The use of tobacco products in Egypt is widespread. It is estimated that approximately twenty percent of the population uses tobacco products daily. Cigarettes are the most common form of tobacco consumption in Egypt, with an estimated twenty billion cigarettes smoked annually in the country. After cigarettes, shisha water-pipes are the most common form of tobacco consumption. Recently legislation has passed in Egypt that prohibits smoking in public places and requires special warnings to be placed on tobacco packaging. Smoking is far more common among men than it is among women, however, the number of women smokers is on the rise. The tobacco industry in Egypt is dominated by the Eastern Tobacco Company; however, since the cultivation of tobacco is prohibited in Egypt the manufacturer must rely entirely on imported tobacco. The number of adults smoking tobacco products in Egypt continues to rise, some suggest by as much as four to five percent annually. Prevalence in Society Smoking in Egypt is prevalent with 19 billion cigarettes smoked annually in the country, making it the largest market in the Arab world. Inside cafes, hookah (shisha) smoking is common. As of 2012 smoking in Egypt has reached an all-time high with an estimated twenty percent, twenty million people, regularly using tobacco products. Egypt is ranked as one of the top ten per capita consumers of tobacco by the World Lung Foundation. Of this twenty percent of the population estimated to use tobacco products, ninety-five percent were daily smokers. Sixteen percent smoke only cigarettes, 3.3% smoke shisha water-pipes, and 2.6% use smokeless tobacco products. While consumption of tobacco in adults is in decline or stagnant in many countries, in Egypt, the number of adult cigarette smokers is increasing at a rate of four to five percent per year Smoking in Egyptian History It is not entirely clear when the use of tobacco first began in Egypt. Tobacco use in the Middle East can be dated back to the sixteenth century. Islam and smoking Although Islam has no specific ban on smoking tobacco, several Islamic principles are cited in support of the religion-based banning of tobacco. Depending on the location and community, Islamic authorities have either deemed smoking as makruh (to be avoided) or haram (forbidden). On September 5, 1999, Nasr Farid Wasel, the then Grand Mufti of Egypt, issued a fatwa (a religious ruling) against tobacco smoking. Smoking in Public In Egypt, the