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Political will ushers in a new era for tobacco control in Israel

2011; Elsevier BV; Volume: 378; Issue: 9804 Linguagem: Inglês

10.1016/s0140-6736(11)61738-8

1474-547X

L.S. Rosen, Haim Geva, Greg Connolly,

School Health and Nursing Education

A new era for tobacco control in Israel began in May, 2011, with the Israeli Cabinet's approval of a national tobacco control plan.1Siegel J Cabinet approves creation of unit to fight tobacco use. Jerusalem Post.http://www.jpost.com/HealthAndSci-Tech/Health/Article.aspx?id=222712Date: May 30, 2011Google Scholar The plan seeks to lower the stagnant smoking rate (23·3%),2Department of Health Education and PromotionThe Health Minister's report on smoking in Israel 2010. Israel Ministry of Health, Jerusalem2011Google Scholar protect non-smokers from tobacco-smoke exposure, and prevent young people from starting smoking. It is largely legislative, and includes regulation of smoking in public places and enforcement of new and existing regulations, as well as marketing restrictions, tax increases, media campaigns, and additional aid for smokers. Full implementation, which faces an uphill battle, is dependent on Knesset (parliamentary) approval.1Siegel J Cabinet approves creation of unit to fight tobacco use. Jerusalem Post.http://www.jpost.com/HealthAndSci-Tech/Health/Article.aspx?id=222712Date: May 30, 2011Google Scholar Before the Cabinet decision, various Ministries, as well as health maintenance organisations and non-governmental organisations, had made efforts to reduce tobacco use and exposure. The Gillon Commission, appointed by the Ministry of Health more than a decade ago, was tasked with reducing damage from smoking, but did not complete its work.3Segev A Tobacco companies under siege.Ha'aretz. Feb 25, 2000; (accessed June 9, 2011).http://lists.essential.org/pipermail/intl-tobacco/2000q1/000068.htmlGoogle Scholar In 2005, a tobacco control subcommittee was established in the context of the Ministry of Health's Healthy Israel 2020 initiative; the subcommittee set goals and objectives, and produced a comprehensive plan for tobacco control.4Rosen L Rosenberg E McKee M et al.A framework for developing an evidence-based, comprehensive tobacco control program.Health Res Policy Syst. 2010; 8: 17Crossref PubMed Scopus (19) Google Scholar Some of the recommendations were implemented on an ad-hoc basis—eg, cessation medications were added to the subsidised national basket of services. However, no central body existed to systematically implement the recommendations, and no earmarked funding was available. A new Deputy Minister of Health and Director General of Health were appointed after the previous national elections. The two appointed a Public Committee to Reduce Harm from Tobacco. The objective was to complete the work of the Gillon Commission, and develop an implementable plan for tobacco control based on the 2020 recommendations.4Rosen L Rosenberg E McKee M et al.A framework for developing an evidence-based, comprehensive tobacco control program.Health Res Policy Syst. 2010; 8: 17Crossref PubMed Scopus (19) Google Scholar The completed plan was approved by the Cabinet on May 29, 2011. Why was this plan approved now? Part of the answer might be found in Julius Richmond's model, which posits that effective prevention policy is a function of three factors: a knowledge base, a social strategy, and political will.5Richmond J Fein R The health care mess: how we got into it, and what it will take to get us out. Harvard University Press, Cambridge, MA2007Google Scholar Until this year, knowledge (about local conditions and evidence-based means to reduce tobacco use) and a social strategy (from the Healthy Israel 2020 initiative) were present, but political will was missing. With the introduction of political will, which emerged after a change of government, all three necessary factors were in place to pursue tobacco control aggressively. The vote signalled a historic moment in tobacco control in Israel; hopefully, the Israeli landscape will soon become smoke-free. We declare that we have no conflicts of interest.