November 28, 2016

Thailand on front lines of tobacco control

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Thailand has won praise from a United Nations conference on tobacco control for its success in fighting off legal challenges from the tobacco industry in the last two years.

Thailand requires some of the world's largest pictorial warnings and is moving toward plain tobacco packaging, as shown in the mockup above, which prohibits the use of logos, colours and branding. Photo: Chanat Katanyu

The conference commended Thailand and six other countries for conveying the message to the tobacco industry that public health and human rights must prevail over trade considerations.

The message was delivered at the seventh Conference of Parties to the World Health Organisation Framework Convention on Tobacco Control (FCTC), held in Greater Noida, near New Delhi, from Nov 7-12.

"We must applaud the bold action taken by many parties during the last two years and it is reassuring that the treaty and the standards adopted by [the conference] have helped you protect your decisions against legal challenges," said Dr Vera da Costa e Silva, head of the convention secretariat.

"To name a few examples, Australia, Kenya, Thailand, India, Uruguay, the United Kingdom and France have shown a steady approach to tobacco industry-initiated court cases, showing that international trade cannot expand at the expense of health and human rights."

Thailand and India now require pictorial warnings on cigarettes and other tobacco products covering 85% of the space on packets. Only Nepal has a higher requirement, at 90%, a standard that Vanuatu will adopt next year. Thailand and India, particularly the latter, also levy high taxes on tobacco products.

Thailand, along with Laos and Vietnam, also dedicates tobacco excise revenues to tobacco-control programmes, according to a report by the Southeast Asia Tobacco Control Alliance (Seatca).

However, a new Seatca scorecard, measuring FCTC compliance in Asean, places Thailand third with a 67.1% enforcement rate after Singapore (80.5%) and Brunei (71.%). The scores reflect factors such as protection from tobacco industry interference, price and tax measures, packaging and labelling rules, smoke-free environments, protection from exposure to tobacco smoke, education, communication and public awareness; tobacco advertising, promotion and sponsorship; tobacco dependence and cessation programmes.

This month's meeting in India adopted significant decisions relating to tobacco industry interference, electronic nicotine and non-nicotine delivery systems, civil liability, tobacco-control strategies that reflect gender-specific risks, and economically sustainable alternatives to tobacco growing.

According to the FCTC, tobacco will kill about one billion people in the 21st century and by 2030, over 80% of all tobacco-related mortality will be in the low- and middle-income countries.

The 180 participating nations also adopted a resolution to ensure that non-tobacco producing countries do not start producing tobacco. As well, they agreed that governments of producing countries should do more to explore alternative crops that provide farmers with similar or better incomes.

India and Bangladesh proposed to collaborate with Southeast Asian countries in finding alternative crops and livelihoods for tobacco farmers.

"We will arrange a meeting of tobacco farmers with the ministries of commerce and agriculture," Arun Kumar Panda, an additional secretary in the health ministry, told Asia Focus.

India, Thailand and Uruguay also proposed the creation of expert groups to devise recommendations for combating legal challenges from the tobacco industry.

Around 30 million farmers in India, mainly located in Prime Minister Narendra Modi's native Gujarat and the two southern states of Karnataka and Andhra Pradesh, grow tobacco. While the Gujarat farmers grow tobacco for beedis (slim and cheap Indian traditional cigarettes), the southern farmers produce flue-cured Virginia (FCV) tobacco. The country earns around US$4.5 billion from taxes on tobacco products.

Surprisingly, only 11% of the tobacco grown goes into legal cigarettes that contribute 87% of India's tobacco excise revenue. The rest is consumed in the form of illegal cigarettes, beedis, smokeless tobacco such as khaini (raw tobacco) and gutkha (a combination of areca nut, slaked lime and paraffin wax, sweet or savoury flavourings and tobacco), according to the Tobacco Institute of India.

Ravi Mehrotra, director of the Institute of Cytology and Preventive Oncology under the Department of Health Research, says 82% of smokeless tobacco users live in the WHO's Southeast Asia region, which groups Thailand, Indonesia and Myanmar with India, Sri Lanka and Bangladesh.

He cited a 2014 study estimating that 350,000 people die from smokeless tobacco in India every year, including 100,000 cancer deaths.

Manoj Reddy, manager for exports with the Indian Tobacco Board, told Asia Focus that the country exported raw tobacco and tobacco products worth $901 million to 100 countries. He said it would be difficult to find alternative crops as remunerative as tobacco, a cash crop grown in light and heavy black cotton soil.

Ironically, the Indian government owns more than a 30% stake in Indian Tobacco Co Ltd, which has major stakes in hotels, consumer goods and tobacco production. Recently, the Union Health Ministry asked the government to withdraw its stake.

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