Tobacco industry interference: A review of three South East Asian countries.

BACKGROUND: The WHO Framework Convention on Tobacco Control (FCTC) Article 5.3 requires governments to protect tobacco control policies from the commercial interest of the tobacco industry (TI). TI interference is the biggest barrier to implementing comprehensive tobacco control measures. OBJECTIVE: This paper reviews the extent of the TI's interference in tobacco control policy development in three countries, Thailand, Myanmar, and Indonesia, and the governments' efforts to protect these policies. METHODS: The paper draws on incidents of TI interference reported in the 2016 Tobacco Industry Interference Index: ASEAN Report on Implementation of the WHO FCTC Article 5.3. Base data were obtained through a questionnaire on twenty most commonly reported incidents of interference from the FCTC Article 5.3 Guidelines recommendations. A scoring system was developed. RESULTS: All three countries faced varying levels of TI interference. Thailand, though known for its stringent tobacco control measures, still faced interference while Myanmar remains vulnerable. Indonesia faced the highest industry interference which may explain why it is lagging behind in tobacco control and remains a nonparty to the WHO FCTC. The TI gains access to government officials through offers of technical assistance and its corporate social responsibility activities. Transparency in dealing with the TI is needed in all three countries. Most governments have not set up disclosure procedures when dealing with the TI. CONCLUSION: Outside the Department/Ministry of Health, other departments remain unaware of Article 5.3, not utilizing its strength to regulate the TI. More concerted effort is needed to implement Article 5.3 to achieve greater success in tobacco control.

The relevance and prospects of advancing tobacco control in Indonesia.

Using published data about consumption, economic aspects, and legislation, this paper analyzes tobacco control in Indonesia, a major consumer and producer of tobacco products. Given its large population and smoking prevalence, Indonesia ranks fifth among countries with the highest tobacco consumption globally. Over 62% of Indonesian adult males smoke regularly, contributing to a growing burden of non-communicable diseases and enormous demands on the health care system. Tobacco control policies, however, have remained low on the political and public health agenda for many years. One reason was the contribution of tobacco to government revenues and employment, particularly in the industrial sector. But tobacco's importance in employment has fallen significantly since the 1970s from 38% of total manufacturing employment compared with 5.6% today. Widespread use of tobacco since the 1970s and the concomitant burden of non-communicable diseases have given rise to a more balanced view of the costs and benefits of tobacco production over the last decade. The first tobacco control regulation passed in 1999, succeeded by amendments in 2000 and 2003. Today, few restrictions exist on tobacco industry conduct, advertising, and promotion in Indonesia. We examine the relevance and prospects of advancing in Indonesia four cost-effective tobacco control strategies: price and tax measures, advertising bans, clean air legislation, and public education. We conclude with several suggestions for action for the public health community.