Armenia’s high rate of poverty – with almost one-third of the country’s 2.97 million people living below the poverty line -- correlates strongly to high rates of smoking, as individuals use tobacco to cope with stress and relieve boredom.
A 2009 Health Systems Performance Assessment conducted by the Armenian Ministry of Health, the World Health Organization and the World Bank estimated that 58 percent of Armenian males 20 years old and over smoke daily, one of the highest rates in Europe. The rate among women, though disputed, is believed to be growing as well.
The practice leaves Armenian adults increasingly at risk for diseases associated with tobacco consumption, including lung cancer, as well as cardiovascular and pulmonary disease. Children, meanwhile, are increasingly vulnerable to sudden infant death syndrome, ear infections and allergies. Over 90 percent of children aged 13 to 15 years old live in houses where they are regularly exposed to second-hand smoke, according to the World Health Organization.
“Our population really underestimates the risk of cardiovascular diseases,” said Dr. Narine Movsisyan, senior program manager of the American University of Armenia’s Center of Health Services Research and Development, and a member of the Coalition for a Tobacco-Free Armenia. “They say they love their children -- that they are the best fathers and mothers -- but the fathers smoke around children and the mothers don't object.”
Without widespread public awareness about the dangers of smoking, the national practice of puffing away at home most likely will not diminish, said Movsisyan, who is researching the number of Armenians who smoke at home. “We've never had mass campaigns on TV, and it's difficult to change public awareness without mass campaigns,” she said.
Meanwhile, the access to supply looks set to increase. Legislation adopted this year lowered the tax-rate gap between international and national brands, a move seen as favoring international tobacco imports. Philip Morris International, which exports nine cigarette brands to Armenia, plans to expand its presence in the country. Company representatives declined to elaborate to EurasiaNet.org about whether lower taxes played a role in corporate decision-making.
Although packaging for both imported and domestic cigarettes carries obligatory health warnings and billboard and television advertisements for cigarettes have been banned, most Armenians are not aware of smoking-related health risks, anti-smoking activists assert. Many also lack an understanding of the country's tobacco control laws.
Six years after its adoption, compliance with a 2005 law that bans smoking in hospitals, cultural and educational institutions and on public transportation remains haphazard. Similar neglect marks the 2006 introduction of separate sections in restaurants and cafes for smokers and non-smokers.
“There are laws, but very few people follow them. That's why we have so many smokers everywhere, including offices, hospitals and schools,” said Tigran Tshorokhyan, head of the environmental protection group Kanachastan, which runs a “Thank You for Not Smoking” campaign in Yerevan with support from the US government and the British non-governmental organization Counterpart International.
City officials who oversee Yerevan’s smoking prohibition policy “freely speak with you about the harmful effects that cigarettes cause people and simultaneously smoke in their offices,” Tshorokhyan alleged.
City Hall spokesperson Shushan Sardanyan noted that smoking is not banned in City Hall. “This is a personal matter, dependent on the individual,” she said.
City cafes, apparently, are another matter. Sardaniyn asserted that café managers have received official notices about the need to respect the rights of both smokers and non-smokers. The city also recently fired several drivers who violated the smoking law, she added.
Explanations for smoking in hospitals are less clear. According to the government’s 2010 Public Health Report, roughly 40 percent of the country’s 13,177 physicians are smokers.
Dr. Alexander Bazarchyan, coordinator of the Ministry of Health’s Tobacco Control Program, says changes in habits will come with the passage of time. Armenia’s anti-smoking regulations went into effect decades after most international anti-smoking laws, Bazarchyan noted.
Movsisyan, the American University of Armenia expert, blames a lack of enforcement. “At the moment, it is possible to enforce [no-smoking rules] only in public transportation and there is no other enforcement mechanism relating to other worksites,” she said.
Tshorokhyan, the anti-smoking activist, alleged that police do not keep statistics about violations of anti-smoking regulations. In September, Kanachastan representatives plan to start visiting Yerevan police stations to monitor the enforcement of anti-smoking laws, he said. Kanachastan, which has an active Facebook presence, also plans to post information about Yerevan's smoke-free businesses. “We hope that at the end of the year, we can have at least a 10-percent increase in the number of smoke-free places,” Tshorokhyan said.
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