies used by stakeholders in enforcing the smoking ban. Various media campaigns were employed to sensitize smokers on the dangers of smoking and the advantages of avoiding the habit. Were the campaigns successful?
3. The effectiveness of the Under 20 campaign against tobacco use. Have the increase in cigarette prices affected the perception and attitudes of the youth towards cigarette smoking? Also, the research intends to evaluate if various marketing and advertising strategies employed by antismoking campaigners have been successful in changing the perceptions and attitudes of this age group.

Justification of the study

According to the World Health Organization (WHO), governments and civil societies must act to prevent a possible scenario where tobacco use would be responsible for a billion deaths every year as this century progress (Kader & Bardsley, 2007). By 2030, tobacco-related illnesses and deaths would reach the eight million mark if antismoking campaigns are not given priority. In the Middle East, half of all adult males are smokers, “with a consumption pace of 2,280 cigarette sticks per individual on an annual basis” (Hassan, 2007). In total, nations under the Gulf Cooperation Council (GCC) were spending more than USD 800 million on an annual basis on tobacco use. This trend had to be reversed using all known mechanisms, smoking bans being one of them. Dubai Health and Municipality officials had to brainstorm and come up with tobacco smoking bans that could be used in the protection and enhancement of public health, and the protection of non-smokers from passive smoking.

Dubai Municipality was mandated with the role of implementing the smoking bans and awareness campaigns beginning May 31, 2007. The first tobacco antismoking phase targeted public places and government establishments. The Second phase targeted educational establishments, health clubs, hair salons, food courts, internet cafes, and other offices. Shopping malls and other amusement centers such as cinemas were targeted in the third phase. All these measures were reinforced by the fact that cigarette smoking was causing a lot of health-related risks, killing some 200,000 individuals on an annual basis due to exposure to tobacco smoke in public places. People were dying in their thousands every year due to illnesses occasioned by passive tobacco smoke (Ahmed, 2007). This trend was worrying and called for the immediate introduction of smoking bans.

This study is justified by the desire to evaluate if the smoking bans have indeed helped reverse the health-related problems occasioned by tobacco smoke. Health is paramount to the survival of individuals. Productivity in the workplace has deteriorated owing to tobacco use. Millions of dollars are going to waste on an annual basis due to cigarette indulgence. Have the relevant stakeholders done enough to ensure that smoking bans would be able to achieve the intended results? This forms the justification of the study.

Research methodology

Research design

This research focuses on the evaluation of the effectiveness of Dubai Antismoking Campaigns. To this end, a qualitative research design is viewed as the most ideal methodology that would assist in the interpretation of the research questionnaires and interviews. Creswell (2008) suggests that the qualitative approach is the most applicable in studies focused on “people’s attitudes, behaviors, value systems, concerns, motivations, aspirations, cultures, and lifestyles”. On the other hand, Lee and Johnson (1999) articulate that quantitative research concentrates on what participants do rather than understanding their actions or views. Therefore, the qualitative approach is the most significant research method that will be effective in acquiring the desirable results. As Creswell (2008) asserts, the qualitative approach can highly be relied upon especially in instances where the views of participants are being considered. In addition, Greenhalgh and Taylor (1997) contend that qualitative research “touch the core of what is going on [the focus of the study] rather than just skimming the surface” as is the case in quantitative research.

Given that no evaluation had been carried within the past one year that the smoking bans had been in operation, the research is intending to evaluate the effects that smoking bans have had on public places, minors under 20, and if indeed the marketing campaigns employed to sell the strategies to people were successful. In this regard, questionnaires and interviews specifically designed to accommodate open-ended questions were viewed as the best tools to use in the data collection process.

Research instruments

Questionnaire

According to Creswell (2008), the best method to minimize the measurement error is to “use a good [research] instrument” (p. 394). Therefore, one of the research instruments used in this study is an open-ended questionnaire. The use of open-ended questions will enable individuals to express their views freely without having any limitations (Cohen, Manion, & Morrison, 2002) based on their “cultural and social experiences” (Creswell, 2008, p. 399). Cohen, Manion, and Morrison (2002, p. 255) furthermore states that “open ended questions can catch the authenticity, richness, depth of response, honesty and candour which is […] the hallmarks of qualitative data”. Therefore, to evaluate the effectiveness of the Dubai antismoking campaign, the most appropriate method of data collection is by using an open-ended questionnaire.

The questionnaire was to be administered personally. According to Creswell (2008), personal administration has the obvious advantage of making the respondent understand the questions and concepts involved. Personal administration also allows a respondent to ask for clarifications. Personal administration also yields the lowest refusal rate among respondents. It also allows for detailed, longer, and more complicated interviews to be undertaken (Lee & Johnson, 1999).

Interview

Using a questionnaire alone may not give the desired results of the study. Therefore, a face-to-face interview will also be conducted to collect data. According to Cohen, Manion, and Morrison (2002), individuals have different significations to the same question given in the questionnaire. It is therefore important to offer an interview to dig deeper into the subject. In addition, an interview is the most appropriate method used to obtain respondents’ beliefs and attitudes, according to Cohen, Manion, and Morrison. According to Knight (2002), face-to-face inquiry presents a possibility to change the direction of the interview by probing to accommodate new comments and insights made by the participants (p. 50).

Data collection

Although the population of the emirate of Dubai was about 1,422,000 by 2006, the study will be concentrated in the central district of Dubai. This is due to travel costs and constraints of time. A more comprehensive study would have shed more light on the effectiveness of the Dubai Antismoking campaigns. Overall, the process of data collection is poised to go on smoothly without major occurrences save for a few logistical problems. One of the logistical problems involved is inadequate respondents. This can sufficiently be dealt with by personal administration of the questionnaire when respondents became available, mostly in the evening.

Data Analysis

Once data is collected, data for the study will be analyzed using various statistical packages to generate frequencies and percentages needed to answer the research objectives. The analysis would be carried on the effectiveness of smoking in public places, especially workplaces, restaurants, shopping malls, and cinema halls. Data on the effectiveness of the various marketing strategies will also be analyzed to give direction about the effectiveness of the smoking bans. Lastly, Data on the restrictions of the “under 20” age group will be analyzed about their effectiveness. Data from these vital areas would then be compared to bring empirical revelations of how successful the antismoking campaigns have been.

References

1. Ahmed, A. (2007). “Celebrities to endorse smoking ban.” Gulf News.
2. Brown, S. & Kissinger, P. (2007). Dubai: Smoking regulation takes effect in malls.
3. Cohen, J.P., Manion, C.W., & Morrison, P.M. (2002). Handbook of Qualitative Research. London, International Educational and professional Publisher.
4. Creswell, J.W. (2008). Marketing Research: Planning, Conducting and Evaluating Quantitative and Qualitative Research. (3^rded). New Jersey, Prenhall.
5. Hassan, A. (2007). Smoking ban in Dubai.
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8. Lee, M., & Johnson, C. (1999). Principles of advertising: a global perspective. Haworth press. Web.
9. Rahimi, S. (2007). “No smoking” areas set up in Dubai malls.
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11. Sabera, M., Aljandy, B., & Za’Za’, B. (2004). “UAE to ban public smoking soon.’ Gulf News.