AAYLF delegate from Australia Abigail Slater discusses the need to reduce smoking and tobacco usage in ASEAN
One in five adults in ASEAN nations smoke, and many of them begin smoking before the age of 201. Although smoking prevalence is generally declining in industrialised countries such as Australia (13.8% of adults in 20182), smoking prevalence continues to increase in ASEAN (26.6% of adults in 20131). The introduction of strong tobacco control policies is required to curb this epidemic.
The Burden of the Tobacco Epidemic
Aside from the known health effects, tobacco use is strongly linked to increased poverty and lower levels of educational attainment. Tobacco perpetuates vicious cycles of poverty, as smoking addicts are driven to spend a large proportion of their income on cigarettes, which deprives them of household income and decreases their spending on basic necessities. Tobacco users are also highly likely to fall seriously ill from tobacco-related diseases, with tobacco causing more than half a million deaths in ASEAN each year. Most ASEAN governments spend significantly more in tobacco-related healthcare costs than they gain from tobacco revenue1. Hence, greater funding, awareness and governmental support for tobacco control will be essential in the fight against poverty in ASEAN.
Tobacco Industry Interference
The ASEAN tobacco epidemic is marked by strong interference from local and multinational tobacco industries. These industries have effectively lobbied and dissuaded governments from developing and implementing effective tobacco control policies. The World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC)3 provides a set of recommendations to support governments in shielding their policies from industry influence.
All countries in ASEAN have ratified the FCTC except Indonesia4; this lack of progress in Indonesia is attributed to strong industry interference. Despite having a number of government objectives in place to warn the public about the health dangers of tobacco, Indonesia places no restrictions on tobacco advertising, promotion and sponsorship and there has been no change in the affordability of cigarettes since 20085. Given that Indonesia has the highest smoking prevalence in ASEAN (36.1% among adults4) and accounts for over 50% of the smoking population in ASEAN (50.68%4), urgent action is needed to garner political support and commitment from Indonesia’s government and stakeholders.
An ironic example of the unscrupulous tactics employed by tobacco companies was highlighted in 2017. Philip Morris International, a multinational tobacco company, announced that they would be funding a new non-profit organisation, ‘Foundation For A Smoke-Free World’6. This obvious conflict of interest has provoked unanimous opposition to the initiative from the WHO, academics and tobacco control advocates.
ASEAN-Australia Cooperation to Improve Tobacco Control
Smoking was ubiquitous in Australia in the mid 20th century, however, Australia’s smoking prevalence is now among the world’s lowest. Australia’s plain packaging laws, for example, were a world first when introduced in 2012, and set a precedent which has encouraged other countries to adopt similar laws. Thailand, an ASEAN leader in tobacco control, introduced plain packaging in September this year7. Singapore will implement plain cigarette packaging in July 20208.
With the economic and social burden of tobacco smoking expected to significantly increase in ASEAN over the next decade9, strategic ASEAN-Australia collaboration may help prevent and treat the tobacco epidemic. Practical ways in which ASEAN-Australia collaboration may support improved tobacco control include:
- Partnerships between tobacco control leaders (such as Australia, Thailand and Singapore) and other ASEAN nations to lend pro bono expertise for the development of tobacco control policies.
- Research collaboration to investigate effective means of tobacco control in developing nations, as previous findings from developed nations may not always be relevant. E.g. The efficacy of subsidising nicotine replacement therapy in developing nations.
- Generalised capacity building of health infrastructure to prevent and treat tobacco-related illnesses.
- Southeast Asia Tobacco Control Alliance. The Tobacco Control Atlas: ASEAN Region. (2018).
- Australian Bureau of Statistics. Smoking in Australia 2017-18. (2019).
- World Health Organization. WHO Framework Convention on Tobacco Control: Guidelines for implementation. (2013).
- Southeast Asia Tobacco Control Alliance. The ASEAN Tobacco Control Report. (2014).
- World Health Organisation. WHO report on the global tobacco epidemic: Indonesia. (2019).
- Yach, D. Foundation for a smoke-free world. Lancet 390, 1807–1810 (2017).
- Southeast Asia Tobacco Control Alliance. Thailand is first in Asia to usher in standardized tobacco packaging. (2018). Available at: https://seatca.org/thailand-is-first-in-asia-to-usher-in-standardized-tobacco-packaging/.
- Menon, M. Cigarette packs to be sold in standardised plain packaging from July 1 next year. The Straits Times (2019).
- The Cancer Council Australia. Australian aid and cancer control: Medium-term regional priorities. (2006).