CAIRO: An Egyptian court deemed the photograph of a limp cigarette that was placed on cigarette packs to be “inappropriate,” ruling that the Ministry of Health stop using it in its anti-smoking campaign. The limp cigarette comes with a statement warning that “long-term smoking has an effect on marital relations.” This warning's message is implicitly similar to the version used in the European Union, in which a photograph displays an unsatisfied couple in bed accompanied by the far-from-subtle statement that smoking “causes impotence.” Although the implicit message was delivered in a much coyer manner in Egypt, it still shocked many Egyptians and managed to stir a lot of controversy. “This was not the first graphic message to illustrate the dangers of smoking on cigarette packs in Egyptian markets, but this photo stirred debate,” said Nagwan El-Laithy, a media consultant for the Ministry of Health's Department of Smoking Control. “No obscenity or erotic nuances were intended, and we did not expect people to find it offensive or inappropriate.” El-Laithy explained the rationale behind choosing this picture, stating that the issue of fertility is very important to Egyptians, emphasizing that linking potential infertility to tobacco would make an impact. “We do not expect smokers to quit immediately after seeing the photo,” she said. “But at least it will leave them pondering.” She added that the warning graphics on cigarette packs change every six months, and that use of the limp cigarette photo was already discontinued before the court made its ruling. While expressing respect and compliance with the court's decision, Fatimah El-Awa, the regional advisor on tobacco control at the World Health Organization, stated that a strong shock to the culture might be required in order to deflate the machismo of smoking. Despite the Ministry of Health's efforts, however, cigarette sales did not change, according to Samir El Abed, a sales services employee for the Eastern Company for Tobacco — Egypt's leading cigarette manufacturer. “The photos were repulsive but not effective,” El Abed stated. “Our sales were steady and we did not witness any change that is worth mentioning. What happened was that people saw the photos and either hid them or bought [a separate] carton box to [carry] their cigarettes.” El Abed added that the campaign resulted, primarily, in a surge in the production of spare cigarette cartons. Even amateurs began producing their own cigarette boxes manually and sold them in kiosks, according to El Abed. “Smoking is innate in the culture of Egyptians, [which makes] it really hard to get them to quit by [using] a photo,” Hussein El-Sayed, a taxi driver, said while puffing smoke out of his car window. “If they put a coffin for me in the cigarette box, I would not quit.” Maha Mounir, the director of program execution for the Ministry of Health's Department of Smoking Control, said that although the final results might not have shown any significant changes in smoker's behavior, the campaign of the graphic images on the cigarette packs did indeed have an effect on smokers. She explained that test group results showed that 42 percent of smokers were affected by the image but did not think about quitting, while 44.6 percent indeed considered quitting after viewing the image. “We can never get a smoker to quit smoking by a mere photo,” Mounir said. “However, the fact that we [planted] a seed in [the smoker's] mind might help him reduce — or eventually quit — smoking in the future.” Many were confused by the fact that impotence and tobacco were related, while others were concerned about exposing women to “direct sexual allusions.” Others expressed concern that spreading such information might alter women's perceptions of men who smoke. Recent studies showed that 25–30 percent of Egyptian men suffer from impotence. The study, conducted by Al-Qasr Al-Aini Teaching Hospital, identified the pesticides used in food, the city's pollution, and the significantly high smoking rates as potential factors that caused impotency of the men studied. Egypt currently has the highest cigarette consumption rate in the Arab region. “The ministry respects the court ruling,” Mounir said. “Had the picture been in use, we would have complied with the court's decision and removed it. We will be keeping … cultural sensitivity [in mind] when choosing graphics from now on.”
