By Jennie Lyn Reyes
BANGKOK, Thailand, Nov 20 2020 (IPS)

While the COVID-19 pandemic has elevated public health to a top priority in every country in the world, it has left many poorly resourced governments receptive to any and all aid that can provide immediate assistance to help their people.

The pandemic pandemonium has provided unprecedented opportunities for the tobacco industry to boost its corporate social responsibility (CSR) activities to get closer to health and senior government officials.

Using charity to gain access to senior officials, foster good ties, and gain political capital to influence and interfere with public policies is a prominent tobacco industry tactic revealed in the 2020 Asian Tobacco Industry Interference Index.

Because of the deceptive and powerful influence of CSR activities exploited by the tobacco industry, the WHO Framework Convention on Tobacco Control (FCTC) calls on Parties to the treaty to denormalize these activities and even ban them. Nearly all Asian countries are parties to this treaty.

The Index is a civil society report card that ranks 18 Asian governments on their efforts to protect health policies from the influence and interference of commercial and other vested interests of the tobacco industry in line with Article 5.3 guidelines of the FCTC.

Japan, Indonesia, and China top the report’s list with the highest level of tobacco industry meddling. These countries also have the largest smoking populations in the world. Brunei, Pakistan, and Nepal made the best progress to protect public policies from industry influence.

Banning the tobacco industry at any level or stage of health policy development is one of the key recommendations of the 2020 Asian Tobacco Industry Interference Index. Credit: SEATCA

Key findings:

• Health policy is undermined when the tobacco industry is included in the policymaking process. Participation and influence in tobacco control policies are revealed to be the highest in China, Indonesia, Japan, and Philippines.

• Tobacco industry buys influence through CSR activities. Industry-sponsored CSR activities remain common even in countries where restrictions are in place. Funding social causes, such as sports and disaster relief, allows the industry to promote itself as a “good corporate citizen” in the eyes of governments as shown in Bangladesh, Indonesia, Japan, Korea, Pakistan and Vietnam.

• Governments give benefits to the industry. With the exception of Brunei and ignoring the devasting harms of tobacco, many governments have been persuaded by the tobacco industry on its importance for economic growth and grant it preferential treatment such as tax breaks, facilitation of trade agreements, and delayed and weakened implementation of tobacco control measures. These are detrimental to tobacco control and tend to drain national coffers of tax revenues.

• Unnecessary interactions with the industry foster government endorsement. High-level government representatives participate in events organized by the tobacco industry. Activities related to combating smuggling are common where the tobacco industry works side-by-side with governments.

• Lack of transparency in interaction with the tobacco industry. The lack of transparency in government interactions with the tobacco industry remains a problem in almost all countries. Most countries do not have a procedure for public disclosure.

• Protective measures are needed. Only half (nine) of the countries included in the report have adopted policies to prevent tobacco industry interference as part of good housekeeping and governance.

The global tobacco industry is dominated by five tobacco companies all having a foothold in Asia – China National Tobacco Corporation (CNTC), Philip Morris International (PMI), British American Tobacco (BAT), Japan Tobacco Inc. (JTI), and Imperial Tobacco Group (ITG).

These transnational companies have already ventured into e-cigarettes and heated tobacco products that they are misleadingly promoting as safer alternatives to cigarettes.

Tobacco products contribute to the deaths of over eight million people every year, with low-and-middle-income countries bearing the brunt of its toll on public health and the economy. Tobacco use places smokers at an even higher risk of severe COVID-19 disease.

The ASEAN bloc of countries, home to 125 million tobacco users, is targeted by the industry to grow its profits. These countries are moving slowly, and in some instances, even regressing in their efforts to ward off tobacco industry influence.

There is light at the end of the tunnel as countries that have successfully protected their policies, such as Brunei and Thailand, are showing a decline in numbers of smokers, without suffering economic losses, as the industry typically claims.

A whole-of-government-and-society approach is fundamental to address industry interference. Governments and civil society must keep ahead of the many insidious ways the tobacco industry works. Constant vigilance and pro-active countermeasures remain vital.

About SEATCA
SEATCA is a multi-sectoral non-governmental alliance promoting health and saving lives by assisting ASEAN countries to accelerate and effectively implement the tobacco control measures contained in the WHO FCTC. Acknowledged by governments, academic institutions, and civil society for its advancement of tobacco control in Southeast Asia, the WHO bestowed on SEATCA the World No Tobacco Day Award in 2004 and the WHO Director-General’s Special Recognition Award in 2014.

Follow @IPSNewsUNBureau
  

Excerpt:

Credit: SEATCA

By Hana Ross and Sophapan Ratanachena-McWhortor
BANGKOK, Thailand, Jul 21 2020 (IPS)

A factoid is unreliable information repeated so often that it becomes accepted as fact. One such factoid repeatedly echoed across the globe by the tobacco industry is that tobacco tax increases worsen cigarette smuggling.

For governments facing challenges to curb smuggling, particularly in the global South, this factoid has scared political leaders from effectively using taxes as a public health tool.

Tax increases used as part of comprehensive tobacco control have been shown to successfully reduce smoking in many countries, including Australia, Thailand, Philippines and South Africa.

In 2016, Australia implemented annual increases in tobacco excise of 12.5% a year till 2020, raising the cost of a pack of cigarettes to about AUD 40. Australia’s current smoking prevalence at less than 13 percent is one of the lowest in the world.

According to the World Bank, taxes and prices have only a limited impact on the illicit cigarette market. In fact, another study found that lower income countries, where cigarette taxes and prices are low, have higher levels of cigarette smuggling than higher income countries with high taxes and prices.

The tobacco industry supports small tax increases but opposes large increases that effectively reduce the affordability of their products. Asia being a major market for tobacco companies, it is tactical for them to defeat or undermine effective tobacco tax increases in Asian countries.

Tobacco industry-commissioned studies routinely link high levels of smuggling to tax increases. One such report is the Asia Illicit Tobacco Indicator 2017 report sponsored by Philip Morris International (PMI) and done by Oxford Economics (OE), a U.K. based think tank.

The study, for example, shows Malaysia having among the highest tobacco smuggling in the world at 56%, followed by Pakistan at 42%. However, alternate studies on illicit trade in both countries show significantly lower levels at 27% and 16% respectively.

Many governments have been fed data from this PMI-funded report by OE, which has been described as severely flawed in a critique recently released by the Southeast Asia Tobacco Control Alliance (SEATCA). The critique uncovers the report’s poor data quality, identifies multiple deficiencies in the methodology, and exposes the deceptive presentation of study results, underlining the fact that industry-commissioned reports do not provide scientifically sound information to policy makers and are biased to the interests of the tobacco industry.

Previous critiques, More myth than fact and Failed, already identified similar flaws of industry-funded OE reports on illicit trade in 2012 and 2013.

Using think tanks to conduct industry-friendly research is a known tactic of the tobacco industry. These research reports are launched using high profile spokespersons to promote the report findings.

This was clearly seen in Malaysia when the report was referred to by a criminologist and used as a launching pad for tobacco company activities to counter smuggling. The industry continues to use this tactic because of its impact on governments that are vulnerable to economic downturn and lack resources to curb illicit trade.

The illicit trade factoid is a key “go-to” narrative used repeatedly by the tobacco industry to undermine tobacco control efforts across countries in Asia and globally, whether tax increases, standardized packaging, large pictorial health warnings, advertising bans, public smoking bans, or bans/regulations on new and emerging tobacco products, such as e-cigarettes and heated tobacco products.

During the current global economic slowdown, despite a recognized link between smoking and COVID-19, tobacco companies continue to manufacture and profit from tobacco products.

Governments must therefore use this COVID-19 pandemic as an opportunity to level up their tobacco control policies and programs and redouble their efforts to protect public health policies from tobacco industry influence, as there is an irreconcilable conflict of interest between public health and the commercial and vested interests of the tobacco industry.

Governments must recognize that tobacco is a harmful and unessential product and should reject partnerships with the tobacco industry and fully scrutinize any information provided by tobacco companies. Governments must seek to eliminate the problem of illicit tobacco trade, but they shouldn’t be intimidated by the tobacco industry’s illicit trade factoid.

*SEATCA is a multi-sectoral non-governmental alliance promoting health and saving lives by assisting ASEAN countries to accelerate and effectively implement the tobacco control measures contained in the WHO FCTC. Acknowledged by governments, academic institutions, and civil society for its advancement of tobacco control in Southeast Asia, the WHO bestowed on SEATCA the World No Tobacco Day Award in 2004 and the WHO Director-General’s Special Recognition Award in 2014.

The Economics of Tobacco Control Project (ETCP) is housed in the Research Unit on the Economics of Excisable Products (REEP) at UCT’s School of Economics. The ETCP aims to expand current research efforts in the economics of tobacco control and to enhance the knowledge of economic and tax issues among tobacco control advocates and policymakers to strengthen support for tobacco tax and price increases in sub-Saharan Africa. These expanded efforts will increase the quantity and quality of research on the economics of tobacco control in the region, facilitate the growth of a new generation of tobacco control economics researchers and contribute to the creation of a centre of research excellence in sub-Saharan Africa.

Excerpt:

Credit: Bigstock

By External Source
CAPE TOWN, South Africa, May 31 2020 (IPS)

Tobacco use kills more than 8 million people each year. Most adult smokers start smoking before the age of 20. This implies that if one can get through adolescence without smoking, the likelihood of being a smoker in adulthood is greatly reduced.

Preventing young people from becoming addicted to tobacco and related products is therefore key to a smoke-free future.

With the advent of novel tobacco products and the tobacco industry falsely marketing them as less harmful than their combustible counterparts, the adage “prevention is better than cure” has never been more important for governments to heed if we are to achieve a smoke-free future.

Here are five things that governments need to do to ensure that a smoke-free future is realised.

1. Raise taxes on tobacco products

Tobacco taxation is one of the most effective population-based strategies for decreasing tobacco consumption. On average, a 10% increase in the price of cigarettes reduces demand for cigarettes by between 4% and 6% for the general adult population.

Because they lack disposable income and have a limited smoking history, young people are more responsive to price increases than their adult counterparts. Young people’s price responsiveness is also explained by the fact that they are also more likely to smoke if their peers smoke. This suggests that an increase in tobacco taxes also indirectly reduces youth smoking by decreasing smoking among their peers.

2. Introduce 100% smoke-free environments

Smoke-free policies reduce opportunities to smoke and erode societal acceptance of smoking. Most countries have some form of smoke-free policy in place. But there are still many public spaces where smoking happens. Many of these places are frequented by young people – or example, smoking sections in nightclubs and bars – contributing to the idea that smoking is acceptable and “normal”.

Research from the United States shows that creating smoke-free spaces reduces youth smoking uptake and the likelihood of youth progressing from experimental to established smokers. In the United Kingdom, smoke-free places have been linked to a reduction in regular smoking among teenagers, and research from Australia finds that smoke-free policies were directly related to a drop in youth smoking prevalence between 1990 and 2015. By adopting 100% smoke-free policies governments can denormalise smoking and turn youth away from tobacco and related products.

3. Adopt plain packaging and graphic health warnings

The tobacco industry uses sleek and attractive designs to market its dangerous products to young people. All tobacco products should therefore be subject to plain packaging and graphic health warnings so that their attractive packaging designs do not lead youth to underestimate the harm of using these products. Currently 125 countries require graphic images on the packaging of tobacco products. Countries like South Africa that rely on a text warning message are far behind the curve. Plain packaging on tobacco products has been adopted in 13 countries to date and, in January 2020, Israel became the first country to apply plain packaging to e-cigarettes.

4. Outlaw tobacco advertising, promotion and sponsorship

Traditional advertising and promotion of tobacco products has been banned in most parts of the world. But the tobacco industry has developed novel ways of keeping its products in the public eye.

Some common strategies used by the industry to target youth include hiring “influencers” to promote tobacco and nicotine products on social media, sponsoring events, and launching new flavours that are appealing to youth, such as bubble gum and cotton candy, which encourages young people to underestimate the potential harm of using them. Evidence also shows how the tobacco industry uses point-of-sale marketing to target children by encouraging vendors to position tobacco and related products near sweets, snacks and cooldrinks, especially in outlets close to schools.

Governments need to outlaw these tactics and impose hefty fines on tobacco companies that make any attempt to circumvent the law.

5. Educate young people

Given that tobacco kills half of its long-term users, the tobacco industry needs to get young people addicted to its products to ensure its survival. Young people need to be made aware of this. Governments should launch counter-advertising campaigns that educate young people on the tactics employed by the industry to target them so that they do not fall prey to them.

Sam Filby, Research Officer, Research on the Economics of Excisable Products,, University of Cape Town and Corné van Walbeek, Professor at the School of Economics and Principal Investigator of the Economics of Tobacco Control Project, University of Cape Town

This article is republished from The Conversation under a Creative Commons license. Read the original article.

“Sofia,” a 17-year-old tobacco worker, in a tobacco field in North Carolina. Benedict Evans/Human Rights Watch

By Margaret Wurth
NEW YORK, Dec 3 2019 (IPS)

Legal action against British American Tobacco (BAT), one of the world’s largest tobacco firms, could see the company punished for profiting from child labor and force the industry to finally confront its treatment of vulnerable workers.

The case, brought by human rights lawyers on behalf of hundreds of tenant farmers and their children in Malawi, contends that the company is guilty of “unjust enrichment.” Martyn Day, a senior partner at Leigh Day, the firm bringing the case, told The Guardian that the tenant farmers cultivating tobacco for one of BAT’s main suppliers are paid so little and the work involved is so labor intensive that they are forced to rely on help from their children.

The claimants are suing for compensation, and their lawyers believe it could force the company to pay more for the leaf it buys to ensure proper livelihoods for the workers and farmers at the bottom of its supply chain.

BAT said it takes the issue “extremely seriously” and makes clear to all its farmers and suppliers that exploitative child labor “will not be tolerated.”

Driven by poverty, children work in tobacco farming to help their families make ends meet, to raise money for school fees or books, or to help their parents increase their earnings or save money on hired labor

Over the last six years, I’ve interviewed hundreds of child workers involved in back-breaking, dangerous work on tobacco farms in the United States, Indonesia, and Zimbabwe. The tobacco they help to produce ends up in products sold by the largest tobacco companies in the world.

The impossibly difficult situation that tobacco farming families in Malawi face mirrors what I’ve seen in all the countries where I’ve investigated child labor in tobacco farming. Driven by poverty, children work in tobacco farming to help their families make ends meet, to raise money for school fees or books, or to help their parents increase their earnings or save money on hired labor.

In the United States, I spoke with children as young as 7 and their parents. One farmworker, a single mother of five children, told me, “What I earn is not sufficient for my family. My children have to work to buy school supplies, clothes, the things you have to pay for at school.”

Small-scale tobacco farmers in Indonesia told me they were too poor to hire laborers, so their children often helped in the fields.

Poverty has also fueled child labor in tobacco farming in Zimbabwe, where children work to raise money for school fees or food. “I am looking for money for survival,” one 16-year-old tobacco worker told me. She earned just $3 a day on tobacco farms.

Work in tobacco farming is especially hazardous for children because tobacco plants contain nicotine, which can be absorbed through the skin and cause acute nicotine poisoning. Many child workers report nausea, vomiting, headaches, or dizziness while they work – all symptoms of the poisoning. Child workers are also often exposed to pesticides, and they work long hours in extreme heat, sometimes using dangerous tools or machinery.

For years, my colleagues and I have been urging tobacco companies to eradicate child labor in their global supply chains. Though most companies have policies against child labor, none of them prohibit children from all work handling tobacco—the best policy for protecting children from harm. And year after year, investigations in the tobacco sector show persistent problems with child labor.

Ending child labor requires action by governments and companies to provide children with quality education, to enact strong child labor laws and policies with serious monitoring and inspection, and – crucially – to address family poverty. In the tobacco sector, that means companies ensuring that the price they pay for tobacco leaf lets workers and small-scale tobacco farmers actually earn a living wage.

After years of work on this issue, I still can’t comprehend how – in 2019 – big tobacco companies can profit without penalties from tobacco produced by child workers who are exhausted, overworked, falling behind in school, and exposed to toxins that could have lasting effects on their brains and bodies.

That’s why news of the lawsuit gave me hope. Though it could take years, the case could force BAT to pay workers and farmers fairly and finally eradicate child labor in its supply chain.

Children shouldn’t need to sacrifice their health and education to help their families survive.

Excerpt:

Credit: WHO

By Dr. Mary Assunta and Dr. Ulysses Dorotheo
BANGKOK, Thailand, Oct 25 2019 (IPS)

The tobacco industry’s new rhetoric that smoking is harmful and that its so-called less risky products will reduce the global tobacco epidemic, should see the industry stop opposing or fighting government efforts to reduce tobacco use. However, this is not the case.

The first Global Tobacco Industry Interference Index report found the tobacco industry continues to undermine and derail government’s tobacco control efforts to protect public health around the globe.

Furthermore, this Global Index shows many governments continue to move at a glacial pace in countering industry meddling, although they are empowered to act under the global tobacco treaty, the WHO Framework Convention on Tobacco Control (FCTC).

This report card ranked countries according to their efforts in protecting public health policies. Japan, Jordan, Egypt and Bangladesh are among those that scored the highest in the level of tobacco industry influence, which means weaker resistance of governments from industry meddling, while the United Kingdom, Uganda and Iran lead in protecting health policy from industry meddling.

The ranking is based on civil society reports from 33 countries covering about 70% of the world population. The Global Tobacco Index is released by the STOP (Stopping Tobacco Organizations and Products) project.

Key global findings

• Transparency matters. Countries fared better when they were more transparent about their interactions with the industry, including recording meetings or any donations and FOI regimes. Political contributions and gifts from the tobacco industry are banned in Brazil, Canada, France, Iran, Myanmar, Turkey, U.K., Uganda and Uruguay. Among the countries surveyed, transparency on political contributions is required only in Kenya and the U.S.
• Wooing senior government officials was rampant across countries. Tobacco companies targeted departments of finance, commerce and trade to achieve policy influence. They even used frivolous awards to access and obtain endorsement from senior officials.
• Tax breaks benefitted the industry in many countries. Many governments still consider the tobacco industry’s business portfolio as a major economic driver and grant the industry with trade incentives, exemptions, and duty-free tobacco allowance that boost production and sales in markets that may have other regulations in place.
• E-cigarettes pose a new threat. There is growing evidence of the industry using harm reduction claims about e-cigarettes to justify interactions with government officials to promote and open their doors to these new alternative products. In 2018, tobacco companies lobbied to make it easier for them to sell or promote e-cigarettes in Philippines, Mexico, Lebanon and Turkey.

Meddling by the tobacco industry comes from all directions and in various forms, presenting big challenges to governments. Countries that resisted industry interference and prioritized protecting health over foreign tobacco investments sometimes paid a hefty price – they were sued by the tobacco industry for their tough stance on tobacco control. India, Kenya and Uganda endured such legal challenges and were delayed in implementing their strong tobacco control laws.

Industry interference is rife in Asia, a huge, profitable market for transnational tobacco companies. In recent years, Japan Tobacco International (JTI), for example, acquired domestic cigarette companies in Indonesia, Bangladesh and the Philippines, which will increase its profits in these developing countries. JTI has opposed tax increases in Bangladesh, the Philippines, Malaysia and elsewhere.

Contrary to its public stance on the dangers of smoking, Philip Morris successfully sued the small City of Balanga (96,000 residents) in the Philippines for passing stringent legislation that creates a tobacco-free environment to protect its people, particularly the young generation.

The Southeast Asia Tobacco Control Alliance has been annually reviewing government efforts in implementing WHO FCTC Article 5.3 for the past six years through a regional index across ASEAN.

Over the years, some governments have made progress to protect public health policy, albeit slowly. Thailand and Myanmar have been steadily improving in tackling industry interference, such as ending tobacco-related CSR activities and rejecting recommendations from the tobacco industry to be included in their health policies.

The Philippines and Malaysia, on the other hand, have deteriorated over the years showing they have succumbed to industry interference. Malaysia, which in 2016 announced plans for standardised packaging of tobacco, has not moved forward on the policy.

The tobacco industry targets non-health departments, particularly finance, industry, and trade, to protect or promote its interests and disassociate its image from the health harms caused by the inherently defective products it manufactures and sells.

Governments must close this gap and tackle industry interference by applying a whole-of-government approach. All departments need to cooperate in putting public health first to strengthen overall tobacco control.

Governments can short circuit the ‘divide-and-rule’ tactic of the tobacco industry and fulfil their obligation under the WHO FCTC to implement measures that protect themselves and public health policies from being hijacked by the tobacco industry. It is in governments’ hands to stop the interference.

About STOP (Stopping Tobacco Organizations and Products)

STOP is a global tobacco industry watchdog whose mission is to expose the tobacco industry strategies and tactics that undermine public health. STOP is a partnership between The Tobacco Control Research Group at the University of Bath, The Global Center for Good Governance in Tobacco Control (GGTC), The Union and Vital Strategies.

Excerpt:

By Mark Hurley
WASHINGTON DC, Oct 23 2019 (IPS)

New information published in the Morbidity and Mortality Weekly Report shows that action taken by just 11 countries – most of them low- or middle-income – has resulted in 20 million fewer adult tobacco users in 2017 compared with 2008. Seventy percent of the world’s tobacco users live in low- and middle-income countries.

This promising progress is a testament to strong government action and its effects are far reaching. Between 2008 and 2017, over 53 million fewer adults were exposed to secondhand smoke in indoor public places like restaurants, government buildings and healthcare facilities.

Exposure to secondhand smoke can result in lung cancer, heart disease, asthma and bronchitis even in people who do not smoke.

Other promising findings in the study indicate that more than 12 million adult tobacco users in the countries studied were considering quitting because of graphic warning labels on tobacco products, and that close to 100 million fewer adults were exposed to tobacco advertising, promotion and sponsorships.

The remarkable progress in reducing tobacco use shown in this study is a dramatic affirmation that evidence-based policies can and have protected millions of people from the deadly harms of tobacco use.

These policies – many of which are called for in the World Health Organization’s international health treaty, the Framework Convention on Tobacco Control – include eliminating tobacco advertising, promotion and sponsorship, adding graphic warning labels to tobacco packs, and increasing tobacco prices through higher taxes.

All of the countries studied have signed on to the WHO treaty.

Virtually all of these life-saving policies have been passed in spite of fierce pushback from tobacco companies. In Uruguay for example, Philip Morris International challenged the country’s tobacco control laws in a World Bank tribunal. Philip Morris lost the challenge in dramatic fashion in a decision affirming that countries have the legal right to pass policies necessary to protect the health of their people.

Tobacco companies fight these policies because they know they work. Around the world, tobacco companies and their deadly marketing tactics remain the single greatest obstacle to curbing the global tobacco epidemic.

The companies continually find new ways to market cigarettes and other nicotine products to young people, fight life-saving tobacco control policies, and promote products such as e-cigarettes and heated cigarettes with unproven health claims.

The world’s biggest tobacco companies would have us believe that they desire a healthier world even while they continue to introduce and heavily market cigarettes and their e-cigarettes are being linked to explosions in nicotine addiction among youth.

Governments cannot let these products undermine progress on tobacco control, especially among kids. In the United States, a lack of regulation has led to a dramatic increase in youth use of e-cigarettes with one in four U.S. high school students using e-cigarettes.

In order to end the tobacco epidemic, governments must pass and implement the proven policies known to work to protect future generations from the harms of tobacco and nicotine addiction. Without urgent action, tobacco will kill one billion people this century.

Excerpt:

Smoking-related diseases are the major causes of premature death worldwide. Every year, six million smoking-related deaths are reported worldwide. If current smoking trends persist, 8 million deaths can be expected by 2030, of which four-fifths will occur in lower- and middle-income countries.

Start them young
Many studies show that smoking is typically learned and started during adolescence. Owing to nicotine addiction, the earlier someone starts to smoke, the higher the likelihood he or she will continue the habit into adulthood, and the smaller the likelihood of stopping smoking.

Jomo Kwame Sundaram

The first Global Youth Tobacco Survey (GYTS) in 2003 found that 20.2% of 13-15 year-old school-based adolescents were already smoking. Prevalence was much higher among males (36.3%) compared to females (4.2%). Subsequently, the 2009 GYTS reported reduced prevalence (18.2%) of current cigarette smoking among adolescents, mainly due to less male smokers (30.9%) while female smokers increased (5.3%).

Electronic cigarettes new threat
Many studies have reported increasing e-cigarette usage worldwide. E-cigarettes were touted as a means to help smokers stop smoking. However, studies suggest no difference between e-cigarette users and non-users in rates of successfully quitting.

As the vaping epidemic spreads, health risks associated with nicotine rise dangerously. Young people are vaping in record numbers in many parts of the world. “Adolescents don’t think they will get addicted to nicotine, but when they do want to stop, they find it’s very difficult,” notes Yale neuroscientist Marina Picciotto.

Despite many research reports highlighting its dangers and marketing tactics to hook teenagers and young adults, the number of vaping users continues to climb. And while it is possible to buy liquid or pod refills without nicotine, it is much harder to find them.

Many observers, including policymakers, overlook or underestimate the role of nicotine, a key ingredient in the vapours inhaled. Most teens do not realize that nicotine is deeply addictive. Studies show that young people who vape are much more likely to move on to cigarettes, which cause a broad range of diseases.

Wan Manan Muda

The mesolimbic dopamine ‘reward’ system is a more primitive part of the brain which positively reinforces behaviour needed to survive, such as eating. As the mechanism is etched into the brain, it is hard to resist. When a teen inhales vapour with nicotine, the drug is quickly absorbed through blood vessels lining the lungs, reaching the brain in about 10 seconds. There, nicotine particles fit ‘well’ into receptors on nerve cells (neurons) throughout the brain.

Why nicotine cravings persist
“Nicotine, alcohol, heroin, or any drug of abuse works by hijacking the brain’s reward system”, according to Yale addiction neurobiologist, Nii Addy. The reward system was never meant for drugs, but evolved, enabling nicotine to biochemically interact well with natural neurotransmitters which activate the muscles in our body.

Once nicotine binds to the receptor, it signals the brain to release dopamine, a well-known neurotransmitter which generates a ‘feel-good’ feeling. Dopamine is part of the brain feedback system signalling that “whatever just happened felt good”, training the brain to repeat the action.

Unlike other drugs such as alcohol, nicotine quickly leaves the body once it is broken down by the liver. And once it is gone, the brain craves nicotine again. Craving, due to the drug that causes the dopamine rush, makes it difficult for addicted youth to quit nicotine.

Recent research, including human brain imaging studies, shows that “environmental cues, especially those associated with drug use, can change dopamine concentrations in the brain”. Simply seeing a person one vapes with, or visiting a school toilet where teens vape during the school day, can unleash intense cravings, making it difficult not to relapse.

Physical changes caused by nicotine
Nicotine also causes physical changes to the brain, some temporary, while others could be long-lasting. Cigarette smoking research has long shown that acetylcholine receptors in the brain increase with continuous exposure to nicotine, intensifying cravings.

But the receptors decrease after the brain is no longer exposed to nicotine, implying that such changes are reversible. Animal studies also show nicotine adversely affecting brain functions, relating to focus, memory and learning, which may be long-lasting.

According to Picciotto, nicotine can cause a developing brain to increase connections among cells in the cerebral cortex region in animals, which would cause cognitive function and attention problems, if also true for humans.

Vaping vs regular cigarettes
Comparing the pros and cons of vaping versus smoking is complicated. On the one hand, unlike regular combustible cigarettes, e-cigarettes probably do not produce 7,000 chemicals, some of which cause cancer. However, aerosol from vaping devices contains lead and volatile organic compounds, some of which are linked to cancer, while the long-term health effects of vaping are still unresearched.

E-cigarettes have not been approved by the US Food and Drug Administration (FDA) as smoking cessation devices. But according to the US Centers for Disease Control and Prevention (CDC), e-cigarettes may be better for adult smokers if they completely replace smoking.

The ‘pod mod’ is a newer, popular vape device outcompeting many other e-cigarettes. The nicotine in these pods is two to ten times more concentrated than most ‘free-base’ nicotine in other vape liquids. A single pod from one vape manufacturer contains 0.7 mL of nicotine, about the same as 20 regular cigarettes.

Despite its highly addictive nature, people can successfully quit nicotine, particularly with personalized approaches under the guidance of suitably trained physicians. For young people, early intervention could significantly improve the quality of the rest of their lives.

To learn more, visit yalemedicine.org

Professor Wan Manan Muda was professor of nutrition and public health at Universiti Sains Malaysia. Jomo Kwame Sundaram was an economics professor and United Nations official.

Credit: WHO/2017

By Mafoya Dossoumon and Ryan Forrest, Sara Rose Taylor
OTTAWA, Sep 2 2019 (IPS)

Trends in global consumption of cigarettes haven’t improved since the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) came into force, according to a study published in the British Medical Journal (BMJ) earlier this summer.

Perhaps this is because the FCTC on its own is not a magic bullet. Governments have paid the issue of tobacco-use a lot of lip service but they have invested very little to match the global burden of the epidemic.

Simply agreeing on what needs to be done (i.e. negotiating and ratifying the FCTC) will not on its own lead to reductions in tobacco use. What’s important is whether countries are adopting, implementing and enforcing tobacco control laws and policies in line with their obligations under the treaty.

Tobacco control policies work when implemented, and one of the key lessons to take from the study in the BMJ is that countries urgently need support to do so.

Framing the debate on FCTC impact

Among the most quickly and most universally ratified treaties in existence, FCTC has long been hailed as a breakthrough in efforts to protect the world’s citizens and economies from the harmful effects of tobacco use, which remains a leading global cause of preventable death.

Credit: BMJ 2019;365:l2287

The value and importance of the FCTC and the usefulness of the efforts of the large global tobacco control community that has worked for many years to negotiate the treaty and later to support its ratification and implementation around the world are widely acknowledged.

Much less is known, however, about the impact of the FCTC on smoking patterns.

But what is most needed is a nuanced understanding of how the FCTC impacts cigarette smoking patterns in different regions of the world and the contribution of the treaty to tobacco control policy development and implementation.

We know, indisputably, that tobacco control policies work when implemented, but we also know from experience that implementation and enforcement of these policies is a major challenge in many low- and middle-income countries (LMICs).

These countries often lack the data, organisational structures, human resources, and funds necessary to develop sustainable national tobacco control programmes.

Oiling the wheels of progress

Funding is perhaps the biggest challenge in most LMICs. A 2011 report by the World Health Organization notes that public spending on tobacco control in LMICs ranged from just US$0.0048 to US$0.01 per capita – far short of the estimated per capita cost of US$0.11 required to implement effective tobacco control programs in most LMICs.

There has also been a shocking lack of international investment in tobacco control – amounting to just US$70 million in Development Assistance for Health (DAH) in 2017 according to the Institute of Health Metrics and Evaluation’s most recent report. That’s just 8.5% of all DAH allocated for non-communicable diseases, and an even tinier fraction of all DAH.

WHO criteria for the highest level of achievement of key tobacco control demand-reduction measures. Credit: The Lancet Public Health Volume 2, ISSUE 4, Pe166-e174, April 01, 2017

The new analysis in the BMJ of the FCTC’s impact since its adoption should serve as an urgent call to action for the international community. Tobacco use causes more than 8 million deaths compared to approximately 3 million deaths for malaria, HIV/AIDS and tuberculosis combined.

Progress on reducing global tobacco use requires a concentrated effort on strengthening FCTC implementation in LMICs. Despite the growing evidence that accelerating FCTC implementation contributes to progress in decreasing tobacco use, too many countries are still lagging behind and failing to invest in tobacco control.

Understanding the priorities and accelerating progress

The newly adopted Global Strategy to Accelerate Tobacco Control identifies specific areas where governments can focus action to create the most impact. Immediate priorities include strengthening national tobacco control plans and adopting stronger price and tax measures.

Raising tobacco taxes to increase tobacco product price and decrease affordability is a particularly compelling policy proposal. A 10% increase in price yields a 4% decrease in consumption in high-income countries and a 5% decrease elsewhere, and the best way for governments to influence prices is to substantially increase taxes.

This is the case in the European Union (EU), where new evidence published in the Tobacco Control journal suggests that high cigarette prices are extremely effective in decreasing cigarette consumption and contributing to public health.

Credit: Universal Health Coverage (UHC) Movement for the UN High-Level Meeting on UHC Key Ask 5: Invest More, Invest Better – Sustain public financing and harmonise health investments

A conclusion that is in line with the new FCTC impact analysis in the BMJ, which points out that some of the difference in consumption trends between high- and low-income countries may be due to the effects of “EU accession rules requiring stringent tobacco control measures among new members”.

Taking a whole- of-government approach

Tobacco use is one of the most challenging health issues that modern societies face. Trying to understand what this challenge means for low- and middle-income countries is crucial. Equally important is to understand that the full and immediate implementation of the FCTC reduces tobacco use.

In just a few weeks, developed and developing countries will meet in New York to review progress on the Sustainable Development Goals (SDGs). Countries cannot afford to overlook the tobacco epidemic and how tobacco control efforts captured under SDG 3.a – though critically under-resourced – are contributing to decreasing tobacco use.

In LMICs, in addition to civil society stakeholders, various government sectors (not only health) must have equal responsibility for ensuring full and effective FCTC implementation. In fact, Article 5 of the treaty addresses tobacco control governance considerations with a view to encouraging robust multi-sectoral mechanisms and protection of tobacco control policies from the commercial and other vested interests of the tobacco industry.

Making the public health case for FCTC implementation is not enough. An economic case can also be made, for instance. The total global economic cost of smoking was estimated to have been US$1.4 trillion in 2012.

This economic burden is particularly damaging for LMICs, who already lack economic resources for development; in 2012, LMICs shouldered 40% of the total economic cost. A multi-faceted approach is vital for LMICs because country delegations to international negotiations such as the upcoming SDG Summit typically comprise representatives of Departments of finance, trade, agriculture and other sectors.

For sustainable development, there is much to be done. There will be little progress if there is no urgent action to reduce tobacco use in LMICs. It’s time for the international community to match the scale of the tobacco use problem with the resources and financing needed to enable progress.

Excerpt:

By Wendell Balderas
BANGKOK, Thailand, Jun 14 2019 (IPS)

The U.S. Food and Drug Administration’s (FDA) decision authorizing the sale of Philip Morris International (PMI)’s heated tobacco system, IQOS, in the United States inadvertently puts a foot in the door to increase sales of new tobacco products in the developing world.

In April this year, the FDA authorized the sale of IQOS heated tobacco products in the US. However, it clarified that it has not approved IQOS as a ‘modified risk tobacco product’ (MRTP). But PMI is riding on this ‘US-FDA approved for sale’ of its IQOS as also safer alternative to regular cigarettes to Asian governments.

In Indonesia, PMI’s local subsidiary PT HM Sampoerna signed a Memorandum of Understanding (MOU) with the Ministry of Research, Technology and Higher Education (Kemenristek Dikti) to support IQOS research and capacity building.

Local tobacco control advocates have criticised this collaboration claiming this is an industry tactic to attract new smokers, especially among the younger generation. Meanwhile PMI’s plans to sell even more cigarettes in Indonesia remain on track reflected by its ubiquitous cigarette advertisements.

While Malaysia’s Control of Tobacco Products Regulation requires pictorial warning on all tobacco products, IQOs is being sold as safer alternatives to regular cigarettes without these warnings.

IQOS is marketed via social media and have escaped the arm of regulators. BAT and JTI are now applying pressure on the government to allow sales of their versions of heated tobacco products.

In the Philippines, PMI claims on one-hand that cigarettes are harmful, smokers should quit and children should not buy them, however in the same breath it continues to refute evidence about smoking.

PMI’s lawyer, representing the Philippine Tobacco Institute (PTI), has filed two court cases challenging Balanga City, Bataan which has passed laws to ban smoking in public places and protect its youth from being exposed to cigarette promotions.

Also, the tobacco industry is trying to sneak Heated Tobacco Products (HTPs) into the bills being deliberated in the Philippine Senate and House of Representatives to regulate e-cigarettes (Electronic Nicotine Delivery Systems).

This deception is a typical duplicitous move by the tobacco industry to weaken tobacco product regulation simultaneously deceiving the public to embrace its HTPS as less harmful than regular cigarettes.

In Vietnam, PMI’s President of South and Southeast Asia has met with the Vice Chairman of the National Assembly (NA) promoting its research and development of less harmful product.

PMI’s request to the National Assembly leader was tactical – that they should provide a legal framework to enable its new products to be developed in Vietnam, and on its part, it will provide its own scientific research as well as research from organizations in the United States and Europe.

According to a press report, the Vice Chairman of the National Assembly was ready to create favorable conditions for foreign businesses to invest and expand their business. In investment talks, the emerging evidence on the risks associated with these new tobacco and nicotine products are somewhat lost and even challenged.

Korea’s Ministry of Food and Drug Safety announced in June last year that five cancer-causing substances were found in HTPs including PMI’s IQOS, British American Tobacco’s (BAT) Glo and Lil, with the level of tar detected in some of them far exceeding that of conventional cigarettes.

PMI has filed a lawsuit against the South Korean government to demand the disclosure of detailed information on Seoul’s test results of harmful substances found in electronic cigarettes.

The World Health Organization (WHO) has warned that all forms of tobacco, including heated tobacco products (HTPs), are harmful and that there is no evidence to demonstrate that HTPs are less harmful than conventional tobacco products.

A research paper from the University of California San Francisco also concluded “despite delivering lower levels of some toxins than conventional cigarettes, PMI’s own data fail to show consistently lower risks of harm in humans using its heated tobacco product, IQOS, than conventional cigarettes.”

In April 2019 a Swiss lab found a highly toxic substance, isocyanates, emitted from the filters of IQOS. According to pulmonologist and former vice-president of the Swiss Lung League, Rainer Kaelin, inhaling very small amounts of this toxic substance can cause serious health damage.

Tobacco is inherently toxic and contains carcinogens and toxicants even if not burned. HTPs such as IQOS are not harmless, and the precautionary principle to protect consumer safety must be applied to HTPs.

Around 40 countries already ban the sale of e-cigarettes and emerging tobacco products such as HTPs. Among these are four ASEAN countries: Brunei Darussalam, Cambodia, Singapore and Thailand.

Others include Argentina, Australia, Brazil, East Timor, Kuwait, Taiwan, UAE, and Uruguay. The FDA’s decision should not cause these countries to roll back their ban. These countries have implemented strict tobacco control measures based on the WHO Framework Convention on Tobacco Control (FCTC) and have seen their smoking prevalence decline steadily.

Under the guise of ‘harm reduction’, new and emerging tobacco products such as HTPs pose new threats to society. While continuing to increase sales of cigarettes, transnational tobacco companies are aggressively selling e-cigarettes and HTPs as part of their revamped “smoke-free” image and ironic claims to be part of the solution to the smoking epidemic.

Policy makers should be aware of these veiled attempts of tobacco companies to influence governments to create exemptions for their HTPs and roll back tobacco control policies so as to mislead the public, renormalize tobacco use, increase social acceptability for their products and get more people to be addicted to their products.

Excerpt:

By Ulysses Dorotheo
BANGKOK, Thailand, Apr 11 2019 (IPS)

The image of a smoking toddler from Indonesia horrified the world but did little to motivate local policy makers to enact measures to protect children and youth from the harms of tobacco use. Indonesia has one of the world’s highest smoking rates where two out of three men and about 40 percent of adolescent boys smoke.

Cigarette prices in Indonesia are among the cheapest in the region, where a pack of Marlboros is sold for as little as US$ 1.70, while local brands or loose sticks are dirt cheap ($ 0.05 per stick), easily affordable to the nation’s 65 million smokers.

Indonesia has a complex tobacco taxation structure of 12-tiers, dividing between machine-made white cigarettes, machine-made Kretek cigarettes, hand-rolled cigarettes, size of manufacturing factories, and more. Annual increases in tobacco tax are small, having little impact on cigarette prices to reduce consumption, especially among the poor, who form the bulk of smokers.

In 2017, the Ministry of Finance issued a Regulation on Tobacco Excise Tax to increase tax for 2018 and at the same time stipulated a roadmap for the simplification of tax tiers, reducing from 12 tiers to 5 tiers by 2021.

The tier simplification roadmap was viewed as a win for public health, as fewer tiers will close the tax and price gaps and reduce the incentive for smokers to switch to cheaper cigarettes. However, a year later, in November 2018, the simplification roadmap was suddenly revoked thereby cancelling the tax increase and tier reduction.

In his review of hundreds of news articles, Mouhamad Bigwanto, a public health researcher from the University of Muhammadiyah Prof. Dr. HAMKA, saw pro-tobacco industry groups unfold a systematic, tactical plan that led to the defeat of the tobacco tax increase and tiers simplification.

Documented in Tobacco Industry Interference Undermined Tobacco Tax Policies in Indonesia, released by the Southeast Asia Tobacco Control Alliance (SEATCA), his findings illustrate the tobacco industry’s plan to present the industry as being crucial to the economy, while simultaneously undermining and derailing the tobacco excise policy through a coordinated multi-pronged strategy.

In mid-2018, the Coordinating Ministry of Economic Affairs released a new Tobacco Roadmap on the importance of the industry. This Tobacco Roadmap was the product of Independent Research and Advisory Indonesia (IRAI), a think-tank that the Ministry engaged, whose founder and head was the former CEO of Sampoerna Foundation, the charity arm of PT HM Sampoerna, which is owned by one of the world’s biggest cigarette manufacturers. IRAI lists Sampoerna Strategic, a tobacco-related entity, as one of its clients.

The pro-industry Tobacco Roadmap rationalizes the importance of the tobacco industry to the economy and argues for its protection and growth until 2045, rehashing past arguments used by the industry to oppose tobacco control.

It formed the basis to initiate and support measures to reject tobacco tax increase and simplification. The Roadmap was introduced and explained to various government departments including with the Ministry of Health.

Various pro-tobacco industry front groups were mobilized to build support and create public pressure. These groups vocalized a consistent main message that increasing tax will ruin the industry that employs 6 million workers, resulting in massive unemployment and reduction in government revenue.

The messages of these groups were all well-aligned, echoed, and re-echoed to reinforce one another. Media coverage of their messages reached a crescendo at the appropriate time. On cue, academics and research institutes generated and released evidence that rejected tax increase and tiers simplification.

A prominent religious organization which has a powerful voice in the Muslim majority country issued a clear message that the government must revoke the excise simplification plan. Champions from relevant government ministries, such as Labor and Industry, made pro-industry statements that influenced the decision-making process up to the highest executive level (President’s level).

In contrast, voices from health groups supporting tax increase and simplification were less in frequency and magnitude compared to the pro-tobacco industry voices, such that at the end of 2018, following strong pressure from various pro-tobacco industry groups and institutions and systematic interference from the tobacco industry, the Government announced it will not increase the excise tax in 2019 and revoked the simplification roadmap.

The cancellation of the tax increase and annulment of the simplification roadmap show both the might of the tobacco industry in influencing policy makers and the vulnerability of the Government to industry interference.

While the tobacco industry’s strategy to defeat tax increase may not be new or novel, the willingness of policy makers to respond positively to the industry is astounding when juxtaposed against current global awareness on the harms of tobacco use.

Across the globe countries are setting target dates to become tobacco-free, but the Indonesian government is moving purposefully in the opposite direction to protect the tobacco industry for the next two decades, unmindful that about 230,000 Indonesians are killed annually by tobacco-related diseases.

Paradoxically, at high level meetings, Indonesia has committed to implement the UN Sustainable Development Goals (SDGs), which include a target to achieve health for all by reducing tobacco use.

Clearly other measures are needed to protect public health policy from being undermined by commercial interests. These include:

• • Adopting a government code of conduct that regulates interactions with the tobacco industry and its affiliates to ensure transparency and prevent industry interference.

• • Prohibiting institutions and individuals with tobacco industry ties from developing tobacco control policies because of their clear conflict of interests.

• Requiring political parties to disclose their funding sources as part of good governance.

*SEATCA is a multi-sectoral non-governmental alliance promoting health and saving lives by assisting ASEAN countries to accelerate and effectively implement the evidence-based tobacco control measures contained in the WHO FCTC. Acknowledged by governments, academic institutions, and civil society for its advancement of tobacco control movements in Southeast Asia, the WHO bestowed on SEATCA the World No Tobacco Day Award in 2004 and the WHO Director-General’s Special Recognition Award in 2014.

Excerpt:

A cigarette vendor in Manila sells a pack of 20 sticks for less than a dollar. Credit: Kara Santos/IPS

By Mary Assunta and Wendell Balderas
BANGKOK, Thailand, Mar 14 2019 (IPS)

International Women’s Day on 8 March recognized and celebrated the progress women are making globally. The day also acknowledged the risks, exploitation and suffering many continue to endure.

The Southeast Asia Tobacco Control Alliance (SEATCA) puts the spotlight on the tobacco industry’s marketing tactics targeting women and girls especially in Asia to market its deadly products.

While smoking prevalence among females remains relatively low in Asia, smoking rates among adolescent girls in the Philippines, Malaysia, and Thailand however are higher than the rate among adult women respectively (9.1% vs 5.8%; 2.4% vs 1.4%; 5.2% vs 1.7%). Despite governments’ efforts to protect public health, tobacco use remains at epidemic proportions.

This is no coincidence. The tobacco industry needs “replacement” customers to maintain and increase its profits, and women and girls are an important market segment which represent the largest product-marketing opportunity the tobacco industry exploits.

Internal tobacco industry documents reveal that the tobacco industry has been notoriously targeting women and girls through their ads and novel products that promote social desirability, independence, sophistication, glamor, romance, and fun.

Women and girls, especially in low and middle-income countries (LMICs), are smoking in greater numbers than ever before. The tobacco industry has been introducing new products framed as “innovation” by refreshing brand marketing devices and imagery to appeal to women and young girls.

Through these product “innovation”, transnational tobacco companies (TTCs) introduce cigarette brands with new characteristics as flavored capsules and flavored filters and packaged and labelled with glitzy promotion.

These so-called innovations are gimmicks on specific product designs including filters, capsules, flavors, shape, color and perceived product’s strength or mildness.

Credit: Bigstock

Some of the tobacco industry’s deceptive tactics which blur the truth about the hazards of tobacco and instead promote smoking in developing countries among women and girls include the following:

• • In Indonesia, Malaysia and Singapore, some cigarettes brands are in “Lipstick” packs. Female-targeted elegant slims or super slim cigarettes are also packaged in slimmer packs and influences beliefs about smoking and weight control – an important predictor of smoking behavior among women.

• • In Malaysia, Cambodia and Vietnam “Less smoke smell (LSS)” technology has been used to promote cigarettes designed to reduce secondhand smoke odor.

• • Kiddie packs (10 to 12 sticks) are also available in Indonesia and the Philippines.

• • Flavor capsules in cigarettes are becoming increasingly popular and increase attractiveness of smoking. Some cigarettes sold in Cambodia, Indonesia, Malaysia, Philippines, Singapore and Vietnam have capsule filters that can be crushed to release additional menthol or other flavoring.

• Colors play an important role to enhance cigarette packaging and labeling to represent flavors and strength within brand families. The brand image is created by attention-grabbing designs and appealing colors to indicate flavors (such as strawberry, orange and apple) and communicate the false impression of lower tar or mild cigarette. Gold and silver convey ‘low-tar’, green for menthol and blue for ‘light’ or icy/cool.

To divert public attention away from the harm and damage caused by the industry, the TTCs have been conducting public relations stunts about employment and gender equity.

Philip Morris International boasted an ‘Equal-Salary certification’ it received, conveniently timed for International Women’s Day. TTCs routinely receive an obscure ‘top employer’ awards while simultaneously fighting smoke-free policies.

According to the US Centers for Disease Control and Prevention (CDC), “a woman’s risk of dying from smoking has more than tripled and is now equal to men’s risk”. This means that women are also at higher risk for heart attacks, strokes, lung cancer, emphysema, and other serious chronic illnesses such as diabetes.

A sudden concern for smoking is the new public rhetoric of the tobacco industry to justify a new range of so-called “less harmful” products such as heated tobacco products, while simultaneously selling regular cigarettes which form the bulk of their profits.

The current sixty-third session of the Commission on the Status of Women (CSW) at the United Nations Headquarters in New York, (11 – 22 March) is expected address women empowerment and their vital roles as agents of development in making progress across all Sustainable Development Goals (SDGs) and targets.

It is timely to discuss the tobacco epidemic among women especially in the LMICs and the concerted effort governments must make to curb this scourge.

Preventing an epidemic of tobacco-related diseases among women in the LMICs is one of the greatest public health opportunities for governments of our time. The global health treaty, WHO Framework Convention on Tobacco Control (FCTC) has been explicitly identified as a means to achieve the SDG health goal.

Steps governments should take to prevent this epidemic include banning tobacco advertising and promotions such as pack displays and applying plain packaging which requires cigarette packs to be sold in a standardized size, shape, and drab brown color, free of any logos or images.

In September 2019, Thailand’s legislation on standardized packaging of tobacco will take effect and Singapore will follow soon. Standardized packaging removes the attractiveness of tobacco products and reduces the ability of tobacco packaging to mislead consumers about its harmful effects.

Other equally important actions in the FCTC include increasing tobacco taxes and making public and work places 100% smoke-free.

*SEATCA is a multi-sectoral non-governmental alliance promoting health and saving lives by assisting ASEAN countries to accelerate and effectively implement the evidence-based tobacco control measures contained in the WHO FCTC. Acknowledged by governments, academic institutions, and civil society for its advancement of tobacco control movements in Southeast Asia, the WHO bestowed on SEATCA the World No Tobacco Day Award in 2004 and the WHO Director-General’s Special Recognition Award in 2014.

Excerpt:

Tobacco pickers carry leaves to one of the sheds where they are cured on the Rosario plantation in San Juan y Martínez, in Vuelta Abajo, a western Cuban region famous for producing premium cigars. Credit: Jorge Luis Baños/IPS

By Wendell C Balderas
BANGKOK, Thailand, Nov 20 2018 (IPS)

Thailand is set to become the first Asian country to introduce standardized packaging of tobacco. On 14 November 2018, the Thai National Committee on Tobacco Control approved the Ministry of Health Regulation that requires cigarettes in Thailand to be sold in packaging stripped of the fancy, colorful and unique cigarette branding.

Instead, the packs will be in drab brown color, free of any logos or images with 85 percent pictorial health warnings on both sides. Tobacco brand names can only be printed in a standardized font type, size, color, and location. This regulation will be gazetted soon and implementation will be in 270 days.

Standardized packaging is the global best practice in packaging tobacco products as recommended in the WHO Framework Convention on Tobacco Control Article 11 (Packaging and labelling) and 13 (Tobacco advertising, promotion and sponsorship) Guidelines and are designed to make smoking less appealing.

With this move, Thailand continues to be a leader in tobacco control in Asia joining seven other countries worldwide already implementing standardized packaging.

Standardized packaging’s promises to reduce the attractiveness of tobacco products, eliminate tobacco packaging as a form of advertising, and increase the noticeability and effectiveness of pictorial health warnings.

This will also reduce the tobacco industry’s ability to market to young people who have not started using tobacco, support adult tobacco users who want to quit, and help prevent ex-users from relapsing. But is there evidence to support this?

While the tobacco industry denies the evidence, studies done in Australia and the United Kingdom show standardized packaging works. A national survey measuring Australian smokers’ responses one-year post-implementation found that more adult smokers noticed graphic health warnings and attributed their motivation to quit to the warnings.

A year after implementation, another study showed sustained reduction in visible smoking. The sustained reduction suggests that plain packaging may be changing norms about smoking in public.

A global independent network, the Cochrane review, has reviewed, 51 peer-reviewed studies, investigating the impact of standardized packaging focusing on associations between the use of standardized packaging and changes in the prevalence of smoking, number of people starting smoking, the number of people stopping, or the number of people relapsing after attempting to quit.

This systematic review of the evidence points to the effectiveness of plain packaging.
The review also mentions evidence from eye-tracking studies that adults and teenagers pay more attention to health warnings on standardized packs compared to branded packs.

Tobacco from standardized packs has been rated as tasting worse than from branded packs by smokers, and as being lower quality. There is also evidence supporting the idea that teenagers who see standardized packaging are less likely to report wanting to start smoking than those who see branded packaging.

Thailand’s new regulation is part of a comprehensive set of measures in the Tobacco Products Control Act passed in March 2017 by the Thai National Legislative Assembly. Other important measures in the law include the ban on tobacco-related Corporate Social Responsibility (CSR) activities, ban on single stick sales, requiring the tobacco industry to report its marketing activities, and increased penalty fee for smoking in prohibited areas from THB 2,000 ($60.89) to THB 5,000 ($152.23).

Earlier this November, Singapore announced its plans for standardized packaging and the domino effect has begun. Singapore’s Tobacco Control of Advertisements and Sale Act will be amended moving towards standardized packaging to come into effect in 2019.

Worldwide, Australia was the first country to mandate plain packaging in 2012. Since then, eight other countries, namely, France, the United Kingdom, Hungary, Ireland, New Zealand, Norway, Uruguay, Slovenia, and Mauritius have also introduced plain or standardized packaging laws, and at least 16 other jurisdictions are formally considering the same.

Since plain packaging is effective and will reduce smoking, the tobacco industry countered by suing Australia, France, the UK, and the EU, but failed in all its legal challenges.

In June this year, a World Trade Organization (WTO) dispute panel upheld Australia’s plain packaging law as being consistent with international trade and intellectual property laws.

The tobacco industry has a history of using the threat of legal challenges to intimidate governments, particularly in low and middle-income countries that have limited resources to fight the industry in court, but these latest announcements by Thailand and Singapore and the recent WTO ruling in favor of Australia should encourage more countries to adopt and implement this life-saving measure.

SEATCA is very delighted with this important development in the the history of tobacco control in Asia and we look forward to Thailand implementing this law and monitoring the compliance.

This new law will not only help the more than 10 million current smokers to quit but more importantly stop children from being addicted to tobacco and protect the Thai people from being exposed to secondhand smoke.

Stay tuned for the next country in Asia who will follow Thailand and Singapore’s strategic action to protect public health.

Excerpt:

According to the World Health Organisation (WHO), there will be between 1.5 and 1.9 billion smokers worldwide in 2025. Credit: Marius Mellebye/CC-BY-2.0

By Diana Mendoza
ABU DHABI, Apr 2 2015 (IPS)

The numbers are in, and there’s not much to celebrate: every year, about six million people die as a result of tobacco use, including 600,000 who succumb to the effects of second-hand smoke.

Whether consumed by smoking or through other means, tobacco is a deadly business, and while usage statistics vary drastically across countries, time periods and age-groups, one thing is plain to policy makers all over the world: tobacco is going to be a huge development challenge in the coming decade.

“In tobacco and smoking, we see death and disease. The tobacco industry sees a marketplace." -- Matthew Myers, president of the Campaign for Tobacco-Free Kids
According to the World Health Organisation (WHO), “Tobacco is the only legal drug that kills many of its users when used exactly as intended by manufacturers.” Smoking in particular, and other forms of tobacco use to a lesser degree, has been found to increase the risk of non-communicable diseases (NCDs), including chronic respiratory conditions, cardiovascular illnesses, and cancers of all stripes.

Already the global burden of NCDs is tremendous, accounting for the most number of deaths worldwide. Some 36 million die annually from NCDs, representing 63 percent of global deaths. Of these, more than 14 million people die prematurely, before the age of 70.

In a bid to stem this rampant loss of life, governments all over the world have signed numerous treaties and protocols, including the WHO Framework Convention on Tobacco Control (FCTC), which presently boasts 180 states parties covering 90 percent of the world’s population.

One of the convention’s goals is to achieve a 30-percent reduction in tobacco use among people aged 15 years and older by 2025.

By some calculations, the international community is moving slowly but surely towards this target. For instance, a new WHO study released last month found that in 2010 there were 3.9 billion non-smokers aged 15 years and over in WHO member states (or 78 percent of the population of 5.1 billion people over the age of 15).

The number of non-smokers is projected to rise to five billion (or 81 percent of the projected population of 6.1 billion people aged 15 and up) by 2025 if the current pace of tobacco cessation continues, the report said.

According to a study published last month by the UK-based medical journal, The Lancet, the prevalence of tobacco smoking among men fell in 125 out of 173 countries surveyed, and the smoking rate among women fell in 156 countries out of 178, in the 2000-2010 period.

But while these trends are positive, a closer look at the data shows that at current levels of progress, only 37 countries worldwide, or just 21 percent of all member states, stand ready to meet the Global Action Plan for the Prevention and Control of NCDs 2013-2020.

In fact, according to the WHO, there will be between 1.5 and 1.9 billion smokers worldwide in 2025, representing a potential health crisis of severe proportions.

Catching them young – killing them young?

Last month some 3,000 tobacco control advocates closed the 16th World Conference on Tobacco or Health (WCOTH) here in Abu Dhabi, capital of the United Arab Emirates (UAE), with appeals to world leaders to crack down on the tobacco industry’s campaign to lure young people into the habit.

Among other demands, activists and experts pressed governments to enforce bans on massive advertising campaigns, which many see as a gateway to what could become a lifetime of smoking.

In 2008, the WHO reported that 30 percent of young teens worldwide aged 13 to 16 smoke cigarettes, with between 80,000 and 100,000 children taking up the habit each day.

The organisation estimates that half of those who start smoking in their adolescent years will continue smoking for the next 15 to 20 years of their life, lending credibility to the widely held fear that when tobacco use starts young, life might also end young.

From the music and fashion industries to food and sports, the multi-billion-dollar tobacco industry is finding marketing and advertising opportunities to attract scores of potential young consumers, since their curiosity and tendency to experiment have long marked them as a key ‘target’ group.

“In tobacco and smoking, we see death and disease. The tobacco industry sees a marketplace,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids, a leading US-based tobacco control campaign organisation.

In a statement released back in January, Myers alleged, “The tobacco industry spends 8.8 billion dollars a year – one million dollars an hour – on marketing, much of it in ways that make these products appealing and accessible to children.”

“They also use all means – legal and illegal – to sell their deadly products, deceive the public and policy makers by attempting to appear credible and trustworthy, and use lawyers, lobbyists, and public relations firms to undermine good government and the will of the people,” Myers said during the WCOTH last month.

From rock concerts to sporting events and from cafes to nightclubs, where young people of a higher income bracket typically socialise, cigarettes are readily available, making it difficult to avoid the pull of peer pressure.

Experts say young women, especially those who are economically independent, also fall into the category of an emerging market for the tobacco industry, as they seek fresh outlets for expressing their newfound freedom.

Myers cited Russia, where 25 percent of young women between 18 and 30 years old have taken up the habit, and China, where the equating of cigarette smoking with high fashion is evident in the country’s major cities like Beijing and Shanghai.

Neither Russia nor China is expected to meet the smoking component of the global NCD target by 2025.

Although Russia could witness a decrease in the number of smokers from 46.9 million in 2010 to 36.6 million in 2025, and China is slated to slash its smokers from 303.9 million in 2010 to 291 million in 2025, the rate of decrease in both countries is too low.

The situation is particularly dire in China, where an estimated 740 million suffer from exposure to second-hand smoke. The WHO estimates that 1.3 million die here each year from lung cancer, accounting for one-third of lung cancer-related deaths globally.

Judith Mackay, senior adviser of the World Lung Foundation, said Asian women in particular are being targeted by the industry because of the number of developing countries and fast-growing economies in the region with large young female populations.

“For developing countries in this region, the style of advertising in the 50s has come back – portraying smoking among young women as cool and sexy,” she said during a press conference in Abu Dhabi.

A 2010 report by the George Institute of Global Health stated that Asia and the Pacific were home to 30 percent of all smokers in the world, with India and China contributing hugely to these numbers.

In a bid to help member countries meet the smoking component of the NCD target, the WHO introduced a set of measures called MPOWER, encapsulating efforts to monitor tobacco use, protect people from tobacco smoke, offer help to those seeking to quit the habit, warn about the dangers of tobacco use, enforce bans on advertising, promotion and sponsorship, and raise taxes on tobacco products.

Such measures will not be easily implemented but as WHO Director-General Margaret Chan pointed out, “It’s going to be a tough fight but we should not give up until […] the tobacco industry goes out of business.”

Edited by Kanya D’Almeida