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Myanmar

Southeast Asia: Indonesia lags in curbing tobacco industry interference in policy making

11 Oct, 16 | by Marita Hefler, News Editor

Indonesia has once again emerged as a clear laggard in curbing tobacco industry interference in policy-making, according to a report ranking countries in the Southeast Asia region based on their level of implementation of Article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC). It is the third annual report on tobacco industry interference prepared by the Southeast Asia Tobacco Control Alliance (SEATCA).

Indonesia is the only country whose score increased in both the 2015 and 2016 reports among the seven surveyed in all three years (Brunei, Philippines, Cambodia, Malaysia, Thailand, Lao PDR, Vietnam and Indonesia). Its 2014 score of 78 (the first year of the survey) reflected a very high level of interference, and exceeds the scores of all other countries in any year of the survey. Indonesia’s score has continued to worsen, and stands at 84 in the 2016 report. The maximum possible score is 100; a higher score reflects a greater level of interference.

fig-5-seatca-rankings

Ranking of countries in the Southeast Asia region by tobacco industry interference, as calculated by SEATCA. Source: 2015 ASEAN report on implementation of WHO Framework Convention on Tobacco Control Article 5.3.

 

 

 

 

 

 

 

 

 

 

The dismal result is a stark illustration of why Indonesia, one of only a handful of countries that has not signed the FCTC, is a tobacco control ‘rogue state’. The country achieved worldwide infamy in 2010 when a video of a smoking toddler went viral. The video prompted increased media coverage of the striking absence of effective tobacco control policies and regulation in Indonesia, a situation which tobacco companies have taken full advantage of to saturate the country in cigarette advertising.

The Global Adults Tobacco Survey (GATS) of 15 low and middle income countries with high tobacco use published in 2012 found that Indonesia was among the countries with the highest adult male smoking prevalence at 67%. The lax regulations extend to failure to protect Indonesians from secondhand smoke; the GATS also found that 85% of people who visited restaurants were exposed to tobacco smoked and 82% reported seeing cigarette advertising within the last month – exposure far higher than any other country surveyed. Unsurprisingly, Indonesia’s (male) youth smoking prevalence is among the highest in the world; according to the 2014 Global Youth Tobacco Survey, 35% of boys aged 13-15 are current smokers.

At the other end of the scale, the standout countries in the 2016 report were Brunei and the Philippines. Brunei was ranked first for the third year in a row with a score of 29, unchanged from 2014 and 2015. The Philippines has seen a dramatic improvement from a score of 71 in 2014 down to 38 in 2016. Cambodia and Malaysia have also shown consistent improvement from their 2014 scores to be ranked equal fourth at a score of 49 in 2016.

The SEATCA report can be accessed by clicking here. 

Postcard from Myanmar: tea houses and tobacco promotion

22 Apr, 14 | by Marita Hefler, News Editor

 

Guest post by Peter Worland

The ubiquitous Myanmar tea house. You can hear the buzz of Burmese conversation emanating from such meeting places day and night. Old people on their daily catch up with neighbours meet here. Young people hang out and compare their new mobile phones here. New mums show off their beautiful babies here. We love these plentiful and congenial meeting places and can’t wait to find a table every morning as “coffee-o’clock” comes round. They call them tea houses and yes, the green tea comes complementary – but you pay for the coffee, and what coffee it is!

For foreigners like us it’s quite a display. With a broad smile and a flourish we see the young Burmese attendant hold a can high in the air and squirt condensed milk into a tin mug before adding a hot coffee mixture and depositing the combined steaming sweet stuff into tiny white cups. We have had to leave our usual coffee tastes behind, reminding ourselves that this is not our favourite Italian cafe back home in Sydney. No tattooed baristas proudly producing perfect espressos here. Myanmar coffee might not be to our taste, but it’s how the locals like it. So we’ve just had to get used to it.

But there is something happening in Myanmar’s tea houses that we will not get used to, nor accept: the massive increase in young people smoking, and the way in which the happy atmosphere and simple daily pleasantries of this much-loved tea house tradition have been besmirched by cigarettes and tobacco promotion.

Over the last four years my partner and I have been visiting Myanmar, we have seen one of the poorest countries in the world begin a magnificent transformation. When we first came, villagers we talked to would not speak Aung San Suu Kyi’s name for fear they would be taken away. Internet and mobile phones were restricted, new cars were as rare as hens’ teeth. But no more: the Myanmar that was a closed oppressive place four years ago with less than 300,000 visitors a year, will in 2014 welcome more than one million people. It is opening up to, and being accepted by, the world.

Must these people, now on the brink of political liberation after waiting for 60 years, be conned by the great marketers, big tobacco, into a life of increased disease and premature death?

In the tea house we see all the tricks and methods we witnessed in our youth in Australia. On each table next to the chilli sauce and serviette dispenser is a small clear plastic container containing loose cigarettes. Yesterday there was a promotion, so these cigarettes were free. Today the same cigarettes are five cents each. Pavlovian behaviour predicts that each day more and more young people will experiment. As we watch we see this happening; finding five cents to purchase a single cigarette is easy. The young boys who deliver our coffees with laughter and jokes also carry loose cigarettes from table to table, unashamedly pushing them on all they meet – old and young, some very young. We despair. The more who take it up, the more fashionable it becomes and so big tobacco’s insidious recruitment rolls on. 

Tobacco is arguably the most efficient man-made ‘murdering machine’ of non-combatants the world has known. Yet just as some countries are turning the tide, the peddling of this poison in many emerging economies is growing exponentially. Myanmar ratified the WHO Framework Convention on Tobacco Control in 2004, but we see no impact of it in the daily rituals of the tea houses. Does opening up to the world also have to mean welcoming the tobacco industry to the country?

As a tobacco warrior from the mid-1980s in Australia, I remember well the battle to get the first legislation in the world to ban tobacco advertising and hypothecate cigarette levies for health promotion purposes through the upper house of the Victorian state parliament. I personally witnessed Bruce Redpath (a noted Cancer Council supporter and prominent Australian business leader) phone the three main funders of the political party which were threatening to block the legislation. I listened to these leaders agree that “no one in business worth their salt would work for a tobacco company today. It is time to act?”

Act they did, and in 1987 the legislation passed into law. The Victorian Health Promotion Association – VicHealth – was born, and today the state of Victoria is a global leader in tobacco control. In 2001, Myanmar’s neighbour Thailand took the same step and established the Thai Health Promotion Foundation. Thailand’s achievements in tobacco control in the 13 years since show that the rise of the tobacco epidemic is not an inevitable and unavoidable by-product of economic development.

As we sip on our super-sweet coffees in our now favourite Mandalay tea house and look around us at the unfettered tobacco promotion, we can only hope that leaders like Bruce Redpath will emerge with the intellectual and moral courage to say it’s now time to act to control tobacco promotion in Myanmar; to stop the epidemic in its tracks.

Peter Worland is a former advisor to the Victorian Minister for Health. The full story of the Victorian Tobacco Act 1987 can be accessed here.

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