Indians have traditionally been cleanliness and hygiene freaks-probably that can justify the concept behind Diwali's Spring Cleaning fervour or the glary warnings from Grandmas not to wear shoes in kitchens. It was a tradition in many households to broom the house twice- once in morning and then yet again in evenings. Heights to it is the concept of mopping the floor with a wet cloth with bare hands. It was the duty of the maid to do it every day without fail. Before you settle in your mind that this post relates to mopping/brooming(not your fault the title and so far my writing suggests this only) I need to clarify (cleaning bug stings me here again with my lingo) that this is about India's status as not so clean country in world scenario. The first thing one gets to see after getting off the airplane or train is FILTH. Why are our roads covered with wrappers, bottles, cow dung or even human dung????? Why our homes are sparkly clean but not our roads that lead to our homes? Why do little children do not care before throwing their Mc Donalds wrappers and Coke cans out of their moving cars on main roads -which is dangerous also considering it might hurt the traffic at the back.

I remember one summer break when two of my very irritating cousins came to stay with us. Dad and mom tagged the morons with me for the night walk and not much to my delight got ice creams for them. They opened it, slurped it like hungry cats and vainly threw the wrappers on the road and not in cane basket which was right next to them. I was so so so annoyed that I asked both of them to pick the wrappers from the road and then throw it in basket. They declined yet again proving their feline nature. I lectured them for next 15 minutes while my parents talked to some other couple nearby. They were just not understanding the concept behind throwing it in the bin. The elder of the two who was in grade 9th then simply told me the MCD sweeper will clean it in the morning. I was shocked to hear it and knew there was no point in filtering some wisdom through the holes in their minds as they were as small as salt and pepper shaker's holes. I picked them up and threw in the bin. What the wrappers not the cousins!!! :D

I have always loved going to India gate and sitting next to the lake and enjoy yet again Ice cream. Families come to India gate to have a nice picnic brunch and share a jolly good time. Wow what a time for family bonding! But hey what about the mess they leave on the grass. Forget the grass-they dump the plastic bottles in the lake there. And how can I forget mentioning the chewing gums in public transport or toilets. Ewwwww the toilets are the worst- the much avoided trip to the public toilet is like a battle the little twitchy nose has to bear and defend itself against the poisonous potions served by the apocalyptic Nebraskians. It is indeed not the nebraskians fault because there was no concept of toilets or flushing in their era! Sorry dear......

Has any one seen the sad state of Dal Lake in Kashmir- its an open garbage. Has anyone seen the Taj Mahal's dirty city locales in Agra? Has anyone seen any any historical monument or temples of Varanasi or Haridwar or Rishikesh clean? Taking a dip near the Ganges is a dirty business- you can see people washing their clothes, rinsing their mouths, women potty training their kids and washing their bums- all in the holy water of Ganges. Here I would like to add that the mosques and gurudwaras and churches are still way cleaner. People enjoy mangoes and bananas and leave the skins for the holy cow maata to chew. The cow maata then blesses us with cakes of her dung right in the middle of the road.

Technically and practically it is quite difficult to clean a country as big as India. But even if a tiny step is taken wouldn't it be a tiny step less for someone to do cleaing of our own waste? Even if we see someone throwing a wrapper on the road a friendly reminder to tell them to throw in the dust bin may help in the long run. I know few people have thick hide (a la my moronic cousins) but still the thought will get in their mind next time whenever they will throw something on the road. We can actually give a really frowning disapproving look to people who spit on the road or enjoyingly paint the sanguine of their lovely Paans drawing a graffiti on the walls? I feel the smallest of the efforts can only help in India and not some big campaigns like- 'Clean Delhi Healthy Delhi' or some others. Such campaigns are like little pictures which flash for few seconds across our brains. But a small lecture or a disapproving frown will effect the iotic brains of the whole filthy nebraskians to behave and realize their presence in the current century. Its important to remind everybody that its not only our house that needs brooming-its our roads, our surroundings and not to forget EVEN OUR BRAINS!

Hey but we need Dr Dolittle to explain the sense to this mighty vain cow! Eh :D

But this time, there had been no call for a shutdown. Only that people had shut everything down to attend a rally of the Gorkha Janmukti Morcha in Siliguri.

Garden sources confirmed that only six of the 70-odd estates in Darjeeling were open today. Tea labourers who attended the meeting are expected to work on Sunday instead.

While there was not a single taxi available, the number of private vehicles plying could be counted on the fingers. Tourist spots like Lloyd Botanic Garden and Dhridham temple were open, but there were few visitors. Instead, most of them had lined up early in the morning for the Darjeeling Himalayan Railway’s famed joy ride to Ghoom and back. Since the demand for the ride was high, the DHR officials attached three bogies to the train, which usually has two compartments. [Inset: (Top) A deserted Chowkbazar and motor stand in Darjeeling. (Suman Tamang)

There were no reports of tourists being stranded in town as most of them had left last evening.

“We had apprised the tourists about the expected situation in Darjeeling today. Only tourists bound for Gangtok stayed back and vehicles from Sikkim had been booked for them. Others had left last evening. However, we had some people who were supposed to check in today but it is unlikely that they will make it this evening,” said Naresh Yonzone, an executive of Hotel Anand Palace.

Tashi Pencho, the proprietor of Hotel Seven Seventeen, echoed him: “Most tourists who were supposed to go today had checked out yesterday.”

To tourists, however, it came as a shock that an entire town could empty out “just to attend a meeting”.

“People are telling me that there is no bandh here but everything is closed. It is amazing that an entire town has emptied just to attend a political meeting,” said Rajeev Mehta, a tourist from Delhi.

While schools and colleges were shut, no business was conducted in banks and other government offices. Attendance in government offices was almost negligible with many employees having applied for a day’s causal leave. [The Telegraph]

Good morning to everyone taking part in No Smoking Day events across the country. This year marks the run up to the 1st of July Smoking Ban in public places. And as a project catering for the disadvantaged in our borough and tackling health ineqaulites, BSTP will be working at the London Muslim Centre between 10:30am and 2:30pm. Hope to see a lot of interested people who want to quit and also hoping to get a lot of women wanting to give up tobacco use today as DR Haque's numbers need to be in by the end of March.

I'm also hoping that Vishnee from No Smoking Day will have a lot of interest from the Asian press as this is something of a bonus to the local community. Recent Channel S referrals have been a good sign of recruits picking up!!! We hope that the PCT see sense in funding all innovative projects :)

This week began with the news of a survey highlighting NHS cuts in Stop Smoking Services across England http://news.bbc.co.uk/1/hi/health/6443271.stm

And a clarification from the Regional Team here suggests thatt the survey is unfounded;

"NHS Stop Smoking Service figures published on 28 February showed the
number of people successfully quit at the 4 week stage with the support of
the NHS Stop Smoking Services was 12% down for the first 6 months of
2006/07 compared to 2005/06. This had recovered from 14% down in the first
quarter of 2006/07. Compared with the first 6 months of 2003/04 the number
of 4 week quits is still some 72% higher.

The same statistical publication reported that total expenditure on NHS
Stop Smoking Services in the first 6 months of 2006/07 was £23.6m. This
compared with £23.2m for the first 6 months of 2005/06 ? an increase of 2%;
and compares with some £14.8m in the first six months of 2003/04 ? an
increase of 60%.

The Department of Health has allocated £56m to the NHS for smoking
cessation services this year ? up from £51m a year ago. These services
remain hugely effective in helping people quit ? for example, between April
2005 and March 2006 nearly 330,000 people remained quit after four weeks.

We have already exceeded our three-year target to help 800,000 people quit
by March 2006, and still more and more people are successfully kicking the
habit. The latest figures published at the end of February show that in
the first 6 months of 2006/07 around 125,000 smokers had quit at 4 weeks
with NHS Support.

We do expect that many people will be using 1 July as a springboard to
quitting, and NHS Stop Smoking Services will be crucial in supporting these
people to quit. PCTs will need to ensure that these services are adequately
resourced to cope with the demand ? but we know that a lot of preparatory
work has already started.

In addition, smoking cessation products such as nicotine replacement
therapy are available on prescription, which are free for more than 80% of
the population.

Overall our tobacco control policies have delivered real reductions in
smoking rates across the population since we published Smoking Kills, the
first ever White Paper on smoking, in 1998. Today, compared with smoking
rates in 1998 there are around 1.6 million fewer smokers. This compared
with a halt in the historical fall in smoking rates in the mid-1990s: and
indeed some evidence in 1996 that smoking rates may have been rising again.

Through our effective action on tackling smoking ? with advertising bans,
stark pack warnings, the highest price cigarettes in the EU, free,
professional services to support smokers to quit, and the forthcoming
smoking legislation on 1 July and increasing the age of sale from 16 to 18
on 1 October, we have a track record of real delivery on reducing the
single biggest cause of ill health and premature death in the country.

Smoking rates today are lower than since records began in England at
24%;and we are on track to deliver our target of 21% or lower adult smoking
rates by 2010."
Hope this helps re your responses locally, Nicky Willis Team Leader - Supporting Smokers to Stop Tobacco Policy Team DOH'

Next is something that we all must be going thru everyday. Moron’s who never dip their light, who always ride in high beam, who use fog lamps as a status symbol rather than its purpose. And those useless ACTIVA lkb’s who have a lighthouse instead of a headlamp. <u assole, the light is for the road so that u can see, its not for blinding my eyes>.  This defect can never be rectified. No one considers another human’s eye balls and their vision as something not to play with. Baah!! Even friends don consider. All of us are full of shit but no fart. Next time ur riding, try not to spit <road’s not some huge tar coated wash basin U fegs!!>, try and avoid high beam. You maybe a super sexy driver and road rash pro, but please understand that if u blind me… Well nothing, ill curse under my breath and carry on..

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We have already been offered an opportunity for expansion before March, which is excellent! Obviously our targets have gone up slightly we now have the extra hours to really focus on work all over Tower Hamlets and not just within the parameters of the Dental Institute!

After March we hope to get stuck in to the new wave Cancer Research UK mouth cancer screening sessions that will run over ten weeks.

The project will be joined by two new workers and we will be working on 'special projects' to enhance recruitment and work in prevention work. So we will be trying to stop people taking up tobacco use as well as helping them to stop.

I have noticed over the last couple of months that the most popular tags and articles seem to be about tobacco whether its halal or haram? And about paan cessation. Hopefully I will try and elaborate a bit more on those topics.

We have recently started working with East London Mosque to target health inequalities and recruit people from a broader BME background and to enable a sustainable stop smoking project upon exit in three months time. The work started on the 11th May with two sessions for recruiting people in to the drop in sessions starting on the 24th May.

Our wonderful Public Health Advisor is responsible for finally being able to penetrate the ranks within the Mosque and pinning down a couple of people to support this new initiative. In our first meeting with the Mosque we had their full support and enthusiasm. They agreed to have an Imam trained in Level Two and enable staff to have access to basic Level One training also. The idea was to allow the the Imam to work shadow our project workers and then at the end of the pilot BSTP and the PCT will pass the project on to the Mosque to run.

We left the meeting with a feeling that the Mosque had another vision to our own and that the PCT already offered them something that could clash with the Imam taking the pilot project on board. There was no clear session or worker identified for female Mosque goers. And finally, my Manager predicted that the Imam would not attend the Level Two training.

Now....to date Dipul and I are supporting the 3 hour drop in sessions at the mosque with our Public Health colleagues. The Imam didn't turn up for the Level Two Training and our sessions have been extended due to high demand. Now high demand due to the 76 people being intrested in the sessions.

We have have also had the advantage of using the CR-UK's 'Open up to Mouth Cancer' screening mobile on the 31st May for WNTD to coincide with the sessions. The day proved to be a success and we have learnt a lot.

Working with the Mosque has been rather difficult at times as there are so many things going on and it is difficult to pin people down. When it comes to the crunch they are very helpful and the facility is very accessible.

I have noticed a pattern emerging with regards to accessing women and it was only over the 4 weeks of working at the mosque and asking questions did it confirm for me where and how to access the ladies.

According to one of three female link workers who share a full time post, women are only at the Mosque during funerals and weekends. So, now how do we approach women who are there for a funeral? Plus working over the weekend does not sound appealing over the next six weeks.

I plan to now raise awareness at the Sunday 11-1pm sessions and direct them towards the Thursday drop in sessions (Inshaallah!)

Smoking: A Social Poison

Muhammad al-Jibaly
Copyright © 1996 by Al-Qur'an was-Sunnah Society of North America
All Rights Reserved.

1. Introduction
   1. Discovery of Tobacco
   2. Smoking among Muslims
2. Definintion
3. Evidence for the Prohibition of Smoking
   1. Harm to the Deen
   2. Harm to the Human Body
   3. Harm to the Mind and Will Power
   4. Harm to the Environment
   5. Harm to the Property
   6. Moral Decadence
   7. Evil Substance
   8. Resembling the People of the Fire
   9. Bad Example
   10. Hostility Toward the Good People
   11. Low Self-esteem
   12. Scholars' Verdict
4. Warnings
5. Treating the Disease of Smoking
6. References
7. Footnotes

Introduction

Discovery Of Tobacco

Tobacco was discovered by the Spanish sailors on the American shores at about 1500 CE (900 AH). Since its discovery, the epidemic of smoking has continued to spread all over the world. In our times, one seldom finds a house not afflicted by it.

As early as the Seventeenth Century, the European countries realized the dangers of smoking and fought against it Laws were ordained in England, Russia, Denmark, Sweden, Austria, and other countries, prohibiting smoking and punishing violators.

Nowadays, the Western countries continue their attempts to protect their peoples from the harms of smoking. They employ media means, ordain laws and regulations, and apply other methods to discourage people from smoking. Because of that, the rate of smokers has declined to a certain degree in those countries.

http://qss.org/articles/smoking.html

On the way home this evening I that a very large venue is opening up on the corner of Mile End and Burdett Road. Where the 'Purple' nightclub used to reside there is now 'Hookah'. With its red sign and clubby feel how does this venue escape the ban?

A quick guide to the smokefree law

The new law is being introduced to protect employees and the public from the harmful effects of secondhand smoke.

Key points are:

• From 1 July 2007 it will be against the law to smoke in virtually all enclosed and substantially enclosed public places and workplaces. See below for definitions.
• Public transport and work vehicles used by more than one person will also need to be smokefree.
• No-smoking signs will have to be displayed in all smokefree premises and vehicles.
• Staff smoking rooms and indoor smoking areas will no longer be allowed, so anyone who wants to smoke will have to go outside.
• Managers of smokefree premises and vehicles will have legal responsibilities to prevent people from smoking.
• If you are uncertain where you can or can't smoke, just look for the no-smoking signs or ask someone in charge.

Penalties and fines for breaking the smokefree law

If you don't comply with the new smokefree law, you will be committing a criminal offence. The fixed penalty notices and maximum fine for each offence are:

• Smoking in smokefree premises or work vehicles: a fixed penalty notice of £50 (reduced to £30 if paid in 15 days) imposed on the person smoking. Or a maximum fine of £200 if prosecuted and convicted by a court.
• Failure to display no-smoking signs: a fixed penalty notice of £200 (reduced to £150 if paid in 15 days) imposed on whoever manages or occupies the smokefree premises or vehicle. Or a maximum fine of £1000 if prosecuted and convicted by a court.
• Failing to prevent smoking in a smokefree place: a maximum fine of £2500 imposed on whoever manages or controls the smokefree premises or vehicle if prosecuted and convicted by a court. There is no fixed penalty notice for this offence.

Local councils will be responsible for enforcing the new law in England.

A telephone line (0800 587 166 7) will also be in operation from 1 July 2007 to enable members of the public to report possible breaches of the law. This information will be passed to local councils to follow-up as appropriate.

Definition of enclosed and substantially enclosed

Premises will be considered 'enclosed' if they have a ceiling or roof and (except for doors, windows or passageways) are wholly enclosed either on a permanent or temporary basis.
Premises will be considered 'substantially enclosed' if they have a ceiling or roof, but have an opening in the walls, which is less than half the total area of the walls. The area of the opening does not include doors, windows or any other fittings that can be opened or shut.

Businesses and organisations should contact their local council if they require further guidance on whether their premises are 'enclosed' or 'substantially enclosed'. (http://www.smokefreeengland.co.uk/what-do-i-do/quick-guide.html)

When Rasheda the Health Advocate invited us along, I was expecting the usual meet and greet and we'll put it in writing scenario. But, what I saw there was something that works and people are prepared to put time and effort in to it. Winning the NHS 'Innovative projects' Award also helps!

We entered the session while everyone had there pulse, blood pressure and blood glucose level checked. While the nurses did their administration and pressure checks, the gentlemen took care of their own blood glucose levels and had them recorded.

The Cardiac Rehab team provide a unique after care program for people with heart bypass operations and get them back on the road to fitness. The group comprised of ten Bangladeshi men of ages between 40 to 70 years. Most of these men had diabetes prior to and after the bypass operations. I was surprised at how young some of the men were who had bypass operations as well as managing diabetes.

As this was a 'phase 3' group the patients had to be supervised. Two Nurses and an Advocate from Cardiac Rehab and a Fitness Instructor from Healthy Lifestyles (possibly funded by the Local Area Partnership, PCT and GLA) were on hand.

After talking Rasheda I found out that 'phase 3' becomes 'phase 4' and patients start using the main gym along with everyone else.

The sessions are good fun and judging by the enthusiasm of the eldest patient there, (who was also the fittest!) moving along to some old Bengali classic tunes and leading a healthy life, the scheme is a success!

The Bangladeshi Stop Tobacco Project has been asked to run a few sessions with the tobacco chewers that attend. And I think it will develop in to an interesting partnership.

The initiative is particularly aimed at chewers of paan [Photo cutline]

People who spit in the street will be forced to clean up or face an £80
fine, police in north London have said.

The clampdown is particularly aimed at chewers of paan, a tobacco
leaf-based mixture, which authorities blame for staining pavements in
central Wembley.

Posters and leaflets are being handed out warning spitting is "unhygienic"
and an "act of anti-social behaviour".

"Paan damages walls and pavements and costs taxpayers thousands of pounds
a year to clean," said Ch Insp Raj Kohli.

Dirty pavements

Paan spittle hotspots are Ealing Road and part of the High Road near St
Johns Road, according to Brent Council.

"This sort of anti-social behaviour has to stop if Wembley wants to
become the iconic landmark of London it has all the potential to be"

Ch Insp Raj Kohli

"Spitting leaves the pavements looking dirty and unpleasant and there has
been quite a lot of local concern, particularly in health terms," said
council officer John McSwan.

"The initiative is particularly aimed at people spitting 'paan' which
leave stains on pavements which are extremely difficult to remove," he
said.

Council officers will join Wembley Central police officers to help
identify spitters and take part in spittle clean-up operations.

Local paan retail outlets have received information packs and advised
about the forthcoming enforcement activity.

Police said those caught spitting, which also includes chewing gum, would
be given the option of cleaning up their spittle or receiving an £80
penalty notice.

"This sort of anti-social behaviour has to stop if Wembley wants to become
the iconic landmark of London it has all the potential to be," said Mr
Kohli.
Full Story

I've added here a some Islamic scholarly responses on tobacco use and whether it is halal or haram.

Is Smoking Permitted? Is it a Munkar?
Answered by Shaykh Faraz Rabbani, SunniPath Academy Teacher

In the Reliance, Sh. Nuh translated a fatwa stating that smoking cigarettes is haram because it is like committing suicide on oneself due to the fact that doctors have come out and said that smoking does kill. What about smoking the Hookah (the smoking device found in most Arab countries)? Is there an opinion on that specifically? The Hookah has been around much longer than cigarettes and some classical scholars may have commented on it. I'm trying to understand if there is a difference between cigarettes and the hookah, either by the tobacco that's being used, or how it works. Is it haram, makruh, etc to use such a device?

Walaikum assalaam,

Smoking is differed upon among scholars, and the ruling for hookahs follows that of smoking. The opinion mentioned in the Reliance is also taken by many major Hanafis in our times and in the past. This is certainly the more precautious opinion, and seems to make sense both socially and individually.

HOWEVER, other great scholars still hold that smoking is disliked and not impermissible. While one may not agree with them, their reasoning is has legal grounding and is certainly not baseless. Among such scholars are major Hanafis of India and Pakistan, who say that the actual act of smoking is disliked (makruh tanzihan) unless grave harm is feared from it in one’s specific case. They are well aware of the medical evidence, and take it into consideration in their ruling. I heard this opinion, for example, from Mufti Mahmoud Usmani (Allah preserve him), whose knowledge, wisdom and understanding where eye-opening.

NOW, one may not follow this opinion, but it opens a difference of opinion in the issue, which means that it is no longer obligatory for us as individuals to forbid the evil if one sees someone smoking, though, given one’s belief and the direction religious caution and worldly considerations point, it would be recommended and praiseworthy to advise such smokers to desist, out of nasiha (advice). Faraz Rabbani.'
Further Scholarly views relating to the Islamic perspective of Tobacco use

 

Excerpts from the Opinions of Muslim Scholars

Concerning the Islamic Ruling on Smoking

http://www.emro.who.int/Publications/HealthEdReligion/Smoking/Excerpts.htm

In the following pages we present a summary of each fatwa, or religious opinion, given by highly esteemed religious scholars in respect of the Islamic ruling on smoking. This section is followed by the full text of each fatwa to enable the reader to follow the reasoning used by the scholars in arriving at these conclusions.

Islamic Ruling on Smoking

It has become abundantly clear that, sooner or later, smoking, in whichever form and by whichever means, causes extensive health and financial damage to smokers. It is also the cause of a variety of diseases. Consequently, and on this evidence alone, smoking would be forbidden and should in no way be practiced by Muslims. Furthermore, the obligation to preserve one’s health and wealth, as well as that of society as a whole, and medical evidence now available on the dangers of smoking, further support this view.

Sheikh Gadul Haq Ali Gadul Haq

Grand Imam of Al-Azhar

Having read the several medical reports on the effects of smoking and the risks it poses to health and to society, I would say that it is absolutely forbidden (haram). Smokers should stop smoking and non- smokers should never take up the habit.

Dr Abdul Galil Shalabi

Member, Islamic Research Academy

The Islamic ruling which one feels most happy about and which would leave our consciences clear is that smoking is haram. It is not wholesome due to its foul taste, bad smell and the serious health risks it causes.

Dr Hamid Jamie,

Former Secretary of Al-Azhar University

Consultant, Islamic Fiqh Encyclopedia, Kuwait

Now that medical experts and specialists have settled this issue, the general ruling on smoking would range from haram to censurable, bordering on haram. The same ruling would apply to trading in tobacco and tobacco products. Those who wish to trade in tobacco products ought to be aware of the consequences of their action.

Professor Zakaria al-Birry

Chairman, Islamic Sharia Department

Faculty of Law, Cairo University

Member, Islamic Research Academy

Member, Al-Azhar Fatwa Committee

Whether smoking is ruled to be haram or censurable, fighting it is certainly supported and approved in Islamic law, because, as a general rule, Muslims are urged to preserve and safeguard all aspects of their physical, mental, spiritual and economic health and well-being.

Sheikh Attia Saqr

Member, Al-Azhar Fatwa Committee

Member, Islamic Research Academy 

Sooner or later, all forms of smoking are bound to cause illness and disease. Most serious of these are heart diseases and cancer of the respiratory system and the urinary tracts. Smoking also involves wasting money. Accordingly, smoking, from the Islamic point of view, is haram, and people should, by virtue of their religious obligations as well as common sense, refrain from it.

Sheikh Mustafa Muhammad al-Hadidi al-Tayr

Member, Islamic Research Academy

Since reliable religious and medical authorities have unanimously judged smoking and drug taking harmful and wasteful to the human body, mind and soul, and that they are an abuse of one’s health and wealth, the Islamic ruling could only be that they are haram. All those who import, trade in or use these substances, whether in small or large quantities, should be liable to the appropriate religious and legal penalties.

Sheikh Abdullah al-Mishad

Member, Islamic Research Academy

Chairman, Al-Azhar Fatwa Committee

Since the damage caused by smoking to human life is so evident, there is no doubt that it is haram.

Dr Ahmad Omar Hashim

Chairman, Hadith Studies Department

Faculty of Theology, Al-Azhar University

Based on available evidence, we can categorically say that smoking is haram, and that it is the duty of all Muslims to fight this harmful and deadly habit.

Dr Al-Husayni Hashim (deceased)

Deputy Rector, Al-Azhar University

In view of the harm caused by tobacco, growing, trading in and smoking of tobacco are judged to be haram. The Prophet PBUH is reported to have said, “Do not harm yourselves or others”. Furthermore, tobacco is unwholesome and God says in the Quran that the Prophet PBUH enjoins upon them that which is good and pure and forbids them that which is unwholesome.

Permanent Committee of Academic Research and Fatwa, Saudi Arabia

Abdul-Aziz bin Baz, Chairman

Abdul-Razzaq Afifi, Vice-President

Abdullah bin Ghadian, Member 

Abdullah bin Qa’oud, Member

http://www.emro.who.int/Publications/HealthEdReligion/Smoking/Excerpts.htm

 

 

 

 

Smoking: A Social Poison

Muhammad al-Jibaly
Copyright © 1996 by Al-Qur’an was-Sunnah Society of North America
All Rights Reserved.

1. Introduction
   1. Discovery of Tobacco
   2. Smoking among Muslims
2. Definintion
3. Evidence for the Prohibition of Smoking
   1. Harm to the Deen
   2. Harm to the Human Body
   3. Harm to the Mind and Will Power
   4. Harm to the Environment
   5. Harm to the Property
   6. Moral Decadence
   7. Evil Substance
   8. Resembling the People of the Fire
   9. Bad Example
   10. Hostility Toward the Good People
   11. Low Self-esteem
   12. Scholars’ Verdict
4. Warnings
5. Treating the Disease of Smoking
6. References
7. Footnotes

According to the 'Mapping BMEG tobacco prevention resources' by Crosier and McNeil in 2003, most projects were short term and an approach was needed to share good practice at national and local level. Some of the projects identified were no longer running because of limited or short term funding. Evidence based work at local level to target BMEG and therefore to back cessation programs was lacking for specific community groups or the evidence base was not being utilised. The report called for regional and local advocates from BMEG groups to work and promote cessation programs in their locality and encouraged upstream activity looking at the points were tobacco is accessed within a community. For example Ethnic minority tobacco use is related to social and economic differences and promoting public health policy specifically with BMEG will improve success rates. So, in 2003 we ran a campaign leading up to No Smoking Day working with local Bengali retailers who were likely to sell paan and tobacco products. 10,000 carrier bags were distributed to 150 retailers in two phases. Before and after surveys of the level of knowledge the retailers had in health and safety and tobacco packaging were surveyed. The bags advertised the project supporting tobacco chewers and raised the knowledge of retailers with regards to selling tobacco and paan materials.

The shops would sell products that were easily accessible to children and paan or betel nut would be stored on the bottom shelves. The tobacco products came with no health messages and sometimes no indication of ingredients. The campaign successfully raised awareness about the importance of packaging and health safety with regards to storage and increased people wanting to give up tobacco use.

High demand should be met with a culturally sensitive approach providing a cessation service; with language support, male and female workers for cultural and religious sensitivities With all this in mind we then find that …'Where there is demand: There should be provision culturally, linguistically accessible and appropriate' West, McNeill & Raw, 2004.

Highlights of the report below,

• nProjects are short term: a strategic approach to share good practice
• nFew previously identified projects still existed
• nLittle needs assessment at local level: who should be targeted by special services?
• nRegional advocates
• nUpstream activity

One of the most important aspects of our pojects success is that the recognition we have got from our Primary Care Trust and the ongoing support that we get is one of our reasons for success.

For Asian men, smoking is second nature and a sign of belonging - but some areas are more committed than others in providing help for them to quit. Tina Bexson reports

Wednesday July 30, 2003
The Guardian

Rufon Uddin is trying to give up smoking - and he is finding it very difficult. One of the biggest obstacles is being out with his friends in Newcastle upon Tyne's West End, where they all live and work. It is tough also because smoking is very much part of being a Bangladeshi man. It is viewed with a strong sense of social acceptance, social bonding and tradition."It's very hard when they are all smoking and you are not - you feel apart, as though you are missing out," Uddin says. "It's also often the only real time when you can smoke properly because once our people get married, we won't smoke at home in front of the wife because she doesn't like it."

Nor can he smoke in front of anyone older than him, because it is customary for Bangladeshis never to smoke in front of elders. "It's a respect thing in Bangladeshi society," Uddin explains. "I don't smoke in front of my parents, even though my father smokes, and they know I smoke. And if I pass a group of lads in their 20s who are smoking, they will hide their cigarettes or put them out until I've gone past, out of respect for me. But I see lots of white people, when they get to 16, smoking in front of their parents, and with their parents even buying cigarettes for them."

He can smoke at work, however. "Ninety-five per cent of us work in an Indian takeaway or restaurant," he says. "And there are many more opportunities to smoke at work than there are for white people, whose day is usually more structured. As long as we go outside, we can have a cigarette whenever we need."

Although Uddin recognises that giving up is ultimately down to the individual, he would like to join a local smoking cessation programme run by Newcastle primary care trust (PCT) to give him a head start. But he feels it is geared towards the white population and fails to acknowledge the different cultural concerns and problems facing smokers from his culture.

This may be considered surprising because, according to a survey by the Department of Health (DoH), smoking is much more common among Bangladeshi men (44%) than among white men (27%). For Bangladeshi men aged 50-74, the rate is as high as 56%. There are serious health consequences. Cardiovascular disease (angina, heart attack, stroke, high blood pressure and diabetes) is 60%-70% higher among Bangladeshi and Pakistani men than among the general population.

Research by the school of population and health sciences at the University of Newcastle upon Tyne, published recently in the British Medical Journal (BMJ), suggests there is a drastic need for culturally-sensitive smoking cessation interventions in Newcastle. Comparable places, such as Bradford, Birmingham and Tower Hamlets in east London, are already running successful interventions, such as campaigns that take place during Ramadam. And since the DoH launched an NHS Asian tobacco education campaign in August 2001, local smoking cessation services run by PCTs are growing in other south Asian communities throughout Britain. So why not in Newcastle?

Judy Loggie, manager of Newcastle and North Tyneside's smoking cessation service (one of the services offered by Newcastle PCT), who has only recently taken up her post, admits that more should be done. "We did have Asian smoking cessation workers working on and off for two years, but it wasn't a programme; it was just how we had responded to Asian needs so far. It's not enough - and we need to do some more."

Martin White, senior lecturer in public health at Newcastle University, conducted the BMJ research. He was struck by "how many white, middle-class professionals within healthcare will view south Asians as a singular population with the idea that they can develop a 'one-size-fits-all' approach to interventions for them".

White adds: "But it's fundamentally wrong. For example, it doesn't make sense that what should work for young male Bangladeshis who work antisocial hours in the restaurant trade should work for elders sitting at home all day. They are almost different cultural groups."

Since it is almost expected for the elders to smoke, Shazan Uddin, a bilingual community health worker and cardiac rehabilitation nurse for the Westgate Heartbeat project in Newcastle, says that it takes a major health crisis for many of them to give up. Many of his clients are elderly south Asians with coronary heart disease and diabetes.

"Usually, they've either had a heart attack or are going to have heart bypass surgery before they give up," Shazan Uddin says. Targeting those who are not suffering any ill-health effects, and who do not want to give up, is very difficult. "They say they've smoked all their life and don't think it's doing them any harm; it helps them relax."

The position is not helped by acute lack of awareness of the serious health risks posed by smoking. Health department figures indicate that only 27% of Pakistanis and Bangladeshis associate smoking with heart disease. Religion has little influence because, despite tobacco being seen as "Haram" (immoral or unclean), it is not specifically banned by the Islamic faith, as is alcohol. Nor do women have much impact. "Their wives do put pressure on them, but they say that they as men are the decision makers in Asian families," says Shazan Uddin.

There has been little information available in Bengali on the damage smoking causes and on how to give up, Shazan Uddin maintains. But leaflets are anyway of limited use, he argues, and any culturally-sensitive smoking cessation programme would have to include structured group sessions.

Jamal Sarwar, 35, was one of the Bangladeshi advisers working for the PCT. Now he works as a community interpreter during the day and in an Indian restaurant in the evening. He is himself a light smoker. "It is absolutely necessary we have a proper smoking cessation programme in place," says Sarwar. "When I was working as a smoking cessation adviser, we found that we needed a central place where clients could go and see a doctor and where they could get advice, nicotine replacement therapy, counselling and join a group. But we did not have that."

White points out that there is the possibility of a tailored programme being seen as intrusive and patronising, "with people preaching to the Asian community". However, he adds: "On the other hand, there are many people in the community who do want to give up."

Sarwar agrees. "They would welcome a Bangladeshi smoking cessation programme," he says. "There is nothing at the moment and leaving it purely up to will power is very hard. If the programme is geared towards my community, then I don't think it can be patronising at all.

"Also, the elders would only be happy on a programme with their own age group and taken by an adviser of their own age group. The same goes for the younger men, who have different pressures and influences, such as Indian films, where the hero is always smoking. Our people need to feel the comfort of their own people."

If he ever joined a smoking cessation programme, Rufon Uddin would want the adviser to understand the pressures of working in an Indian takeaway or restaurant and to know what goes on in his community. "A person from a different culture wouldn't," he says. "But a Bangladeshi man would."

Custom-led cure

The Tower Hamlets primary care trust in east London funds a smoking cessation project serving the Bangladeshi community. It uses bilingual male and female advisers who are aware of the socio-cultural context of tobacco use and the impact this has on the prospects of cessation.

Although smoking is acceptable among Bangladeshi men, among women it is regarded as a taboo and disrespectful. Only 4% of the women smoke, but they do chew tobacco in paan - a mixture of spices and nuts wrapped in a leaf. It is especially popular among those over 55, of whom an estimated 56% chew.

Chewing tobacco is just as harmful as smoking, contributing to heart disease and cancer of the mouth. "But we don't want to take anything away from them - it's traditional within their culture," says tobacco cessation adviser Shamsia Begum. So our message is, 'Enjoy your paan, but leave out the tobacco.'"

Other partners in the project are Queen Mary University of London and a community organisation, Social Action for Health. Ray Croucher, professor of community oral health at Queen Mary and the project's joint manager, says: "We don't wait for people to contact us - we recruit from the community by being present at, for example, a local food co-op."

Once clients have entered the programme, they receive one-to-one counselling, nicotine replacement therapy and weekly advice. "Then we continue to make contact in the community or provide domiciliary visits," says Croucher. "Our success rate is around 62%, compared to the national average of 48%-50%." The approach is "holistic", he adds, sometimes offering guidance on housing and benefits issues.

· The project's 24-hour advice line is on 020-7377 8481.

Based on the part time hours that both of us are working and managing a caseload of 190 people each. Our numbers increased due to increase in referrals from other agencies e.g. GPs, Nurses and other Health Professionals. The PCT also have put a considerable amount of effort in to advertising the services in that last 6 months pushing our referrals up. So on the one hand our outreach community based work has halved, with referrals from the Health Practitioners doubling.

Ah, also before I forget I had an extensive list of clients from our community based contact ‘Majlish Homecare Services’ that are supporting Dr Haque’s Study.

So another successful year and an unusual one lay ahead, the PCTs would have been given there target list for the coming year and no doubt they will negotiate and increase our numbers.

Lets see what happens after the meeting with the PCT next week.

My name is Shamsia Begum and I have been working with this innovative project since 2000. I have been following the developments of grass roots tobacco cessation initiatives helping the Tower Hamlets Bangladeshi community.

The project's approach is culturally sensitive, seeking to provide a tailored local solution to a global problem.

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