Tobacco Control – Lessons learnt from

fieldTara Singh Bam – Regional Advisor The Union Asia Pacific Office, SingaporeEmail: tsbam@theunion.org

The Tobacco Epidemic Worsening... Unless We Act Now

World Health Organization. WHO report on the global tobacco epidemic, 2008

The Leading Preventable Cause of Death in the World

World Health Organization. WHO report on the global tobacco epidemic, 2008

World Cigarette consumption- 2009Nearly 5.9 trillion cigarette consumed

• About 800 million adult men worldwide smoke cigarette (20% in high income and 80% in low income countries)

• Nearly 200 million adult women worldwide smoke cigarette

World cigarette consumption by region, 2009

Today’s teenager is tomorrow’s potential regular customer – Philip Morris USA 1981

Tobacco industry marketing campaigns targeting youth and children

Tobacco industry tactics

Smoke-Free Indonesian Cities

2008

2014100% smokefree policy

Limited smokefree policy, allowing designated smoking areas

Neighboring country

Neighboring country

6 provinces and 22 cities and districts with comprehensive (100% SF) SF policy. They cover about 56 million population

Indonesia- Smoke-free Laws reduce indoor air pollutionMean Concentrations of PM2.5 in Buildings in Bogor

Mea

n Co

ncen

tratio

ns o

f PM

2.5

Reducing indoor air pollution due to tobacco smoke by banning tobacco smoke in all indoor public places and work places

The use of ventilation, filtration, and “designated smoking areas” do not protect the public from the harms of secondhand smoke

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Pictorial health warning in Indonesia

Text to pictorial health warning - 2014

Target- Ban Inter-tabac Asia 2014

How Tobacco trade fair was stopped in Bali, Indonesia- lessons learned

Positive attitudes – converting the challenges into Opportunities - Change toward tobacco free

Goal- Tobacco Free Bali

Establishing target/goal

Thinking systematically

Learning from experience

Engaging others

Providing feedback

Authority- Governor

Responsibility but not authority – Udayana University, Bali-

Local actions- dissemination of local Data, smoke-free law – press meet, social mediaLetter of attention to Governor, mobilize student

Engaged people beyond health-Human Rights Commission-Muhammadiyah, NU-Bali Hotel Association-MOH-Child Protection agencies-ASEAN countries-OIC / global partners

Reviewed each activity at the end to figure out what went well.

Dortmund had planned to hold the trade fair Inter-tabac ASIA 27-28 Feb. 2014 in Bali. The company had obtained the required permits from Indonesian Ministry of Industry and Trade. Despites this, the trade fair must now be postponed. The Police of Bali have instructed this in writing

Governor statement-There is no space in Bali – you (TI) go to Hell

Bali successes encouraged – MOH circulated a letter to ban tobacco fairProvincial government of Jakarta banned

World Tobacco Asia Sep. 2014

Tobacco free world

How to lead When you are not the boss?

Mayors’ and Regents’ Alliance for Tobacco and NCD control – Indonesia -2011

Mayors Alliance to • Adopt and implement 100% smoke-free policy • Ban tobacco advertisements, promotion and

sponsorship • Advocacy for ratification of FCTC and tobacco

control law• Stop and discourage tobacco industry interferences

Some examples from Myanmar

Myanmar- Measuring indoor air (PM2.5) in smoking and non-smoking restaurants in Mandalay

Café City Mandalay- smoking Café Corner Mandalay –

Complete ban of smoking in indoor

Average level 21.7

Average level 175.6

Fine particle levels in this location are above the WHO guidance limit all of the time and suggest smoking leads to very poor air quality in this location

MOH, Myanmar February 2013 July 2013

The Government of the Republic of the Union of

Myanmar The Ministry of Health

Notification No. 5 / 2014 March 3, 2014

The notification bans smoking in all indoors of public and work places

Some examples from Nepal

Politics in pictorial health warning in Nepal 2010 -11

Always think Big

Pictorial health warning, an effective intervention in building community awareness to prevent future generation from tobacco use

Survey report of Pictorial Health warning in Nepal shows heightened the public awareness on danger

of tobacco use (n=275)

Media

What have we learnt?•building political will and its translation into actions•Enhancing people participation, enforcement •Disclosing tobacco industry interferences •Building positive story •Safeguarding tobacco control advocates

So what works?Leadership all about change. Anyone can lead •Determined the goals and act now•Perceived that challenges are the opportunities to bring changes- please – Do not miss opportunity •Systematic thinking and understanding of your environments •Engaging the people and organizations – think out of box•Self motivation inspires others •Your strategic actions lead to YOU WIN