Iraq: an important start in the Kurdish region.

In a time of great difficulty in Iraq, during which most coverage of it in the world's media is dominated by security issues, it is easy not to realise that wherever possible, at least in the more secure areas, Iraqi people are trying to get on with their lives and work. For public health officials, this includes the formidable challenge of tobacco control which, due to the virtual absence of activity by the former regime, effectively means starting from scratch. The Kurdish region, regarded as the most secure part of the country, has been a federal state within Iraq since October 2005. Five and a half million people live there, some 80% of them ethnic Kurds and 15% Arabs, a direct reversal of the proportions of ethnic groups for Iraq as a whole. Life expectancy at birth is 61.4 years for men and 64.9 for women; among the top five causes of mortality and morbidity are cardiovascular disease, cancer, respiratory disease, and hyperten-sion, with smoking, unsurprisingly, a significant factor. Current laws include a ban on smoking in all government buildings, but it is widely disregarded and smoking can be seen everywhere, from hospitals and health clinics to schools and administrative office buildings. Although tobacco advertising is banned on television and in mass media, most people have satellite televisions with access to channels from every country in the region, many of them still carrying tobacco advertising, emphasising the urgent need for regional collaboration. Meanwhile, there are still plenty of highly visible tobacco advertisements on billboards, especially giant ones beside main roads and in downtown areas of the cities, as well as in shops and tobacco vendors' stands. Even among the relatively low earning mass of the population, smoking is easily affordable. While a pack of Marlboro Lights is around US$2, much cheaper brands are the popular choice—around US$0.40c for brands imported from South Korea, for example. They are available all over the Kurdish region, freely sold to minors, and the low price is accounted for by the absence of any kind of duty or import tax. Water pipe smoking is also popular, especially among students and other young people of similar age, who generally believe it to be harmless. Water pipes are readily available in restaurants and internet cafés, accessible to the 70% of the population who live in urban areas. As in any serious tobacco control programme, the regional government's …