SEATCA Tobacco Control Atlas ASEAN Region 4th Ed Sept 2018 PDF

Southeast Asia Tobacco Control Alliance
The
T bacco
ControlAtlas ASEAN Region
Fourth Edition September 2018

The Tobacco Control Atlas: ASEAN Region, Fourth Edition
Authors
Tan Yen Lian
Ulysses Dorotheo
Editorial Team:
Ms Bungon Ritthiphakdee, Dr Mary Assunta Kolandai, Dr Domilyn Villarreiz, Ms Sophapan Ratanachena, Dr May Myat Cho,
Ms Worrawan Jirathanapiwat and Ms Jennie Lyn Reyes.
Suggested citation:
Tan YL. and Dorotheo U. (2018). The Tobacco Control Atlas: ASEAN Region, Fourth Edition,
September 2018. Southeast Asia Tobacco Control Alliance (SEATCA), Bangkok. Thailand.
ISBN 978-616-7824-04-8
First published: September, 2018, 1,000 copies
Published by:
Southeast Asia Tobacco Control Alliance (SEATCA)
Thakolsuk Place, Room 2B, 115 Thoddamri Road, Dusit, Bangkok 10300 Thailand.
Telefax: +66 2 668 3650
Printed by:
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Tel: +66 87 331 6459
The information, findings, interpretations, and conclusions expressed herein are those of the author(s) and do not necessarily reflect the views of the
funding organization, its staff, or its Board of Directors.
While reasonable efforts have been made to ensure the accuracy of information presented in this report at the time of publication, SEATCA does
not warrant that the information in this document is complete and correct and shall not be liable for any damages incurred as a result of its use.
Any factual errors or omissions are unintentional. For any corrections, please contact SEATCA via email: info@seatca.org.
© Southeast Asia Tobacco Control Alliance 2018

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For more information, visit: www.seatca.org.

The
T bacco
ControlAtlas ASEAN Region
Tan Yen Lian

Ulysses Dorotheo
Fourth Edition September 2018

The Tobacco Control Atlas: ASEAN Region
Table of Contents
Foreword
. Professor Dr Judith Mackay iii
. Dr Hai-Rim Shin iv
. Dr Thaksaphon Thamarangsi v
Preface
. E. Ulysses Dorotheo vi
About SEATCA vii
Acknowledgements viii
THE PROBLEM
Chapter 1: Profiting from Deadly Products 3

. Tobacco industry players in ASEAN
. Tobacco leaf and cigarette production, sales, imports, and exports in ASEAN
. Market structure and distribution channels of cigarette sales in ASEAN
. Corporate Cover Up: PMI, BAT and JTI CSR in ASEAN
. Tobacco industry interference
. Lao PDR: Tobacco tax revenue losses
. Legal challenges by tobacco industry against tobacco control in ASEAN
. Tobacco industry front and lobby groups
THE IMPACT
Chapter 2: Nicotine and Tobacco Addiction 19

. Adult smoking rates in ASEAN
. Cigarette per capita consumption in ASEAN
. Average age of smoking in ASEAN
. Adult smokeless tobacco use in ASEAN
. Quit attempts
. Youth smoking rates in ASEAN
. Youth smoking initiation and targeting by tobacco industry
Chapter 3: Basic Needs Sacrificed 29

. Monthly cigarette expenditure among smokers ≥ 15 years old
. Poverty and Inequality
. Education level of adult smokers in ASEAN
. Tobacco expenditures, basic needs, and lost opportunities
Chapter 4: Burden of Death, Disease and Disability 33

. Annual tobacco-related deaths in ASEAN
. Direct and indirect tobacco-related health care costs in ASEAN
. Global economic cost and health burden of tobacco use
THE SOLUTION: WHO FCTC
Chapter 5: Human and Financial Resources for Tobacco Control 51

. Human resources for tobacco control in ASEAN
. Tobacco control and health budgets in ASEAN
. The Way Forward: Innovative National Financing Solutions
. Innovative funding mechanisms in ASEAN
. Case studies: Thailand and Vietnam
i
Table of Contents
Chapter 6: Insulating Public Health Policies from Insidious Interference 59
. FCTC Article 5.3 as an anti-corruption and good governance measure
. Implementation of FCTC Article 5.3 in ASEAN
Chapter 7: Reducing Tobacco Affordability and Consumption 65

. Prices and affordability of most popular cigarettes in ASEAN
. Cigarette tax systems in ASEAN
. Tobacco tax administration in ASEAN
. Tobacco taxation: higher revenues, better health, and benefits the poor
. Case studies: Thailand, Singapore, and Philippines
Chapter 8: Clearing the Air for a Healthier Environment 75

. 100% smoke-free public places (indoor) policy in ASEAN
. Secondhand smoke exposure in ASEAN
. Smoke-free settings (indoors and outdoors) based on national law in ASEAN
. Penalties or fees for violating smoke-free policy in ASEAN
. Regional smoke-free networks
. Smoke-free Cities Asia Pacific Network (SCAN)
. Smoke-free Heritage Sites & Cities Alliance (SHA)
. Smoke-free Universities Network (SFUN)
. Smoke-free Cities Model: Philippines
. Smoke-free awards: Malaysia and Philippines
Chapter 9: A Picture is Worth a Thousand Words 85

. Pictorial health warnings in ASEAN
. Among the world’s largest: Thailand, Brunei, Lao PDR, and Myanmar
. ASEAN image bank of copyright-free pictorial health warnings
. Evolution of pictorial health warnings in ASEAN
. Plain or standardized packaging: around the world and in ASEAN
. Disclosure of relevant constituents and emissions on tobacco packages
. Ban on false or misleading descriptors in ASEAN
Chapter 10: Pulling the Plug on Tobacco Marketing and Corporate Philanthropy 95
. Tobacco advertising at point-of-sale in ASEAN
. Bans on tobacco advertising, promotion and sponsorship in ASEAN
. Tobacco marketing channels
. Bans on retail display of tobacco products: Brunei, Singapore and Thailand
. Curbing tobacco industry CSR activities In ASEAN
. ISO 26000
Chapter 11: Protecting Future Generations from Nicotine Addiction 99

. Ban sale of single sticks of cigarettes in ASEAN
. Youth access to cigarettes
. Targeting youths with menthol and fruit-flavored cigarettes and kiddie packs
. Ban/restrictions on sale of heated tobacco products, e-cigarettes, and shisha in ASEAN
. Tobacco-free generations: Philippines, Singapore, and Thailand
Chapter 12: Alternative Livelihood for Tobacco Growers 105

. Tobacco farming in ASEAN
. Kenaf: Malaysia’s sustainable alternative to tobacco
. Profitability of other crops vs tobacco: Cambodia, Indonesia, Philippines
References 109
ii
Foreword
“...this atlas gives an immediate and visual comparison between countries, tracking
changes since the first edition. It is far more than just a statement of the status quo
of the epidemic – it is a challenge and a call to countries in the region to step up
action.”
With the publication of this 4th edition, the series of Indonesia always requires special mention – the enormity
Tobacco Control ASEAN Region Atlases is now of the tobacco epidemic, influence of the tobacco
established as a valuable source of information on the 10 industry, lack of political will and, unlike its neighbours,
ASEAN countries, presented against a wider global its incomprehensible failure to ratify the WHO
backdrop. Complex statistics on many aspects of tobacco Framework Convention on Tobacco Control (up to
are presented in a simple, colourful, graphic format, publication date of this atlas). Top of my personal wish
understandable ‘at a glance.’ list for the ASEAN region is that the 5th edition of the
atlas will be celebrating Indonesia finally ratifying the
The atlases are meticulously researched, and the authors WHO FCTC.
rely on authentic, solid scientific data sources, such as
WHO, The World Bank, The Tobacco Atlas, GATS But the problem is more widespread - under-funding of
surveys and official national statistics. tobacco control is extreme, except for Singapore, and
some countries still have no government funding
One of the greatest barriers for government action is mechanisms for tobacco control.
economic misconceptions that it might harm the
economy, and the atlas focuses on the huge economic The news is not all gloomy. Country after country is
debit of tobacco. The reality is that tobacco control is introducing sustained tobacco control measures, such as
good for the wealth as well as the health of nations. tobacco taxation designed to prevent youth smoking,
smoke-free areas, large graphic pack warnings, and more.
The atlas series spells out the way the tobacco industry,
its allies, front and lobby groups have continued to In conclusion, this atlas gives an immediate and visual
obstruct policy. Worryingly, only half the ASEAN comparison between countries, tracking changes since
countries have a code of conduct or guidelines on the the first edition. It is far more than just a statement of the
WHO Framework Convention on Tobacco Control status quo of the epidemic – it is a challenge and a call to
Article 5.3 on the protection of tobacco control policies countries in the region to step up action.
from tobacco industry interference.
Indonesia holds the unenviable record of 13 instances of

the tobacco industry’s use of legal challenges against
government policy, followed by 11 cases in the Professor Dr Judith Mackay
Philippines. Yet this is from an industry which cynically Director, Asian Consultancy on Tobacco Control
claims to be working towards a smoke-free world! Senior Advisor, Vital Strategies
iii
Foreword
“We need to continue to build on the gains we have made in ASEAN and around
the globe, but we cannot do so alone. Only by continuing to work alongside valued
partners like SEATCA will we eventually win this battle for public health.”
Tobacco control advocates in ASEAN and throughout tobacco control through insulating public health policy
the Asia Pacific are making progress in fighting the global from the influence of the tobacco industry, establishing
tobacco epidemic, but we continue to face a formidable strong tobacco control governance, and establishing
foe – an industry whose activities cause close to 7 million sound and innovative ways of financing to make tobacco
preventable deaths per year globally. products less affordable and to make tobacco control and
universal health more achievable. These and other
ASEAN is home to 10% of the world’s smoking measures have combined to contribute resoundingly to
population, and one in five adults smoke – many of them the achievement of our public health goals.
start before the age of 20. The tobacco industry in
ASEAN countries continues to rake in billions (USD) in We need to continue to build on the gains we have made
profits annually from their deadly products, leaving the in ASEAN and around the globe, but we cannot do so
public, and especially the poor, to bear the burden of alone. Only by continuing to work alongside valued
addiction and illness. In ASEAN countries, almost 586 partners like SEATCA will we eventually win this battle
billion cigarettes were produced in 2016, and 1.327 for public health.
billion cigarettes are smoked by adults daily.
Publications like this most recent edition of the Tobacco
Industry continues to use every weapon in its arsenal to Control Atlas for the ASEAN Region are important tools
protect this market and hinder our efforts to reduce the in our fight against the global tobacco epidemic. They
sale and consumption of tobacco products. But even help us to measure our progress, address any weaknesses
their huge profits are not enough, as industry tries to lure in our approaches, be mindful and vigilant to the
new generations into the tobacco trap by introducing relentless drive of the tobacco industry, and find new
novel products – sleek and shiny e-cigarettes and heated ways to unite and advance in order to protect our health
tobacco products peddled in gleaming flagship stores as a and the health of future generations.
“reduced risk products” by an industry that has proven
that it cannot be trusted. We congratulate SEATCA on having produced another
important milestone in our collective journey towards a
But we have at our disposal a proven solution to the tobacco-free world.
problem: the WHO Framework Convention on Tobacco
Control (FCTC). Implementation by countries of the Dr Hai-Rim Shin
comprehensive tobacco control measures in the WHO Acting Director
FCTC has averted many deaths and has pushed back Division of NCD and Health through the Life-Course
forcefully to protect people from the harms of tobacco World Health Organization
use. Some countries in ASEAN have blazed a trail for Regional Office for the Western Pacific
iv
Foreword
“Tobacco Industry Interference Index could helps policy makers to realize gaps in
implementation of the Article 5.3 and provide guidance to take steps for redressal. It
has been observed that the three SEAR countries faced tobacco industry interference
at varying levels.”
Tobacco use is global number one health risk, it is one of All SEAR countries face interference by tobacco
the largest causes of preventable deaths worldwide. industry. South East Asia Tobacco Control Alliance
Tobacco use harms health, well-being, quality of life of (SEATCA) has been mapping tobacco industry
population, users and non-users, bankrupts governments interference in three SEAR countries – Indonesia,
and families; as well as damage societal socio-economic Myanmar and Thailand as part of ASEAN region and
growth as well as environment and social equity. documents the same in Tobacco Industry Interference
In another word, tobacco use curbs sustainable Index with relevant examples of the TI’s interference
development in all forms. activities in nine countries in the ASEAN region and
provides a ranking for the countries. Tobacco Industry
WHO South-East Asia Region (SEAR) is home to one Interference Index could helps policy makers to realize
fourth of the world’s population. There are 246 million gaps in implementation of the Article 5.3 and provide
smokers and 290 million smokeless tobacco users in guidance to take steps for redressal. It has been observed
WHO SEAR, which makes it one of the largest tobacco that the three SEAR countries faced tobacco industry
consuming Regions in the world, housing one fourth of interference at varying levels. The tobacco industry gains
the global smokers and more than 80% of the smokeless access to government officials through offers of technical
tobacco users. assistance and its corporate social responsibility (CSR)
activities. Most governments have not set up procedures
Tobacco epidemic is driven by tobacco industry (TI) for disclosure when dealing with the tobacco industry
marketing and interferences. The industry interferes with and its representatives which is a lacuna impeding efforts
governments’ efforts in protecting public health through made for implementing effective tobacco control
various tactics. They all seek to lobby and dissuade policies.
governments from developing and implementing
stringent tobacco control policies that are effective in WHO Regional office for the South-East Asia stands
reducing tobacco use. Obliged by all Member Parties, the ready to work with our Member States and SEATCA to
WHO Framework Convention on Tobacco Control address the tobacco industry interference.
(FCTC) Article 5.3 Guidelines provides a set of
recommendations that governments can undertake to Dr Thaksaphon Thamarangsi
shield their policies from industry influence. Director,
Department of Noncommunicable Diseases and
Environmental Health,World Health Organization,
Regional Office for South-East Asia
v
Preface
“...SEATCA’s commitment to stand with ASEAN countries in the unending battle

waged by the tobacco industry against public health and to support country efforts to
fast-track implementation of tobacco control measures that protect and promote
health and save lives.”
Like its predecessors, this fourth iteration of SEATCA’s As usual, SEATCA is grateful to all of our country
Tobacco Control Atlas focusing on the ASEAN region is partners from all 10 ASEAN countries and TFI/WHO
packed with facts and figures and other useful country offices for their ever-valuable contributions
information on the state of tobacco control in ASEAN without which this atlas would not be possible. My
countries. It describes in no uncertain terms the gravity co-author, Ms. Tan Yen Lian, and I also thank all our
of the tobacco problem and the urgent need to accelerate SEATCA colleagues, who helped us update this edition,
implementation of tobacco control measures in line with as well as Dr. Judith Mackay for her encouragement and
the WHO Framework Convention on Tobacco Control. the Bill and Melinda Gates Foundation for its financial
support to SEATCA. We hope this updated edition will
We are certainly pleased that past editions of the atlas be as informative and useful as past editions, and we
have been well received, not only by health advocates and welcome all comments and suggestions to further
partners in ASEAN countries but also around the world. improve it in the fifth edition in 2020.
In highlighting both the progress that has been achieved
by ASEAN countries and the gaps and challenges that For now, turn the page, read the facts, be encouraged by
remain, this updated atlas reaffirms SEATCA’s our successes, and get fired up to keep fighting the good
commitment to stand with ASEAN countries in the fight!
unending battle waged by the tobacco industry against
public health and to support country efforts to fast-track
implementation of tobacco control measures that protect
and promote health and save lives. The success of our
collaborative efforts, therefore, will be best manifested in
future editions of the atlas that describe declining trends
in tobacco use and tobacco harms as a result of
strengthened tobacco control programmes in each E. Ulysses Dorotheo, MD, FPAO
country. Executive Director, SEATCA
vi
About SEATCA
Vision: “A healthy, sustainable and tobacco-free ASEAN”

Mission: “Working together to save lives by accelerating effective implementation of the FCTC
in ASEAN countries”
The Southeast Asia Tobacco Control Alliance (SEATCA) In recognition of SEATCA's outstanding contributions to
is a regional multi-sectorial alliance that supports ASEAN tobacco control in the region, WHO conferred SEATCA
member states in developing and implementing effective with its World No Tobacco Day Award in 2004 and the
and evidence- based tobacco control policies in line with WHO Director-General Special Recognition Award in
the WHO Framework Convention on Tobacco Control 2014.
(FCTC).
"SEATCA has emerged as a major catalyst for advances made in
Since 2001, SEATCA's programmes have contributed to tobacco control in the South East Asia Region, especially with
the advancement of the tobacco control movement in regard to policy and legislation."
Southeast Asia particularly in Cambodia, Indonesia, Lao - Dr. Shigeru Omi, then WHO Regional Director
PDR, Malaysia, Myanmar, Philippines, Thailand and for the Western Pacific, 2004.
Vietnam. Working closely with country partners, SEATCA's
strategies have been to support progressive policy "This award recognizes the valuable contribution of SEATCA as
development, strengthen national tobacco control working a regional ally especially in the area of tobacco taxation. SEATCA
groups, generate more local evidence for advancing policies, is a key catalyst and leader in tobacco tax reform in the ASEAN
and increase the number and capacity of tobacco control community bringing together various stakeholders and working
advocates. closely with ministries of health and finance."
- Dr. Shin Young-soo,WHO Regional Director
Over the years, SEATCA's efforts have been recognized for the Western Pacific, 2014.
nationally and internationally. SEATCA has also been
engaged by emerging alliances in tobacco control to share
the SEATCA model as a learning platform for tobacco
control best practices and lessons learned.
Southeast Asia Tobacco Control Alliance (SEATCA): Team Members

Dr Ulysses Dorotheo, Executive Director
Ms Bungon Ritthiphakdee, Advisor and Founder
Dr Mary Assunta Kolandai, Senior Policy Advisor
Dr Domilyn Villarreiz, Smoke-free Program Manager
Ms Tan Yen Lian, Knowledge and Information Manager
Ms Sophapan Ratanachena, Tobacco Tax Program Manager
Dr May Myat Cho, Sustainable Funding for Health Program Manager
Ms Worrawan Jirathanapiwat, Tobacco Industry Denormalization Program Manager
Ms Jennie Lyn Reyes, Monitoring and Evaluation Manager
Mr Pikasit Sitta, Information Systems Manager
Mr Wendell Balderas, Media and Communications Manager
Ms Sumalee Wangchotikul, Administrative Officer
Ms Supaporn Chiamchit, Operational Officer
vii
Acknowledgements
SEATCA would like to acknowledge the valuable contributions and support of all our various partners in the preparation of
this fourth edition “The Tobacco Control Atlas: ASEAN Region”. In particular, we would like to thank the following:
Brunei: Dr Hajah Norhayati Haji Kassim, Head of Health Promotion Centre, Ministry of Health, Brunei
Dr Siti Rosemawati binti Haji Md Yussof, Senior Medical Officer, Health Promotion Centre,
Ministry of Health, Brunei
Haji Amran bin Haji Ibrahim, Acting Deputy Controller of Customs, Royal Customs and Excise Department,
Ministry of Finance, Brunei
Haji Muhammad Faisal bin Haji Ahmad, Senior Health Officer, Health Enforcement Unit,
Ministry of Health, Brunei
Cambodia: Dr Yel Daravuth, National Professional Officer, WHO TFI Cambodia
Dr Mom Kong, Executive Director, Cambodia Movement for Health (CMH)
Indonesia: Dr Widyastuti Soerojo, Chair of Tobacco Control Special Unit, Indonesian Public Health Association (IPHA),
Indonesia
Dr Nunik Kusumawardani, Head of NCD and Mental Health Research Sub Division (Section),
Centre for Public Health Research and Development, National Institute of Health Research and Development
(NIHRD), Ministry of Health, Indonesia
Dr. Abdillah Ahsan, Lecturer, Faculty of Economics and Business and Vice Director,
Center for Islamic Economics and Business, University of Indonesia
Mr. Mouhamad Bigwanto, Vice Secretary General, Indonesian Public Health Association (IPHA), Indonesia
Lao PDR: Dr Maniphanh Vongphosy, SEATCA Project Coordinator, Lao PDR
Mr Douangkeo Thochongliachi, National Professional Officer, WHO TFI Lao PDR
Phonesathien Xayyalasy, Technical Officer, Hygiene and Health Promotion Department, Ministry of Health, Lao PDR
Malaysia: Dr Noraryana Hassan, Senior Principal Assistant Director, Tobacco Control Unit and FCTC Secretariat,
Disease Control Division (NCD), Ministry of Health, Malaysia
Dr Norliana Ismail, Senior Principal Assistant Director, Tobacco Control Unit and FCTC Secretariat,
Disease Control Division (NCD), Ministry of Health, Malaysia
Myanmar: Dr Mya Lay New, Deputy Director, Noncommunicable Diseases (NCD) Section, Disease Control Division,
Department of Public Health, Ministry of Health and Sports, Myanmar
Dr U Than Sein, President, People’s Health Foundation, Myanmar
Philippines: Dr Cristina Galang, Tobacco Control Program, Disease Prevention and Control Bureau,
Department of Health, Philippines
Ms Aurora Banda, Health Promotion and Communication Service, Department of Health, Philippines
Ms Rowena Sta. Clara, Statistics Division, Fiscal Policy and Planning Office, Department of Finance, Philippines
Ms Alexandra Leonardo, Statistics Division, Fiscal Policy and Planning Office, Department of Finance, Philippines
Mr Melanio "Morick" Mauricio III, Research Coordinator, HealthJustice Philippines
Mr Ralph Emerson Degollacion, Project Manager, HealthJustice Philippines
Singapore: Mr Chan Lit Fai, Manager Substance Abuse Department, Preventive Health Programmes Division,
Health Promotion Board, Singapore
Thailand: Prof Dr. Prakit Vathesatogkit, Executive Secretary, Action on Smoking and Health (ASH), Thailand
Dr Sarunya Benjakul Instructor, Department of Health Education and Behavioral Sciences, Faculty of Public Health,
Mahidol University, Thailand
Dr Pantip Chotibenjamaporn, Director, Bureau of Tobacco Control, Ministry of Public Health, Thailand
Mr Rungsun Munkong, Senior International Relations Specialist, Thai Health Promotion Foundation (ThaiHealth),
Thailand
Vietnam: Dr Luong Ngoc Khue, Director, Vietnam Tobacco Control Fund, Ministry of Health, Vietnam
Dr Phan Thi Hai, Vice Director, Vietnam Tobacco Control Fund, Ministry of Health, Vietnam
Dr Pham Thi Hoang Anh, Country Director, HealthBridge Foundation of Canada, Vietnam Office
Ms Le Thi Thu, Senior Project Manager, HealthBridge Foundation of Canada, Vietnam Office
Dr Nguyen Tuan Lam, National Professional Officer, WHO Country Office for Vietnam
Photo credits:
Dr Domilyn C. Villarreiz, Dr Ulysses Dorotheo, Dr Maniphanh Vongphosy, Mr Mouhamad Bigwanto, Ms Tan Yen Lian, Cambodia Movement
for Health (CMH), HealthJustice Philippines, Health Promotion Board, Singapore, Action on Smoking and Health (ASH), Thailand, HealthBridge
Foundation of Canada, Vietnam Office and collections from SEATCA Tobacco Industry Denormalization program, or as indicated.
viii
The
Pro
Produces products that kill around 7 million people worldwide annually.
Inventing new ways

Produces products specifically aimed at vulnerable group including teens,
women and girls.
blem
Sues governments to undermine, weaken or delay life-saving tobacco control
measures worldwide.
to sell harm.
Employs child labour to make tobacco products.
(%)
Rothmans of Pall Mall Myanmar Pte Ltd 40
British American Tobacco Myanmar Service Ltd
Myanmar Japan Tobacco Co
24
18 Tobacco industry players in ASEAN
Other companies 18
% Market Share (2016)
(%)
Lao Tobacco Co Ltd 62
Myanmar Lao-China Hongta Good Luck Tobacco Co Ltd 22
British American Tobacco Plc 2.5
Philip Morris International Inc 1.3
Other companies 12.2
(%)
Lao PDR Vietnam National Tobacco Corp (VINATABA) 59.9
British American Tobacco Plc 26.9
Dong Nai Tobacco Co 7.2
Vietnam Philip Morris International Inc 3.3
Japan Tobacco Inc 1.5
Other companies 1.3
Thailand
(%) (%)
Thailand Tobacco Monopoly 69.8* British American Tobacco Cambodia Ltd 32.3
Philip Morris (Thailand) Ltd 28 Huotraco International Ltd 31
Japan Tobacco International 0.3 Viniton Group Co Ltd 19
Other companies 1.9 Cambodia Japan Tobacco International 3.7
Other companies 14
* In 2018, Thailand Tobacco Monopoly market
share has dropped to 55% as a result of new tax Philippines (%)
rates that came into force in September 2017. Philip Morris Fortune Tobacco Corp 65.1
JT International (Philippines) Inc 26.1
British American Tobacco (Philippines) Ltd 0.8
La Suerte Cigar & Cigarette Factory 0.1
Other companies 8
Brunei Darussalam**
**No tobacco manufacturer and importer.
Malaysia
(%)
British American Tobacco (Malaysia) Berhad 57.1
JT International Tobacco (M) Sdn Bhd 24.2
Philip Morris (Malaysia) Sdn Bhd 14.7
AKJ Marketing Sdn Bhd 1.5
Other companies 2.5 (%)
Singapore Philip Morris Singapore Pte Ltd 46.9
Japan Tobacco International (Singapore) Pte Ltd 25.2
British American Tobacco (Singapore) Pte Ltd 20.7
Nanyang Bros Tobacco Co Ltd 1
(%)
Other companies 6
HM Sampoerna Tbk PT 28.8
Gudang Garam Tbk PT 23.1 Indonesia
Djarum PT 13
Bentoel Internasional Investama Tbk PT 7.2
Nojorono Tobacco Indonesia PT 5
Philip Morris Indonesia PT 4.8
Gelora Djaja PT 0.7
KT&G Corp 0.4
Other companies 17
3
Chapter 1
Profiting from Deadly Products
In the global tobacco market, transnational tobacco In an effort to enlarge their footprints in some ASEAN
companies (TTCs) have been shifting from developed countries, TTCs are undertaking mergers and joint
countries and targeting markets in poorer, less developed ventures, resulting in increased market control by a few
countries, where tobacco control is not as stringent and international companies. PMI has bought controlling
where tobacco use is significantly high among men and stakes in local cigarette companies in the Philippines and
attractively low among women. In 2018, the tobacco Indonesia. Imperial Brands (IB) (formerly Imperial
market growth in ASEAN is projected to reach a total of Tobacco Group) maintains its majority ownership in Lao
548 billion cigarettes sold, primarily in Indonesia, Tobacco Ltd (LTL), its joint venture with the Lao
Philippines, Thailand, and Vietnam. Government. State-owned companies are the leading
manufacturers in Thailand (Tobacco Authority of
Three of the world’s five largest TTCs – British American Thailand, the former Thailand Tobacco Monopoly –
Tobacco (BAT), Philip Morris International (PMI), and TTM) and Vietnam (Vietnam National Tobacco Corp –
Japan Tobacco International (JTI) control the cigarette VINATABA). PMI has the most (17 out of 46)
markets in several countries in ASEAN such as manufacturing facilities located in ASEAN countries,
Cambodia, Malaysia, Philippines, and Singapore. In while JTI, BAT and IB operate six, four and two
2016, tobacco manufacturers in six ASEAN countries manufacturing facilities, respectively, in selected ASEAN
(Indonesia, Malaysia, Philippines, Singapore, Thailand countries.
and Vietnam) produced close to 586 billion cigarettes.
Two ASEAN countries (Indonesia and Philippines) were The tobacco industry has been making billions in profits
among the world’s top 10 cigarette producers in 2016. from selling cigarettes in ASEAN with combined profit
of the world top four TTC (PMI, BAT, JTI, ITG)
estimated to be USD 27 billion in 2017.
Tobacco company shares of global cigarette market, 2016

Over the last decade, the
world’s five largest TTCs
(China National Tobacco
Corporation, Philip Morris
International, British American
Others 20% Tobacco, Japan Tobacco
International and Imperial
Tobacco) have dominated
Imperial Brands
(formerly Imperial Tobacco) the global cigarette market
China National Tobacco
4% Corporation (CNTC) (80% in 2016).
42%
Japan Tobacco International (JTI) [Operates mainly in China]
8%
British American Tobacco (BAT) Philip Morris International (PMI)

11% 14%
4
Chapter 1: Profiting from Deadly Products
Tobacco industry profit in global market (2017)
Cigarette production facilities Countries

Profit in USD (Billion)
11.5
Global Asia
9.19
Operates Operates
46 42 Operates
Operates
Located in Located in over
37* 51
32 55 Located in over
Sold in over
70 160
4.1
3.88
2.51
2.32
Philip Morris British American Japan Tobacco Imperial Brands

International (PMI) Tobacco (BAT) International (JTI)* (formerly Imperial Tobacco Group)*
*No data for Asia profit.
Big transnational tobacco companies consolidating their power in ASEAN

TTCs Year Acquisition and Merger
Japan Tobacco 2017 Japan Tobacco Group acquired assets of Mighty Corporation (including the distribution network, manufacturing
(JT) equipment, inventories and intellectual property) for PHP 46.8 billion (USD 936 million). It became No. 2 tobacco
company in the Philippines.
2017 Japan Tobacco acquired Karyadibya Mahardhika (KDM) and its distributor, PT. Surya Mustika Nusantara (“SMN”)
for USD 677 billion. It became the 6th largest tobacco company in Indonesia.
Philip Morris 2010 Philip Morris Philippines Manufacturing Inc merged

International with Fortune Tobacco Corp in 2010 known as “This transaction is a tremendous strategic fit for
(PMI) PMFTC Inc. It became the No. 1 tobacco company our business that will cement our leadership in
in the Philippines. South East Asia.”
Matteo Pellegrini,
President of Phillip Morris in Asia 2010,
referring to Philippines merger
2005 Philip Morris International bought a controlling stake in local cigarette manufacturer PT Hanjaya Mandala Sampoerna
for USD 5.2 billion in 2005. It became the No. 1 tobacco company in Indonesia.
British American 2009 BAT acquired PT Bentoel Internasional Investama Tbk for USD 494 million and became No.4 tobacco company in
Tobacco (BAT) Indonesia.
Imperial Brands 2001 Imperial Tobacco (now Imperial Brands), through its subsidiary, Coralma International (a French company) and S3T
Pte Ltd (a Singaporean company) entered into a joint venture with Lao Government to form Lao Tobacco Ltd (LTL)
that allows foreign investor to enjoy tax privileges and special benefits. It became the No. 1 tobacco company in
Lao PDR.
5
PMI in 32
Philip Morris International (PMI) operates 46 production facilities in 32
different countries and produces and sold over 800 billion cigarettes with 7
billion net profits in 2016. About 17 out of 46 manufacturing facilities are
countries located in ASEAN countries. Other tobacco companies including JTI, BAT
and IB have operated in six, four and two manufacturing facilities in
selected ASEAN countries respectively.
Country Tobacco manufacturing facilities in ASEAN

Philip Morris Japan Tobacco British American Tobacco Imperial Brands
International (PMI) International (JTI) (BAT) (IB)
Indonesia Dopok Jakarta Selatan Jakarta Selatan
Bantul
South Pandaan
Pandaan
Ngoro
Kertosono
Malang
Surabaya
Bojonegoro
Cepu
Blora
Mranggen
Bekasi
Malaysia Seremban* Kuala Lumpur Kuala Lumpur
Philippines Tanauan Malolos Rosario, Cavite

Marikina
Lao PDR Vientiane
Myanmar Yangon Yangon
Vietnam Ho Chi Minh City Ho Chi Minh City Ho Chi Minh City
Cambodia Phnom Penh Phnom Penh
* Philip Morris Malaysia (PMM) announced to discontinue its manufacturing plant in Malaysia in 2012 and currently operates a Cast Leaf plant in Seremban, which uses tobacco dust
and stems to manufacture reconstituted tobacco to be used as one of the blend components in Primary Processing in the PMI manufacturing centers around the world. This 100%
export facility is the largest in the world for PMI and its products are exported to PMI businesses around the globe.
In the Philippines, PMI has a tobacco leaf warehouse in the Subic Bay Free Port Zone and a
manufacturing facility in the First Philippines Industrial Park. It received income tax holiday
(ITH) for four (4) to a maximum eight (8) years; after the ITH, exemption from national and
local taxes with only a special 5% tax rate on gross income; and exemption from duties and
taxes on imported capital equipment spare parts, material and supplies.
6
_
Indonesia and Philippines: Tobacco leaf production (2010 2017)
(Million kg)
250
226,704,000
214,524,000
195,260,000 197,507,000 196,154,000
200 Indonesia
150 164,448,000
135,678,000
100
67,864,901 68,726,727
51,946,673 56,455,000 51,024,000
50 Philippines
0
2010 2011 2012 2013 2014 2015 2016 2017
Cigarette production in ASEAN (2016)
Vietnam
(Million sticks) 106,848
Thailand
36,143 Indonesia
342,000
Singapore
6,698
Philippines
84,963
Malaysia
9,422
7
2 ASEAN countries in world’s top 10 cigarette markets by volume (2016)
2,350.5
316.1
(Million sticks) 350
Retail Volume
278.4
300
263.4
250
200 173.9
150 79.1
105.5 90.0
100 86.1 84.9
50
0 Country
China Indonesia* Russia USA Japan Turkey Egypt Bangladesh India Philippines
* Not including hand-rolled kreteks.
Quick In 2016, over 5.5 trillion cigarettes were sold to more than one billion smokers worldwide - 61.4% of
Fact
the volume of all cigarettes sold in the five largest cigarette consuming nations China, Indonesia,
Russia, U.S. and Japan. The cigarette retail values in 2016 were worth USD 683.4 billion.
Import and export of cigarettes in ASEAN (2016)

(Million sticks)
35,000
32,146 31,768
Import Export
30,000 27,903
25,000 24,000
20,000
18,807
15,000
11,925
7,015
10,000
5,912 6,439
5,000
1,587 2,236
0
Indonesia Malaysia* Philippines Singapore** Thailand Vietnam***
* Philip Morris Malaysia (PMM) operates a Cast Leaf plant in Seremban.
** Singapore is a major global transhipment hub. Japan Tobacco International (Singapore) Pte Ltd and Philip Morris Singapore Pte Ltd are distributor and retailer of tobacco products.
*** Saigon Tobacco Company (BAT) and VinasaTobacco Joint (PMI) are joint venture companies that produce Dunhill, 555, Pall Mall (for BAT) and Marlboro (for PMI) respectively.
8
_
Cigarette sales volumes in ASEAN region (2011 2021)
ASEAN countries with the highest cigarette sales volumes: Indonesia, Philippines, Thailand and Vietnam
(Million sticks) Indonesia Philippines Thailand Vietnam
350,000 320,400
308,300 314,312 316,075 311,334 306,352
302,500 301,144 295,724
300,000 279,600 290,105
250,000
200,000
150,000
82,620 83,481 85,301 70,370 73,889 76,251 79,682 83,666 79,483 81,470 83,914
100,000
50,000
0
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Sales of cigarettes in Cambodia, Lao PDR, Malaysia, Myanmar and Singapore

(Million sticks) Cambodia Lao PDR Malaysia Myanmar Singapore
15,000 13,772 13,646
13,064 12,960
12,000 11,417 10,047 10,147 10,239 10,300 10,352 10,372
10,126 10,339
9,629 9,889
8,989 9,349
9,000 4,960 5,456 6,438 7,854 8,561
6,000
3,000
0
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Quick Over six trillion cancer sticks produced annually In ASEAN,
Fact worldwide, a three-fold jump in what it was

producing annually back in the 1960s.
550 billion cancer sticks
sold in 2016.
9
_
Indonesia: Cigarette production by type (2010 2017)
(Billion sticks)
250,193 255,330 252,247 251,550 Kretek cigarette
250,000 237,216
212,682 by machine (SKM)
262,611
200,000 179,713
150,000
90,571 96,535 93,269 87,945
100,000 74,661 72,690 70,803 68,046 Kretek cigarette
by hand (SKT)
50,000
18,113 18,669 19,810 20,724 19,662 20,070 18,677 16,743 White cigarette
by machine (SPM)
0
2010 2011 2012 2013 2014 2015 2016 2017
Most common source of the last purchase of manufactured cigarettes in ASEAN

(%) 96.4
79.8 77.1 79.6 79

68.4
64.3
52.8
34.5
28.8
17.9 19.1 19
10.5 17.6 16.6
3.8 0.1 6.5 2.8*
0.2 0.1
Cambodia Indonesia Lao PDR Malaysia Philippines Singapore Thailand Vietnam
(2014) (2011) (2015) (2011) (2015) (2013) (2017) (2015)
Grocery store Convenient store/kiosk/supermarket Traditional market Tea stall/street vendor Food shops/hawker centres Others
*2.8 include the categories at duty-free shop and abroad, from another person, and any other specified sources.
Number of points-of-sale in selected ASEAN countries

Country Total smokers Cigarette retailers* Cig retailer per 10,000 smokers Physicians per 10,000 pop**
Indonesia 65,188,338 2,500,000 383 2
Malaysia 4,991,458 80,000 160 12
Philippines 16,500,000 694,821 421 12
Singapore 345,000 4,617 134 20
Thailand 10,676,361 870,000 815 4
Vietnam 15,600,000 303,333*** 194 12
*Does not include street vendors. In Indonesia, street vendors make up 50% of all cigarette sales.
** Table 8: Health outcomes in Human Development Report 2016. Available at: http://hdr.undp.org/sites/default/files/2016_human_development_report.pdf
***Ho Chi Minh City has reportedly more than 70,000 cigarette retailers.
10
Market structure and distribution channels of cigarette sales in ASEAN
Convenience Stores Supermarkets Newsagent-tobacconists/ Non-Grocery Specialists (Drugstores/ Bar-tobacconists
Forecourt Retailers Food/drink/tobacco specialists kiosks Parapharmacies) and others Hotels/restaurants/bars
Hypermarkets Independent Small Grocers Street vendors Non-retail channels
(% of retail volume) 49.5

47.3
43.6
30.8
25.6
23
15.9
11.7 10.4 9.5 8.7
6.7 5.6 5.5 6.5 5.4 4.5 6.4
4.6 4.7 4.2
2.5 2.8 1.6 2.6 2.7
0.1 0.1 1.1
Cambodia Indonesia Lao PDR
51.4
43.0
30.2
24.6 24.8
19
10.8 10.6 10.7

8.3 7.3 8.8
6.9 7.3
4.9 5.7 5.0 4.5
3.1 2.3 3.7
2.0 1.3 0.1 1.2 0.9
Malaysia Myanmar Philippines
67.8
36.1
33.9
21.6
19
11.9 11.5 12.1

10.1 9.9 9.7 9.0 8.7
5.6 6.2 6.3
3.5 4.5 3.9
2.0 3.1 2.4
0.2 0.1 0.7 0.2
Singapore Thailand Vietnam
11
Corporate Cover Up: PMI, BAT and JTI CSR in ASEAN

To promote its corporate image and distance itself from its harmful products, PMI has been conducting more corporate social
responsibilities (CSR) activities across the ASEAN region. Indonesia (USD 6,224,231) and the Philippines (USD 1,870,373) are two
countries where PMI invested the most money in CSR activities in 2017. Both countries are vital tobacco markets for PMI as it holds
33.6% and 65.1% of total market in Indonesia and the Philippines respectively.
Except for JTI, the CEOs of the three other transnational tobacco companies (TTCs) were paid more in 2017 than the previous year,
reflecting the growth of their companies’ profits. André Calantzopoulos, CEO of PMI, alone was paid more than double PMI’s total
expenditure on CSR activities in the ASEAN region in 2017.
What TTCs spend on CSR activities is paltry compared to the remuneration paid to their top executives.
Tobacco industry’s miniscule CSR grants in ASEAN compared to its profits and remuneration for the CEO
TTCs CEO Remuneration in 2017 2017 profits in global Total expenditure on CSR
(USD) market (USD) activities in ASEAN (USD)
Philip Morris André Calantzopoulos 18.977 M 11.5 B 8,753,391 (2017)
International (PMI)
_
British American Nicandro Durante 15.301 M 9.19 B 1,853,263 (2013 2017)*
Tobacco (BAT)
Imperial Brands Alison Cooper 6.238 M 2.51 B No data available
_
Japan Tobacco Mitsuomi Koizumi 1.287 M 3.88 B 4,921,697 (2012 2019)
International (JTI)
*BAT expenditure on CSR activities was estimated to be more than USD 1.853 million. There was no reporting on total expenditure in some of the CSR activities carried out between 2013 and 2017.
PMI has reduced slightly its expenditure on CSR activities in the ASEAN region in recent years. More than half of the investment was
channeled into Indonesia with USD 6 million annually to support various CSR activities including empowering women, education,
disaster relief and economic opportunity. Generally, fewer organizations benefited from PMI’s charitable fund, some of which have
been regular recipients for many years.
_
Philip Morris International CSR activities in ASEAN (2011 2017)
4,792,016
1,406,105 1,876,676 1,764,273 1,870,373

2,457,126
(USD)
2,252,938
6,500,000
6,224,231
5,994,850
6,181,796
5,852,043
6,424,999
6,252,917
2011 2012 2013 2014 2015 2016 2017

Total value 9,219,921 10,200,285 12,532,016 8,158,148 8,635,951 8,561,072 8,753,391
Indonesia Malaysia Philippines Singapore Thailand Vietnam
12
Distribution of Philip Morris International CSR Activities in ASEAN (2017)
USD 75,000
Disaster/Emergency relief and preparedness
USD 1,000,000
Others
USD 1,168,963
Economic opportunity, Empowering
women/Access to education
USD 6,059,933
Access to education
USD 449,495
Economic opportunity Total expenditure on CSR:
USD 8,753,391
Lao PDR: Tobacco tax revenue and tobacco tax revenue loss
The Lao government continues to lose revenues due to its unfair Investment License Agreement (ILA) with the tobacco industry
signed on 23 November 2001. The ILA has capped ad valorem tobacco tax rates at between 15% and 30% (25-year tax holiday) until
2026 when the country's standard rate is 55%. The new tax law implemented in 2016.
_
Tobacco Tax Revenue and Tobacco Tax Revenue Loss in Lao PDR (2002 2014)*
9.94
30.00
(USD Million)
The government collected net tobacco tax

25.00 revenue of USD 85.59 million only with an
estimated loss of USD 89.22 million 9.48
between 2002 and 2014. If the ILA is not 8.98
20.00 terminated, the Lao government will continue 21.83
8.66
to suffer more revenue loss till 2026.
15.00
8.37
13.25
10.00 7.67 7.99 12.3
6.05 6.27
5.13 9.91
3.55 3.93
5.00 3.20
4.22
0 1.06 1.17 1.40 1.65 1.71 2.09 2.17
0.98
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Tobacco tax revenue Tobacco tax revenue loss
*No official revenue data available after 2014.
13
Tobacco industry undermines tobacco

control in ASEAN using legal challenges
8 court cases brought against tobacco control 11 court cases - including 2 by the Philippine Tobacco
measures. In the latest, Philip Morris Thailand along Institute, 4 by Philip Morris, 4 by Fortune Tobacco Corp, and 1
with other tobacco companies including BAT and JT by Mighty Corp brought against the government for a variety
have challenged Thailand’s legislation increasing of tobacco control measures including pictorial health
pictorial warnings from 55% to 85% in the warnings on cigarette packs.
Administration court. • PMPMI, FTC, JTI, Mighty, La Suerte (5 separate cases) vs
DOH re AO 2010-13 requiring graphic health information
• PTI vs DOH and FDA re power to regulate tobacco products
• PMFTC vs DOH re tobacco promotions
• PTI for declaratory relief re outdoor advertising
• Individuals paid by PMFTC vs MMDA re smokefree
Thailand
Philippines
3 court cases filed by Philip Morris Malaysia against the

Ministry of Health for requiring Ministry’s approval for the
retail price of tobacco products, rejecting the retail price of its
cigarettes’, requiring an increase in the selling price of its
cigarettes.
Malaysia
13 court cases brought against tobacco control measures

after the Health Law 36/2009 was passed in October 2009.
These include rejecting Article 113 on the addictive nature
of tobacco, Article 114 on the mandated pictorial health
warnings, and Article 115 to allow designated smoking area in
Indonesia smoking-free places.
The farmers claimed the Health Law severely damaged their
livelihoods.
At the local level, 2 cities/districts (Jakarta and Bogor) have
faced litigation challenges mainly on Local Smoke Free
Ordinances.
14
Tobacco Industry front groups and lobby groups to fight tobacco control Businessmen
The tobacco industry rallies and funds front groups to fight tobacco control Retailers
measures at both international and national level. The International Tobacco
Growers Association (ITGA) is one such group which mobilizes tobacco
growers to interfere in tobacco control policy development in ASEAN countries
and fight FCTC implementation particularly Articles 9, 10, 17 and 18. Other
front groups include retailers and trade associations, coffee shop associations or Farmers
research groups which challenge tobacco control legislation.
Country Front groups and lobby groups in ASEAN

Regional International Tobacco Growers Association (ITGA)
Farmers
groups
Indonesia Indonesia Tobacco Farmers Association – Asosiasi Petani Tembakau Indonesia (APTI)
Indonesian Clove Farmers Association - Asosiasi Petani Cengkeh Indonesia (APCI)
Association of Tobacco Farmers and Traders of Magelang - Paguyuban Petani Pedagang Tembakau Magelang (P3TM)
Malaysia Kelantan Tobacco Growers and Curers Association (PITAS)
Philippines Philippine Tobacco Growers Association (PTGA)
Katipunang Manggagawang Pilipino Federation of Free Farmers (FFF)
Thailand Thai Tobacco Growers, Curers and Dealers Association
Tobacco Farmer Association (TFA)
Chiangmai Tobacco Curing Association
Sukhothai Burley Tobacco Farm Association
Petchaboon Burley Tobacco Farm Association
Thai Northeastern Tobacco Farmer
Cambodia Association of Tobacco Industry in Cambodia (ATIC)
Manufacturer
associations
Indonesia Indonesia Tobacco Society Alliance – Aliansi Masyarakat Tembakau Indonesia (AMTI)
Corporate of Indonesian White Cigarette Makers – Gabungan Pengusaha Rokok Putih Indonesia (GAPRINDO)
Corporate Federation of Indonesian Cigarette Industries –Gabungan Perserikatan Pabrik Rokok Indonesia (GAPPRI)*
Cigarette Manufacturing Association - Paguyuban Mitra Produksi Sigaret Indonesia (MPSI)
Philippines Philippine Tobacco Institute (PTI)
Federation of Philippine Industries (FPI)
Thailand Thailand Tobacco Monopoly State Enterprise Workers Union
Lao PDR Lao Tobacco Co Ltd
State-owned
company /
State agency
Philippines National Tobacco Administration (NTA)

Thailand Thailand Tobacco Monopoly (TTM)
Vietnam Vietnam Tobacco Association (VTA)
Indonesia Indonesian Forum of Tobacco Industry Community - Forum Masyarakat Industri Rokok Indonesia (FORMASI)**
Retailer
groups
Federation of Trade Unions of Cigarette, Tobacco, Food and Beverages - Federasi Serikat Pekerja Rokok, Tembakau,
Makanan Minuman (FSP RTMM-SPSI)
Philippines Peoples’ Coalition Against Regressive Taxation (PCART)
Philippine Association of Supermarkets Inc. (PASI)
Vietnam Association of Vietnam Retailers (AVR)
15
Country Front groups and lobby groups in ASEAN

Regional US-ASEAN Business Council (US-ABC)
Business groups
ASEAN Intellectual Property Association (ASEAN-IPA)

Property Rights Alliance (PRA)
International Trademark Association (INTA)
Indonesia Indonesia Clove Cigarette Community – Komunitas Kretek
Clove National Rescue Coalition – Koalisi Nasional Penyelamat Kretek (KNPK)
Cigarette Company Association of Kudus – Persatuan Pengusaha Rokok Kudus (PPRK)
Association of Cigarette Companies – Gabungan Perusahaan Rokok (GAPERO)
Communication Forum of Small Cigarette Businessmen – Forum Komunikasi Pengusaha Rokok Kecil (FKPRK)
Indonesian Association of Personal Vaporizer – Asosiasi Personal Vaporizer Indonesia (APVI)
Malaysia Malaysia-Singapore Coffee Shop Proprietors General Association (MSCSPGA)
Philippines Philippine Aromatic Tobacco Development Association, Inc. (PATDA)
Trade Union Congress of the Philippines (TUCP)
The American Chamber of Commerce of the Philippines, Inc.
Thailand Thai Tobacco Trade Association (TTTA)
Vietnam Vietnam Chamber of Commerce and Industry (VCCI)
Indonesia Wise Smokers Community – Komunitas Perokok Bijak (KOJAK)
Consumer
groups
Philippines Proyosi Inc

Thailand End Cigarette Smoke Thailand Group (ECST)
Thai Smokers Community
Regional Factasia.org***
Legal
Think tanks/
Lao PDR Lao Law & Consultancy Group

Malaysia Institute for Democracy and Economic Affairs (IDEAs)
*Federation of kretek cigarette industries.

**Association of small-scale tobacco industry.
***Factasia.org (www.factasia.org) is a Hong Kong based non-government organization, which promotes e-cigarettes and campaigns for its use, funded by Philip Morris
International and Tobacco Vapor Electronic Cigarette Association (TVECA).
16
Tobacco is a
GLOBAL THREAT
The
Im
1.1 Smokers worldwide
( - 945 million -180 million)
Billion 300 million in developed countries
800 million in developing countries
Lives lost from tobacco use annually

More than 6 million deaths
result from direct tobacco use
7+
890,000 non-smokers are killed Million
due to exposure to secondhand smoke
Tobacco is a SILENT KILLER that

contributes to significant MORTALITY,
ILLNESSES and SUFFERING worldwide
pact
USD Global annual costs from tobacco-related
healthcare and lost productivity
1.4 Trillion Growing health care costs and burden
of disease from tobacco use
Adult tobacco users living in poverty worldwide

More than 10% of household income is spent on 226
tobacco products – meaning less money for food,
education and healthcare (in low-income countries) Million
Tobacco use not only DAMAGES HEALTH but also

WORSENS POVERTY and causes DEVASTATING social,
economic and environmental HARMS
43.8% 8.4% 26.1% Smoking prevalence: Adult male
50.8% 7.1% 27.9%
and female smokers in ASEAN
Male Female
Myanmar* Total % of adult smoking prevalence
(2014)
Lao PDR
(2015)
37.7% 1.7% 19.1%

45.3% 1.1% 22.5%
41.9% 5.8% 23.8%

Thailand
(2017) 32.9% 2.4% 16.9% Vietnam
(2015)
Philippines
(2015)
Cambodia
(2014) 36.3% 3.7% 19.9%
43% 1.4% 22.8%

Brunei Darussalam
(2016)
Malaysia 21.1% 3.4% 12%

(2015)
Singapore
MOST LEAST
(2017) 36.3% 12%
of the Indonesian of the Singaporean
66% 6.7% 36.3% population smoke population smoke
In ASEAN, male smoking prevalence is

Indonesia highest in Indonesia (66%) and lowest in
(2013) Singapore (21.1%). Female smoking rates
are particularly high (between 5.8% and
8.4%) in Indonesia, Lao PDR, Myanmar
* The study was a population-based survey of adult aged 25-64.
and Philippines.
19
Chapter 2
Nicotine and Tobacco Addiction
Globally, more than 1.1 billion people use tobacco, with This highly additive product is commonly used by
adult male smokers (945 million) significantly different segments of the population including
outnumbering women (180 million). This alarming vulnerable groups such as women, youth, and children.
number represents about one-third of the global More than 15 billion cigarettes are smoked every day
population aged 15 and above. It has grown substantially worldwide (1.327 billion sticks in ASEAN). In 2017, an
in low- and-middle-income countries (82% world’s estimated 546 billion cigarettes were sold in ASEAN
smokers). In the ASEAN region, there are currently 122 countries with 94% primarily consumed in Indonesia,
million adult smokers, half of whom live in Indonesia Philippines, Thailand, and Vietnam. Due to the
(65 million). expansion of the world’s population and dynamic
economic growth, the number of smokers is expected to
reach at least 2 billion people by 2030.
World cigarette consumption by region Among ASEAN countries, adult male smoking
prevalence is highest in Indonesia (66%) and lowest in
Singapore (21.1%). Adult female smoking rates are
Western Europe 9% particularly high (between 5.8% and 8.4%) in Indonesia,
Lao PDR, Myanmar and Philippines.
North America 5% 2016

Asia Pacific 64% Globally, more than
Middle East and 1.1 billion
people use tobacco
Africa 9% ASEAN has 122 million
adult smokers, half of whom 945 million
Latin America 3% live in Indonesia.
180 million
Total ASEAN population:
Eastern Europe 10% 632,812,000 (2016)
Australasia 0%
Brunei Lao PDR
39,037 824,016
Vietnam
15,602,400
Singapore Thailand
345,000 10,676,361
ASEAN has 10% of world’s smokers
Indonesia
Philippines 65,188,338 Total adult
Distribution of total adult smokers smokers in ASEAN:
in ASEAN countries 16,500,000
122,087,477
Myanmar
6,240,000
Malaysia 4,991,458
Cambodia 1,680,867
20
Chapter 2: Nicotine and Tobacco Addiction
(%) Male Female (%)

Adult Smoking Brunei (2016) 36.3 3.7
Numbers don’t lie:
Percentage of adult male and Cambodia (2014) 32.9 2.4
female smokers in ASEAN
Indonesia (2013) 66 6.7
Lao PDR (2015) 50.8 7.1
Malaysia (2015) 43 1.4
Myanmar*(2014) 43.8 8.4
Philippines (2015) 41.9 5.8
Singapore (2017) 21.1 3.4

adults in
ASEAN Thailand (2017) 37.7 1.7
smoke Vietnam (2015) 45.3 1.1
65,188,338
16,500,000
15,602,400
10,676,361
Numbers don’t lie: Adult smokers in ASEAN

Total numbers of adult smokers
6,240,000
Adult smoking prevalence (%) 4,991,458
1,680,867 824,016
39,037
345,000
19.9 16.9 36.3 27.9 22.8 26.1 23.8 19.1 22.5

12
Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar* Philippines Singapore Thailand Vietnam
(2016) (2014) (2013) (2015) (2015) (2014) (2015) (2017) (2017) (2015)
*The study was a population-based survey of adult aged 25-64.
21
Cigarette per capita consumption in ASEAN (2011 and 2016)

1,800 1,673
1,596 1,539 2011
1,600
(Sticks)
2016
1,400
1,224 1,206
1,200 1,125
1,048
1,000
819 854 816
800 706 729 661
600 579
600
427
400
234
200 139
0
Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Vietnam
sticks smoked daily

1.327
billion
by adults in ASEAN
Number of cigarettes smoked daily by adult smokers in ASEAN
684,477,549 Average number of cigarettes smoked daily

Total number of cigarettes smoked by adults daily
213,720,000
181,500,000
105,847,081
91,343,681
25,885,352 10,959,413 4,500,000
18.3
15.4 13.7
13.3 12
10.5 11 10
9.1
9,360,000
355,237 1.5
Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Vietnam
(2016) (2014) (2013) (2015) (2015) (2014) (2015) (2013) (2017) (2015)
22
Average age of smoking initiation in ASEAN
15-20 20 >19 18 18.8

17.6 17.4 17.2 17.5 On average, smokers in
17.1
ASEAN started smoking
before the age of 20.
Average age of smoking initiation

(daily smokers)
(2016) (2014) (2011) (2015) (2011) (2014) (2015) (2013) (2017) (2015)
Number and percentage of adults who use smokeless tobacco in ASEAN
Brunei 2.1% (4,119)

(2016) 1.7% (3,335) Female Male Total
1.9% (3,727) Smokeless
Cambodia
8.6% (451,126) tobacco use
0.8% (36,191) highest in
(2014) 4.9% (487,317) Myanmar (43.2%),
4.8% (4,320,033) Malaysia (10.9%)
Indonesia 3.9% (3,493,678) and Cambodia
(2013) 4.3% (7,813,711) (4.9%).
8.6% (141,835)
Lao PDR 0.5% (8,117)
(2015) 4.3% (149,952)
0.8% (89,643)
Malaysia 20.4% (2,293,463)
(2015) 10.9% (2,383,106)
Myanmar 24.1% (5,678) 62.2% (3,079)
(2014)
43.2% (8,758)
0.7% (240,084)
Quick
Philippines 2.7% (924,203)
(2015) 1.7% (1,164,966)
Thailand
(2017)
2.7% (789,462)
1.5% (406,921)
2.1% (1,196,383)
Fact In 2014, there were 346 million smokeless tobacco
users – 7% of the world’s population. 80% of these
users reside in the South East Asian region, and are at
Vietnam 2% (686,100) an increased risk from oral cancers.
(2015) 0.8% (267,900)
1.4% (954,000)
23
Quit attempts
Percentage of current smokers (aged ≥ 15 years old) who intend to quit within next 12 months
(%) 60
48.9 45.8 Male Female Total
50 48.8
40
30
20 17.7
14.1 17.2 14.1
9.3 9.3 9.3 10.9 12.5 11 12.6 12.6
10
4.2 4.1 4.2
0
Cambodia Indonesia Lao PDR Singapore Thailand Vietnam
(2014) (2011) (2015) (2013) (2011) (2015)
Percentage of current smokers who attempted Years gained by quitting smoking by age
to quit in the past 12 months
_
55 64 4
Brunei 62.5
62.7
(2016) 62.6 _
45 54 6
Cambodia 0.5
8.0
(2014) 4.1 _
Male 35 44 9
Indonesia 29.8
44.6 Female
(2011) 30.4 _
25 34 10
Lao PDR 29 Total
15.9
(2015) 27.2
Quick
Malaysia 52.1
59.2
(2015) 52.3
Fact
Myanmar 42
52.5
(2014) 43.7
Philippines 51.5
57.1
(2015) 52.2 Half a billion people alive
Singapore 37.3 today can be expected to
(2013) 38.4
45.7 be killed prematurely by
their smoking unless they
Thailand 20.7
23.6 quit.
(2017) 20.8
Vietnam 39.8
32.8
(2015) 39.6
24
Youth Smoking
_
Numbers don’t lie: Percentage of smoking among boys and girls (13 15 years)* in ASEAN
Boys Girls
Brunei (2014) 13.9 4.3
Cambodia**(2016) 2.9 1.9
Indonesia**(2014) 35.3 3.4
Lao PDR (2016) 10.7 2.1
Malaysia (2016) 26.1 2.4
Myanmar (2016) 17 1.5
Philippines (2015) 20.5 9.1
Thailand (2015) 17.2 5.2
Vietnam (2014) 4.9 0.2
Quick In the Western Pacific Region, more than 1 million students
Fact currently smoke cigarettes (7.7% of the youth aged 13–15 years).
Numbers don’t lie: Total % of youth smoking prevalence in ASEAN

(%) 20 19.4
14.8 14.5
15
11.3
10 8.9
8.3
6.4
5 4
2.4 2.5
0
Brunei Cambodia** Indonesia** Lao PDR Malaysia Myanmar Philippines Singapore*** Thailand Vietnam
(2014) (2016) (2014) (2016) (2016) (2016) (2015) (2014-2016) (2015) (2014)
* Percentage of students who smoked cigarettes on one or more days in the past 30 days. **The data is based on currently use any tobacco product anytime during the past 30 days.
***Youth smoking prevalence (4%) is a consolidated figure from three different surveys among youth aged 13-20 between 2014 and 2016.
25
Youth Smoking Initiation

Early initiation of youth smoking among ever smokers* in ASEAN
Country Boy (%) Girl (%) Total (%)
Brunei** (2014) 75.4 66.2 72.8
Indonesia (2014) 18.2 32.5 19.8
Lao PDR (2011) 28.6 30.9
Malaysia*** (2016) 10.0 25.1 12.1
Globally,
Myanmar (2016) 15.3 28.3 17.2
Philippines*** (2015) 10.7 14.5 12
25 million
youth smoke and
Thailand (2015) 16.8 9.2 14.5 the smoking rates
Vietnam (2014) 16.4 24.4 17.7 among girls are
quickly catching
*Percentage of ever smokers who first smoked before the age of 10 years up to boys.
**Percentage of students who first tried cigarette smoking before age of 14 years
*** Percentage of ever smokers who first smoked at the aged of 7 or younger.
Quick “They represent tomorrow's cigarette business. . . As this 14-24 age group
Fact matures, they will account for a key share of the total cigarette volume --
for at least the next 25 years.”
September 30, 1974
R.J. Reynolds Tobacco Co. marketing plan
presented to the company's board of directors.
Bates No. 501421310-1335
Intentions of non-smoking youths to start smoking in the next year
Brunei (2013) 9.3%
Cambodia (2016) 5.6%
Indonesia (2014) 8.8%
Lao PDR (2011) 6.6%
Malaysia (2016) 10.4%
Myanmar (2016) 5.9%
Philippines (2015) 13.2%
Thailand (2015) 7.4%
Vietnam (2014) 5.7% Individuals who start smoking at younger

ages are more likely to smoke as adults.
Note: Years of the Global Youth Tobacco Survey (GYTS) differ between countries.
26
Smoking initiation trend among Indonesian between 1995 and 2013

(%) 70
63.7 _
New smokers aged 10 14 almost double in 18 years
60 58.9 56.9
_
54.6 New smokers aged 15 19 increased by 13.6 percentage
50.7 points between 2010 and 2013
50
43.3
Total number of new smokers between 10 and 19 years
40 old: 16.4 million/year
17.2
30
25.8 23.9
14.6
20 17.5 19 16.3 18.6
16 17.3
12.6 3.1 2.6
10 0.6 9 9.5
1.7 1.7 6.3 4.8 5.5 4.4 6.9 3.6
0.4 1.9 1.5 4.3 3.8
1.82
0
5-9 10 -14 15 -19 20 - 24 25 - 29 >30 Age group
1995 2001 2004 2007 2010 2013
Tobacco industry recruits replacement smokers
230,862 Indonesians/year 16.4 million new Indonesian smokers (10 - 19 years old)/year
632.5 Indonesians/day 45,000 new youth smokers (below 19 years old)/day
Quick 19.8%
Fact
Indonesia has one of the highest smoking rates About of youth
in the world where 66% of adult males and 41% first tried cigarettes before
of youths (aged between 13 and 15) smoke. the age of 10.
27
Youth susceptibility to tobacco advertising and promotion in ASEAN
(%)
80
70
60.7*
60
50.6*
50
40 35.2 36.5 42.3
30 17.7
20
10 14
6.7 9.0 7.1 4.7 5.6 8.7 9.3 7.1
0
Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Thailand Vietnam
(2013) (2016) (2014) (2016) (2016) (2016) (2015) (2009) (2014)
Tobacco advertisement or promotion at point-of-sale seen by youth (%) Youth who have object with a tobacco brand on it (%)
* Advertising seen at POS.
Percentage of youths offered free cigarettes by a tobacco company representative in ASEAN
(2016) Malaysia 2.5% 5.5% Brunei (2013)
(2016) Myanmar 5.9% 7.3% Thailand (2015)
(2016) Cambodia 8%
9% Philippines (2015)
(2014) Indonesia 7.9%
(2014) Vietnam 3.1% 3.9% Lao PDR (2016)
28
Average monthly expenditure for manufactured
cigarettes (in USD) among smokers ≥ 15 years old
12.9 (LAK 106,528) Average monthly expenditure for manufactured cigarette
Myanmar* (USD)
Lao PDR (2015)
23.8 (THB 805.88)

10.3 (VND 221,400)
14.96 (PHP 678.40)

Thailand (2017) 9.7 (KHR 38,800)
Vietnam (2015)
Philippines (2015)
Cambodia (2014)
55.9 (MYR 178.8)

Brunei Darussalam*
Malaysia (2011) 30.6 (SGD 38.3)
Singapore (2012/2013)
22.7 (IDR 272,255)**
Indonesia (2013)
*No data available on average monthly expenditure for manufactured cigarette.

**Refer to monthly expenditure of smoker household in 2013.
29
Chapter 3
Basic Needs Sacrificed
Tobacco use is inextricably linked to poverty. Tobacco available for basic necessities such as food, health care,
consumption varies according to socioeconomic group, shelter, and education. Tobacco also exacerbates poverty
but in most countries, those who tend to consume among families of tobacco users, who are at high risk of
tobacco the most are the poor and the poorest and men falling seriously ill from tobacco-related diseases and
with low education. dying prematurely, thereby imposing heavy health care
costs on families and depriving them of much-needed
In many ways tobacco perpetuates the vicious cycle of household income.
poverty that many smokers are in. Nicotine addiction
drives smokers to spend a large proportion of their
income on tobacco and reduces the amount of money
Quick
Fact
Globally, around 226 Smoking prevalence was strongly linked to the level of
million adult tobacco educational attainment. In most countries, smoking and
users live in poverty. other forms of tobacco use are much higher among the poor.
Poverty and Inequality

Education level of adult smokers in ASEAN
48.2 Less than primary Primary Secondary (lower/upper) College or above
(%)
40 37.7 38.1 37 (upper) 35.4
(lower)
35 34.6 (lower) 32.9 33.9

33.3 32.9 29.7
(lower)
30 26.7 26.7 (upper)
25.2 24.6
25 24.7 24.7*
22.1 20.2 22.7
20.5 17.6
20 (upper) 18.5 19.9
14.2 18.4
15 14.6 14.3
10
10 8.4
9.1
5
0
Brunei Cambodia Indonesia Lao PDR Malaysia Philippines Thailand Vietnam
(2016) (2014) (2013) (2015) (2015) (2015) (2017) (2015)
* The percentage of primary and less than primary.
30
Chapter 3: Basic Needs Sacrified
Tobacco expenditure and basic needs

Country Poorest households expenditure (USD) on
Tobacco Education Health Clothing
Indonesia (2013) 13.2 1.9 1.2 4.9
(IDR 137,652) (IDR 20,215) (IDR 12,328) (IDR 51,586)
Philippines (2003) 2.6 1.6 1.3 2.6

(PHP 141) (PHP 87) (PHP 71) (PHP 141)
Singapore (2012/13) 16 76.6 133.5 24.2

(SGD 20) (SGD 95.7) (SGD 166.9) (SGD 30.2)
Quick Among poor families in urban slum

areas of Indonesia, households where
Paternal smoking diverts household
money from food to tobacco (22% of
Fact the father was a smoker are at greater

risk of household food insecurity.
weekly per capita household expenditures)
and exacerbates child malnutrition.
Price of most popular cigarette brands (per pack) relative to quantity of rice and eggs in ASEAN
Country Most Popular Cigarette Brand Quantity of
Brand name Price Rice (kg) Eggs (pieces)
Brunei Djarum Super* BND 6.90 USD 5.11 5.8 35
Cambodia Fine KHR 3,500 USD 0.88 1.06 6
Indonesia A Mild IDR 22,300 USD 1.63 2.08 14
Lao PDR Adeng LAK 7000 USD 0.86 0.84 7
Malaysia Dunhill MYR 17 USD 4.27 5.7 46
Myanmar Red Ruby MMK 800 USD 0.60 0.46 6
Philippines Marlboro PHP 80 USD 1.59 2.11 14
Singapore Marlboro SGD 14 USD 10.45 5.4 67
Thailand SMS THB 60 USD 1.90 4.3 18
Vietnam Craven A VND 20,000 USD 0.88 1.42 7
* Djarum Super was the most popular brand sold prior to May 2014. There are no licensed tobacco importers and retailers in Brunei since May 2014. Hence, there are no cigarettes
being sold legally in the country at present.
31
Annual tobacco expenditures = Lost opportunities

Annual expenditure of
USD 201,534,701 spent on tobacco in
2014. Of these, USD 168,860,800 on
manufactured cigarettes, hand-rolled 108,938 or 40,306 or 310,053
cigarettes (USD 14,545,709) and loose Motorbikes 125cc wooden houses in tons of high quality
(2016) rural areas rice
tobacco (USD 18,128,192).
Annual spending on
cigarettes by smokers (among the
poorest group) in 2013. or or
14 times 6 times 2 times
the average expenditure the average expenditure the average expenditure
on meat on milk and eggs on fish and vegetables
or or
7 times 11 times
Quick
the average expenditure the average expenditure
on education on health
Annual expenditure of
current smokers on cigarettes is USD 179.55
Fact
(PHP 8,140.80) per smoker in 2015. In low-income
Rice or Fish
(PhP 38/kilo) (PhP127.50/kilo) countries, sometimes
214 kilos/year 63.85 kilos/year more than 10% of
household income is
spent on tobacco
or Green Leafy or Egg products – meaning
(PhP 31.24/kilo) (PhP 5.64 per piece) less money for food,
261 kilos/year 1443 pieces of eggs
education and
healthcare.
Annual expenditure on
tobacco is estimated to be USD 20.87 Billion
(THB 65.76 Billion) in 2017. 0.69 times or 2.6 times
household expenditure expenditure on Bangkok Mass
on education Transit System (BTS) Sky train
(THB 95.3 Billion) (THB 25,000 Million)
Average annual expenditure

on cigarettes is USD 132 (VND 2,656,800)
per smoker in 2015.
1.25 times or 1.85 times
the average expenditure the average expenditure
on health per person on school fee per
person
32
61,937
Annual deaths attributed to major
tobacco-related diseases in ASEAN
6,225
Myanmar
Lao PDR
75,429 40,000 107,183
Thailand 10,000 Vietnam

Philippines
Cambodia
> 200
24,185 Brunei Darussalam
Malaysia 1,949
Singapore
193,876
Indonesia
Quick
Fact
More than 500,000 people die On average smokers lose
from tobacco-related diseases 15 years of their life.
annually in ASEAN. Millions of people stop
smoking by dying.
33
Chapter 4
Burden of Death,
Disease and Disability
When used as intended by the manufacturer, tobacco is Tobacco also imposes a heavy economic burden on
the only legal product that kills up to two thirds of its society and government through increased health care
regular users, currently killing more than 7 million costs and human productivity losses. The economic and
people globally each year, including about 890,000 societal costs of tobacco-related diseases are staggering
non-smokers, who lose their lives due to exposure to and cost an estimated USD 1.4 trillion annual
secondhand smoke. As such, tobacco use continues to be expenditure in tobacco-related healthcare costs and in
the world’s single largest preventable cause of diseases, lost productivity due to illnesses and early deaths.
harming almost every organ of the body.
Most ASEAN governments already spend significant
Given the current trends of the tobacco epidemic being amounts of their budgets for tobacco-related health care
exported from high-income countries to low-and costs that are many times higher than revenue gained
middle-income countries, it is estimated that tobacco use from tobacco.
will kill more than 8 million people annually by 2030,
with 80% of these premature deaths in low-and
middle-income countries. In the ASEAN region, tobacco
already causes more than half a million deaths every year.
Quick
Fact Every year, over 7 million people die from tobacco-related diseases globally
which claim more lives than HIV/AIDS, malaria and tuberculosis combined.
Tobacco kills more people, but tobacco control is severely underfunded

Deaths in LMICs (millions/year) Funding to LMICs (billions/year)
4.30 Tobacco USD 0.07
1.16 Tuberculosis USD 1.27
1.17 Malaria USD 1.79
1.39 HIV/AIDS USD 7.70
34
Chapter 4: Burden of Death, Disease and Disability
21st
century
Tobacco – Global agent of death
Tobacco will kill Tobacco use killed about 100 million

20th people worldwide in the 20th century,
century
1 Billion people and remains a serious and growing
concern that will claim 1 billion or
in the 21st century more lives in the 21st century unless
urgent action is taken.
Global death toll from tobacco use About 5% of all deaths

from communicable diseases, including 7%
of tuberculosis deaths and 12% of deaths
due to lower respiratory infections.
12% of all adult deaths worldwide.
14% of all deaths from NCDs
including heart disease, cancer,
Quick
diabetes and lung disease.
Fact Tobacco use is a leading

common risk factor for
41 million people killed by NCDs each year,
equivalent to 71% of all deaths globally, including
non-communicable diseases. 15 million people aged between 30 and 69 years.
Projected global tobacco-caused deaths, by cause, 2015 Tuberculosis 1% (0.09 million)
Digestive diseases 3% (0.2 million) Lower respiratory infections 2% (0.15 million)
Malignant neoplasms 33% (2.12 million)

Trachea, bronchus, lung cancers
Cardiovascular diseases 29% (1.86 million) Mouth and oropharynx cancers
Ischaemic heart disease Oesophagus cancer
Cerebrovascular disease Stomach cancer
Other cardiovascular diseases Liver cancer
Other malignant neoplasms
Diabetes mellitus 2% (0.13 million)

Respiratory diseases 29% (1.87 million)
35
Direct and indirect tobacco-related health care costs in ASEAN

Cambodia KHR 644.75 billion For tobacco-related diseases (1.05% of Cambodia’s 2013 GDP)
(2013) (USD 162.7 million) 5
Indonesia IDR 596.61 trillion For 28 tobacco-related diseases

(2015) (USD 45.9 billion)
Lao PDR LAK 28.51 billion
(2007) (USD 3.34 million) For 3 tobacco-related diseases
Malaysia MYR 2.92 billion For 3 tobacco-related diseases

(2005) (USD 790.47 million)
Myanmar MMK 156,269,383 For 8 tobacco-related diseases
(1999) (USD 260,449)
Philippines PHP 177 billion
(2012) (USD 4.09 billion) For 4 tobacco-related diseases
Singapore SGD 609.37 million For 4 tobacco-related diseases

(2014) (USD 479.8 million)
Thailand* THB 11.2 billion
(2009) (USD 3.74 billion) Health care (22% of economic burden)
Vietnam VND 24,679.9 billion For 5 tobacco-related diseases

(2011) (USD USD 1.1732 billion) (0.97% of Vietnam’s 2011 GDP)
*Direct and indirect medical care cost for overall tobacco-related diseases in Thailand.
Global economic cost and health burden of tobacco use

USD 422 Billion USD 657 Billion
Healthcare expenditure due to Indirect cost of mortalities
smoking-attributable diseases caused by smoking
5.7%
USD Malignant neoplasms
of total global healthcare 1.436 Cardiovascular diseases
Respiratory diseases
expenditure
Trillion Lower respiratory infections
Tuberculosis
(2012)*
USD 357 Billion
Indirect cost of morbidities caused
by smoking
1.8%
40% world GDP
of the total economic costs
are incurred in LMICs
* Total economic cost of smoking (from health expenditures and productivity losses together).
36
The
Solu
FCTC compliance in ASEAN
WHO FCTC Ratification
Brunei Cambodia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Vietnam
are Parties to the WHO FCTC. Indonesia is a non-Party to the WHO FCTC
WHO FCTC Articles 5.1: Tobacco control strategies and plans and 5.2: Coordinating mechanism or
focal point for tobacco control
have established or reinforced and financed a national coordinating mechanism for tobacco control, as well
as developed multi-sectoral national tobacco control strategies, plans, and programmes in accordance with
the WHO FCTC
WHO FCTC Article 5.3: Protection from tobacco industry (TI) interference
Philippines Singapore Thailand
have code of conduct or guidelines on protection of tobacco control policies from tobacco industry interference
WHO FCTC Article 6: Price and tax measures
Myanmar Philippines Singapore Thailand
have regular adjustment processes or procedures for periodic revaluation of tobacco tax levels
tion
The WHO Framework Convention on Tobacco Control (WHO FCTC) provides a framework for effective
tobacco control measures to be implemented at the national, regional and international levels.
WHO FCTC Article 8: Protection from exposure to tobacco smoke
introduced laws on smoke-free public places
WHO FCTC Article 11: Packaging and labelling
require pictorial health warning labels on tobacco packaging
WHO FCTC Article 13: Comprehensive bans on tobacco advertising, promotion, and sponsorship
Brunei Cambodia Lao PDR Singapore Thailand Vietnam
have implemented a fairly comprehensive ban on tobacco advertising, promotion and sponsorship
WHO FCTC Article 26: Financial resources
Lao PDR Malaysia Thailand Vietnam
have established health promotion or tobacco control fund

Solution
WHO FCTC:
A Comprehensive Package of Measures
Designed to counter the global tobacco epidemic, the
World Health Organization (WHO) Framework
Convention on Tobacco Control (FCTC) is the first
public health treaty negotiated under the auspices of
the WHO. It is a landmark legal instrument in
international, regional, and national tobacco control
that has changed the paradigm of public health
policies. At present, 181 governments, representing
90% of the world’s population, are Parties to the
WHO FCTC and have committed to implementing
the treaty’s various lifesaving measures. Indonesia is
the only ASEAN country that has not ratified the
WHO FCTC.
The WHO FCTC provides a framework for guidelines and protocols to reduce tobacco
consumption through evidence-based supply and demand regulatory interventions,
among others: (a) protection of public health policies from commercial and vested
interests; (b) raising taxes on tobacco; (c) banning smoking in public places; (d) use of
pictorial health warnings; (e) bans on tobacco advertising, promotion and sponsorship; (f)
controlling illicit trade in tobacco products; (g) providing alternative livelihoods to
tobacco farming; (h) preventing sales to and by minors; and (i) collecting and sharing data
on tobacco use and prevention efforts.
Because tobacco poses a major threat to life and health, it also threatens sustainable global
and national development. A multisectoral, whole-of-government and whole-of-society
approach is therefore essential for the implementation of the WHO FCTC as a means to
achieving the Sustainable Development Goals (SDGs) and to meet the global target of a
30% relative reduction in tobacco use prevalence among persons aged 15 and over by
2025 as agreed by WHO Member States.
39
Higher taxes 100% smoke-free

Plain packaging TAPS ban
Within ASEAN, most countries have made significant progress in implementing measures
to reduce tobacco use in accordance with the WHO FCTC since its entry into force in
2005.
Over the past several years, ASEAN member states have demonstrated growing
commitment and leadership in adopting FCTC-compliant policies and interventions,
particularly to (a) protect the public from exposure to secondhand smoke by restricting
smoking and ensuring smoke-free environments in public places and workplaces (Article
8) and (b) raise public awareness of health risks of tobacco use, help motivate quit
attempts, and discourage tobacco use uptake through prominent pictorial health warnings
on all tobacco packages (Article 11).
That said, full implementation of the WHO FCTC remains a work in progress, and
further strengthening of national tobacco control policy is needed in order to achieve the
objective of the treaty. This includes reducing tobacco product affordability through
tobacco tax systems strengthening and regular excise tax increases (Article 6); enforcing a
comprehensive ban on tobacco advertising, promotion and sponsorship, including plain
or standardized tobacco packaging, prohibiting corporate social responsibility (CSR)
activities by the tobacco industry, and banning retail display of tobacco products (Article
13); and securing sustainable financing for tobacco control (Article 26), such as through
establishment of health promotion/tobacco control mechanisms funded through tobacco
surcharge taxes. It is also widely acknowledged that most ASEAN member states still lag in
safeguarding their public health policies from tobacco industry interference (Article 5.3),
which is a major obstacle to effective tobacco control implementation.
Large pictorial warnings

Sustainable financing
Multisectoral coordination Code of Conduct
40
Tobacco control policy milestones in ASEAN
Brunei WHO FCTC Ratification: 3 June 2004 | Tobacco Control Law Enacted: Tobacco Order 2005 and its Regulations
1 Mandatory textual health 6 Tobacco Order 2005 9 National Committee on 11 100% smoke-free airport
Tobacco control milestones
warnings on cigarette packs (S49/05) passed Tobacco Control established
Expansion of smoke-free areas
2 All government building declared Sale of single sticks of Pictorial health warnings (PHWs)
smoke-free cigarettes ban implemented (Top 50% front and 2nd rotation of PHWs (Top 75% front
back) and back)
200% increase in tobacco tax Kiddie pack (less than 12 No more licensed tobacco retailer
20-stick) ban 10 New tobacco tax and price (since May 2014)
3 Royal Brunei Airlines became (Cigarettes – BND 0.25 per stick)
smoke-free Smoking cessation clinics Smoking cessation clinics expanded to
established Point-of-sale (POS) pack display all health centers nationwide and one
4 Schools declared smoke-free ban hospital
7 Tobacco Regulations 2007
5 Ratified WHO FCTC (3 June) enacted Additional requirements for 13 Increased in licensing fee for importer
tobacco retail license and retailer
Haram fatwa on smoking issued 8 Tobacco Control Unit
established 14 Increased in tobacco tax by 100%
(Cigarettes – BND 0.50 per stick)
Tobacco retail licensing
enforced
Adult smoking prevalence in Brunei

(%)
35.5 36.3
32.6
31.1
Male
20
Adult 18.4 18 19.9
5.3
Female 4 3.7
2.3
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1991 1992 1993 1994 1995 1996 1997a 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011a 2012 2013 2014b 2015 2016c 2017
a - adult aged 19 years and over b - adult aged 15 years and over c - adult aged 18 and over
Key measures Brunei: Progress in WHO FCTC implementation

Article 5.2 National Committee for Tobacco Control Multi-sectoral Taskforce for Health
Article 5.3 Code of conduct is being finalized by the Prime Minister’s Office
Article 6 Licensing of tobacco retailers (No licensed tobacco importers and retailers in Brunei since May 2014)
Tax all tobacco products in a comparable manner
Tobacco tax burden as % of retail price (62%)
Article 8 100% smoke-free indoor in
No smoking zones include areas within a distance of 6 meters from the perimeter of the no smoking buildings
Penalties or compound for violating smoke-free policy
Article 11 PHWs in 2008 and 2nd rotation in 2012 Top front and back (75%) No ban on false or misleading descriptors
Article 13 Ban on direct TAPS, advertising at POS, pack display at POS, sale of single sticks of cigarettes and sale of all types of heated tobacco products, electronic
cigarettes, shisha and water pipe
Article 16 Less than 20-stick pack ban
Required a clear sign inside POS on prohibition of tobacco sales to minors and also sellers request for evidence before sale
Article 26 Health Promotion Centre (operational budget), Ministry_ of Health, Brunei
Total budget: USD 130,434 (BND 180,000) for 2017 2018
Airport Bars & pubs Educational facilities Health care facilities Hotels Restaurants (aircon) Restaurants (non-aircon) Shop & shopping complex Transport terminals
Transportation (public) Universities Workplaces/offices Workplaces/offices (open area) Parks & playgrounds Sport complexes
41
Cambodia WHO FCTC Ratification: 15 Nov 2005 | Tobacco Control Law Enacted: Tobacco Control Law 2015
1 Regulation on banning smoking 5 Comprehensive ban of 7 Tobacco Control Law passed 9 Committee for Tobacco Control
in educational, health, religious tobacco advertising, (CFTC) established

and tourism facilities and some promotion and sponsorship Kiddie pack (less than 20-stick) ban
workplaces but not binding (TAPS) (Sub-decree) Sub-decree on establishment and
TAPS via internet ban functioning of the CFTC legislated
2 Inter-ministerial committee on Expansion of smoke free
ducation and reduction of workplaces (Prakas) Point-of-sale (POS) advertising ban 10 2nd rotation of PHWs
tobacco use established (Top 55% front and back)
6 Sales and imports of shisha POS pack display (Allow 1 pack
Strategic plan on tobacco and E-cigarette ban per brand) 490 Tobacco Control Inspection
education and reduction _ Officers established
phase 1 developed (2001 2005) Smoking ban at workplaces False or misleading descriptors ban Strategic plan on tobacco
and public places (Circular) education and reduction _
3 Ratified WHO FCTC 8 Pictorial health warnings (PHWs) phase 2 developed (2018 2022)
implemented (Top 55% front and back)
4 Sub-decree on textual health
warning on cigarette packages Smoking ban at workplaces
and public places (Sub-decree)
Adult smoking prevalence in Cambodia

(%)
48
Male
39.1
32.9
23
Adult 19.5
16.9
3.6 3.4
Female 2.4
1 2 3 4 5 6 7 8 9 10
2000 2001 2002 2003 2004 2005a 2006 2007 2008 2009 2010 2011b 2012 2013 2014b 2015 2016 2017 2018 2019 2020 2021 2022
a - adult aged 18 years and over b - adult aged 15 years and over
Key measures Cambodia: Progress in WHO FCTC implementation

Article 5.2 Committee for Tobacco Control (CFTC)
Article 5.3 Sub-decree on establishment and functioning of the Committee for Tobacco Control (CFTC) has incorporated principles of Article 5.3
Article 6 Tobacco tax burden as % of retail price (25 - 31.1%)
No licensing of tobacco retailers
Article 8 100% smoke-free indoor in Penalties or compound for violating smoke-free
Indoor smoking room allowed in
Outdoor smoking anywhere allowed in
Article 11 PHWs in 2016 and 2nd rotation in 2018 Top front and back (55%) False or misleading descriptors ban
Article 13 Ban on direct TAPS, advertising at POS, cross corder advertising, TAPS via internet, person-to person sale, sale of single sticks of cigarettes and sale of all types
of heated tobacco products, electronic cigarettes, shisha and water pipe
CSR (Ban cigarette brand name only) POS pack display (Allow 1 pack per brand)

Not required a clear sign inside POS on prohibition of tobacco sales to minors and also sellers not requested for evidence before sale
Article 26 No governmental funding mechanisms for tobacco control
42
Indonesia WHO FCTC Ratification: Has not signed the FCTC | Tobacco Control Law Enacted: Under National Health Law No. 36/2009
1 Apply single message of textual 3 No new license issued for false 5 Guideline for managing conflict 7 2nd rotation of PHWs
warning on cigarette packs or misleading descriptors on of interest with the tobacco (Top 40% front and back)
cigarette packs industry in the Ministry of Health
Smoke-free public places policy
4 Pictorial health warnings 6 Point-of-sale (POS) pack display
2 Local smoke-free area (KTR) (PHWs) implemented ban in Bogor
became the key tobacco (Top 40% front and back)
control policy measure to be
spread out
Adult smoking prevalence in Indonesia

(%)
65.6 65.8
62.2 63.1 66
53.4 Male
31.5 34.4 34.2 34.3 36.3

27 Adult
4.5 5.2 6.7

4.1 Female
1.7 1.3
1 2 3 4 5 6 7
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Key measures Indonesia: Progress in WHO FCTC implementation*

Article 5.2 Ministry of Health (MOH) Focal Point
Article 5.3 Ministerial regulation (guidelines) applies to MOH only No code of conduct applies to all government servants
Article 6 Has regular adjustment processes or procedures for periodic revaluation of tobacco tax levels
Tobacco tax burden as % of retail price (62.71%) No licensing of tobacco retailers
Article 8 100% smoke-free indoor in Outdoor smoking area within public places allowed in
Indoor smoking room allowed in Penalties or compound for violating smoke-free
Article 11 PHWs in 2014 and 2nd rotation in 2019 Top front and back (40%) False or misleading descriptors ban
Article 13 TAPS via internet ban No ban on advertising at POS, pack display at POS, cross border advertising, person-to-person sale, sale of cigarette in
POS pack display ban in Bogor only single sticks and sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Partial ban on direct TAPS CSR (Ban publicity only)
Article 16 Not required a clear sign inside POS on prohibition of tobacco sales to minors and also sellers not requested for evidence before sale
No ban on less than 20-stick pack
Article 26 10% local tobacco tax surcharged for social development (50% of the amount is for health - 75% of the 50% allocation for preventive care, 25% for construction
and maintenance)
*Indonesia is a non-Party to the WHO FCTC but has implemented some of FCTC measures.
43
Lao PDR WHO FCTC Ratification: 6 Sep 2006 | Tobacco Control Law Enacted: Tobacco Control Law (2009)
1 National Tobacco Control Policy 2 Tobacco Control 2010 Task Force 5 Specific tax (100 LAK per pack) 7 National Tobacco Control
approved by the Health Minister Committee (10 representatives from introduced Committee established
• Increase tobacco tax Ministries) established
• Control cigarettes smuggling Tobacco Advertising, 8 Lao PDR Tobacco Control Fund
• Ban on tobacco advertising 3 Ratified WHO FCTC Promotion and Sponsorship established
• Smoke free Minister of Health Regulation (TAPS) ban
• Ban selling cigarettes to minor required 30% text warning 9 Pictorial health warnings
(<18) TAPS via internet ban (PHWs) implemented
• Health Education on tobacco 4 Tobacco Control Law legislated (Top 75% front and back)
harms False or misleading descriptors ban
• Government budget support Sale of single sticks of cigarettes ban Corporate Social Responsibility
• Establish the National Tobacco 6 Specific tax increased to (CSR) ban
Control Committee Kiddie pack (less than 20-stick) ban 500 LAK per pack
Smoke-free health and education
facilities as well as public
transportation
Adult smoking prevalence in Lao PDR (Aged 15 years and over)

(%)
50.8
43
Male
25.5 27.9
Adult
8.4
Female 7.1
1 2 3 4 5 6 7 8 9
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Key measures Lao PDR: Progress in WHO FCTC implementation

Article 5.2 National Tobacco Control Committee
Article 5.3 No code of conduct
Article 6 Tobacco tax burden as % of retail price (16 -19.7%)
No licensing of tobacco retailers
Article 8 100% smoke-free indoor in No penalties or compound for violating smoke-free
Outdoor smoking area within public places allowed in
Article 11 PHWs in 2016 Top front and back (75%) False or misleading descriptors ban
Article 13 Ban on direct TAPS, advertising at POS, CSR, cross border advertising, person-to-person sale, TAPS via internet and sale of single sticks of cigarettes
POS pack display (allow 1 pack per brand)
No ban on sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe

Not required a clear sign inside POS on prohibition of tobacco sales to minors and also sellers not requested for evidence before sale
Article 26 Lao PDR Tobacco Control Fund
Total budget: USD 116,700 (LAK 945,266,000) for 2017
44
Malaysia WHO FCTC Ratification: 16 September 2005
Tobacco Control Law Enacted: Control of Tobacco Products Regulation 2004 and Control of Tobacco Product (Amendment)
Regulations 2008; 2009; 2010; 2011 and 2013 under the Food Act 1983, National Tobacco Control Law already drafted
1 Control of Tobacco Products 2 Ratified WHO FCTC 4 Pictorial health warnings 6 2nd rotation of PHWs
Regulation 2004 under the (PHWs) implemented (Top 50% front and 60% back)
Food Act 1983 3 Malaysian Health Promotion (Top 40% front and 60% back)
Direct and indirect tobacco, Board (MySihat) established 7 Expansion of smoke-free
advertising, promotion and False or misleading descriptors ban places (23 places)
sponsorship (TAPS) ban
5 Kiddie pack ban enforced Expansion of smoke-free
TAPS via internet ban (delayed since 2004) cities (5 cities)
Kiddie pack (less than 20-stick)
ban
Sale of single sticks of
cigarettes ban
Adult smoking prevalence in Malaysia (Aged 18 years and over)

(%)
49.1
48.8
46.6
45.1 Male
24.7 24.6
22.8 24 Adult
3.5
1.9 1.1 1.4
Female
1 2 3 4 5 6 7
1996 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Key measures Malaysia: Progress in WHO FCTC implementation

Article 5.2 Framework Convention on Tobacco Control (FCTC) Secretariat
Article 6 Tax all tobacco products in a comparable manner No licensing of tobacco retailers
Tobacco tax burden as % of retail price (53 - 58%)
Indoor smoking room allowed in Outdoor smoking anywhere allowed in
Indoor smoking anywhere allowed in Penalties or compound for violating smoke-free
Article 11 PHWs in 2009 and 2nd rotation in 2014 Top 50% front and 60% back False or misleading descriptors ban
Article 13 Ban on direct TAPS, advertising at POS, person-to-person sale, TAPS via internet and sale of single sticks of cigarettes
Partial ban on cross border advertising
No ban on CSR, pack display at POS and sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Article 16 Less than 20-stick pack ban Not required sellers request for evidence (reached full legal age) before sale
Not required sellers request for evidence (reached full legal age) before sale
Article 26 Malaysian Health Promotion Board (MySihat)
Total budget: USD 1.91 million (MYR 7.5 million) for 2018
45
Myanmar WHO FCTC Ratification: 21 Apr 2004
Tobacco Control Law Enacted: Control of Smoking and Consumption of Tobacco Product Law (2006)
1 Designated health facilities, all 5 Control of Smoking and 6 Offer cessation service 8 Notification on posting signage
basic education schools and Consumption of Tobacco for no smoking area issued
sports fields and ground as Product Law legislated 7 Central Tobacco Control
tobacco free Committee established 9 Pictorial health warnings
Smoking prohibited in public (PHWs) implemented
2 Prohibition of tobacco places, Tobacco use in all government (Top 75% front and back)
advertising, promotion and
sponsorship (TAPS) from all Total direct TAPS ban offices’ compounds and
electronic and printed media buildings is prohibited False or misleading descriptors ban
including billboards Restriction of access to tobacco –directive by the President
products by legal minors Office 10 2nd rotation of PHWs
3 Training of health personnel for (Top 75% front and back)
tobacco control activities Sale of single sticks of
cigarettes ban
4 Ratified WHO FCTC
Text warning on tobacco
product packages
Adult smoking prevalence in Myanmar (Aged 15 years and over)

(%)
44.8
Male 43.8
26.1
22
Adult
7.8 8.4
Female
1 2 3 4 5 6 7 8 9 10
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Key measures Myanmar: Progress in WHO FCTC implementation

Article 5.2 Central Tobacco Control Committee
Article 6 Has regular adjustment processes or procedures for periodic revaluation of tobacco tax levels No licensing of tobacco retailers
Tobacco tax burden as % of retail price (50 – 60%)
Indoor smoking room allowed in
Penalties or compound for violating smoke-free
Article 11 PHWs in 2016 and 2nd rotation in 2017 Top front and back False or misleading descriptors ban
Article 13 Ban on direct TAPS, cross border advertising, person-to-person sale, TAPS via internet and sale of single sticks of cigarettes
No ban on advertising at POS, CSR, pack display and sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Article 16 Required a clear sign inside POS on prohibition of tobacco sales to minors Not required sellers request for evidence (reached full legal age) before sale
Article 26 No governmental funding mechanism for tobacco control
46
Philippines WHO FCTC Ratification: 6 June 2005
Other Tobacco Control Laws Enacted: Tobacco Regulation Act 2003 (RA 9211), Sin Tax Reform Law (RA 10351),
and Graphic Health Warnings Law (RA 10643)
1 Tobacco Regulation Act 2003 4 CSC-DOH Joint Memorandum 7 Pictorial health warnings 8 Executive Order 26 “Smoke Free
(Republic Act 9211) legislated Circular 2010-01 for protecting (PHWs) implemented Public Places”
the bureaucracy against tobacco (Bottom 50% front and back)
2 Ratified WHO FCTC industry interference National
_ Tobacco Control Strategy
False or misleading descriptors (2017 2022)
3 Partial tobacco advertising, DOH Red Orchid Award ban
promotion and sponsorship introduced 9 2nd rotation of PHWs
(Bottom 50% front and back)
(TAPS) ban implemented
5 National Tobacco_Control
Strategies (2011 2016)
6 Sin Tax Reform Law legislated
Adult smoking prevalence in Philippines

(%)
56.3
50.6
Male 49.5
41.9
34.8
23.5 29.7
Adult 23.8
8 12.1
10.1
Female 5.8
1 2 3 4 5 6 7 8 9
2000 2001a 2002 2003b 2004 2005 2006 2007 2008 2009c 2010 2011 2012 2013 2014 2015c 2016 2017 2018
a - adult aged 18 years and over b - adult aged 20 years and over c - adult aged 15 years and over
Key measures Philippines: Progress in WHO FCTC implementation
Article 5.2 Non-Communicable Diseases Cluster, Disease Prevention and Control Bureau, Department of Health
Article 5.3 Code of conduct is enforced by the whole government
Article 6 Has regular adjustment processes or procedures for periodic revaluation of tobacco tax levels No licensing of tobacco retailers
Tobacco tax burden as % of retail price (61.7%)
Article 8 100% smoke-free indoor in Indoor smoking room allowed in
Penalties or compound for violating smoke-free Outdoor smoking area within public places allowed in
Article 11 PHWs in 2016 and 2nd rotation in 2018 Bottom 50% front and back False or misleading descriptors ban
Article 13 Ban on direct tobacco advertising and TAPS via internet No ban on advertising at POS, CSR, pack display at POS, cross border advertising, person-to-person
Partial ban on tobacco promotion and sponsorship sale, sale of single sticks of cigarettes and sale of all types of heated tobacco products, electronic
cigarettes, shisha and water pipe
Article 16 Required a clear sign inside POS on prohibition of tobacco sales to minors and also sellers request for evidence before sale
Article 26 85% of incremental sin tax revenue earmarked for health (80% for Universal health coverage and 20% for medical assistance and health enhancement
facilities programme)
47
Singapore WHO FCTC Ratification: 14 May 2004
Tobacco Control Law Enacted: Smoking (Prohibition in Certain Places) Act (1992), Tobacco (Control of Advertisements
and Sale) Act (1993) and its Notifications and Regulations
1 Tobacco advertising, promotion 4 Ratified WHO FCTC 6 3rd rotation of PHWs 8 Point-of-sale (POS) pack
and sponsorship (TAPS) via (Top 50% front and back) display ban
internet ban Tobacco (Control of
Advertisements and Sale) Act False or misleading 9 Ban on the possession and
2 Singapore Health Promotion descriptors ban use of e-cigarettes
Board established Pictorial health warnings
(PHWs) implemented 7 Ban emerging tobacco products
3 Ban on sale of single sticks of (Top 50% front and back) (smokeless cigars, smokeless
cigarettes and kiddie packs (less cigarillos and smokeless cigarettes;
than 20 sticks per pack) 5 2nd rotation of PHWs dissolvable tobacco or nicotine)
(Top 50% front and back)
Adult smoking prevalence in Singapore (Aged 18 - 69 years)

(%)
Male 33.2
27.1 24.3 23.7 24.7

21.8 23.1
18.3
Adult 21.1
15.2
13.8 13.6 14.3 13.3
12.6
12
3.2 3.7 4.2 3.8
3.6 3.5
3.1 3.4
Female
1 2 3 4 5 6 7 8 9
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Key measures Singapore: Progress in WHO FCTC implementation

Article 5.2 Health Promotion Board
Article 5.3 Code of conduct is enforced by the whole government
Article 6 Has regular adjustment processes or procedures for periodic revaluation of tobacco tax levels Licensing of tobacco retailers
Tax all tobacco products in a comparable manner Tobacco tax burden as % of retail price (67.5%)
Article 11 PHWs in 2004, 2nd rotation in 2006 and 3rd rotation in 2013 Top front and back (50%) False or misleading descriptors ban
Article 13 Ban on direct TAPS, advertising at POS, advertising at POS, pack display at POS, cross border advertising, cross border advertising, person-to-person sale, TAPS via
internet, sale of single sticks of cigarettes and sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe ban
CSR (Ban on publicity only)

Required a clear sign inside POS on prohibition of tobacco sales to minors and also sellers request for evidence before sale
Article 26 Singapore Health Promotion Board
Total budget: USD 185.61 million (SGD 245 million) for 2018
48
Thailand WHO FCTC Ratification: 8 Nov 2004
Tobacco Control Law Enacted: Tobacco Products Control Act B.E. 2535 (1992), Non-Smokers’ Health Protection Act
B.E. 2535 (1992) and Tobacco Products Control Act (2017)
1 National Committee for TC 8 Excise tax 79% of factory price 12 3rd rotation of PHWs 16 Tobacco Products Control
(Top 55% front and back) Act 2017

2 Tobacco Control Office in MOPH 9 2nd rotation of PHWs
(Top 55% front and back) Regulation of Department of Sale and import of shisha
3 Tobacco Products Control Act and Disease Control regarding how and e-cigarettes ban
the Nonsmoker’s Health Protection False or misleading to contact tobacco
Act descriptors ban entrepreneurs and related Minimum age requirements
4 Ban smoking scene on television persons (20 years old)
Excise tax increased to 80%
5 ThaiHealth of factory price 13 Excise tax increased to Restrictions on sale and
87% of factory price promotions (including
Excise tax 75% of factory price 10 Smoking ban in pub / bar / Corporate Social
discotheques 14 4th rotation of PHWs Responsibility (CSR)
6 Ratified WHO FCTC (Top 85% front and back)
7 PHWs implemented
11 Excise tax increased to 85% Disclosure and reporting
(Top 50% front and back) of factory price 15 Excise tax increased to
90% of factory price
POS pack display ban
59.3 Adult smoking prevalence in Thailand (Aged 15 years and over)

Male 54.5 (%)
48.4
43.7
32 41.7 40.5 41.7 40.5
Adult 28.8 39
25.5 39.3
37.7
23
21.2 20.7 21.4 20.7
19.9 19.9
Female 5 19.1
3.5
3
2.6 2.1 2.2
1.9 2 2.1 1.8 1.7
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1989 1990 1991 1992 1996 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Key measures Thailand: Progress in WHO FCTC implementation

Article 5.2 National Committee for Tobacco Control
Article 5.3 Ministerial regulation only apply to its MOH No code of conduct applies to all government servants
Article 6 Has regular adjustment processes or procedures for periodic revaluation of tobacco tax levels Tobacco tax burden as % of retail price (70%)
Licensing of tobacco retailers
Article 11 PHWs in 2005, 2nd rotation in 2007, 3rd rotation in 2010 and 4th rotation in 2014 Plain packaging (Ministerial Regulation to be developed)
Top 85% front and back False or misleading descriptors ban
Article 13 Ban on direct TAPS, advertising at POS, CSR, cross border advertising, pack display at POS, person-to-person sale, TAPS via internet, sale of single sticks of
cigarettes, sale and import of shisha and e-cigarettes
Article 16 Less than 20-stick pack ban Not required a clear sign inside POS on prohibition of tobacco sales to minors
Required sellers request for evidence (reached full legal age)
Article 26 Thai Health Promotion Foundation (ThaiHealth)
Total budget: USD 128.97 million (THB 4,372.1) for 2017
49
Vietnam WHO FCTC Ratification: 17 Dec 2004 | Tobacco Control Law Enacted: Tobacco Control Law (2012)
1 National Strategy on Tobacco Harm 4 Vietnam Tobacco Control Fund 5 Revision of Law on Excise Tax passed
Prevention and Control (2000-2010) (tobacco excise tax rate increased to

approved by the Prime Minister Pictorial health warnings (PHWs) 70% effective on 1 January 2016
implemented (Top 50% front and back) and 75% on 1 January 2019)
2 Ratified WHO FCTC
False or misleading descriptors ban 6 Kiddie pack (less than 20-stick) ban
3 Tobacco Control Law legislated
Point-of-sale (POS) advertising ban
(Allow 1 pack/carton per brand)
Tobacco advertising, promotion and
sponsorship (TAPS) via internet ban
National Strategy on Tobacco Harm
Prevention and Control till 2020 approved
by the Prime Minister
Adult smoking prevalence in Vietnam (Aged 15 years and over)

(%)
56.1
49.2 47.4 45.3
Male
23.8
22.5 Adult
1.8
1.5 1.4 1.1
Female
1 2 3 4 5 6
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Key measures Vietnam: Progress in WHO FCTC implementation

Article 5.2 Vietnam Steering on Smoking or Health (VINACOSH)
Article 6 Tobacco tax burden as % of retail price (35.3%)
Licensing of tobacco retailers
Article 8 100% smoke-free indoor in Outdoor smoking area within public places
Indoor smoking room allowed in Outdoor smoking anywhere allowed in
Penalties or compound for violating smoke-free
Article 11 PHWs in 2013 Top front and back (50%) False or misleading descriptor ban
Article 13 Ban on direct tobacco advertising, and promotion, advertising at POS, CSR (Ban on publicity only) No ban on sale of cigarette in single sticks
person-to-person sale and TAPS via internet No ban on sale of all types of heated tobacco products, electronic cigarettes,
Partial ban on tobacco sponsorship and cross border advertising shisha and water pipe
Article 16 Less than 20-stick pack ban Not required sellers request for evidence (reached full legal age) before sale
Required a clear sign inside POS on prohibition of tobacco sales to minors
Article 26 Vietnam Tobacco Control Fund
Total budget: USD 15.65 million (VND 355,379 million) for 2017
50
3
18 Human resources in ASEAN
1
2,080,000
Number of Government staff (MOH) working on
2 tobacco control
1 Full-time Part-time
412,008***
Myanmar
Number of NGOs working on tobacco control
Number of smokers per one full time tobacco
control staff
40 Lao PDR
20* 24
266,909 14
6
7 650,100 40**
5 16
2 412,500***
Thailand 240,123
Vietnam
Philippines
Cambodia 14
25
2,788
10
23
499,145
Brunei Darussalam
29
2
Malaysia 11,896
Singapore
10
71
6,518,833
Indonesia
*About half of the NGOs are not solely working on tobacco control issues but on other health-related ones as well.
**National Tobacco Control Programme is included in the Lifestyle-related Diseases Prevention and Control Programme of the Disease Prevention and Control Bureau and they are also working
with the Health Promotion and Communication Service. Both offices underlined are under the Department of Health, Philippines.
***The ratio estimate based on number of part-time tobacco control staff in Department of Health, Philippines.
51
Chapter 5
Human and Financial Resources
for Tobacco Control
Knowledgeable and skilled human resources and Generally many countries still lack the necessary
effective multi-sectoral collaboration at different levels of structural, human, financial, and technical resources to
government and society are necessary for effective implement cost-effective and sustainable tobacco control
development and implementation of a wide range of programmes. Few national governments in ASEAN have
tobacco control activities. To this end, the WHO FCTC a sufficient number of staff working full-time on tobacco
requires Parties to establish or reinforce and finance a control. Both Singapore and Thailand have strong
national coordinating mechanism or focal point in order tobacco control policies in place with support from a
to develop, implement, periodically update, and review significant number of national level tobacco control staff,
comprehensive multi-sectoral national tobacco control while other countries in the region need to build
strategies, plans and programmes (Articles 5.1 and 5.2). national capacity (human, financial, and technical) to
effectively and efficiently deliver tobacco control.
Country National Mechanism for Tobacco Control Governmental funding mechanisms

for tobacco control
Brunei National Committee for Tobacco Control Yes
Multi-sectoral Taskforce for Health
Cambodia Committee for Tobacco Control (CFTC) No
Indonesia None, only Ministry of Health (MOH) Focal Point Yes
Lao PDR National Tobacco Control Committee Yes
Malaysia Framework Convention on Tobacco Control (FCTC) Secretariat Yes
Myanmar Central Board of the Control of Smoking and Consumption of Tobacco Products No
Philippines Non-Communicable Diseases Cluster, Disease Prevention and Yes
Control Bureau, Department of Health
Singapore Health Promotion Board Yes
Thailand National Committee for Tobacco Control Yes
Vietnam Vietnam Steering on Smoking or Health (VINACOSH) Yes
WHO FCTC:
Article 6 Guidelines recommend countries “dedicate revenue” to fund tobacco
control and other health promotion activities.
Article 26 requires all Parties to secure and provide financial support for the
implementation of various tobacco control programs and activities to meet the
objectives of the convention.
52
Tobacco control and health budgets in ASEAN
0.1167 million (LAK 945.27 million) Tobacco control (USD) Tobacco control (per capita in USD)
0.018 (LAK 142.8) Health (USD) Health (per capita in USD)
Myanmar* 15.65 million (VND 355,379 million)

Lao PDR (2017) 0.17 (VND 3,834) 1.23 million (PHP 62 million)
0.012 (PHP 0.6)
2.98 billion (PHP 150.26 billion)
28.9 (PHP 1455)
11.8 million (THB 400 million) Vietnam (2017)
0.17 (THB 5.93)
3.855 billion (THB 130.7 billion)
57.2 (THB 1,937.6) Philippines (2017)
0.225 million (KHR 90 million)

0.015 (KHR 5.9)
Thailand (2017) 27,982.5 (BND 38,615.80)**
0.07 (BND 0.09)
234.695 million (BND 323.88 million)
554.8 (BND 765.7)
Cambodia (2016)
25,510 (MYR 100,000)***
0.0008 (MYR 0.003)
5.79 billion (MYR 24.88 billion)
182.9 (MYR 785.8) Brunei Darussalam
(2017)
183.33 million (SGD 253 million)****
32.71 (SGD 45)
7.77 billion (SGD 10.73 billion)
Malaysia (2017) 1385.9 (SGD 1913)
Singapore (2017)
8,117 billion (IDR 111 trillion)

31,376 (IDR 429,060)
Indonesia (2018)
*Myanmar does not have any government budget for tobacco control.
**The budget use for tobacco related programmes come from the operational budget of Health Promotion Centre.
***Estimation budget of MYR 100,000 for tobacco control from Malaysian Health Promotion Board (MySihat) only.
****Budget of USD 183.33 million (SGD 253 million) is for all non-communicable diseases (NCDs) programmes and not solely for tobacco control.
53
The Way Forward: Innovative National Financing Solutions
In many countries tobacco control is often not a national Five out of ten ASEAN countries have established health
priority. Consequently, domestic resources for WHO FCTC promotion or tobacco control funds through surcharged taxes
implementation are far from secure and must compete with (Thailand, Lao PDR and Vietnam) and treasury budget
other programmes for government funding. An effective way to (Malaysia and Singapore). Initiatives in Cambodia, Philippines
address this is the introduction of dedicated surcharge taxes on and Myanmar are underway to establish similar fiscal
tobacco and alcohol, which can aid in reducing consumption mechanisms.
of these harmful products and, more importantly, provide a
more secure funding stream for health promotion and tobacco
control programmes.
Tobacco control is under-funded

Governments collect more than USD 250 billion in
180 178.94 total tobacco excise tax revenues each year worldwide,
(USD per capita)
Per capita excise tax revenue but spend only around USD 1 billion combined on
160 from tobacco products tobacco control – with 95% of this spent by
high-income countries.
Per capita public spending on
Quick
140 tobacco control
120
100 Fact Too few resources applied to tobacco control

in low-and middle-income countries.
80
60
Fund currently available
from public spending
USD
per capita
0.019
and foreign assistance
40 34.53
20
1.14 0.01 2.39 0.0048
Fund needed to
implement tobacco control
“Best Buys” measures
USD
per capita
0.11
0
High-income Middle-income Low-income
Note: Based on 87 countries with available data on public spending on tobacco control and tobacco excise revenue data. Expenditure on tobacco control for several of these countries was estimated
from figures between 2004 and 2016, adjusting for inflation (average consumer prices, IMF World Economic Outlook 2016). Tax revenues are tobacco product (or cigarette) excise revenue for 2016
and 2015 (or where unavailable, 2014 or 2013 converted to 2016 values for the countries covered). Per capita value is calculated by using 2016 UN forecasted population age 15 years and above.
UN Declarations:
“Recognizes that price and tax measures on tobacco can be an effective and important means to reduce tobacco
consumption and health-care costs, and represent a revenue stream for financing for development in many countries”
Declaration of the United Nations 3rd International

Conference on Financing for Development,
Addis Ababa, Ethiopia, July 2015
“45. (d) Explore the provision of adequate, predictable and sustained resources, through domestic, bilateral, regional
and multilateral channels, including traditional and voluntary innovative financing mechanisms.
“49. Promote all possible means to identify and mobilize adequate, predictable and sustained financial resources and
the necessary human and technical resources, and to consider support for voluntary, cost-effective, innovative
approaches for a long term financing of non-communicable disease prevention and control, taking into account the
Millennium Development Goals”
Political Declaration of the High-level Meeting of the
UN General Assembly on the Prevention and Control of NCDs,
New York City, September 2011
54
Earmarked taxes: A Global View
Iceland
Estonia*
Ireland* Lithuania
Switzerland*
Romania
United States of America Republic of Korea*
Morocco Iran
Algeria Nepal
Egypt Thailand* Lao PDR
Guatemala
Mauritania Philippines
El Salvador Jamaica Cape Verde
Costa Rica Bangladesh Vietnam*
Panama
Colombia Palau
Côte d'Ivoire
Congo Comoros Indonesia
Cook Islands
Around 35 countries Mauritius
earmarked tobacco Madagascar
tax revenues for
health purposes Argentina Tobacco control
Non-communicable Diseases
Health insurance/Universal Health Care
* Countries that have established health promotion or tobacco control fund using earmarked tax for funding source. Other/more general health programmes
Types of innovative funding mechanism in ASEAN

Funding source Year of establishment Details/ Total Budget (USD)
Health Promotion Centre (operational budget), 2008 115, 942 (BND 160,000)* (2016-2017)
Ministry of Health Budget
Ministry of Health, Brunei 130,434 (BND 180,000)* (2017-2018)
Singapore Health Promotion Board 2001 183.33 million (SGD 253 million)** (2017)
185.61 million (SGD 245 million)** (2018)
Philippines Department of Health budget 2012 85% of incremental sin tax revenue earmarked for health
Philippine Health Insurance Corporation • 80% for Universal health coverage
• 20% for medical assistance and health enhancement
facilities programme
Lao PDR Tobacco Control Fund 2013 2% profit tax plus LAK 200 (per pack)
Earmarked Surcharge Tax
116,700 (LAK 945,266,000)***(2017)
Thai Health Promotion Foundation (ThaiHealth) 2001 2% surcharge levied on excise tax from alcohol and tobacco
121.12 million (THB 4,275.7 million) (2016)
128.97 million (THB 4,372.1 million) (2017)
Vietnam Tobacco Control Fund 2013 1% excise tax, effective 1st May, 2013;
1.5% from 1st May, 2016; and 2% from 1st May, 2019
15.65 million (VND 355,379 million)
Malaysian Health Promotion Board (MySihat) 2006 1.65 million (MYR 7.1 million) (2017)
National Treasury
Allocation
1.91 million (MYR 7.5 million) (2018)
Indonesia Local Cigarette Tax 2014 Distribution of 10% local cigarette tax revenue to provinces
for health****
*The estimate budget also covers other NCD prevention programmes (healthy eating, physical activity, school health and community programmes), in both children and adults. ** Budget for all non-communicable
diseases (NCDs) programmes. ***The total budget excluded the amount that failed to collect from imported brands as the tobacco industry refused to pay the 2% profit tax and LAK 200 per pack.****10% local
tobacco tax surcharged for social development (50% of the amount is for health - 75% of the 50% allocation for health are to be used for preventive/promotive care including reducing NCD risk factors, 25% for
construction and maintenance).
55
Governance and roles of health promotion/tobacco control funds in ASEAN

Type and Year Type Governed and Report to Role of organization
Established chaired by
Granting Policy Implementing Building
agency development health promotion capacity
programs
Thai Health Autonomous Board of Cabinet and to
Promotion agency Governors, chaired both houses of
Foundation by Prime Minister Parliament
(ThaiHealth) (2001)
Singapore Health Statutory Board Board of Directors Minister of Health

Promotion Board under MOH and chaired by and Parliament
(2001) independent
Chairman
Malaysian Health Semi-autonomous Chairman appointed Minister of Health

Promotion Board agency under by the Prime
(MySihat) (2006)* MOH Minister upon the
advice of the
Minister of Health
and Board of
Directors appointed
by the Minister of
Health
Vietnam Tobacco Semi-autonomous Inter-sectoral Government and

Control Fund (2013) agency and a unit Management Board National Assembly
in MOH chaired by Minister
of Health
Lao PDR Tobacco Unit in MOH Tobacco Control National Tobacco

Control Fund (2013) Fund Council Control Committee
(National Tobacco and Government
Control Committee)
*MySihat will be integrated with the service of Health Education Division, Ministry of Health as part of the Government Service Rationalization Programme.
56
Chapter 5: Human and Financial Resources for Tobacco Control
_
Thailand: Annual budget for health (2010 2017)
(Year) (THB Million)
2017 300,516.7 4,372.1 1.45
286,694.3 4,275.7 1.49

2016
224,621.90 4,111.31 1.83 Ministry of Public Health (MoPH) and

2015
Fund for the National Health Security
221,279.60 4,064.74 1.84 Thai Health Promotion Foundation
2014
(ThaiHealth)
2013 208,532.70 3,811.55 1.83
ThaiHealth budget as percentage of
combined MoPH budget and Fund for
2012 199,810.90 3,561.27 1.78 National Health Security (%)
2011 187,962.40 3,391.77 1.80
2010 161,010.20 3,110.30 1.93
0 50,000 100,000 150,000 200,000 250,000 300,000 350,000
Thaihealth funding for selected major NCDs risks reduction programmes (2017)
(USD Million)
9.9 (THB 335 million)
11.2 (THB 380 Million)
Tobacco 24.5
Alcohol (THB 830 million)
Traffic accident
Physical activity
Diet/ Nutrition 86.1
Healthy Community Strengthening (THB 2,918)
Health Literacy Promotion +
Healthy Media System and 18 7.6 (THB 260 million)
(THB 608 million)
Spiritual Health Pathway Promotion
7.1 (THB 240 million) 7.8 (THB 265 million)
57
Vietnam: VNTCF distribution for tobacco control programmes (2017)

Developing the training material and integrating
the training into the school program 4% Supporting the cost of administration and
performance of VNTCF
1% 1%
Contingence
Awareness raising among policy
makers and the public on the tobacco
harms and tobacco control law Disseminating smoke-free
models in state agencies
40% and provinces/cities
44%
Capacity building on network of
tobacco control collaborators
2% Improving and strengthening tobacco
cessation service quit line and
Implementing research serving for tobacco control programs consultancy service in all health settings
2% 6%
In 2017, a total 105 grantees were funded by VNTCF with a total of USD 15.65 million (VND 355,379 million) of the fund
distributed among 28 ministries, mass organization agencies and 67 provinces/cities agencies and 10 hospitals. The projects supported
mainly communication campaigns related to tobacco prevention and control, smoke-free development, capacity building for law
enforcement.
In 2015, the Thai government accepted and acted on a proposal by the Thai Tobacco
Monopoly (TTM) to investigate and reorganise - Thai Health Promotion Foundation
(ThaiHealth). The investigation resulted in negative press for ThaiHealth. ThaiHealth is
recognised as an international success case study of health promotion funded by 2% surcharge
on tobacco and alcohol tax revenues.
In Vietnam, the government accepted an offer to collaborate with the tobacco industry in
controlling tobacco smuggling. The Ministry of International Trade has endorsed a
recommendation from the tobacco industry to divert 50% of the tobacco control fund for
enforcement of tobacco smuggling problem. In March 2015, the Ministry of Finance issued
Directive 04/CT-BCT which specifies the role of Vietnam Tobacco Association (VTA) to fund
government activities in controlling illicit trade of tobacco.
58
Implementation of FCTC Article 5.3 in ASEAN
Implementation of FCTC Article 5.3 code of conduct, guidelines,
or other policy
Myanmar
Yes
No
Lao PDR
Philippines
Implementation of code of conduct
(Joint Memorandum Circular
_
2010 01 (JMC)) that is enforced
Thailand Vietnam by the whole government.
The ministerial regulation
(code of conduct) or guidelines
only apply to its Ministry of
Health. Cambodia
The Sub-decree on establishment and
functioning of the Committee for
Tobacco Control (CFTC) has
incorporated principles of Article 5.3.
Brunei Darussalam
The code of conduct on protection of
tobacco control policies from tobacco
industry interference that applies to all
Malaysia government servants is being finalized by
the Prime Minister’s Office.
Singapore
Implementation of internal code of conduct
that is enforced by the whole government.
Indonesia
The ministerial regulation (code of conduct) or
guidelines only apply to its Ministry of Health.
59
Chapter 6
Insulating Public Health Policies
from Industry Interference
The tobacco industry is not like any other business. Article 5.3 of the WHO FCTC requires Parties, when
Despite selling a highly addictive and inherently defective setting and implementing their public health policies
product that kills up to two thirds of its consumers, it with respect to tobacco control, to protect these policies
continues to escape commensurately stringent regulation from commercial and other vested interests of the
of its business and products by interfering at all tobacco industry in accordance with national law. By
levels of tobacco control policy development and unanimously adopting the WHO FCTC Article 5.3
implementation. Through both overt and covert means, Guidelines at the third session of the Conference of the
the industry uses its massive resources to deter and Parties (COP3) in 2008, Parties to the treaty formally
thwart governments' efforts to protect public health recognized the irreconcilable conflict between the
policies. Tobacco industry interference remains a major tobacco industry’s interests and public health policy
problem in the ASEAN region as in other parts of the interests.
world.
Within ASEAN, four countries (Indonesia, Philippines,
The tobacco industry employs an extensive range of Singapore and Thailand) have taken concrete steps to
unethical and intentionally orchestrated tactics and protect their public health policies from tobacco industry
strategies, at both the country level and internationally, interference by developing a policy, guidelines, or a code
to directly and indirectly challenge, defeat, discredit, of conduct to prevent unnecessary interactions with the
dilute, obstruct, delay and circumvent implementation of industry and ensure transparency of any interactions that
effective tobacco control measures. These include do occur, while other countries still have to institute
political lobbying to manipulate and hijack the political similar preventive measures in line with the Article 5.3
and legislative process through drafting and distributing Guidelines. Regardless of such actions taken, there has
industry-friendly legislation, providing incentives to been increasing industry interference in many countries,
government officials and politicians to take a and this is expected to continue into the future. Hence
pro-industry position, and hiring former prominent there remains much room to institute or strengthen
government officials or appointing them to be tobacco mechanisms at the highest levels to prevent or reduce
industry spokespersons or board members. Other tactics such industry interference in tobacco control.
include intimidating governments and individuals with
litigation or threat of legal suit, mobilizing front groups
Quick
to advance its cause, and making false claims and
spreading half-truths and misinformation through
position papers, news items, posters, and paid ads.
Fact
USD In 2015, philanthropists Michael R. Bloomberg and Bill Gates
4 Million contributed USD 4 million to help developing countries fight legal
suits by tobacco companies.
On 7 March 2018, philanthropist Michael R. Bloomberg allocated
USD 20 million funding to launch Stopping Tobacco Organizations
and Products (STOP), a new global watchdog that aims to aggressively
USD monitor deceptive tobacco industry tactics and practices to undermine
20 Million public health. STOP will function as a robust global monitoring system
that complement existing efforts in identifying industry deception.
60
Chapter 6: Insulating Public Health Policies from Insidious Interference
FCTC Article 5.3 acts as an anti-corruption and good governance measure

Anti-corruption measures Article 5.3 guidelines
Protections against policy manipulation for profit Safeguard public health policymaking from tobacco industry
Public access to information Tobacco industry should release informationto government
Transparency of dealings and decision-making Transparent interactions between tobacco industry and governments
Lobbying and conflict of interest disclosure Government officials disclose conflicts of interest, lobbying register
Codes of conduct through which conflicts of Establish a code of conduct that dictates the terms of interactions between government
interest can be avoided officials and the tobacco industry
Bribing/financial disclosure Government officials should not take money from or invest in the tobacco industry
All 10 ASEAN countries have anti-corruption laws. This legal framework has huge potential for harnessing the
political and legal power to protect public health interests against tobacco industry interference in line with Article 5.3
guidelines.
Globally
Quick
Fact
International Organisations
36
countries
- UN Economic and Social Council (ECOSOC)
- United Nations Global Compact (UNGC)
- United Nations (UN) have adopted good practices
- United Nations Development Programme (UNDP) and measures to prevent
tobacco industry interference in
Have adopted or developed policies to be consistent the development and implementation of
with or to support the Implementation of WHO FCTC public health policies with respect to
Article 5.3. It aims to address tobacco industry interference, tobacco control in accordance with the
and have the legal personality and medium to influence recommendations provided by the
governments and international bodies. Article 5.3 Guidelines.
61
Implementation of FCTC Article 5.3 in ASEAN

Tobacco industry interference in policy development
The tobacco industry works to defeat, dilute and delay effective tobacco control policy. They participate in policy development in
order to undermine any stringent tobacco control policy a government may propose.
Brunei Cambodia Malaysia Lao PDR Thailand

Brunei, Cambodia and Malaysia do not allow the TI to unduly influence decisions in the policy development.
The Lao government did not accommodate the tobacco industry’s request to reduce the size of the pictorial health warning
(PHW) from the proposed 75% to 50%. Although the industry tried to interfere, the government successfully passed the law
requiring 75% PHW in 2016.
In Thailand, there was no reported incidence of the government accepting, or responding to any initiative from the tobacco
industry in implementing tobacco control measures.
Industry-related CSR activities

Tobacco companies have been trying to re-brand themselves as “socially responsible” corporations. They use corporate social
responsibility (CSR) activities to circumvent laws regulating the industry, and as a strategy to gain access to elected officials who are
empowered to approve and implement tobacco control policies.
Lao PDR Myanmar Thailand Cambodia Indonesia Singapore Vietnam

Among ASEAN countries, only Lao PDR, Myanmar and Thailand have banned on all tobacco-related CSR activities, while
Cambodia, Indonesia, Singapore and Vietnam have banned the publicity of such CSR activities.
Preventive measures
Procedure for disclosing records of interactions with the tobacco industry and its representatives is still not implemented in most
countries. There is no obligation for the tobacco companies to disclose how much they spend on marketing and promoting their
products and funding front groups and trade/retailer groups for their lobbying activities.
Philippines Indonesia Thailand Malaysia Vietnam

Philippines continues to show leadership in implementing its Joint Memorandum Circular 2010-01 (JMC) for protecting the
bureaucracy against tobacco industry interference as more government departments draw up Codes of Conduct for their
respective officials.
Indonesia and Thailand Health Ministries have put in place a policy to protect government officials within the National
Ministry of Health administration from tobacco industry interference.
Indonesia, Malaysia, Thailand and Vietnam require the tobacco industry to submit information on tobacco production,
manufacture, market share, and revenues; however, they are not required to provide information on marketing expenditures,
expenses on lobbying, philanthropy, and political contributions.
62
Chapter 6: Insulating Public Health Policies from Insidious Interference
Forms of unnecessary interaction

Most countries showed minimal progress in reducing unnecessary interaction with the tobacco industry.
Brunei Cambodia Malaysia Myanmar

No records of public officials (from Brunei, Cambodia, Malaysia and Myanmar) had attending any social functions of the
tobacco industry nor accept any assistance from the tobacco industry for enforcement activities.
Vietnam Indonesia
In 2016, there are incidents of several ministerial level officials attended TI-related events or presented awards to the TI. In
Vietnam, the Ministry of Labour presented BAT with HR Award for successful human resource management. Similarly in
Indonesia, several Ministers presented various awards (such as ‘Zero Accident Award’, top tax contributors) to the tobacco
companies.
Greater transparency needed

Most governments have not set up rules or a procedure for the disclosure of meetings and interactions with the tobacco industry or
registration of tobacco industry entities, affiliates organizations and individuals acting on their behalf including lobbyists. This
includes not indicating when the meetings with the industry take place, their purposes, or the contents and outcomes of the meetings.
Minutes may be taken during these meetings, however they are not made public.
Philippines Thailand Myanmar Indonesia Vietnam

The Philippines’ Joint Memorandum Circular (JMC) 2010 requires government departments to report on their interaction
with the industry; however, the Civil Service Commission (CSC) does not have any full information about meetings of other
agencies with the tobacco industry. Department of Agriculture and the Department of Trade and Industry do not publicly
disclose such meetings nor submit documentation/ reports to the CSC, while the Department of Health is required to keep a
public record of persons and entities identified as part of the tobacco industry.
In Thailand, minutes of meetings with the tobacco industry are recorded, including those attended by high-level officials;
however, they are not made public.
JTI Myanmar claimed it obtained formal approval from the Ministry to place an advertisement in the newspaper following the
meeting held between Myanmar Health Ministry’s and JTI officials. However, the Ministry denied granting such an approval.
The Indonesian and Vietnamese governments are “open” about their interactions with tobacco industry as they see this
interaction as “normal”; however, details about the interaction are not publically available.
63
Conflicts of interest
Brunei Lao PDR Vietnam

Brunei prohibits political contributions from the tobacco industry and continued to not have any conflict of interest.
In Lao PDR, there was no retired government official assumed a position with the tobacco industry recently.
In Vietnam, the Minister of Industry and Trade appointed his close relative as an inspector to Vinataba and disciplinary action
was taken against him.
Cambodia Indonesia Malaysia Thailand

In Cambodia, the Chairman of BAT still remains as a Senator. The government does not prohibit contributions from the
tobacco industry or any entity working to further its interests to political parties, candidates, or campaigns or to require full
disclosure of such contributions.
In Indonesia, the former Director General of Customs and Excise and also advisor to the Finance Minister on International
Economic Relations was appointed as Chairman of the BAT/Bentoel Company Audit Committee in March 2016 for three
years.
In Malaysia, the Secretary-General of the Ministry of International Trade and Industry (MITI), during her term, led the
Malaysian government in the Trans-Pacific Partnership Agreement (TPPA) negotiations where Malaysia proposed to exclude
tobacco control measures from the TPPA.
In Thailand, retired senior government officials have regularly been appointed as board members of the Thai Tobacco
Monopoly (TTM). Current government officials such as a senior officer from the Excise Department and the Ministry of
Finance are TTM board members. Since the TTM is a state enterprise, the appointment is seen as normal.
Benefits to the tobacco industry

The tobacco industry in many countries continues to receive benefits through a variety of ways.
Cambodia Vietnam Indonesia

The Cambodian Ministry of Commerce announced that Vietnam had agreed to waive all duties on 3,000 tons of dried tobacco
imports from Cambodia. Publicity was given to the exemption urging tobacco growers to take advantage of the duty waiver.
In Indonesia, the Customs and Excise Department was persuaded by the industry that tax increase would worsen illicit
cigarette problem resulting in revenue loss for the government. A lower tax increase (10.54%) was announced for 2017.
For more detailed information, please visit http://tobaccowatch.seatca.org and refer to Tobacco Industry Interference Index (2017 and 2016); A Handbook on the Implementation of
Article 5.3 of the WHO’s Framework Convention on Tobacco Control (WHO FCTC) and Related Actions (2018) and Anti-corruption and Tobacco Control (2017).
64
Red Ruby (0.60)
Mevius (2.11)
Prices of most popular cigarette brands in ASEAN
Adeng (0.85)
Marlboro (1.83) (USD/pack)
Myanmar
Lao PDR
SMS (1.90)
L&M (1.90)
VINATABA (0.84)
Craven A (0.88)
Fortune (1.11)
ARA (0.50) Marlboro (1.92)
Thailand FINE (0.88)
Vietnam
Philippines
Cambodia
Djarum Super (5.11)
Dunhill (4.34)
Brunei Darussalam*
Malaysia Marlboro (10.60)
Singapore
A Mild (1.63)
Marlboro (1.90) Generally, cigarette prices remain affordable and
relatively low throughout the region, but
particularly in Cambodia, Lao PDR, Myanmar and
Vietnam (less than USD 1 per pack) where regular
tax increases are needed to keep pace with
Indonesia economic and income growth.
*Djarum Super was the most popular brand found prior to 2014. There are no licensed tobacco importers and retailers in Brunei since May 2014.
Hence, there are no cigarettes being sold legally in the country.
65
Chapter 7
Reducing Tobacco Affordability
and Consumption
Excise tax increases that significantly raise tobacco product This means applying specific or mixed (specific and ad valorem)
prices and reduce their affordability are among the most taxes on all tobacco products, taxing all tobacco products in a
effective fiscal measures to reduce tobacco consumption (and similar way (to reduce the potential for product substitution),
thereby its adverse health consequences) by discouraging and regularly increasing tax rates so as to continually
purchase of tobacco products, thereby encouraging tobacco reduce affordability of tobacco products. This also means
cessation and preventing tobacco uptake among various strengthening tobacco tax administration (licensing,
segments of the population, in particular price-sensitive young warehousing, anti-forestalling, fiscal markings, and
people and the poor. Tobacco taxes can therefore have large enforcement), considering dedicating tobacco tax revenues to
aggregate benefits for public health and socio-economic tobacco control programmes, and prohibiting or restricting
development, primarily through healthier and more productive tax/duty-free sales of tobacco products.
populations and reduced healthcare costs, reducing poverty,
and providing a reliable source of government revenues. For This chapter provides an overview of the tobacco tax situation
these reasons, tobacco tax increases are described as a win-win in ASEAN countries, where tax policies have been strengthened
policy measure, i.e. a highly cost-effective WHO “best buy” in some countries, but require more improvements in others.
public health intervention and a reliable source of domestic Countries such as Philippines, Singapore, and Thailand are
financing. good examples where tax increases have contributed to a decline
in smoking prevalence rates alongside higher tobacco tax
The World Bank has recommended that the total tax burden revenues. In the case of Lao PDR, the government’s lopsided
should be 66% to 80% of the retail price, and more recently, Investment License Agreement (2001-2026) with Imperial
the WHO has recommended that at least 70% of retail price Brands prevents the Lao government from benefiting, as the
should be excise. The current global guidance for tobacco government continues to lose millions in tobacco tax revenues
taxation, however, remains to be WHO FCTC Article 6 and its (see page 13) while being unable to reduce tobacco use.
implementation guidelines (adopted by the WHO FCTC COP
in 2014), which recommend that governments should adopt
long-term tax and price policies that meet both their public
health and fiscal needs.
Cigarette Affordability: Relative Income Prices (RIP)* of cigarettes in ASEAN

16.25
16
% of p.c. GDP to buy 100 cigarette packs
• The lower the RIP, the more affordable cigarettes are.

• In most countries cigarettes have become more
12 11.56 affordable as indicated by the significant decline in RIP
(apply for the most popular brand) since early 2000.
• Philippines is the only country in ASEAN region that
10 RIP is in the increasing trend. Due to the Sin Tax
8.2 Reform in 2012, it has made a positive impact on
increased cigarette prices.
8 7.69
6 5.32 Brunei
3.94
4.80
4.3
Cambodia
4 Indonesia
3.87 3.66 3.98
3.85
Lao PDR
3.28 3.65
Myanmar
2 2.03 1.89
1.82 Philippines
0.4 Singapore
0 Thailand
2000 2002 2004 2006 2008 2010 2012 2014 2016
* Relative Income Price (RIP) refers to percentage of per capita GDP required to purchase 100 packs of cigarettes. Vietnam
66
Chapter 7: Reducing Tobacco Affordability and Consumption
Prices of most popular cigarette brands in ASEAN

12
(USD/20-stick pack)
Marlboro
Most popular cigarette brand 10.6
Price that stop youth from smoking* 10
10
6.07
6 Djarum Super*** Marlboro
5.11 Dunhill
1.90 4.34
4 Fine Marlboro Mevius Marlboro Craven A

0.88 3.76** 1.83 2.11 1.92 0.88
>3
2.5
SMS L&M
A Mild 1.90 1.90
2 1.63 Fortune
Adeng Red 1.11 VINATABA
Ara 0.85 Ruby >1.1 0.84
0.5 0.6
0
*Findings from youth opinion survey on cigarette prices in five ASEAN countries conducted in 2017. Respondents were aged 13-24 years
**The study was conducted among Indonesians aged between 14 -78.
***Djarum Super was the most popular brand prior to 2014. There are no licensed tobacco importers and retailers in Brunei since May 2014.
Tobacco tax burden as percentage of cigarette retail price in ASEAN

(%) 70
70 67.5
62 62.71
60 53 – 58 50 – 60 61.7
50
40 35.3
25 – 31.1
30
20 16 – 19.7
10
0
Brunei** Cambodia Indonesia Lao PDR Malaysia* Myanmar Philippines Singapore* Thailand Vietnam
*The estimate was calculated based on premium cigarette brand
** There are no licensed tobacco importers and retailers in Brunei since May 2014. Hence, there are no cigarettes being sold legally in the country.
67
Cigarette tax systems in ASEAN
Country Excise Rate VAT Import Tariffs Others
Brunei BND 0.50/stick None None
Specific Tax
Indonesia IDR 100-625/stick (10 tiers) 8.7% 0% from ASEAN plus China Local cigarette tax 10%
40% from outside ASEAN plus China of excise tariff
Malaysia* MYR 0.40/stick MYR 0.20/stick
Myanmar MMK 4-16/stick (4 tiers) None 120% on CIF The income and profit tax is based
on the income tier
5% commercial tax for import, sale
and export of tobacco and tobacco
products
MMK 0.25/stick (cheroot)
Philippines PHP 35.00/pack 12% 0%–10% On 1 January 2024, rates will
PHP 37.50/pack on 1 January 2020 increase by 4% annually
PHP 40.00/pack on 1 January 2022
Singapore SGD 0.427/stick 7% None
Lao PDR** 15-30% of production cost and 10% Flat rate fee of USD 0.40/pack Royalty fee 5% of production cost
Mixed System
LAK 500/pack specific tax
Thailand 20% Ad valorem rate of 7% Exempted but other local taxes are Local tax of THB 0.093/stick,
suggested retail price (SRP) less applied ThaiHealth tax at 2% of excise, and
than/equal to THB 60/pack and TV tax at 1.5% of excise and sport
THB 1.2/stick*** tax 2% of excise
40% Ad valorem rate of SRP Provincial Administration Organization
more than THB 60/pack and tax of THB 1.86/pack, ThaiHealth tax
THB 1.2/stick*** at 2% of excise, and TV tax at 1.5%
of excise, sport tax 2% of excise and
40% Ad valorem rate of SRP 10% of interior tax 10%
and THB 1.2/stick****
Cambodia 20% of 90% of invoice price 10% 7%–35% plus Public lighting tax 3% of invoice
Ad Valorem Tax
10% import VAT value, Profit tax 20% of profit,

Turnover tax 2% of invoice value
Vietnam 70% of ex-factory price 10% 30%–135% Compulsory contribution to Vietnam
(75%, effective on 1 January 2019) Tobacco Control Fund:
30% applies on tobacco materials 1% of taxable price (May 1 2013);
including tobacco leaves and other 1.5% of taxable price (May 1 2016);
materials 2% of taxable price (May 1 2019)
135% applies on cigarettes and
cigars
* GST is removed beginning of 1 June 2018, however, the cigarette prices remain the same. The new tax rate of 10% sales and services tax (SST) will be applied in September.
**Based on the new tax law passed in 2016, the excise tax rate should be 30% (2016-2017); 45% (2018-2019) and 60% (2020 onwards). However, the new tax rate is not enforced due to the
unfair Investment License Agreement (ILA) with tobacco industry signed in 2001.
***This rate will be applied from 16 September 2017 to 30 September 2019.
**** This rate will be applied on 1 October 2019 onwards.
68
Implementation of FCTC Article 6 Guidelines

Have regular adjustment processes or procedures for periodic revaluation of tobacco tax levels.
Indonesia Myanmar Philippines Singapore Thailand
Have had tax increases that are discouraging consumption.
Brunei Philippines Thailand
Tax all tobacco products in a comparable manner, reducing the price difference between various types of tobacco products (cigarettes, cigars,
pipes and other tobacco products).
Brunei Philippines Malaysia Singapore
Dedicate tobacco tax revenues to tobacco control programmes.
Lao PDR Thailand Vietnam
Tax all tobacco products: No duty-free allowance

Duty-free Allowance in the Region Country
No duty-free concession on all tobacco products Brunei
200 cigarettes or 50 cigars or 250 grams of chopped tobacco Cambodia
200 cigarettes or 25 cigars or 100 gm of rolling tobacco Indonesia
200 cigarettes or 50 cigars or 250 gm of tobacco Lao PDR
200 cigarettes or 50 cigars or 225 gm of tobacco Malaysia
400 cigarettes, 50 cigars or 250 gm of pipe tobacco Myanmar
400 cigarettes or 50 cigars or 250 gm of pipe tobacco Philippines
No duty-free concession on all tobacco products Singapore
200 cigarettes or 500 gm of rolling tobacco including cigars Thailand
200 cigarettes or 20 cigars or 250 gm of tobacco Vietnam
69
Tobacco tax administration in ASEAN
Philippines
Singapore
Cambodia
Indonesia
Myanmar
Malaysia
Thailand
Lao PDR
Vietnam
Authorization/licensing
Brunei
Have a license or control system on the manufacture and import or
export of tobacco products.*
Have licensed wholesaling, brokering, warehousing or distribution of

tobacco and tobacco products.
Have enforced a license system on retailing of tobacco products.
Have a control or license system for tobacco farmers and producers.
Requires license on the transporting of commercial quantities of

tobacco products.
Requires license for manufacture, import or export of tobacco

manufacturing equipment.
Requires license for transporting of tobacco manufacturing

equipment.
* No tobacco manufacturers in Brunei Darussalam.
Licensing of tobacco retailers in ASEAN

Country Cost of license (USD/year) Country Cost of license (USD/year)
Brunei* 222 (BND 300) - 2008 Singapore 288.14 (SGD 360) - 2010
444 (BND 600) - 2015 296.30 (SGD 400) - 2016**
Cambodia No Thailand 3.17 – 15.9 (THB 100 – 500)
Indonesia No Vietnam Fee for assessment and recognition:
In city and urban level: 55.8 (VND 1,200,000) In Malaysia, a public
Lao PDR No In district level: 27.9 (VND 600,000) consultation on
licensing of cigarette
Malaysia No Fee for licensing: retailers was carried
In city and urban level: 9.3 (VND 200,000) out in early 2016
Myanmar No In district level: 4.65 (VND 100,000)
but following
Philippines No protests from
retailer groups there
* After May 2014, there was no more licensed tobacco importer. Licensing of tobacco importers and wholesalers is USD 1,850 (BND 2,500)/year in 2008 and was no decision.
it has increased to USD 3,700 (BND 5,000)/year in 2015.
** SGD 340 for a new license and SGD 60 for admin fees. The fee revision took effect 1 January 2016.
70
Thailand: Higher tax rates, higher revenues, and reduced smoking prevalence
Thailand raised its cigarette excise rates 11 times (from The Thai government has further increased the tax rate
55% to 87% of factory price)between 1991 and 2012, to 90% in early 2016, aimed at reducing number of
which resulted in an almost fourfold gain in revenues smokers and raising tax revenue by about THB15 billion
from THB 15.89 billion (USD 530 million) to THB per annum.
59.91 billion (USD 1,997 million) over the same period.
At the same time, overall smoking prevalence dropped In September 2017, a new tax structure and rate on
from 32% (1991) to 21.4% (2011). tobacco came into force to further reduce cigarette
affordability in Thailand.
(Million) 2,463
2400 2,415
2,262 2,191 2,286
2200 2,171 2,130
2,135 2,328 2,110 2,187 2,038 (%)
2,003
1,942 1,958 2,091 2,181 2,020
2000 1,904 1,997 100
1,983 1,826 1,837 1,800 1,906 2,033 1,963
1,810 1,790
1800 1,727
1,793 87 87 87 87 90 90
90
1,716 80 80
79 85 85 85
1600 75 75 75 75 75 1,779 80
1,473
68 68 70 71.5
1400 1,323 1,384 1,348
1,119 1,211 70
60 62
1200 55 55 55 1,188
60
992 988 1,042
937
1000 890 50
803
800 40
32 667 691
28.8
600 530 515 512 25.5 30
23 21.4
21.1 20.7 19.9 19.9 19.1
400 20
200 10
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Excise rate (% of factory price) Sale (million packs) Tax revenue (USD Million) Smoking prevalence (%)
1USD = 30 THB
Source: Excise Tax department, Ministry of Finance
71
Singapore: Highest tobacco tax burden in ASEAN

Concerned by slight increase in smoking prevalence from 2004 to 2017 and noting that the last tobacco excise tax increase was in
2014, the Singapore government decided to increase tax by 10% across all tobacco products in February 2018.
Year Excise Duty of Cigarettes (SGD) Retail Price 20 sticks (SGD) % Smoking Prevalence (aged 18-69 years)
1987 34 per kg 2.80
1990 42 per kg 3.30
1991 50 per kg 3.70 18.3 (1992)
1993 60 per kg 4.90
_
1995 98 115 per kg 5.50 15.2 (1998)
_
1998 99 130 per kg 5.80
2000 150 per kg 6.40
2001 180 per kg 6.90 13.8 (2001)
2002 210 per kg 6.50
Mar 2003 255 per kg 7.70
July 2003 0.255 per stick of < 1g 8.50
2004 0.293 per stick of < 1g 9.50 12.6 (2004)
_
2005 2013 0.352 per stick of < 1g 11.90 13.6 (2007)
14.3 (2010)
13.3 (2013)
2014 0.388 per stick of < 1g 12.00 -
_
2015 2017 0.388 per stick of < 1g 13.00 -
2018 0.427 per stick of < 1g 14.00 12.0 (2017)
Quick
Fact Up to March 2003, excise duty on cigarettes
was by weight per kilogram of tobacco.
From July 2003, excise duty on cigarettes
For unmanufactured tobacco and cut
tobacco, the excise duty is SGD 388 per kg.
For beedies, ang hoon, and smokeless
was revised to a unit-based (per stick) system. tobacco, the excise duty is SGD 329 per kg.
This change to a unit-based system was in For all other tobacco products, the excise
response to the emergence in 2000 of duty is SGD 427 per kg. An additional 7%
low-priced cigarettes that had less tobacco goods and services tax (GST) - on the cost,
content and less weight per cigarette and insurance and freight incurred plus tobacco
which, due to their price, were attracting tax - is imposed on top of the excise duties.
young people to smoke and encouraging
smokers to smoke more, as evidenced in a
shift in consumer behavior pattern (sales of
low-priced cigarettes increased from 6% in
2000 to 25% in 2003).
72
Philippines: Impact of sin tax law
Fiscal gain: Strengthened, more efficient tax administration

Tax structure simplified and higher tax rates
(PHP)
35
Tax rate per 20-stick pack
Unitary
28.3 28 29 30
30 27
Premium Tier 1
25
25
21 25
20 17
Tier 2
15
High 12.0
10 12
Medium 7.56 Tier 1 : Net Retail Price (More than PHP 11.50)
5 Tier 2: Net Retail Price (PHP 11.50 and below)
Low 2.72
0
2012 2013 2014 2015 2016 2017
Fiscal gain: Government revenue increased, exceeding annual targets

Excise tax revenue from tobacco products (2012 – 2017)
(USD Billion)
1.4
Tax revenues
1.2 1.23
(PHP 55.74) 0.92 0.98
0.89 (PHP 49.4)
1.0 (PHP 39.39) (PHP 43.63)
0.8 0.99
(PHP 41.84) 0.81
0.74 0.78 (PHP 40.9)
0.6 0.677 (PHP 37.1)
(PHP 28.6) 0.67 (PHP 33.5)
(PHP 29.6)
0.4
Projected incremental revenue (in billion)
0.2
Actual incremental revenue (in billion)
0
2012 2013 2014 2015 2016 2017
Source: Bureau of Internal Revenue, Department of Finance, Philippines.
73
Public health gain: Reduction in smoking prevalence in Philippines (1998 – 2015)
Prevalence (%)
63.7
59.1 Never smoker Since the passage of
54.5 55 54.3 Sin Tax Law (2012)
Smoking among youth
2012 Sin tax reform law passed
32.7
34.8 DECREASED
31 to 5.5% from 6.8%
25.4 in 2013.
23.3
Current smoker
14.7 15.5
12.8 13
10.2 Former smoker
1998 2003 2008 2013 2015
Public health gain: Department of Health budget between 2010 and 2017 (in billion PHP)
142.98
122.63 Department of Health
budget increased
83.72
86.97 by 240% from
PHP 42.15 million
53.23 in 2012 to
42.15 PHP 142.98 billion
31.83
24.65 in 2017
2010 2011 2012 2013 2014 2015 2016 2017
Sin Tax Revenue
Public health gain: Win for the poor

60
(Billion PHP)
53.2
50
43.9 Philippines
national government
40 37.1
35.2 allocation for
15.3 million families
30 or equivalent to
93.4 million
20 Filipinos with
12.5 12.6 PhilHealth coverage
10
3.5 4.5 5.0 5.0 3.5 by end of 2015.
0.5 0.5 0.5 0.5 0.8 2.9
0
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
74
100% smoke-free public places (indoor) policy in ASEAN
Healthcare Facilities Bars / Pubs Workplaces
Myanmar Education Facilities Public Transportation Hotel Lobby
Government Offices Universities
Lao PDR
Vietnam
Thailand
Philippines
Cambodia No bars/pubs
Brunei Darussalam
Malaysia
Singapore
Indonesia
Quick Brunei: Philippines:

Fact Non-smoking zones include areas
within a distance of 6 meters from
No designated smoking areas allowed
within 10 meters of places where people
the perimeter of the buildings. pass or congregate.
75
Chapter 8
Clearing the Air for a
Healthier Environment
Secondhand smoke (SHS) kills, and WHO and other As recommended in the WHO FCTC Article 8
health authorities have declared that there is no safe level of Guidelines, only a 100% smoke-free environment can
exposure to SHS. Non-smokers exposed to SHS are equally effectively protect persons from exposure to tobacco smoke
at risk of tobacco-related diseases and premature death as and the health hazards of smoking. Public smoking bans
those who actively smoke. Globally, more than a third of all also encourage smokers to quit and discourage youth
people are regularly exposed to SHS. SHS exposure smoking.
commonly occurs in homes and workplaces, but exposure
also occurs in many public places including in restaurants, With growing public awareness and support for smoke-free
bars, markets, airports, public transportation, and even environments, an increasing number of countries have
health and education facilities. It is estimated that around taken steps to protect people from the dangers of tobacco
890,000 premature deaths annually are due to exposure to smoke by enacting laws that ban smoking in all public
SHS causing heart disease, stroke, cancer, acute asthma, places and create smoke-free environments.
and others. Even brief exposure can cause immediate and
serious health harms. This chapter describes the progress achieved by ASEAN
countries to enforce comprehensive smoke-free laws
All people, regardless of age, gender, or socio-economic prohibiting smoking in various public settings. Related
status, deserve protection of their health, and involuntary initiatives include smoke-free cities, smoke-free world
exposure to SHS may be considered a violation of the basic heritage sites, and smoke-free universities with the aim of
human right to life and smoking around children as a form attaining a smoke-free ASEAN.
of child abuse.
Enjoy ASEAN foods in smoke-free environments

100% smoke-free indoor 100% smoke-free indoor Allows designated smoking
air-conditioned restaurant non-air-conditioned restaurant room/area
Brunei
Cambodia
Indonesia
Lao PDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Vietnam
76
Chapter 8: Clearing the Air for a Healthier Environment
Percentage of youths exposed to secondhand smoke inside and outside the homes in ASEAN
66.5
57.3 60.1
56.4 54.2
51.2
47.1
45.5
39.7 38.5 38.6
37.8 38.3
32.5 33.2 33.8
28.4
24.3 In home (%)
Outside home (%)
Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Thailand Vietnam
(2013) (2016) (2014) (2016) (2016) (2016) (2015) (2015) (2014)
Quick Almost 1.5 billion people in 55 countries protected
Fact by smoke-free legislation.
Common places with secondhand smoke exposure in ASEAN

85 87
80.7
78
75.8
70
65.6
63 63.1
59.9
57.5 56.2
49.4 51
48
41.4 42.6
39.1 38.2
37.3 37.1 37.6
33.6 34.7
31 31.5 30.9
27.5
25.8
21.7 21.9
21.6 21.5
18 19.4 18.4
13.6
11.8 11.5
8.2
4.2
Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Thailand Vietnam*
(2014) (2014) (2011) (2015) (2015) (2014) (2015) (2017) (2015)
At workplace (%) At home (%) Inside restaurant (%) Public transportation (%) Government buildings (%) Health facilities (%)
*89.1% reported exposure at bar/cafe/teashops.
77
Smoke-free settings (indoor) based on the national law in ASEAN
Airport ** ** ***
Bars & pubs *
Educational facilities
Health care facilities
Hotels
Restaurants (aircon)
Restaurants (non-aircon)
Shops & shopping complex
Transport terminals
Transportation (public)
Universities
Workplaces/offices
100% smoke-free/No smoking room With smoking room Allows smoking anywhere/not included in the law
*No bars/pubs in Brunei. ** 100% smoke-free by law but not enforced. ***Smoking room will be removed in international airport by December 2018.
Smoke-free settings (outdoor) based on the national law in ASEAN

Airport (Waiting areas)

Bars & pubs (Open area dining) *
Educational facilities (Premises)
Healthcare facilities (Premises)
Hotels (Open area facilities)
Restaurants (Al Fresco dining) *
Shop & shopping complex
(Open area market/shops)
Transport terminals
(Waiting areas)
Universities (Premises)
Workplaces/offices
(Open area for work)
Parks & playgrounds ** ***
Sports complex
100% smoke-free With smoking area within public places

Allow smoking anywhere/not included in the law
*New smoking areas will not be approved but existing outdoor smoking areas are still allowed to continue unless the business operators stop their operation.
**All playgrounds are smoke-free, while parks have the option to set up designated smoking areas.
***Parks and playgrounds may have designated smoking areas except for childcare and recreational facilities for children which should be 100% smoke-free.
78
Smoke-free Airports
Among the world’s 20 busiest airports (2016) In ASEAN
Ranking Smoke-free airports Country
2 Beijing Capital International Airport, China (PEK) Brunei International Airport (BWN) is 100%
Brunei smoke-free. No designated smoking room at the
4 Los Angeles International, California, USA (LAX) Airport Terminal and all office premises, effective
6 Chicago O’Hare International, Illinois, USA (ORD) 1st March, 2012.
7 London Heathrow, UK (LON)
Luang Prabang International Airport (LPQ) is 100%
9 Shanghai Pudong International, China (PVG) Lao PDR smoke-free indoors.
11 Dallas/Forth Worth International, USA (DFW)
14 Istanbul Ataturk, Turkey (IST) Philippines Davao International Airport is 100% smoke-free.
16 New York JFK, USA (JFK)
18 Denver International, Colorado, USA (DEN)
Penalties or compound fees for violating smoke-free policy in ASEAN

Country Penalties (USD)
Smokers Establishments
226 (BND 300) for on-the-spot fines 376 (BND 500) for on-the-spot fines
Brunei
752 (BND 1,000) 752 – 1,504 (BND 1,000 – 2,000)
Cambodia 5 (KHR 20,000) 12.5 (KHR 50,000)
Indonesia Maximum limit of fines: 3,657 (IDR 50 million)
Lao PDR Advice, No Penalty yet (pending approval)
USD 64 (MYR 250) or USD 26 (MYR 100) plus 2,551 (MYR 10,000)
Malaysia
Smoking Cessation Counseling
0.75 - 3.7 (MMK 1,000 – 5,000) 1st Offense 0.75 – 2.24 (MMK 1,000 – 3,000)
Myanmar
Succeeding Offenses 2.24 – 7.50 (MMK 3,000 – 10,000)
Philippines 10 – 200 (PHP 500 – 10,000) 10 – 200 (PHP 500 – 10,000)
Singapore 758 (SGD 1,000) 758 (SGD 1,000)
Thailand 159 (THB 5,000) 95 – 1,587 (THB 3,000 – 50,000)
Vietnam 4.4 – 13.2 (VND 100,000 - 300,000) 132 – 2,418 (VND 3 – 55 million)
79
Smoke-free Cities Asia Pacific Network (SCAN)

The Smoke-free Cities Asia Pacific Network (SCAN) formerly known as
the Smoke-free Cities ASEAN Network, is a coalition of cities, municipal-
ities, provinces, states and districts) in the Asia Pacific countries that
support each other to achieve its goal of making their country smoke-free
(FCTC Article 8).
SCAN was launched in Davao City, Philippines during the 1st

Smoke-free Cities Regional Workshop in 2013. It was organized to bring
together all cities, municipalities and provinces, and other different
smoke-free settings, which includes heritage sites and cities in the
ASEAN that are moving towards becoming smoke-free. SCAN provides
a platform to share experiences and learn from the best practices on
smoke-free of different cities, cities with different cultures but with a
common goal. The establishment of SCAN has increased the awareness
of the political leaders on the importance of creating and adopting strong
smoke-free policies to make cities healthy and livable.
Photo of Philippines President Rodrigo Duterte taken in 2013 while
In 2015, the mayors and governors signed the pledge of commitment he was the Mayor of Davao City.
during the 3rd Smoke-free Cities Regional Workshop in Iloilo City,
Philippines. SCAN officially accepted members coming from the 10
ASEAN countries. At present, there are more than 300 SCAN members.
Krabi, Thailand (2016) Penang, Malaysia (2017)
Iloilo, Philippines (2015)
Balanga City, Philippines (2014)

Davao City, Philippines (2013)
80
Smoke-free Heritage Sites & Cities Alliance (SHA)

Support Smoke-free Tourism!
Malacca, Malaysia Luang Prabang, Lao PDR Ancient Town of Hoi An,
Vietnam
Halong, Vietnam Penang, Malaysia Borobudur, Indonesia
Vat Phou, Lao PDR Bagan, Myanmar Angkor, Cambodia
Prambanan Temples, Historical Town of Sukhotai, Sewu Temple, Indonesia

Indonesia Thailand
81
Smoke-free Universities Network (SFUN)

The Smoke-free Universities Network (SFUN) was launched in
Mandalay, Myanmar in 2016. The People’s Health Foundation (PHF)
and SEATCA organized the Smoke-free Universities Workshop that
initially includes medical universities only but was expanded to include
non-medical universities. These smoke-free universities formed a
network known as the Smoke-free Universities Network and plans to
include other smoke-free universities in the ASEAN.
Several universities joined the selection for the Best Smoke-free

University in Myanmar. Dr Myint Htwe, the Minister of Health and
Sports, presented the awards to the recipients during the 2018 World
No Tobacco Day celebration in Nay Pyi Taw. In recognition of their
successful smoke-free campaign, the top 3 universities were recognized
which includes the University of Medicine (Magway), the University of
Dentistry (Yangon) and the University of Traditional Medicine
(Mandalay).
Smoke-Free Sports in ASEAN

Country
Vietnam 5th Asian Beach Games held on 24 September – 3 October 2016, Danang, Vietnam
Singapore 28th SEA Games held on 5 – 16 June 2015, Singapore
Myanmar 27th SEA Games held on 11 – 22 December, 2013, Myanmar
Cambodia 1st Smoke-Free Sports event held on 20 June 2012
Indonesia 26th Southeast Asian (SEA) Games, held in Jakarta, 11 – 22 November 2011
Lao PDR 25th Southeast Asian (SEA) Games, held in Vientiane City, 9 – 18 December 2009
Malaysia Paralympic Games held on 15 – 19 August 2009
Thailand 24th Southeast Asian (SEA) Games, held in Nathon Ratchasima (Korat), 6 – 15 December 2007
Philippines 23rd Southeast Asian (SEA) Games, held in Manila, 27 November to 5 December 2005
Vietnam 22nd Southeast Asian (SEA) Games, held in Hanoi, 5 – 13 December 2003
82
Smoke-free Cities Model: Philippines

Davao City is the first local government unit to enact
a Comprehensive Anti-Smoking Ordinance in 2002. The
smoke-free policy was further strengthened by the
enactment of City Ordinance 0367-12 in 2013. It
stipulated that smoking of any tobacco products and
vaping of any electronic device is absolutely prohibited in
all enclosed places and outdoor public places. Davao City
was awarded as the 1st 100% Smoke-Free Metropolitan
City in the ASEAN region in 2013 by SEATCA.
Maasin City, Southern Leyte from a smoke-free city to promoting a

100% tobacco-free city. The City Ordinance No. 2017-085 regulating the
use, sale and distribution of tobacco products in the city of Maasin that
prohibits (1) smoking in all public places, public outdoor spaces, public
conveyances or workplaces; (2) selling or distribution of tobacco products
in retail or wholesale within 100 meters from any point of the perimeter of
schools, colleges, public playgrounds, day care centers, hospitals, medical
clinics, dental clinics, optical clinics, health centers, nursing homes,
maternities, homes for the aged, dispensaries, laboratories, or any facilities
and buildings frequented by minors and senior citizens; (3) no sale or
distribution of tobacco products to minors, or any person, below 18 years
old, as well as buying or purchasing of cigarettes or tobacco products from
any minor; (4) ban outdoor or indoor tobacco advertisements including
but not limited to billboards, streamers, posters, flyers, print or broadcast
using any media.
Balanga City, Bataan is a 100% smoke-free City in the

Philippines where smoking is not allowed in all enclosed places and
public places. In Balanga, smoking, selling, distribution, advertising
and promotions of tobacco products and/or electronic nicotine
delivery systems (ENDS) within the declared University Town area
and within THREE (3) kilometers radius from the university town
area are prohibited as stipulated in the Ordinance No. 09 S 2016.
83
Malaysia: Blue Ribbon Award
The Blue Ribbon Campaign was initiated in 2013 as part of the

initiative of the Malaysian Health Promotion Board (MySihat) to
recognize and honour the significant roles played by individuals,
organizations and institutions in advocating a 100% smoke-free
environment in both indoor and outdoor areas in workplaces,
restaurants or hotels. Currently, there are more than 300 premises were
recognised as smoke-free through the Blue Ribbon Premises
Certification. The role of media is honoured through a media award
for raising awareness on the harmful effects of smoking and exposure
to secondhand smoke. An outstanding achievement and special award
were given to individuals, groups, institutions, communities,
government agencies and other stakeholders who have shown
excellence in tobacco control leadership. MySihat was also actively
promoting and supporting the smoke-free cities initiatives in Malaysia,
particularly in Melaka, Johor, Pulau Pinang, Kelantan and Terengganu.
At present, around 33 smoke-free zones have been gazetted in these 5
states between 2011 and 2017.
Philippines: Department of Health (DOH)

Red Orchid Award
The DOH Red Orchid Award is the first of its kind in the world. It aims
to advocate and promulgate DOH Administrative Order 2009-0010 and
Civil Service Commission Memorandum Circular No. 17, dated May
29, 2009 on the 100% smoke-free environment policy and pushing for
full implementation of World Health Organization's Framework
Convention on Tobacco Control (WHO FCTC). The awards started in
2010 in giving out recognition to 100% tobacco-free cities,
municipalities, government offices and health facilities that are strictly
enforcing tobacco control measures. The DOH Health Promotion and
Communication Service manages the awards.
For more detailed information, please visit SCAN FB https://www.facebook.com/SmokefreeCitiesAsiaPacificNetworkSCAN/ and website http://smokefreeasean.seatca.org as
well as refer Smoke-free Index: Implementation of Article 8 of the WHO Framework Convention on Tobacco Control (2016).
84
75%
Myanmar 75% front and back

(Since 2016)
75% Pictorial health warnings in ASEAN
Lao PDR 75% front and back

(Since 2016)
50%
85%
Vietnam 50% front and back
(Since 2013)
50%
Thailand 85% front and back
(Since 2005) Philippines 50% front and back
55% (bottom)
(Since 2016)
Cambodia 55% front and back

(Since 2016)
75%
50%
Brunei 75% front and back
(Since 2008)
Malaysia 50% front; 60% back

(Since 2009)
50%
Singapore 50% front and back

(Since 2004)
40%
Indonesia 40% front and back

(Since 2014)
85
Chapter 9
A Picture is Worth a Thousand Words
Tobacco packaging serves as the most cost-effective (87.5%). Three other ASEAN countries (Brunei, Lao
communications channel for governments to convey PDR, and Myanmar) require PHW sizes that are
health risks associated with tobacco use. Especially considered international best practice (at least 75%).
among those with low literacy levels, pictorial health
warnings (PHWs) are an effective health promotion tool The Article 11 Guidelines also recommend plain or
to increase awareness of tobacco’s harmful effects with standardized packaging, which enhances visibility of the
no costs to government. PHWs and reduces the appeal of tobacco products. In
2012, Australia was the first country to implement plain
As part of a growing global trend, at least 115 tobacco packaging. Eight more countries (France, United
countries/jurisdictions have legislated PHWs to date in Kingdom, Norway, Ireland, New Zealand, Hungary and
accordance with WHO FCTC Article 11 and its Slovenia) have also legislated plain packaging, and there
implementation guidelines, adopted at the third session are at least 16 other jurisdictions that are formally
of the FCTC Conference of Parties (COP 3) in 2008. In considering plain packaging. With the recent World
2016, ASEAN became the first region in the world where Trade Organization dispute panel decision upholding
all ten member states require PHWs on tobacco Australia’s right to require plain packaging, it is expected
packages. that even more countries will follow suit.
The Article 11 Guidelines recommend that health In ASEAN, Singapore and Thailand are in advanced
warnings be as large as possible and include pictures to stages of preparing plain packaging legislation. In 2016,
effectively communicate health harms of tobacco use the Malaysia government had also announced plans to
Thailand currently requires the world’s fourth largest introduce plain packaging but, succumbed to tobacco
PHWs (85% front and back of the pack) after East Timor industry pressure and stalled its preparation.
(92.5%), Nepal and Vanuatu (90%) and New Zealand
_
Increasing number of countries requiring PHWs on cigarette packages (2001 2018)
>115
Philippines (2016, 2018)* Cambodia (2016, 2018)* Myanmar (2016, 2017)* Lao PDR (2016) 105
102
Singapore Thailand Brunei Malaysia Vietnam Indonesia

(2004, 2006, (2005, 2007, (2008, 2012)* (2009, 2014)* (2013) (2014, 2019)*
2013)* 2010, 2014)* 77
72
65
56
41
35
26
18
3 11 12
1 2 2
5
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
* Year of rotation
86
Chapter 9: A Picture Is Worth A Thousand Words
Leader of pack warnings size

Four ASEAN countries among top 14 countries worldwide with the biggest pictorial health warnings size.
Country % Average PHW size % PHW size (front) % PHW size (back)
1 East Timor 92.5 85 100

2 Nepal 90 90 90
3 Vanuatu 90 90 90
4 New Zealand 87.5 75 100
5 India 85 85 85
6 Thailand 85 85 85 Globally,
7 Hong Kong 85 85 85 more than 115
countries/jurisdictions
8 Australia 82.5 75 90
require pictorial
9 Sri Lanka 80 80 80 health warnings
10 Uruguay 80 80 80 on tobacco packages.
11 Canada 75 75 75
12 Brunei 75 75 75
13 Myanmar 75 75 75
14 Lao PDR 75 75 75
Thailand: ASEAN’s biggest pictorial health warnings (85%)
Text
In April 2013, Ministry of Public Health (MoPH) passed a regulation
requiring pictorial health warnings to cover the upper 85% of front
and back panels of packs; however, implementation was delayed due
to a legal challenge by the tobacco industry, including Japan Tobacco
International (JTI), Philip Morris (PM), and British American
Pictogram Tobacco (BAT), that led to an injunction being issued by the Central
85% Administration Court.
On 26 June 2014, the Supreme Administration Court ruled in favor

of the MoPH and cancelled the injunction, clearing the way for
implementation of the larger 85% warnings. All tobacco products
sold in Thailand were required to carry the new pictorial warnings by
23 September 2014.
Quitline number
Cigarette brand 15%
Quick Thailand continues to be a regional leader in the area of tobacco product packaging and labelling. Its
Tobacco Product Control Act enacted in 2017 authorises the Minister of Public Health to prescribe the
Fact standards for package size, colour, marks, labels, and display of trademarks, pictures, and messages on
tobacco packages. Thus the Minister may require plain or standardized packaging.
87
Large PHWs on cigarette packages in four ASEAN countries

Thailand Brunei
Myanmar Lao PDR
ASEAN image bank of copyright-free pictorial health warnings (PHWs)

In collaboration with ASEAN Focal Points on Tobacco
Control (AFPTC), SEATCA has established a sharing
mechanism of copyright-free pictorial health warning ASEAN
images of ASEAN countries. SEATCA continues to:
• Provide technical assistance to countries on

development and implementation of PHWs policies.
• Facilitate access to high-resolution and copyright-free
PHW images from Brunei, Singapore, Thailand,
Malaysia and other ASEAN countries.
• Provide sample cigarette packs from the ASEAN
region for advocacy purposes.
For more detailed information, please visit

http://tobaccolabels.seatca.org/gallery/
88
Pictorial health warnings on cigarette packages in other ASEAN countries

Malaysia Cambodia
Singapore Vietnam
Philippines Indonesia
In Lao PDR, the implementation of PHWs was delayed by 7 months (moved from October 2016
to May 2017) with the industry claiming that it had “a large stockpile of printed packets” and
even requested “a reduction in the warning size from 75% to 50% of the pack.”
In Myanmar, JTI and BAT met with the Myanmar Investment Commission in March 2016
requesting more time to prepare the packs with PHWs, past the September deadline. There are
still tobacco packs being sold which are not compliant with the PHWs requirement.
Similarly in Cambodia, when the new PHWs came into place in July 2016, there was low
compliance of the law among the tobacco companies.
89
Evolution of pictorial health warnings on cigarette packages in ASEAN
Country Years of Position, size Language Number of Cessation messages
implementation and and location rotating current
rounds of rotation health warnings
Brunei 2008, 2012 Top 75% front and back Malay (front), 7
English (back)
Cambodia1 2016, 2018 Top 55% front and back Khmer 4
Indonesia2 2014, 2019 Top 40% front and back Bahasa Indonesia 5 Layanan Berhenti Merokok (0800-177-6565)
Lao PDR3 2018 Top 75% front and back Lao 6
Malaysia 2009, 2014 Top 50% front and 60% back Malay (front), 12 “Infoline: 03-8883 4400”
English (back)
Myanmar4 2016, 2017 Top 75% front and back Myanmar 2
Philippines 2016, 2018 Bottom 50% front and back Filipino (front) 12 “QUIT SMOKING:
English (back) Call DOH Quitline 165-364”
Singapore 2004, 2006, 2013 Top 50% front and back English 6 “YOU CAN QUIT” and
“QUITLINE 1800 438 2000”
Thailand 2005, 2007, 2010, Top 85% front and back Thai 10 “Quitline 1600” and
2014 www.thailandquitline.or.th
Vietnam 2013 Top 50% front and back Vietnamese 6
Implementation timeline of pictorial health warnings in ASEAN

_
Country Size Date of Approval Date of Implementation Duration of compliance for
Front (%) Back (%) 2012 2013 2014 2015 2016 2017 2018 2019 tobacco industry
_
Brunei 75 75 13 March 2012 1 September 2012 Less than 6 months
Cambodia1 55 55 22 October 2015 _ 23 July 2016 9 months
_
Indonesia2 40 40 11 January 2018 1 January 2019 12 months
_
Lao PDR3 75 75 23 May 2016 1 January 2018 19 months
Malaysia 50 60 11 June 2013 _ 1 January 2014 Less than 7 months
Myanmar4 75 75 29 February 2016 _ 1 September 2016 6 months
Philippines 50 50 23 August 2017 _ 3 March 2018 12 months after publication of
PHW templates
Singapore 50 50 12 January 2012 _ 1 March 2013 12 months
Thailand5 85 85 _ 6 months
5 April 2013 2 October 2013
_
Vietnam 50 50 8 February 8 August 2013 for soft pack 6 -10 months
and 8 December 2013 for hard pack
1 - The implementation of 2nd rotation of PHWs will be enforced in October 2018.

2 - The second rotation of PHWs will be enforced on 1 January 2019, one year grace period is given to tobacco industry to clear old PHW cigarette packages.
3 - The full implementation of PHWs was delayed due to strong tobacco industry interference. Tobacco industry was given three times extension deadline from 1 October 2016 and the new implementation date
effective on 1 January 2018 (a total of 19 months grace period after Pictorial Health Warnings Regulation was legislated in May 2016.
4 - Myanmar requires 10 PHWs, only one is to be printed every 12 months beginning on 1 September 2016. The implementation of 2nd rotation of PHWs was delayed till December 2017 due to interference by
tobacco industry.
5 - The full implementation of PHWs was delayed by a court case filed by tobacco companies. The Thai Supreme Administrative Court ruled against the tobacco industry, allowing PHWs to be implemented
effective on 23 September 2014, 90 days after the court decision.
90
Best practice: Australia’s plain packaging – A world first
Plain packaging 75%

prohibits brand colours and logos
90%
requires a standard colour, shape
and format of packages
requires the brand name to appear

in a standard font size and style on
a specific space on the package 25%
10%
Front Back
Australia was the first country to implement plain packaging of cigarettes, effective on the 1st December 2012.
The plain packaging law restricts or prohibits the use of logos, colours, brand images or promotional information on packaging
other than brand names and product names displayed in a standard colour and font style, with graphic health warning images
occupying an average of 87.5% of the front and back panels of the pack, while a fire-risk statement covers the bottom 10% of the
back panel. This is in line with its international obligations under Articles 11 and 13 of the World Health Organization Framework
Convention on Tobacco Control (WHO FCTC).
Philip Morris Asia mounted a challenge in the Singapore-based international court using provisions - known as investor-state
dispute settlement. The legal claim for alleged breaches in the ‘fair and equitable treatment’ obligation under the Australia-Hong
Kong bilateral investment agreement dismissed on 17 December 2015. A six-year legal battle came in favor of public health when
the court ordered Philip Morris to pay the Australian government (about USD 50 million in legal costs after its failed bid to kill off
plain packaging laws in July 2017. On 28 June 2018, a panel of dispute-settlement experts (World Trade Organization) backed the
legality of Australia’s 2011 plain packaging law as being consistent with international trade and intellectual property laws. The
decision upheld Australia’s right to require cigarettes to be sold in plain packs.
The victory has come despite fierce opposition and threatened huge lawsuits from the tobacco industry. Australia has paved the way
and inspiring other countries to move this forward. Australia plain packaging law sets a precedent for the world and encourages
other countries especially in the ASEAN region (Thailand and Singapore) are considering to implement plain packaging. There are
increasing number of countries in various stages of development and adoption of similar laws.
Plain packaging in ASEAN: Under consideration

In March 2017, the Ministry of Health conducted a six-week public consultation on a proposal to introduce
standardised packaging of tobacco products together with enlarged graphic health warnings (the “SP Proposal”) from 5
February to 16 March 2018.
Singapore
Prior to this, a public consultation on proposed measures to enhance Singapore’s tobacco control policies including
standardised packaging was conducted between December 2015 to March 2016.
Ministerial Regulation on plain packaging to be developed following the requirement of standardized packaging as
stipulated in the Tobacco Products Control Act 2017.
Thailand
91
Plain packaging around the world

STANDA
RD ********
LOBAL
Slovenia
Hungary* 1 January 2020
1 January 2020
** G
**** *** 20 May 2019
*****
New Zealand
Manufacturer Level 14 March 2018
Retail Level France 6 June 2018
*In Hungary, plain packaging
required for new brands from
1 January 2017
Hungary*
2020
20 August 2016. France United Kingdom 20 May 2018
20 May 2016 20 May 2017 2019
United Kingdom
Australia 20 May 2016 2018
1 October 2012
1 December 2012 2017
2016 Norway
1 July 2018
2012 Norway Ireland Australia’s
30 September 2018 plain packaging
1 July 2017
Ireland
30 September 2017
Plain packaging has been adopted in 8 countries and is under consideration in at least
16 other jurisdictions. These include Canada, Uruguay, Thailand, Singapore, Belgium,
Romania, Chile, Turkey, Taiwan, Jersey, Guernsey, Georgia, Sri Lanka, Nepal,
Finland, and South Africa.
More governments expressed support for plain packaging implementation such as

Mauritius, Kenya, Gambia, Botswana, and Burkina Faso. New Zealand’s
plain packaging
Quick In February 2016, the Malaysia There were numerous protests from industry lobby groups in the
Fact
Health Ministry announced its media and a month later (on 21 March) the Health Minister said
no implementation date will be announced until his Ministry
plan on plain packaging, though talks with the tobacco companies on intellectual property rights.
no firm dates were included. Since then, there has been no update on this policy.
The Sec-Gen of Ministry of International Trade and Industry (MITI) was appointed as a
Council Member to the Institute for Democracy and Economic Affairs (IDEAS), a
Malaysian think tank that opposes plain packaging. IDEAS received funds from JTI and
PMI in 2015 and 2016. Since 2015, IDEAS has been actively opposing tobacco control
measures - especially plain packaging and tax increase.
92
Disclosure of information on relevant constituents and emissions of tobacco products in ASEAN

Country Details Printing requirement on
packaging of tobacco products
Brunei This Product Contains Nicotine and Tar which Cause Addition and Is Dangerous to Health In the English language on one side
(2012) panel of the pack and in the Malay
Produk Ini Mengandungi Nikotina dan Tar yang Menyebabkan Ketagihan dan language on the other side panel
Membahayakan Kesihatan
Indonesia Tidak ada batas aman! Mengandungi lebih dari 4,000 zat kimia berbahaya, 43 zat penyebab On one side panel and in Bahasa
(2012) kanker Indonesia only
There is no safe limit! Contains more than 4,000 hazardous chemicals and more than 43
cancer causing substances
Lao PDR Cigarette smoke contains Carbon Monoxide the same toxic in vehicle exhaust On two side panels using different
(2016) Cigarette smoke contains Hydrogen Cyanide that destroys lung vessels and tissues qualitative statement and in Lao
Nicotine in cigarette is addictive and use in pesticides language
Cigarette smoke contains Ammonia use in toilet cleaner
Cigarette smoke contains toxic gas Nitrogen Dioxide
Cigarette smoke contains Arsenic use in rat poisons
Cigarette smoke contains Tar that causes lung cancer
Cigarette smoke contains Formalin that use for embalming
Cigarette smoke contains Nitrosamine that causes cancer
Malaysia Produk ini mengandungi lebih 4,000 bahan kimia termasuk tar, nikotina dan karbon On one side panel and in Malay
(2009) monoksida yang membahayakan kesihatan language only
This product contains more than 4,000 chemicals including tar, nicotine and carbon
monoxide that are dangerous to health
Myanmar Cigarettes contain Nitrosamine, Benzopyrene and others which are the compounds that can “Cigarettes contain Nitrosamine,
(2016) cause cancer. Stop Smoking Benzopyrene and others which are
the compounds that can cause
Nicotine, Tar and Carbon Monoxide contained in Cigarettes can cause heart and lung failure. cancer. Stop Smoking” must be
Stop Smoking printed on the left side panel and the
other texts on the right side panel.
Both texts in Myanmar language
(continued)
93
Disclosure of information on relevant constituents and emissions of tobacco products in ASEAN

Country Details Printing requirement on
packaging of tobacco products
Philippines ANG USOK NG SIGARILYO AY MAY AMMONIA On one side panel and in Filipino
[2016) (PANLINIS NG KUBETA) language
Cigarette Smoke Contains Ammonia (Toilet Cleaner)
ANG USOK NG SIGARILYO AY MAY BUTANE
(SANGKAP SA LIGHTER FLUID)
Cigarette Smoke Contains Butane (Ingredient in Lighter Fluid)
ANG USOK NG SIGARILYO AY MAY CYANIDE
(SANGKAP SA CHEMICAL WEAPONS)
Cigarette Smoke Contains Cyanide (Ingredient in Chemical Weapons)
ANG USOK NG SIGARILYO AY MAY FORMALIN (PANG-EMBALSAMO)
Cigarette Smoke Contains Formalin (For Embalming)
Singapore Smoking exposes you and those around you to more than 4,000 toxic chemicals, of On one side panel and in English
(2012) which at least 60 can cause cancer. The chemicals include tar, nicotine, carbon language
monoxide, formaldehyde, ammonia and benzene
Thailand Rat poisons present in cigarette smoke On two side panels using same
(2011, Nicotine in cigarette used in pesticides qualitative statement and in Thai
2015) More than 250 types of toxic substances are in cigarette smoke language
Drugs for embalming present in cigarette smoke
Want to quit must not smoke in the house
To get tuberculosis is easy if smoking
Smoking in the house hurts families
Smoking causes liver cancer
140 people a day, Thais die from smoking
Children imitate their parents who smoke
Note: Only three countries (Brunei, Philippines, and Thailand) prohibit the display of emission yields (tar, nicotine, and carbon monoxide) on packages.
Countries that have banned false or misleading descriptors in ASEAN

Year of 2007 2015
implementation 2009 2012 2013 Cambodia
Thailand
Malaysia 2010 Indonesia Singapore
2016
Lao PDR Vietnam
Philippines
Myanmar
For more detailed information, please visit http://tobaccolabels.seatca.org and refer to SEATCA Tobacco Packaging and Labelling Index:
Implementation of WHO Framework Convention on Tobacco Control Article 11 in ASEAN Countries (2016).
94
POS pack display (Allowed) Tobacco advertising at point-of-sale in ASEAN
POS pack display (Allowed) Ban No ban Point-of-sale (POS) pack display
Myanmar
Lao PDR
POS pack display (Allowed)
POS pack display POS pack display

(Banned, effective 2017) (Allowed display of only 1 pack Philippines
or carton per brand) (2012)
POS pack display
(Allowed display of only
Thailand 1 pack per brand) (2015)
Vietnam
POS pack display

Cambodia
(Banned, effective 2010)
POS pack display (Allowed) Brunei Darussalam
POS pack display

Malaysia (Banned, effective 2005)
Singapore
POS pack display (Allowed)
Indonesia*
*Bogor is the first and only city in Indonesia that bans cigarette display at point-of-sale (POS).
95
Chapter 10
Pulling the Plug on Tobacco Marketing
and Tobacco Philanthropy
To maximize profits, the tobacco industry invests billions of (37 countries in 2016) have reported having adopted a
dollars yearly around the globe on tobacco advertising, comprehensive ban of all TAPS.
promotion and sponsorship (TAPS) to aggressively promote its
deadly products and the social acceptability of tobacco use. A All ASEAN countries are implementing a TAPS ban, but most
wide range of TAPS strategies are employed to directly and are partial bans, with Indonesia having the weakest TAPS
indirectly make tobacco products attractive and pervasive, restrictions in the region.
targeting not only potential tobacco users (i.e. youth, who are
highly receptive to tobacco marketing) and current and former In addition to a ban on direct advertising in most ASEAN
tobacco users, but also policy makers and the public, so as to countries, Brunei, Singapore, and Thailand also ban the
artificially create the impression that tobacco use is normal display of tobacco packs at POS to reduce the visibility of
and non-harmful or that the tobacco industry is a socially tobacco products. These three countries also require licenses
responsible corporate sector. for tobacco retailers to facilitate regulatory compliance.
Therefore, Parties to the WHO FCTC “recognize that a Only two ASEAN countries (Lao PDR and Thailand)
comprehensive ban on advertising, promotion and currently ban CSR activities by the tobacco industry, while
sponsorship would reduce the consumption of tobacco only the publicity of tobacco industry CSR is prohibited in
products” (Article 13) because an effective TAPS ban can Cambodia, Indonesia, Singapore and Vietnam. In Brunei,
reduce the appeal of tobacco use (out of sight, out of mind), there are no tobacco companies operating since May 2014,
thereby helping prevent youth uptake, discouraging tobacco and therefore no tobacco-related CSR activities.
use, and preventing ex-users from relapsing. To be effective, a
TAPS ban must be comprehensive and cover all forms of As this chapter illustrates, more still needs to be done to
TAPS. Partial bans are ineffective because the tobacco industry achieve a comprehensive TAPS ban across the ASEAN region,
will maximize TAPS forms that are not banned (e.g. banning noting that the industry will continue to find innovative ways
mass media TAPS but allowing TAPS at points of sale (POS) and constantly evolve its marketing tactics to promote and
or on the Internet, or allowing CSR activities by the tobacco market its products, such as through creative package designs,
industry). Globally, an increasing number of countries new product flavors, new media, and cross-border advertising.
Status of ban on tobacco advertising, promotion and sponsorship in ASEAN

Direct Pack Cross
Advertising Promotion Sponsorship Ad at POS CSR Display Border
Brunei
Cambodia Ban cigarette
brand name
Allow 1 pack
per brand
Indonesia Ban publicity
Lao PDR
Malaysia
Myanmar
Philippines Allow at POS Sponsor without
cigarette brand
Singapore Ban publicity Ban

Partial Ban
Thailand
No Ban
Allow 1 pack/
Vietnam Ban publicity carton per brand No CSR
POS - Point-of-Sale CSR - Corporate Social Responsibility *Tobacco adverts are allowed on television (between 9.30pm and 5.30am)
96
Chapter 10: Pulling the Plug on Tobacco Marketing and Tobacco Philanthropy
Tobacco marketing channels

On Billboards Person-to-Person Sale
Outdoor tobacco advertising billboards Tobacco industry recruits pretty young girls as promoters to sell cigarettes.
can be found in Indonesia*.
No ban
Indonesia Philippines
Ban
Brunei Lao PDR Myanmar Thailand
Cambodia Malaysia Singapore Vietnam
*The outdoor advertisement falls under the Local Government Regulation.

In 2017, about 11 cities/districts that have implemented TAP Ban
Regulation including Jakarta, Bogor, Bekasi, Payakumbuh, Padangpanjang,
Sawahlunto, Pariaman, Padang, Klungkung, Jembrana and Gianyar.
Ban TAPS via internet in ASEAN

Ban
Cambodia (2015) Malaysia (2004) Singapore (1993)
Indonesia (2012*) Myanmar (2006) Thailand (2017)
Lao PDR (2010) Philippines (2008) Vietnam (2013)
No ban
*Advertising in information technology media shall comply with the provisions of the tobacco
Brunei products trademark website which applies age verification to restrict access only to persons
aged 18 or older.
Best practice: Brunei, Singapore and Thailand set the benchmark

Thailand, the first country in ASEAN region to implement
a complete ban on retail display of tobacco products at
point-of-sale, effective on 25 September 2005.
Brunei has banned point-of-sale displays in 2010 as

prohibition on advertisements relating to smoking and
displaying the cigarette packs was considered as one mode
of advertisement.
Singapore has enforced a ban on displaying cigarette packs

at point-of-sale by 1 August, 2017 to reduce the exposure of
non-smokers, especially among the young, to the
advertising effect of tobacco product displays as well as
encourages current smokers attempting to quit by Thailand
minimising impulse purchases of tobacco products.
Singapore
97
Progress in curbing tobacco industry CSR activities in ASEAN
Ban on corporate social responsibility (CSR) activities: All tobacco-related CSR activities are now banned in Lao PDR, Myanmar
and Thailand. The publicity of such CSR activities is banned in Cambodia, Indonesia, Singapore and Vietnam.
Philippines: Ban on donations to schools: The Philippine Department of Education issued a Department Order No. 6/2012,
restricting interaction of officials with the tobacco industry; this includes a prohibition on the tobacco industry contributing funds
to schools and school officials.
In 2016 the Department of Education issued Department Order No. 48 s. 2016: Policy and Guidelines on Comprehensive Tobacco
Control, which prescribes rules on how parents, teachers, and school officials of private and public schools can facilitate enforcement
of the ban on sponsorships, including so-called CSR of the tobacco industry, and on selling and advertising tobacco within a
100-meter perimeter of schools.
Indonesia: Minister of Education and Culture Regulation No. 64/2015 Tobacco-Free School Premises
states, “Reject any offer of advertisement, promotion, sponsorship, and/or collaboration in any form with tobacco manufacturers
and/or any organization that uses trademark, logo, slogan, and/or colour associated with the specific characteristics of tobacco
industry to support curricular or extracurricular activities inside and outside school premises.” This effectively bans the tobacco
industry from conducting anti-smoking programme in schools.
The government agencies or officials accepts, endorses and participates in CSR activities of the tobacco
industry. These include participating in PT HM Sampoerna’s student creativity exhibition in three
districts of East and Central Java of Indonesia; officiating in Philip Morris-sponsored “Back to School”
programme organised by Yayasan Salam, Malaysia and endorsing the British American Tobacco’s CSR
activities by providing a list of villages in Myanmar where BAT can conduct its activities.
ISO 26000
“Responsibility of an organization for the impacts of its decisions and activities on society and the environment,
through transparent and ethical behaviour that contributes to sustainable development, health and the welfare of
society; takes into account the expectations of stakeholders; is in compliance with applicable law and consistent with
international norms of behaviour; and is integrated throughout the organization and practiced in its relationships.”
TI related ‘CSR’ is not compatible and failed the standard because of how it violates
the FCTC and other widely accepted international standards and rules.
For more detailed information, please visit http://tobaccowatch.seatca.org and refer to SEATCA Tobacco Advertising, Promotion and Sponsorship (TAPS) Index: Implementation of
WHO Framework Convention on Tobacco Control Article 13 in ASEAN Countries (2016) and Hijacking ‘Sustainability’ from the SDGs: Review of Tobacco Related CSR activities in
the ASEAN Region (2017).
98
Sale of single sticks of cigarettes in ASEAN
Ban No ban Price for single stick (USD)
Myanmar
(2006)
Lao PDR Vinataba
(2009) 0.042 (VND 950)
Marlboro
Craven A 0.10 (PHP 5)
0.044 (VND 1,000)
Fortune
0.05 (PHP 3)
Thailand
(2017)
Vietnam
Philippines
Cambodia
(2015)
Brunei Darussalam
(2005)
Malaysia
(2004)
Singapore
(2002)
Marlboro
0.095 (IDR 1,300)
A Mild
0.102 (IDR 1,393)
Indonesia
99
Chapter 11
Protecting Future Generations
from Nicotine Addiction
Youth smokers, particularly in low- and middle-income addiction and other health harms. Such gadgets, with their
countries, are a huge potential market for industry’s future sleek designs and flashy marketing easily appeal to youths and
growth. Tobacco companies target children and youths, whom increase the risk for transitioning to conventional cigarettes,
they refer to as “replacement smokers” to replace older and some countries have already seen a significant rise in teen
smokers who either quit or die from tobacco-related diseases. use. About 83 countries have either banned or restricted the
Youth smoking therefore remains the front line of the tobacco sale of ENDS, including Japan and Australia that have banned
epidemic, as youths are more susceptible to tobacco marketing, e-cigarettes with nicotine. In ASEAN, four countries (Brunei,
and nicotine addiction is more entrenched in the developing Cambodia, Singapore, and Thailand) already ban ENDS.
adolescent brain. On average, most smokers start smoking
before the age of 20. Transnational tobacco companies also produce ENDS and
HTPs and promote these as being less harmful than
The tobacco industry keeps inventing new ways to sell harm conventional cigarettes and as smoking cessation devices.
through novel marketing schemes, attractive packaging (e.g. Noting that there are no long-term studies on the safety of
lipstick packs), new flavors, and new products to appeal to the these devices and insufficient evidence on their benefit as tools
young and first-time smokers. In ASEAN, menthol and for smoking cessation, the WHO and some national health
flavoured cigarettes are unregulated and widely available. authorities, such as the Australian National Health and
Single stick cigarette sales, which increase accessibility to Medical Research Council (NHMRC) and the US National
cigarettes, are banned in all but three ASEAN countries Academies of Sciences, Engineering, and Medicine (NAS),
(Indonesia, Philippines and Vietnam), while the sale of kiddie have recommended a precautionary approach and action to
packs (containing less than 20-sticks) is still allowed in minimize harm to users and bystanders and to protect
Indonesia, Myanmar and Philippines. vulnerable groups such as young people, until clear evidence of
safety, quality and efficacy are produced. For HTPs, the WHO
The emergence and rapid market growth of a new and wider recommends that these be regulated similarly to other tobacco
range of alternative nicotine products such as electronic products.
nicotine delivery systems (ENDS, which include e-cigarettes
and are available in myriads of flavours) and heated tobacco This chapter also highlights initiatives to protect present and
products (HTP) are a new challenge for preventing nicotine future generations from nicotine addiction and tobacco
harms.
Source of cigarettes for youth
Percentage of youth who purchased cigarettes in a store and were not refused purchase because of their age
% Youth purchased cigarettes in a store % Who purchased cigarettes in a store were not
refused purchase because of their age
Brunei (2014) 1.5
Indonesia (2014) 64.9 64.5
Lao PDR (2016) 55.6 59.8
Malaysia (2009) 53.4 53.2
Myanmar (2016) 60.9 62.9
Philippines (2015) 79.4 47.5
Thailand (2015) 67.4 44
Vietnam (2014) 65.1 84.7
Quick 5.6 million will ultimately die early from smoking if we do
Fact
children alive today not do more to reduce current smoking rate.
100
Chapter 11: Protecting Future Generations from Nicotine Addiction
Targeting youths, young adults and women

Menthol and fruit-flavored cigarettes sold in ASEAN
Ban
Cambodia
No ban
Indonesia Lao PDR
Myanmar Malaysia
Philippines Singapore
Brunei Thailand*
Cambodia Vietnam*
* Menthol flavor only
Vietnam Indonesia Philippines Singapore
Countries that have banned kiddie packs (less than 20 sticks per pack) in ASEAN
Ban
Brunei 2005 Singapore 2002
Cambodia 2015 Thailand 2017
Lao PDR 2009 Vietnam 2016 Indonesia
Malaysia 2010
A Mild, the most
popular local brand
No ban sold in 12 and 16
sticks per pack.
Indonesia Myanmar Philippines
Philippines
Marlboro, the most popular foreign
brand sold in 10 sticks per pack.
101
Lipstick pack sold in ASEAN
Quick
Fact In 1981, a Philip Morris
researcher stated:
"Today's teenager is tomorrow's
potential regular customer. . .”
Myron E. Johnston,
Philip Morris researcher, 1981 sent report to
Robert B. Seligman, then vice president of research
and development at Philip Morris in Richmond
Indonesia Malaysia Singapore
Minimum Legal Age for the Purchase, Possession and Use of Tobacco in ASEAN – 18 years old and above
Clear sign inside POS on prohibition of tobacco Sellers request for evidence (reached full legal age)
sales to minors before sale
Required Required
Brunei Myanmar Singapore Brunei Singapore
Malaysia Philippines Vietnam Philippines Thailand
N0 N0
Cambodia Lao PDR Cambodia Lao PDR Myanmar
Indonesia Thailand Indonesia Malaysia Vietnam
Singapore: Ban emerging tobacco products

Smokeless cigars, smokeless cigarillos and smokeless cigarettes; dissolvable tobacco or
nicotine; any product containing nicotine or tobacco that may be used topically for
application, by implant or injection into any parts of the body; and any solution or
substance of which tobacco or nicotine is a constituent that is intended to be used with an
electronic nicotine delivery system or a vaporizer (e-cigarettes); nasal snuff, oral snuff,
gutkha, khaini and zarda.
102
Chapter 11: Protecting Future Generations from Nicotine Addiction
Ban/restrict sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe in ASEAN
Ban Globally, about

Brunei Singapore 30 countries
Cambodia Thailand have either banned or
restricted the sale of
e-cigarettes, including
No ban restricting/ prohibiting
Indonesia Malaysia* Philippines** the sale or requiring
marketing authorization
Lao PDR Myanmar Vietnam for products that have
nicotine.
*The regulation of vapour products is under the state jurisdiction. Four out of 13 states (Johor, Kelantan, Terengganu and Pahang) have banned the sale of e-cigarettes.
**There are seven (7) e-cigarette related bills pending in the 17th Congress.
The Malaysia Health Ministry call for a ban on vaping and sale of e-cigarettes, however, due to strong
lobbying by the vaping industry resulted in the non-nicotine based e-cigarettes being allowed and to be
regulated by the Domestic Trade, Cooperatives and Consumerism (DTCC) Ministry and the Ministry of
Science, Technology and Innovation.
Malaysia: Prevalence of current electronic cigarette/vape users (2016)
_
Adult (aged 18 and above) Youth (aged 13 15)
On a typical day,
Female 0.3% (24,597) Girls 2.8% (50,000) 40.9% used
e-cigarette/vape
Male 6.1% (577,525) Boys 16% (250,000) once a day and
33.9% used
2_5 times a day.
Total 9.1% (300,000) current users of

Total 3.2% (602,122) e-cigarette/vape
103
Philippines: Balanga - World’s First

Tobacco Free Generation City
The tobacco-free generation concept prohibits the sale of
any tobacco products including electronic nicotine
delivery systems (ENDS) and other similar products to
any citizen born on or after 01 January 2000 in the City
of Balanga. This was enforced through the enactment of
Tobacco Free Generation End-Game Strategy Ordinance
of Balanga City, Bataan in 2016.
Singapore: Tobacco-free Generation 2000

(TFG 2000)
Singapore is the first country to call for a ban on sale of
tobacco products to those born after 2000, initiated by
the civil society. It referred to as the millennium
generation (TFG2000), to protect the next generation
from tobacco.
Thailand: Gen Z Strong

Thailand launched Gen Z Strong: No Smoking program targeting at those born
between 1995 and 2009 or aged between 7 and 20 years in 2016 to be a
smoke-free generation
The project uses social media and digital media to convince target participants
not to start smoking and enhance their capacity to actively participate in advocacy
campaigns.
One in two (53%) smokers started smoking before aged 18, 36% started
when they were between18 and 24 years old.
73% of smokers cannot quit smoking - 30% of smokers spend about 20 years
to quit smoking while 70% will addict to smoking until death by
tobacco-related diseases.
Between May 2016 and December 2017, a youth network of 5,000 young tobacco
control advocates was established nationwide. Gen Z young leaders zones were
located in 4 regions of Thailand including Konkean, Ubonratchathani, Surin,
Nakornratchasima, Srisaket, Chiangmai, Lampoon, Maehongson, Krabi and YNET
BKK in Bangkok.
104
Tobacco farmers in ASEAN
Myanmar** Total number of tobacco farmers % of total employment
Lao PDR**
22,075
0.057%
220,000
0.039%
40,982
0.094%
Thailand 19,174
(2016) 0.21%
Vietnam
(2011)
Philippines
(2016)
Cambodia
(2016)
587
0.0042% Brunei Darussalam*
Malaysia***
(2013)
Singapore*
>500,000
0.39%
Indonesia
(2016)
*No tobacco farming activity.

**No data available on total number of tobacco farmers.
***Since 2013, the Malaysia government disengaged from supporting and promoting tobacco and now solely implements policies to regulate the tobacco industry.
105
Chapter 12
Alternative Livelihoods
for Tobacco Growers
In recent decades, transnational tobacco companies have curing) and low leaf prices as determined by tobacco
shifted tobacco leaf cultivation from high-income to companies. Other challenges in the cultivation of
low-income countries, where 90% of tobacco farming tobacco leaf include Green Tobacco Sickness and other
now takes place. Eight of the ten ASEAN countries, health hazards for farmers, environmental degradation,
excluding Singapore and Brunei, are engaged in tobacco unpaid labor, and child labor.
cultivation on different scales. About 329,606 hectares of
land was used for tobacco farming across the region Article 17 of the WHO FCTC requires Parties to
between 2014 and 2017. promote economically viable alternative livelihoods for
tobacco farmers and workers. In ASEAN, the Malaysian
Generally, the number of farmers employed in tobacco government has actively implemented crop substitution
cultivation in ASEAN countries is small compared to since 2004, with kenaf being promoted as an alternative
overall national employment, contributing less than 1% crop for tobacco. Kenaf cultivation increased from 1,331
of total employment in all the producing countries. hectares to 2,502 hectares between 2012 and 2016, and
Tobacco cultivation is highly labor-intensive and employs the total number of tobacco farmers in Malaysia declined
entire households (including unpaid women and significantly to 26 farmers in 2014 from 3,204 in 2010.
children) in many stages of planting, harvesting, curing Tobacco farmers in Cambodia, Indonesia, and
and marketing. Most tobacco farmers are smallholders, Philippines are progressively switching to more profitable
cultivating only part of a hectare, and do not turn a profit alternative crops and livelihoods.
due to major input costs (rental fees to landowners, costs
of seedlings, feritlizers, insecticides, and wood fuel for
200,000
Total yield (Tn)
196,154
Tobacco farming in ASEAN
70,000 66,800
60,000 56,457
50,000
40,000 38,394.52
29,215
30,000 27,352
20,000
14,362
10,000 453
0
Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Thailand Vietnam
(2016) (2016) (2016) (2013*) (2016) (2016) (2016) (2016)
Total area harvested (Ha) 7,973 206,337 6,880 538 14,916 33,593 17,857.92 14,651
* Since 2013, the Malaysia government disengaged from supporting and promoting tobacco and now solely implements policies to regulate the tobacco industry.
106
Malaysia: Sustainable way out - Kenaf alternative crop
Acreage (ha)
2016 2,502 ha (1,086 farmers)
2015 2,274 ha (880 farmers)
2014 2,000 ha (914 farmers)
2013 1,824 ha (1,129 farmers)
2012 1,331 ha (653 farmers) In 2000, Kenaf (Hibiscus Cannabinus L) was
recognized in Malaysia as a new short-term industrial
crop supporting the diversification of the country’s
2011 1,140 ha (687 farmers) commodities sector. It has high potential for
2010 1,693 ha cultivation in a tropical climate and was promoted
(409 farmers) by the government as an alternative crop for tobacco
in 2004. About 5.8 million (USD 1.53 million) was
2009 343 ha (50 farmers) allocated for kenaf research and development
(R&D) to attract industrial players to invest in kenaf
2008 464 ha (167 farmers) between 1996 and 2005.
2007 285 ha (92 farmers) Smaller tobacco farmers are encouraged to switch to alternative livelihood through a
crop diversification program, with started in 2005 and has intensified over the years
which financial support from the government. Incentives in terms of inputs and
2006 112 ha (13 farmers) mechanization will be given to kenaf's growers.
2005 42 ha (25 farmers) Since its introduction in 2004 the area under kenaf cultivation rose from less than
one hectare to 2,502 hectares in 2016. Total number of kenaf growers also rose from
2004 0.4 ha (1 farmers) one to 1,086 over the same period.
The National Kenaf and Tobacco Board (NKTB), formerly known as National
Tobacco Board (NTB) plans to increase total kenaf hectarage to 5,000, production of
7,000 tonnes of fiber and 17,500 tonnes of core by 2020. It aims to export 50,000
tonnes or about RM15 billion worth of kenaf annually when ASEAN Free Trade
Area (AFTA) is fully implemented in 2015.
Indonesia: Profitability of farming other crops vs tobacco Vegetable (cabbage, chili,

tomato, potato, baby-beans)
Ex-tobacco farmers’ yearly income significantly
increased by 69% after they shifted to other crops. Others (coffee, ginger, etc.) 21.5%
Three in four (71%) ex-tobacco farmers shifted to grains 2.1%
followed by vegetables (21.5%), fruits and others crops,
which are much profitable than tobacco.
Fruits (banana, etc.)
Grains (rice, soya beans, corns)
5.2% 71.2%
16 15.2
Tomato Chili 14
12
10 9
8
6
4
2
Coffee 0
From tobacco From other crops
before shifting after shifting
107
Philippines: Profitability of farming other crops vs tobacco
5,639.6
Net income per hectare (in USD)
Sweet Pepper
Farmers in Ilocos Norte, Ilocos Sur, La Union, and Pangasinan (Region 1)

preferred to plant non-tobacco crops since they require less input and labor
compared to tobacco.
Vegetable crops such as tomato, garlic, eggplant, pepper (sweet/hot) and
bitter gourd provided much higher income than tobacco.
4,089.1 Cultivation of mungbean and peanuts also resulted in higher income
compared to tobacco.
Hot Pepper
3,525.3
Bitter Gourd
2,741.60
2,582.3
Onion
Tomato
2,041.2
1,762.2
Eggplant
1,730
Peanut
Garlic
1,147.60
Virginia
707.1 727.78
498.31 428.13
Mungbean
Burley
Corn
Native
Vegetable crop Tobacco leaf
Rice field
Cambodia: Tobacco farmers switched
to other crops
Some tobacco farmers realized that tobacco farming is less
profitable compared to other crops. About 40% of tobacco
farmers have switched from tobacco farming to alternative
crops in the last ten years. This is due to:
Lower profit compared to other crops
Tobacco farming needs more capital
Price fluctuation of tobacco
The alternative crops include rice, corn, peanut, other

industrial crops, such as soy bean and sesame, as well as
other vegetables.
Corn field
For more detailed information, please refer to Child Labour in Tobacco Cultivation in ASEAN 2nd Edition (2018).
108
References
References
THE PROBLEM Philip Morris Manila to merge with Fortune Tobacco-source.
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Philippines Convention on Tobacco Control. Southeast Asia Tobacco Control
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Rule. No. 16-2012. 28 June 2012. Philippines. Philippines
Land Transportation Franchising and Regulatory Board, Executive Order No.26. Providing for the establishment of smoke-free
Department of Transportation and Communication, environments in public and enclosed places. 16 May 2017, Manila,
Memorandum Circular 2009-036.100% Smoke-Free Public Utility Philippines.
Vehicles (PUV) and Public Land Transportation Terminals. 7
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Singapore Sources the same as in the main map.
Smoking (Prohibition in Certain Places) (Amendment) Notification
2017. Percentage of youths exposed to secondhand smoke in and
Smoking (Prohibition in Certain Places) Act 2002. outside home in ASEAN
Smoking (Prohibition in Certain Places) (Composition of Offences) Brunei
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123
Indonesia Thailand
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(Fact Sheet). Lao PDR. Vietnam
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Survey Among Malaysian Adolescents (TECMA) 2016. Ministry
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Myanmar ASEAN
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Survey 2016 (Fact Sheet). Myanmar.
Philippines Smoke-free settings (outdoor) based on the national law in
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Thailand
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Morbidity Survey 2015 – Report on Smoking Status Among Smoke-Free Environment Policy, Restrictions on Interactions with the
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Myanmar Rule. No. 16-2012. 28 June 2012. Philippines.
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Philippines Thailand
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Violations Against Medical Laws, 14 November 2013. Health Warning in Khmer Language and Pictorial on Tobacco
Products Packages. Phnom Penh, 15 February, 2016.
Southeast Asia Tobacco Control Alliance (SEATCA). Smoke-free Royal Government of Cambodia. (2015). Sub-Decree on Printing
Index: Implementation of Article 8 of the WHO Framework of Health Warning in Khmer Language and Pictorial on Tobacco
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Royal Government of Cambodia. (2015). Law on Tobacco
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SCAN FB available at: Indonesia. Number 56 of 2017. Revision of the Regulation of
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NetworkSCAN/ Warning and Health Information on Tobacco Product
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Number 28 of 2013. Concerning Imprinting of Health
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universities awarded in Myanmar. Press release, 1 June 2018. Packaging. 12 April 2013, Jakarta.
Southeast Asia Tobacco Control Alliance (SEATCA), Annex, Minister of Health Regulation Number 28 of 2013. Inclusion
Bangkok, Thailand. of Health Warnings and Health Information on Packaging
of Tobacco Products.
World No Tobacco Day: Commemorating ceremony held in Lao PDR
Nay Pyi Taw. MiTV, 31 May 2018.
Regulation on Tobacco Control Law Implementation. Vientiane,
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Smoke-free Cities Model: Philippines
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Ordinance No. 0367-12, Series of 2012. Tobacco Product (Amendment) Regulations 2008.
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No. 043-02, Series of 2002. Tobacco Products. 29 February, 2016.
Ministry of Health. Notification No 11/2016 – Printing and
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6 September 2016, Philippines. Implementing Rules and Regulations of Republic Act No.
10643 “An Act to Effectively Instill Health Consciousness
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Chapter 9: A Picture is Worth a Thousand Words 27 October, 2014.
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Brunei Consciousness through Graphic Health Warnings on Tobacco
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Singapore Agence France-Presse. (2013). Tobacco giant welcomes Thai

Tobacco (Control of Advertisements and Sale) (Labelling) Regulations court cigarette warning order. Inquirer.net, 27 August 2013.
2012.
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(Amendment) Regulations 2006. No. S 295.
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Procedures, Conditions for Displaying Statements about Dangers and Ministry of Public Health. (2017). Tobacco Products Control Act
Hazards of Consuming Tobacco Products on Cigarette Label B.E. 2560 (2017). Bureau of Tobacco Control Department of
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Procedures and Conditions for Displaying Pictures, Statements Sources the same as in the main map.
Relating to Warning on harm and Contact Channels to quit
Tobacco on Labels of Cigarettes. B.E. 2556 (A.D. 2013). Thailand. ASEAN image bank of copyright-free pictorial health warnings
Notification of the Ministry of Public Health (No. 15) B.E. 2554 ASEAN Image Bank, Tobacco packaging and labelling, Southeast Asia
(A.D. 2011). Re: Criteria, Procedures and Conditions of Words or Tobacco Control Alliance (SEATCA) website. Available at:
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Consumed Motivation on the Labels of Cigarette, Cigar, Shredded
Tobacco or Blended Shredded Tobacco pursuant to Tobacco Product Pictorial health warnings on cigarette packages in other
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Vietnam Sources the same as in the main map.
Ministry of Health – Ministry of Industry and Trade. (2013).
Joint Circular on the Labeling, Printing the Health Warnings on the Evolution of pictorial health warnings on cigarette packages in
Packet of Tobacco Products. ASEAN
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Prevention and Control of Tobacco Harms.17 July, 2013.
Law on Prevention and Control of Tobacco Harms. Law No Implementation timeline of pictorial health warnings in
09/2012/QH13. 18 June 2012. ASEAN
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ASEAN Vietnam
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Chapter 10: Pulling the Plug on Tobacco Marketing and Corporate
Philanthropy Tobacco marketing channels
Main Map: Tobacco advertising at point-of-sale in ASEAN Person-to-Person Sale
Sources the same as in the status of ban on tobacco advertising, Sources the same as in the status of ban on tobacco advertising,
promotion and sponsorship in ASEAN. promotion and sponsorship in ASEAN.
Status of ban on tobacco advertising, promotion and Ban TAPS via internet in ASEAN
sponsorship in ASEAN Cambodia
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2006. Myanmar.
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Singapore Source of cigarettes for youth
Tobacco (Control of Advertisements and Sale) (Ban on Display of Percentage of youth who purchased cigarettes in a store and
Tobacco Products) Regulations 2017. Singapore, 13 July 2017. were not refused purchase because of their age
Thailand Brunei
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Lao PDR
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Philippines: Balanga – World’s First Tobacco Free Tobacco farming in ASEAN

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Southeast Asia Tobacco Control Alliance

Fourth Edition September 2018

First published: September, 2018, 1,000 copies

© Southeast Asia Tobacco Control Alliance 2018

For more information, visit: www.seatca.org.

Tan Yen Lian

Fourth Edition September 2018

About SEATCA vii

Chapter 1: Profiting from Deadly Products 3

Chapter 2: Nicotine and Tobacco Addiction 19

Chapter 3: Basic Needs Sacrificed 29

Chapter 4: Burden of Death, Disease and Disability 33

THE SOLUTION: WHO FCTC

Chapter 5: Human and Financial Resources for Tobacco Control 51

Chapter 7: Reducing Tobacco Affordability and Consumption 65

Chapter 8: Clearing the Air for a Healthier Environment 75

Chapter 9: A Picture is Worth a Thousand Words 85

Chapter 11: Protecting Future Generations from Nicotine Addiction 99

Chapter 12: Alternative Livelihood for Tobacco Growers 105

Indonesia holds the unenviable record of 13 instances of

“...SEATCA’s commitment to stand with ASEAN countries in the unending battle

Vision: “A healthy, sustainable and tobacco-free ASEAN”

Southeast Asia Tobacco Control Alliance (SEATCA): Team Members

Inventing new ways

Tobacco company shares of global cigarette market, 2016

British American Tobacco (BAT) Philip Morris International (PMI)

Tobacco industry profit in global market (2017)

Cigarette production facilities Countries

Philip Morris British American Japan Tobacco Imperial Brands

Big transnational tobacco companies consolidating their power in ASEAN

Philip Morris 2010 Philip Morris Philippines Manufacturing Inc merged

Country Tobacco manufacturing facilities in ASEAN

Philippines Tanauan Malolos Rosario, Cavite

Myanmar Yangon Yangon

Cambodia Phnom Penh Phnom Penh

Cigarette production in ASEAN (2016)

Import and export of cigarettes in ASEAN (2016)

Sales of cigarettes in Cambodia, Lao PDR, Malaysia, Myanmar and Singapore

Quick Over six trillion cancer sticks produced annually In ASEAN,

Fact worldwide, a three-fold jump in what it was

Most common source of the last purchase of manufactured cigarettes in ASEAN

79.8 77.1 79.6 79

Number of points-of-sale in selected ASEAN countries

(% of retail volume) 49.5

Cambodia Indonesia Lao PDR

10.8 10.6 10.7

Malaysia Myanmar Philippines

11.9 11.5 12.1

Singapore Thailand Vietnam

Corporate Cover Up: PMI, BAT and JTI CSR in ASEAN

1,406,105 1,876,676 1,764,273 1,870,373

2011 2012 2013 2014 2015 2016 2017

Distribution of Philip Morris International CSR Activities in ASEAN (2017)

The government collected net tobacco tax

Tobacco industry undermines tobacco

3 court cases filed by Philip Morris Malaysia against the

13 court cases brought against tobacco control measures

Country Front groups and lobby groups in ASEAN

Philippines National Tobacco Administration (NTA)

Country Front groups and lobby groups in ASEAN

ASEAN Intellectual Property Association (ASEAN-IPA)

Philippines Proyosi Inc

Lao PDR Lao Law & Consultancy Group