Breaking the habit: Tobacco control & behavioral solutions can save lives in Jordan

What can we do to help prevent and stop smoking? This is one of the most frequently asked questions in Jordan, a country where more than 6 out of 10 men (and 41% of the overall adult population) are smokers. Jordan has one of highest smoking rates in the world and the highest in the Middle East and North Africa (MENA) region. Alarmingly, 24% of students aged between 13 and 15 are current smokers, a trend that may worsen with the increasing use of e-cigarettes and other vaping devices popular among youth.

Tobacco use is associated with approximately 1 in 8 deaths in Jordan and costs the country an estimated US$2.67 billion in healthcare expenditures and lost productivity.

In Jordan, half of current smokers tried to stop smoking in the last 12 months, and 50% of adults noticed anti- smoking information on TV and radio. But knowledge of smoking risks has not led to lasting behavior change. Therefore, we need more evidence-based solutions that consider the various factors that shape smoking behavior. The Jordanian Minister of Health, Professor Dr. Firas Al-Hawari, highlighted the importance of a productive partnership with the World Bank and cooperation in implementing joint training programs to build the professionals' capacities and promote the adoption of digital solutions and communication principles for behavioral and social change, to raise public awareness about the dangers of smoking. Digital solutions have become a necessity in public health, especially in activities targeting behavior change among young people to encourage them to quit smoking and raise awareness of the importance of adopting a healthy lifestyle.

As a step towards such evidence-based solutions, Jordan's Ministry of Health and the World Bank jointly held a capacity building workshop for representatives from the Government of Jordan, international organizations, and local universities and NGOs to teach participants tools to implement behaviorally informed projects to support tobacco control efforts with insights from behavioral science.

The workshop presented an opportunity to co-create innovative intervention ideas, including use of digital technology like chatbots and social listening, to make life without tobacco in Jordan easier and more rewarding. Participants directly engaged with young people who are actively trying to quit smoking and clinicians offering tobacco cessation services to form solutions. Some of these solutions use successful role models to help address the fear of failure when quitting, and link being an athlete with anti-smoking attitudes to influence the youth.

So, what else can we do to help prevent and stop smoking? Jordan has several untapped opportunities to strengthen tobacco control. Elsewhere, behaviorally informed interventions like highlighting stories from peers and supporting cessation with motivational text messaging have seen success in fostering healthy lifestyles and reducing tobacco use. Such successes can ultimately lead to lower rates of disease and premature death, improved air quality, and healthier economies.

Critically, the poorest people in Jordan are among those most impacted by tobacco use in the country and have the most to gain from progress on this issue. While reducing tobacco use is far from easy, strong multi-sectoral commitment coupled with evidence-based solutions holds great potential to transform Jordan from a cautionary tale to a success story-and the cost of the status quo, especially for the poor, is too great to fail to act.

Acknowledgements: The team would like to thank the workshop instructors, Saud Alrakhayes, Mohamad Chatila, and Nour Nasr for their role in leading the capacity building activities. The work, led by the Mind, Behavior, and Development (eMBeD) unit of the Poverty and Equity Global Practice (GP) and the Health, Nutrition and Population GP's unit in the Middle East and North Africa Region, is supported by the Advancing Health Online (AHO) initiative, a fiscally sponsored project of Global Impact and funded by Meta and MSD to advance public understanding of how social media and behavioral sciences can be leveraged to improve the health of communities around the world, and was financed under the Japan Policy and Human Resources Development Fund.