TOBACCO CESSATION ACTION PLAN: (2015-2016)
Introduction
Smoking is a key public health issue and the single biggest avoidable cause of disease and early death in Qatar. The World Health Organisation (WHO)
has identified tobacco smoking as the primary cause of premature illness and death in developed countries. Tobacco smoking causes serious harm to
the health of smokers and to non-smokers who are exposed to second-hand smoke. It is an important risk factor for coronary heart disease, stroke,
respiratory diseases, many cancers, and is often a cause in fire related deaths.
Tobacco smoking continues to be among the main preventable causes of ill health and premature death in Qatar. Exposure to environmental tobacco
smoke is a major risk factor, particularly for children and young people, contributing to conditions such as sudden infant death syndrome and respiratory
childhood diseases. Smoking in pregnancy is linked to spontaneous abortion, preterm birth, low birth weight and stillbirth.
This Action Plan has been developed to help tackle these challenges.
Purpose of the Action Plan
Under the National Health Strategy 2011-2016 a project was established to reduce tobacco use: NHS Project 3.3. A fundamental part of the project was
to develop and publish an action plan for reducing tobacco consumption.
This 2-year plan (full details at Annex 1) sets out a range of actions for the health sector and its partners to take to tackle tobacco use. In doing so it
provides a direction for tobacco cessation activity and policy in Qatar that allows partners to identify and prioritise work both now and in the future. The
strategy is in pilot some of the tobacco control interventions in Qatar so as to guide the planning after 2016.
The Action Plan draws on WHO MPOWER themes and aims to:
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Strengthen Prevention (aimed mainly at children and young people);
Improve Cessation (aimed at supporting those who smoke to quit); and,
Increase smoke-free Environments (aimed at supporting those who are exposed to second-hand smoke).
To achieve this the actions have been grouped as follows:
1 | P a g e 
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Capacity Building
Education, training, communication and public awareness;
Cessation Services
Research, Monitoring and Evaluation;
Effective implementation of Legislation and Enforcement;
Product Regulation; and;
Governance and Advocacy.
The actions have been developed to build on existing work and to provide a foundation on which further actions can be identified. Taking action as set
out in this Plan will to help Qatar make further progress against the six components of the World Health Organisation (WHO) Framework Convention on
Tobacco Control (FCTC). The actions can be mapped against both the components of the FCTC and the WHO MPOWER measures (see Annex 3).
This Plan was developed through intensive deliberation with the Tobacco Control Taskforce and a wide range of different partners (more details at Annex
2) representing:
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Government;
Charities; and,
Academic bodies.
In finalising the Plan SCH was also pleased to be able to draw on the support of Dr. Judith Mackay the well-known expert in tobacco control globally.
In order to deliver the Action Plan the SCH will work with others to develop a detailed delivery plan, monitor implementation and act where barriers to
delivery arise. Key Performance Indicators have been identified that will help to assess the impact of the Action Plan – See “KPI and Measures” section
below.
We will review the Action Plan every six months and also consider how it can be integrated with the Public Health Strategy for Qatar that is being
developed.
2 | P a g e Tobacco use in Qatar
According to the Global Adult Tobacco Survey (2013), in Qatar households,
currently 12.6% of the overall adult household population residing in Qatar
(10.9% Qatari and 13.5% Non-Qatari) are using tobacco in any form (smoked
or smokeless). Nearly similar levels of tobacco use was reported by both
Qatari and Non-Qatari men (22.0% and 20.7% respectively. Tobacco use
among women was 4.7% among Non-Qatari compared to 0.6% among Qatari.
Overall 51 thousand (representing12.1%) of adults 15 years and above
currently smoked tobacco, (men 20% and women 3.1%). 21.3% of the adult
Qatari males and 0.6% of the adult Qatari females compared to 19.6% for men
and 4.6% for women among non-Qatari population. Approximately, 17.9% of
men and 1.8% of women were current cigarette smokers. The prevalence of
current cigarette smoking among Qatari was 9% (men 18.5% and women
0.3%), compared to 10.9% among Non-Qatari (men 17.6% and women 2.7%).
The prevalence of smokeless tobacco use among Qatari men was 1.5% compared to 1.3% among Non-Qatari men. In common with other Gulf States,
shisha has emerged as a particular problem.
Though the overall prevalence of smoking is low with a very low female prevalence rate, but it is going to be a problem in the near future, as according
to the Global Youth Tobacco Survey (2013), currently among those who are 13-15 years, 15.7% currently used any tobacco products (22.8% of boys, and
8.8% of girls), 12.3% currently smoked tobacco. 9.8% currently smoked cigarettes and 6.1% currently used smokeless tobacco. Moreover, there is a big
increase from 2007 as seen by the graph.
Tobacco Control efforts in Qatar
The WHO FCTC is the first treaty negotiated under the auspices of WHO. The FCTC is an evidence-based treaty that reaffirms the right of all people to
the highest standard of health. The FCTC represents a paradigm shift in developing a regulatory strategy to address addictive substances. In contrast
to previous drug control treaties, the FCTC asserts the importance of demand reduction strategies as well as supply issues. Qatar was the first country
in the WHO Eastern Mediterranean Regional Office area to ratify the FCTC (in 2003) and is fully committed to delivering the FCTC commitments.
3 | P a g e The anti-tobacco legislation of Qatar, Act No 20 of 2002 includes:
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bans tobacco advertisement in all media forms;
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prohibits the import or use of cigarette vending machines;
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forbids smoking in enclosed public places such as means of transportation, schools, hospitals, government institutions, and restaurants; and,

Prohibits sale of tobacco products within 500m of educational institutions and sale of cigarettes to children under 18 years of age.
Those who violate this law are liable to a fine of QR100 up to a maximum of QR5000, and a jail sentence of up to six months.
2% of tobacco taxes is also allocated to the SCH budget for tobacco control activities. As part of other tobacco control efforts in Qatar, a 150% import
duty is levied on tobacco.
The first quit-smoking clinic was established in 2001 in Hamad Medical Corporation and it offers services such as counselling and drug therapy for tobacco
users who wish to quit. Currently PHCC also provides this service with a plan of opening five further clinics soon. The Non-Communicable Disease Control
Unit of the SCH is responsible for tobacco cessation policy, raising awareness of the harms of tobacco use, distribution of educational material related
to tobacco use, inspection & the law enforcement, implementation of the FCTC plus other tobacco control interventions.
In 2011, as part of the National Health Strategy for Qatar, a comprehensive project was established to reduce tobacco consumption, including shisha
and smokeless products: NHS Project 3.3 Tobacco Cessation. The project aims to reduce tobacco consumption by 3%, through various interventions
mainly focussing on enhancing tobacco awareness and cessation support services that deal with all tobacco products and raising awareness of quit
services through other health initiatives e.g. school health, health at work places.
Moreover, the SCH is also strengthening policies to reduce tobacco consumption, for example by reviewing the law 2002 to adopt the FCTC guidelines,
increase in taxation on tobacco products and the use of funds to support health initiatives, pictorial warnings, restriction of shisha consumption in tourist
areas and enhanced enforcement of tobacco laws.
4 | P a g e Key Performance indicators and Measures
Ultimately delivery of the actions in this Plan are is intended to result in visible changes and improvements. We will therefore monitor the following key
performance indicators (KPIs) and measures:
 KPIs:
By the end of the two years the evaluation of this action plan will be based on:
a. Percent of increase in institutions providing tobacco cessation services
b. Percent of increase in people utilize tobacco cessation services
c. Percent of reports published with minimum data set of tobacco control
d. Percent of increase in violations visits ratio
5 | P a g e Annex 1
Tobacco Cessation Action Plan
Theme
Capacity
Building
Education,
communication,
training
and
Main Action
Develop the skills and capacity of
health policy and strategy makers
to enhance their tobacco control
policy, strategy and planning skills.
Timing
December
2016
Strengthen human resource and
infrastructure for tobacco control
in
the
Non-Communicable
Disease section in the Supreme
Council of Health including
recruiting to a Tobacco Control
post, media/social media post
and reviewing the terms of
reference for the Tobacco Control
Unit
Training of health care staff e.g.
doctors, nurses, pharmacists,
dentists in PHCC, HMC and
private sector on counseling and
care for tobacco users to improve
basic skills
Training of school social workers,
counselors and nurses to deliver
delay initiation technique and
tobacco cessation skills
Develop and implement a
comprehensive communications
plan to:
by
October
2016
_
_
_
_
_
By December
2015
_
_
_
By December
2015
by December
2016
_
_
_
_
Key Product or Deliverable
Key health policy and strategy
makers are identified and have
attended development program
Lead
SCH
Stakeholders
HMC,
PHCC,
MoM&UP, Qatar
Red Crescent, Civil
Society, QP, QF
Academia
Revised Terms of Reference for
the Tobacco Control Unit agreed
Staffing Plan
Job descriptions
Posts filled
SCH
Agree target audience
Training
plan
and
materials
Courses delivered
SCH
HMC, PHCC, QP,
QF,
Private
providers
SCH/
SEC
PHCC, HMC, QP,
QF
Private
providers
SCH
PHCC, HMC, QRC,
QP, QF,
World
Lung Foundation,
MoT, Malls & Hotels
course
Agree target audience
Training
plan
and
course
materials
Courses delivered
Media and Communications Plan
Process Indictors
a.
Number of people
trained
b. Quality of training
based on % increase
pre- and post-test
scores, and rating of
courses
by
attendees
c.
Quality of materials
developed
a.
Number
of
messages delivered
6 | P a g e public
awareness

raise awareness of and
propagate tobacco related
health policies and guidelines;
 Raise public and business
awareness
of
the
new
requirements of the new
tobacco law when it is passed.
 Provide
annual,
ongoing
public-focused
media
campaign about tobacco
consumption issues e.g. delay
initiation, cessation, secondhand smoking etc.
 promote tobacco cessation
services
through
regular
health education and social
marketing campaigns
 Develop & implement creative
initiatives to promote tobacco
free culture e.g. smoke free
entrance…etc.
Raise awareness and build support
of local media to promote tobacco
cessation and control issues.
_
First campaign delivered
_
First campaign delivered
_
First campaign delivered
_
Initiative implemented
_
Key
local
media
contacts
identified and have attended
training session
through
channel
by March 2016
b. Number of materials
developed
and
distributed
ongoing
ongoing
each
c.
Percentage
of
audience able to
Recall of messages
after 6 months
a.
Number of people
trained
by March 2016
by
2016
January
SCH
Media
b. Quality of training
based on % increase
pre- and post-test
scores, and rating of
courses
by
attendees
c.
Number & Quality of
Media
materials
developed based on
the training
7 | P a g e Cessation
Services
Research,
Monitoring and
Evaluation
Effective
Implementation
of Legislation
_
Develop and agree a standard
national model of cessation
services for different settings
(public/
private/
community
levels).
By November
2016
SCH
HMC, PHCC, QP,
QF, QRC, private
hospitals & clinics
Number of guidelines
developed
Number of calls received
by the toll free line
Establish a national toll-free quit
line and national website.
By November
2016
_
_
_
SCH
HMC, PHCC, Qatar
Red Crescent, NHIS
SCH
PHCC,
HMC,
Universities, Qatar
Foundation,
_
_
Develop
monitoring
and
evaluation
framework,
and
research plan
Undertake first data collection
Issue first annual report
Number of login in the
website and time spent
on website, materials
downloaded
Number of monthly
reports
published
combing
information
from PHCC, HMC & SCH
Develop and implement unified
national
tobacco
control
monitoring & evaluation system
that includes:_ Regular
surveillance
incorporating the GTSS and
reflecting
the
FCTC
indicators_ Routine information from
PHCC, HMC & SCH with a
minimum data set
Develop and
implement a
research program into priority
areas of tobacco cessation
activities in Qatar, effectiveness of
tobacco control policy and the
behavior of the tobacco industry
Review
what
policies
and
guidelines exist and are required
to implement existing tobacco
control legislation and the WHO
Framework
Convention
on
Tobacco Control effectively
by December
2016
_
by December
2016
_
_
Identify priority areas
Commission new research
SCH
PHCC,
HMC,
Universities, Qatar
Foundation,
Number of research
projects commissioned
by April 2016
_
Report on existing policies and
guidelines and how effectively
they are implemented, gaps
identified and recommendations
for new policies and procedures
and how they should be
implemented effectively
SCH
PHCC, MoT, MoTC,
Customs,
MoF,
MoJ,
MOI,
MoM&UP
Number of
available
legislation
_
_
Collect existing standards and
protocols
Review existing standards and
protocols including effectiveness
Develop and agree standard
guidelines
Scope of Work
Tender issued
Service operational
currently
policies/
8 | P a g e Enforcement
Develop and implement a
comprehensive plan to further
improve tobacco control law
enforcement
by April 2016
_
by December
2016
_
by April 2016
_
By April 2016
by Sept 2016
_
Product
Regulation
_
_
_
Develop, implement and promote
a special complaint-driven system
for the public to allow them to
easily report violations of tobacco
control laws
by September
2016
Review the licensing, testing and
disclosure system for the contents
and emissions of all tobacco
products
Work with the GCC Tobacco
Committee to explore increasing
the size of warnings on packets
and
plain
packaging,
and
extending these to all tobacco
products
by September
2016
_
by December
2016
_
_
Report on review of current
legislation
enforcement
protocols.
Priority policies, MoUs and
protocols
developed
and
published.
A national plan for capacity
building and awareness raising
for law enforcement personnel in
different settings e.g. inspectors,
public prosecution staff, customs
staff, consumers protection
Monitoring and Evaluation Plan
including report templates, data
sets, KPIs.
First report
Review existing systems
Scope of reporting agreed (e.g.
which violations) and protocols in
place for reporting
Communications plan including
plans to feedback on number of
reports, success rates etc to
public
Report with recommendations for
change and improvement
SCH
PHCC, MoT, MoTC,
Customs,
MoF,
MoM&UP,
MoJ,
State Prosecutors
Office, International
Tobacco
Control
(ITC),
consumers
protection
Number of newly
developed policies/
legalisation
b. Number of fines
imposed
by
inspectors
c. Number of sites
visited
by
the
inspectors
SCH
PHCC, Ministry of
Trade,
Customs,
MoF, MoJ, State
Prosecutors Office,
Municipality
Number of complaints
reported through the
complaint-driven system
SCH
Qatar
Standards
and
Metrology,
WHO EMRO
‐
Report on potential to increase
size of warnings and introduce
plain packaging
SCH
GCC
Tobacco
Committee, WHO
EMRO
a.
Quality
improvement
9 | P a g e Work with the relevant bodies on
the potential to ban advertising
and promotion of tobacco
products (TAPS) from the internet
Governance
Advocacy
This action plan will be reviewed
with key stakeholders every 6
months as it is going to be a pilot
plan
Develop and conduct an advocacy
campaign targeting non-health
Govt. bodies which have an impact
on tobacco use and control to
raise
awareness
of
their
responsibilities and impact of their
policies, increase awareness of the
impact tobacco use has (health,
economy) and to generate
support for cross-sector tobacco
control
interventions.
For
example: materials, workshop,
meetings etc.
SCH will work with sporting and
related organizations to explore
opportunities to secure smoke
free (non-smoking venues, no
tobacco sponsorship, promotion
or advertising, health education
messages) sporting and other
mega-events e.g. 2019 World
Athletic championships, 2022
World Cup
by December
2016
by December
2016
_
Report on potential to ban
advertising and promotion of
tobacco products from the
internet
SCH
Qatar ICT,
EMRO
_
A
Review
report
recommendations
with
SCH
PHCC, HMC, MoF
_
Key stakeholders identified and
mapped
Engagement Plan developed
with key messages
Evidence Pack developed
Initial meetings held
SCH
PHCC,
MoT,
MoM&UP,
Customs,
MoF,
MoJ,
State
Prosecutors Office,
SCDL, MoI, SEC,
QOC, MoYS, MoIA
Qatar
Standards
and Metrology
Prepare
evidence
based
advocacy package with similar
cases
Initial discussions with key
stakeholders to explore scope
Plan for developing an approach
to smoke-free large and sporting
events in Qatar
SCH
QOC,
Supreme
Council for Legacy
and Delivery, QFF,
IAAF, WHO EMRO,
MoYS, Katara, MIA
_
_
_
by November
2016
_
_
_
WHO
‐
Number of relevant
bodies
identified
and approached
‐
Number of monthly
reports produced
‐ % of 6 monthly
progress
a. Number of Key
stakeholders
identified
and
mapped
b. Number
of
developed
key
messages
c. Number of Evidence
Pack developed
a.
Number
of
Government
Departments met
b. Numbers
of
partnerships/ MoUs
signed
c. Numbers
of
institutions showed
commitment
to
tobacco ban
10 | P a g e Acronyms:
PHCC – Primary Health Care Corporation
SCDL - Supreme Council for Legacy and
QF – Qatar Foundation
MoT – Ministry of Transport
Delivery
IAAF – International Association of
MoM&UP – Ministry of Municipality and
MoI – Ministry of the Interior
Athletics Federations
Urban Planning
SEC – Supreme Education Council
WHO EMRO – World Health Organization
MoF – Ministry of Finance
QOC – Qatar Olympics Committee
Eastern Mediterranean Regional Office
MoJ – Ministry of Justice
MoYS – Ministry of Youth and Sports
MIA - Museum of Islamic Art
MoIA – Ministry of Islamic Affairs
NHIS – National Health Insurance Scheme
11 | P a g e Annex 2
Stakeholders engaged in the development of the Action Plan:
Supreme Council of Health
Hamad Medical Corporation
Primary Health Care Corporation
Ministry of Interior
Ministry of Finance
Qatar Cancer Association
Qatar Tourism Authority
Awqaf
RAF
Qatar Red Crescent
Qatar University
Weil Cornell Medical College.
12 | P a g e Annex 3
MPOWER
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Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about the dangers of tobacco
Enforce bans on tobacco advertising, promotion and sponsorship
Raise taxes on tobacco
Governing Themes:
 Prevent initiation of smoking: Evidence is building that earlier prevention and intervention has the greatest impact on improving health and
reducing health inequalities (Education).
 Encourage and support smokers to quit: This is enormous potential to assist in helping the smokers to stop. Whilst the vast majority of smokers
quit smoking without accessing support services, evidence based, flexible and responsive cessation services should be available for those that
chose to access them. The success of a quit attempt has also been shown to improve with the use of pharmacological aids and a behaviour
support programme.
This mainly covers (Offering help & Monitor):
a. An effective, evidence based behavioural support programme offering choice and access to smokers who want to stop smoking.
b. Standardised information on the range of nicotine replacement pharmacological aids available, which includes brief information on the
use of products.
c. Ongoing support where required and relapse prevention.
d. Training to healthcare and community workers, to increase intervention for smoking cessation at every opportunity to encourage contacts
into the service.
e. Public health intelligence on smoking cessation.
 Maintain tobacco control and smoking ban, regulation and enforcement and promote smoke free environment (Protect, Enforce& Warn): Smoking
policies should support both prevention and stop smoking activities and should apply to everyone using the premises.
13 | P a g e