Environmental Health in Israel | 2014

Progress and Challenges  One of the major challenges in reducing public exposure to ETS is that 18.7% of the adult population in Israel smokes (data from 2013, based on self-report). According to recent data from the Organisation for Economic Co-operation and Development (OECD), Israel is ranked 12 th (lowest) out of the 40 OECD countries in smoking rates.  There are major challenges in enforcing legislation regarding smoking in public places in Israel. The MoH Report on Smoking highlights the fact that many municipalities fail to report on their activities related to prevention of smoking in public places.  There is a discrepancy between the relatively strict legislation forbidding smoking in public places and the extensive data showing widespread exposure of the non-smoking population to ETS. While Israel was once a leader in legislation regarding smoking in public places, it now lags behind many other countries, both in legislation and enforcement.  Further measures are needed to protect the Israeli population, especially children, from ETS. For example, schools are still not completely smoke-free in Israel.  While asthma prevalence in children is one of the health indicators related to ETS exposure (and to exposure to ambient air pollution), national data on asthma prevalence in children are limited to periodic surveys of adolescents. National data on emergency room visits for asthma in children are limited by differences in hospital reporting, while data regarding asthma medication use in children are not collected on a national basis. In addition, data on asthma medication use, and other relevant endpoints are collected separately by the four large Health Maintenance Organizations in Israel, each of which maintains an electronic medical record database.  The only biomonitoring data available in Israel on exposure of the general population to ETS are from a 2011 study of adults. More research should be directed at measuring biomarkers of ETS in susceptible populations, such as children and pregnant women. Biomonitoring should be used to monitor trends in exposure of the non-smoking Israeli population to ETS.  There is no certified laboratory in Israel to analyze cotinine or other biological markers of ETS in biological samples (urine, serum, saliva). Environmental Health in Israel 2014  Chapter 3 - 28 -