Chai Kritiyapichatkul, National Professional Officer - Tobacco Control at the World Health Organization (WHO) in Bangkok, rues that, "We have one of the best tobacco control laws in the world. But the enforcement is weak. We are working hard to strengthen it. The indirect advertisement and sponsoring by tobacco companies is another challenge the Thai tobacco control network is focussing on."
"The best way is to educate communities," Chai adds, giving an example: "We are now letting schools know that it is dangerous to have tobacco companies sponsor their activities. That it eventually harms the children. That there is enough other ways of funding."
Professor Dr. Prakit Vathesatogkit, Executive Secretary of Action on Smoking and Health Foundation (ASH) Thailand agrees that "there are violators, especially in the provinces. And while the tobacco product control act bans advertisement and promotion, the tobacco industry is violating it. They put their brand-name on non- tobacco products; organize events using their company name, which is not covered by the law; use a pretty girl to promote sale. Poor law enforcement and loopholes make these practices possible."
In her speech marking World No Tobacco Day 2011 (May 31), Dr. Maureen E. Birmingham, WHO representative to Thailand, praised the country for the measures it has taken in tobacco control and implementing the Framework Convention on Tobacco Control (FCTC). However, she conceded that
despite progress, challenges in Thailand persist--"Smoking rates remain high among adult men, a higher proportion of younger women now smoke, and exposure to second hand smoke remains quite high. So much more can be done and must be done."
In an exclusive interview given to Citizen News Service, Dr Birmingham called upon individuals to encourage and help governments to fulfil their commitments under the FCTC treaty, like a social movement for a smoke free environment. She said, "If the tobacco industry sponsors sports events or even events for children, if they launch flavoured cigarettes to have more appeal to women, people can and should react to that. They can help to de-normalize smoking in societies."
Organizations like ASH are trying to spread awareness in communities to make a difference. Executive Secretary Prakit recalls: "When we started 25 years ago we advocated for three groups not to smoke--monks, teachers and medical doctors. At that time, it was common for people, when making merit, to give monks not only food but also packs of cigarettes. Our first poster stated that giving cigarettes to a monk is a sin. It harms the monk. I think in big cities people no longer give them cigarettes now, and in rural areas maybe only some."
Yet, according to Prakrit, even today, of the three groups, the monks remain the biggest smokers, and temples are worse in abiding by smoke free laws than schools and hospitals. Habits are hard to break. But even there, individuals can make a change. He feels that children can influence parents to quit smoking, and so can friends and spouses assist a smoker to quit.
"We now campaign to make people not smoke at home. Making the workplace, home and car smoke free will help a smoker to quit, will make it easier."
Prakit feels that, "the government is still lacking in helping people to stop smoking. Last year, 60 percent of Thailand's current 12 million smokers tried to stop. Some smokers may need medication to stop smoking, but these and other smoking cessation services are not covered under the health insurance coverage. ASH and other organizations are calling upon the government to change this."
WHO Officer Chai, explains that, in the past few years, cessation services have expanded in Thailand. More doctors, nurses, community health volunteers and pharmacists are being trained to help stop smoking. More cessation clinics have opened, and the 'quit line', a national telephone service that people can call for advice, is becoming increasingly popular.
Chai notes, "Most people who want to quit smoking just need good advice, only a few need medicines. Still, one medicine in now covered under the health insurance. We are trying to move forward, requesting the government to include more effective medicines."
Tobacco control advocates are further asking the government to strengthen its taxation system to raise the prices of cigarettes. Prakit emphasizes that hand-rolled cigarettes, are currently often exempted from taxes, and should also be included. "Half of the smokers in rural areas smoke hand-rolled cigarettes, which are very cheap. And the number of smokers who switch to hand-rolled cigarettes is increasing."
As of now, it seems that Thailand has a long way to go for effective tobacco control. Policy makers will have to keep tobacco control as a priority and lessen the hold of the tobacco industry in shaping health policies. It is not enough to enact tobacco control laws. They will have to be implemented with single minded determination, with the cooperation of the public. Only then will the Thais breathe pure air instead of lethal cigarette smoke.
Babs Verblackt - CNS
(The author writes for Citizen News Service (CNS) and is based in Thailand. Email: email@example.com, website: www.citizen-news.org)