Tobacco consumption has declined dramatically in Southeast Asia over the past two decades, at least on a per capita basis. According to a new report from the World Health Organization (WHO),
Between 2000 and 2020, smoking prevalence in the region fell from 54% to 23%, an achievement that demonstrates “strong political commitment, comprehensive policies and community engagement,” Katharina Boehm, WHO Southeast Asia’s officer-in-charge, said in a statement earlier this month.
Experts say the decline reflects the success of long-term public health initiatives.
Most Southeast Asian countries have strengthened their policies on taxation, packaging, advertising restrictions and public smoking bans, said Yvette van der Eijk, an assistant professor at the Saw Swee Hock School of Public Health at the National University of Singapore.
“These measures have made tobacco products less accessible and less socially acceptable,” he told DW.
However, while WHO has praised the region’s progress as a major public health success, some researchers have questioned the logic behind its definition of the Southeast Asian region.
The organization has included India in its Southeast Asia category, while placing Indonesia, the region’s largest country, in the Western Pacific region. Most other international bodies classify India as part of South Asia and Indonesia as part of Southeast Asia.
This inconsistency makes it difficult to compare WHO data with other datasets. A Knife The study published in June found that smoking rates fell significantly in most Southeast Asian countries between 1990 and 2021, but the total number of smokers increased by about 63%.
This is mainly due to population growth, which has increased from about 440 million people in 1990 to more than 700 million today.
strict laws, high taxes
Despite these statistical caveats, experts say the field has made undeniable progress. Singapore was one of the first countries in the world to ban tobacco advertising and smoking in public places in the 1970s.
Thailand became the first low- or middle-income country in Asia and the first globally to adopt plain packaging for tobacco products in 2018.
Nuntawarn Wichit-Wadakan, founding dean of the faculty of public health at Thammasat University in Thailand, told DW that the introduction of larger health warnings on cigarette packs, the creation of smoke-free environments in most public places and blanket bans on almost all forms of direct and indirect advertising have played a major role in reducing consumption.
Southeast Asian countries have also followed best practice measures set out in the WHO Framework Convention on Tobacco Control (FCTC).
Across the region, governments have increased excise taxes to deter smokers. According to government data, the average price of a pack of 20 cigarettes in the Philippines increased by 263% between 2009 and 2021 due to additional fees.
economic cost of smoking
The politics of anti-smoking legislation makes financial sense for most governments. Smoking-related diseases are estimated to cost Southeast Asian economies between 1% and 2% of GDP each year in lost productivity and health care spending, which is a major concern for the region, which must maintain high growth rates to sustain growth.
For example, in Malaysia, tobacco-related health care and productivity losses amount to about 1.7% of GDP, while tobacco tax revenues contribute less than 0.9%.
Indonesia cancels plans to increase tobacco tax
A notable exception is Indonesia, where an estimated 72% of men use tobacco, one of the highest rates in the world. It is the only country in Southeast Asia that has not ratified the WHO’s FCTC framework.
According to official estimates, smoking-related costs amount to approximately $25 billion (€21.4 billion) annually, or 2.6% of GDP.
The Global Tobacco Industry Intervention Index ranks Indonesia as the third worst country globally in terms of the tobacco industry’s influence on government policy. Most other Southeast Asian states rank around the middle of the index.
Earlier this month, Indonesia’s new finance minister, Purbaya Yudhi Sadewa, announced that he would cancel a planned increase in tobacco excise taxes for next year.
He argued that annual tax increases since 2014 have pushed most smokers towards illegal cigarettes, which he intends to crack down on.
Critics said his decision came just hours after a meeting with the Indonesian Cigarette Manufacturers Association, which has aggressively lobbied against further tax increases.
vaping dilemma
Meanwhile, Southeast Asia is also facing a new challenge: the rapid rise of e-cigarettes.
Brunei, Cambodia, Laos, Singapore and Thailand have banned vaping entirely, while Vietnam banned the sale and possession of e-cigarettes this year.
The WHO has warned that vaping is becoming increasingly popular among teenagers aged 13 to 15, with around 7.2% of people globally using e-cigarettes.
Data on vaping in Southeast Asia is limited, but researchers are concerned about “dual use,” when smokers take up vaping but continue to smoke cigarettes.
Furthermore, the vaping ban is primarily aimed at preventing youth vaping, as the vaping industry’s main target is young people, Van der Eijk said. “The goal is to avoid creating a new generation of nicotine users while existing smokers continue to receive support through proven cessation programs,” he said.
However, other Southeast Asian states have been hesitant to crack down on vaping. In Malaysia, efforts to outlaw e-cigarettes have repeatedly faced political resistance.
An attempt to ban vape products in 2015 was canceled after politicians argued that doing so would harm small Malay-Muslim business owners.
The vaping industry in Malaysia is now estimated to be worth around $830 million, with approximately 10,000 retailers nationwide. Most of them are owned by members of the Malay-Muslim community – the same group that is increasingly losing its political support from the ruling coalition.
Prime Minister Anwar Ibrahim’s government is struggling to retain Muslim-Malay voters, with analysts saying the tobacco industry is exploiting political sensitivities to prevent tighter regulation.
Edited by: Srinivas Majumdaru