best practices and challenges on smoke free environments in asean countries
TRANSCRIPT
Bungon RitthiphakdeeBungon Ritthiphakdee
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SFE as SFE as WORLD NO TOBACCO DAY WORLD NO TOBACCO DAY’s ’s themetheme1991 Public places and transport :
Better be tobacco free. 1992 Tobacco free work places :
Safer and healthier. 2001 Second-Hand Smoke :
Let’s Clear the Air. 2002 Tobacco Free Sports – Play it clean.2007 Smoke Free Environment
Smoke-free Policy in ASEAN
Milestones of the Smoking Ban in Singapore1970 Public buses, cinemas, theatres, 1973 Lifts1982 Amusement Centres1988 Hospitals, medical clinics, maternity and nursing homes, indoor areas of fast
food restaurants & indoor ice skating rinks 1989 Air-conditioned restaurants, departmental stores, supermarkets, convention
halls, indoor sports arena, public libraries & museums1992 Private buses, taxis, air-conditioned hair dressing salons, banks, Supreme
Court, Subordinate Courts & Small Claims Tribunals1994 ALL air-conditioned workplaces1995 ALL air-conditioned shopping centres, public queues, underground walkways1997 ALL schools, air-conditioned shops, enclosed areas in universities and private
clubs2005 ALL public toilets, bus shelters and interchanges, community clubs,
swimming pools and open air stadia2006 ALL hawker centres, coffeeshops and similar al-fresco eating establishments2007 ALL entertainment outlets such as pubs, bars, discos & lounges
Brunei: comprehensive in 2007Hospitals, medical clinics & nursing homesAny area in an educational institution or higher educational
institutionEntertainment centre includes amusement centre, cinema &
theatre (NB. Pubs & discos non-existence)Eating place (both A/C & non-A/C) Indoor sports area or sports stadium, bowling alley, billiard
saloon, gymnasium & aerobic & fitness centreShop, Shopping complex, Lobby of a hotel, Internet cafeBuilding or public place used for religious purposesAny motor omnibus, any private bus, any private hire bus, any
school bus, any taxicab, Public transport terminalGovernment premises, includes a building, tent or other
structure, whether permanent or otherwiseQueue of 2 or more person in a public place
Cambodia: religious settingsSmoke Free
Temples
Nine Ministries declare smoke free
Indonesia and Philippines:best practices in cities National
law/regulation allow designated Smoking areas
Lao PDR: Small but beautifulSmokefree World
Heritage citySmokefree HospitalsSmokefree
MinistriesSmokefree Women
UnionSmokefree SEA
Games
Laung Prabang: Smoke Free Heritage citySmoking not allowed in
World Heritage buildingsGovernment and private
officesSchools, hospitals and
templesHotels and guesthousesRestaurants (indoor)Night market
Thailand: Stepwise approach but fast Public transport Health Facilities Education facilities Religious places Government buildings Private office buildings Air conditioned restaurants Hotel lobby Internet shop Public park Indoor sport arena Night club and bar Non air con restaurants public places e.g. market
Vietnam: Strengthening legislative measuresNational policy, 2000: provide guideline for smoking ban including
encouraging people not to smoke at social festivals, weddings, funerals
Directive of MOH, 2001, “health facilities”Directive of Ministry of Transportation 2005, public
transportations, waiting areas and other crowded places.Prime Minister Directive, 2007
a) Total ban smoking at indoor work places, hospital, schools, kindergarten, places with high risks of firing and on public transport.
b) Places with smoking areas: indoor public places (libraries, cinemas, stadiums, exhibition centers and waiting rooms of train stations, bus stops, airports), indoor entertainment areas, restaurants, bars, karaokes, hotels and discos, separate areas need to be arranged for smokers;
100% smoke-free environments! Implement 100% smoke-free
environments for all indoor workplaces and public places
Enact legislation Implement and enforce the law Implement educational strategies to
reduce SHS exposure in the home
1. Not ComprehensiveAllow designated smoking areas
indoorNot cover all indoor workplaces
RestaurantsEntertainment facilities
Miss outdoor public placesMarketBeachBus stop
Can exposures be reduced through ventilation and “air cleaning”?
Aim: Reduce exposures to level of 1 death per 100000 workers per 40 year working lifetime
Current standard:
2.8 air changes per hour
Required ventilation:
8400 air changes per hour
Why designated smoking area should not be allowed?
It fails to protect people’s healthSmokersOthers employees esp. cleaners
Ventilation doesn’t workEconomic burden to owners of the place Risk of fireComplicated to enforced
There is no safe level of exposure to second hand smoke
Implementation of 100% smoke-free environments is the only strategy proven to provide an acceptable level of protection from the dangers of SHS exposure.
2. Need Legislation with penaltiesLegislation is far more effective than other
document,laws:
are binding; establish enforcement mechanisms;impose penalties for infringements; and level the playing field for business.
Where we are?Brunei Comprehensive law and policy
Cambodia Tobacco Control law drafted
Lao PDR Tobacco Control law drafted
Indonesia MOH directives/law drafted
Malaysia (nearly) Comprehensive law
Philippines (nearly) comprehensive law
Singapore Comprehensive Law and policy
Thailand Comprehensive Law and policy
Vietnam Directives/ law drafted
Simple, clear, enforceable, comprehensiveSimple & clear
Avoid complicated tests to determine when or where smoke-free settings are required (e.g. time of day or surface of the premise or designated smoking rooms),
Instead, require all indoor workplaces, public places and public transportation to be 100% smoke-free, all of the time.
EnforceableWho is responsible, what is the system of fines Imposing heavy penalities (for both public and trade offenders)
ComprehensiveProtection FOR ALLAvoid exempting certain classes of premises
Anticipate oppositionclaim that smoke-free laws
are not necessaryare not feasiblewill have a negative impact on business
Say ventilation solves the problemThe tobacco industry use a third party, e.g.
hotel/restaurant association or gambling, to promote its positions
Impact of Smoke-free Workplaces According to Philip MorrisTotal prohibition of smoking in workplaces
strongly affects industry volume Smokers facing these restrictions consume 11–
15% less on average and quit at a rate that is 84% higher than average
Milder workplace restrictions, such as smoking only in designated areas, have much less impact on quitting rates and very little effect on consumption
Philip Morris Inter-Office Correspondence. Philip Morris, USA, 1992
3. EnforcementHow can we have effective
implementation and enforcement with limited resources?
How to gather support to ensure legislation can be implemented successfully?
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Engaging key stakeholders e.g. restaurants association, and workplaces in promoting smoke free areas
Active consultation with the public on implementation
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On-going education on the harmful effects of ETS to create a conducive environment of support for the ban
Important role of media
Educate and consultRaise awareness among the
public and opinion leaders Key messages
Harm caused by SHS exposure
Elimination of smoke indoors is the only science-based solution
Right of all workers to be equally protected by law
No trade-off between health and economics
Develop implementation plan and ensure infrastructureImplementation plan
Involves stakeholdersInformation packages for business
Enforcement planCommunicate that enforcement will be fair and that
policy-makers are serious about it Groups of InspectorsReasonable “grace period”Monitor implementation
Infrastructure for enforcementFunding, signage, toll-free hotline
Involve civil societyCivil society involvement is
critical to creating a supportive political climate
Civil society has access to networks to which governments may not and may have greater freedom of communication
Governments should support and facilitate civil society’s participation in developing and implementing smoke-free laws.
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Smoke free home
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Do parents smoke while being with kids? 64.3% Smoking when going out with
kids 46.5% Smoking at home 37% Smoking in car while with kids 25% Smoking while watching TV with
kids
Kids suffer from parental smoking
(Source: ABAC Survey on parents smoking, November 2003)
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