Here in Jordan, drugs and marijuana are rare because the penalty is severe. As a predominantly Muslim country, alcohol is not available in most restaurants, and liquor stores are hard to find. However, sugar, caffeine, and tobacco are affordable and available vices.Jordanians love their sweets. We’ve seen mini-Oreos served as an after breakfast treat. Stores dedicated to traditional sweets: baklava and other treats dripping with honey are common. Tea and coffee are sweetened unless you ask for them without sugar. Pop cans are about half the size of those in the US, but abundantly available as are sugary juices. We haven’t seen sugar-free soda or juices. During a snorkeling break we were offered packaged candy wafers. Our Wadi Rum lunches had juice with the first ingredient sugar, as well as a strawberry pop tart, date-filled cookies (I did eat that) and a candy bar.We love the coffee. Turkish coffee is boiled and served in espresso size cups and there is a thick sludge at the bottom. It is usually mixed with cardamom and this morning we had cardamom seeds floating in our brew. It adds a rich and spicy twist. Most people add several teaspoons of sugar to their cup.

In Amman we visited a liquor store near our hotel. It was one of three in a two block area located in a suburb. The owner who was from New Jersey told us that you had to be Christian to own a liquor store and it was a lucrative business. Although devote Muslims don’t drink, some do and unfortunately it happens in while driving, because they cannot bring it home. Stores selling alcohol were rare in the smaller towns and villages we visited, although we did find empty bottles of scotch whiskey, a small bottle of vodka and beer in the desert in Wadi Rum. Four-wheeling or camel-racing and drinking, I suppose! But in Jordan, smoking appears to be the real vice. Cigarettes are cheap: between 1-2 dinar a pack or $1.50-3.00 US. Tobacco companies decreased the cost in 2014 by fifteen percent to compete with the bootleg variety from Syria. Seventy percent of Jordanian men smoked in 2015, up from 42% in 2000. Compare that with smoking prevalence moving the other direction in most countries: 28% (2000) and 20% (2015) in the US, and 67% and 59% in Russia, respectively. All the major tobacco brands are here, but Marlboro is the most popular, made by Philip Morris, the largest tobacco company in the US and one of the world’s largest companies all of which sell sugary foods, tobacco and alcohol—those vices!! Although smoking was banned in hospitals, universities, government buildings, and public transit, compliance is haphazard and you cannot find a restaurant where smoking is prohibited. Ash trays appear in hotel rooms, although you can stay in smoke free rooms. Men smoke while they drive, before and after they eat. We were told it was a stress reliever and the anecdote to boredom. Our Bedouin guides in Wadi Rum shared tea and cigarettes under a goat haired shelter while they waited for their tourists to return from hiking. Our guide smoked less than other guides and he told us he tried to limit his smoking to five a day because he knew it wasn’t healthy.

However, smoking the Hookah, Shisha or Nargila may be the biggest challenge for nonsmoking advocates. Water pipe smoking came with the Turks and the Ottoman Empire, and it was adopted big time in Jordan. Fifty nine percent of Jordanian men smoked hookah in the past 30 days and 26% of women according to a Canadian study. Compare that with 15% of Syrian men, 28% in Lebanon, and 33% in Pakistan. The only comparison for the US and the UK is among university students, where past-30 day rates were 10% in the US and 8% in the UK.Shisha is sheik. Stores are dedicated to selling different hookahs in all colors and with lovely metal filigree patterns. However, we saw it used by lower income folks as well. It is smoked all times of the day. Although, rarely smoked in Wadi Rum and by the Bedouins, it was in Amman, Aqaba and Petra. We joined our Amman drivers for a birthday dinner at an upscale Amman restaurant and in the “smoking” room groups of women, groups of men and couples smoked shisha as they ate. It was clearly a social event. Tobacco flavors include apple, blueberry, lemon and most fruits. Quite frankly, it has a lovely fragrance. One article suggested that smoking a shisha pipe for one hour equals 100 cigarettes.

Jordan has obligations under agreements with WHO to reduce smoking, but only $45,000 was committed to this effort in 2016. This is a poor country with a population of nearly 10 million. Compare that to the state of Ohio, with a population of 14 million that had 9.6 million state and federal dollars committed to tobacco control in 2010. There was evidence of efforts to confront the health hazards of cigarettes and water pipes. One of the clinics we visited displayed the poster in the picture. That’s a start. Physicians we worked with knew about the hazards of smoking, but often smoked themselves. Marcus Welby, MD never lit up, but other television doctors did until the US Surgeon General's landmark report in 1964 on the dangers of smoking to the health. In 1971 cigarette television commercials were banned from the airwaves. You may or may not remember the Marlboro Man. The smoking cowboy was introduced in 1954, and it was used until 1999.Jordan has a long battle ahead. Jordan’s rates are higher than any other country in the region. The health implications are yet to be seen. Behavior change is a long and persistent battle. As they say in Arabic: Shway, shway, little by little.