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 hypertension, 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 …