Non-communicable diseases kill 41 million people each year. Among them are heart disease, cancer, diabetes and lung disease, for which tobacco use is a leading but entirely preventable common risk factor. Tobacco use is also inextricably linked to poverty, as nicotine addiction drives smokers to spend a large proportion of their income on tobacco and reduces the amount of money available for basic necessities such as food, healthcare and education. The economic and societal costs of tobacco-related diseases are staggering and cost an estimated US$1.4 trillion (Bt45 trillion) annually in healthcare costs and lost productivity due to illnesses and early deaths.
“This updated atlas captures in detail the continuing battle waged by the tobacco industry against public health. The good news is that countries are fighting back to protect health and save lives. The bad news is that progress isn’t fast enough,” said Dr Ulysses Dorotheo, executive director of SEATCA.
Among Asean countries, male adult smoking prevalence is highest in Indonesia at 66 per cent and lowest in Singapore at 21.1 per cent.
All 10 Asean countries have implemented pictorial health warnings on cigarette packs, four of which are among the biggest in the world – Thailand (85 per cent front and back of the pack), Brunei, Laos and Myanmar (75 per cent), while Singapore and Thailand are in advanced preparatory stages to require plain packaging.
Tobacco tax policies have been strengthened in Brunei, Indonesia, Myanmar, Philippines, Singapore and Thailand and have helped to reduce affordability of tobacco products. However, the cigarette prices still remain affordable and relatively low (less than $1 per pack) in Cambodia, Laos, Myanmar and Vietnam.
The tobacco industry continues to escape stringent regulation by interfering at all levels of tobacco control policy development and implementation. Only four Asean countries – Indonesia, Philippines, Singapore and Thailand – have taken steps to protect their public health policies from tobacco industry interference by developing a policy, guidelines or a code of conduct to prevent unnecessary interactions with the industry and ensure transparency of any interactions that occur.
The tobacco industry keeps inventing new ways to sell harm through novel marketing schemes, attractive packaging, new flavours and new products to appeal to youths, women and first-time smokers. Tobacco companies are producing e-cigarettes in myriads of flavours and promoting these as less harmful than conventional cigarettes and as smoking cessation devices. Only four Asean countries (Brunei, Cambodia, Singapore and Thailand) have banned sale of all types of heated tobacco products, e-cigarettes, shisha and water pipes.
Wendell C Balderas