5th Ed - The Tobacco Control Atlas - ASEAN Region - 2021 - FINAL

Southeast Asia Tobacco Control Alliance
The
T bacco
Control Atlas ASEAN Region
Fifth Edition December 2021

The Tobacco Control Atlas: ASEAN Region, Fifth Edition
Authors
Tan Yen Lian
Ulysses Dorotheo
Editorial Team:
Ms Bungon Ritthiphakdee, Dr Mary Assunta Kolandai, Dr Domilyn Villarreiz, Ms Sophapan Ratanachena,
Ms Worrawan Jirathanapiwat and Ms Jennie Lyn Reyes.
Suggested citation:
Tan YL. and Dorotheo U. (2021). The Tobacco Control Atlas: ASEAN Region, Fifth Edition,
December 2021. Southeast Asia Tobacco Control Alliance (SEATCA), Bangkok. Thailand.
Published by:
Southeast Asia Tobacco Control Alliance (SEATCA)
Apartment 4D, Thakolsuk Place, 115 Thoddamri Road, Dusit, Bangkok 10300 Thailand.
Tel/fax: +66 2 668 3650
Disclaimer
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 2021

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

The
T bacco
Control Atlas ASEAN Region
Tan Yen Lian

Ulysses Dorotheo
Fifth Edition December 2021

The Tobacco Control Atlas: ASEAN Region
Table of Contents
Foreword
. Professor Dr Judith Mackay iv
. Dr Takeshi Kasai v
. Dr Poonam Khetrapal Singh vi
Message
. H.E. Ekkaphab Phanthavong vii
Preface
. Tan Yen Lian and E. Ulysses Dorotheo viii
About SEATCA ix
Acknowledgements x
THE PROBLEM 1
Chapter 1: Profiting from Deadly Products 4

. Tobacco industry players in ASEAN 3
. Tobacco leaf and cigarette production, imports, and exports in ASEAN 11
. ENDS market sizes in ASEAN 13
. Corporate cover up: PMI, BAT and JTI CSR in ASEAN 14
. Tobacco industry interference 18
- Legal challenges of the tobacco industry to undermine tobacco control in ASEAN 18
- Lao PDR: Tobacco tax revenue losses 19
- Tobacco industry front groups and lobby groups to fight tobacco control 20
THE IMPACT 23
Chapter 2: Nicotine and Tobacco Addiction 26

. Adult smoking and ENDS prevalence in ASEAN 25
. Cigarette per capita annual consumption in ASEAN 31
. Cigarette sales volumes in ASEAN 33
. Adult smokeless tobacco use in ASEAN 34
. Quit attempts 35
. Youth smoking and ENDS prevalence in ASEAN 37
. Youth smoking initiation and targeting by tobacco industry 39
Chapter 3: Basic Needs Sacrificed 46

. Monthly cigarette expenditure among smokers ≥ 15 years old 45
. Poverty and inequality 46
. Education level of adult smokers in ASEAN 46
. Tobacco expenditure, basic needs and lost opportunities 47
i
Table of Contents
Chapter 4: Burden of Death, Disease and Disability 50
. Annual tobacco-related deaths in ASEAN 49
. Direct and indirect tobacco-related health care costs in ASEAN 53
. Global economic cost and health burden of tobacco use 54
THE SOLUTION: WHO FCTC 55
Chapter 5: Human and Financial Resources for Tobacco Control 70

. Human resource for tobacco control in ASEAN 69
. Tobacco control and health budgets in ASEAN 71
. Innovative funding mechanism in ASEAN 74
- Case studies: Thailand and Vietnam 75
Chapter 6: Insulating Public Health Policies from Industry Interference 78

. Monitoring center 79
. Implementation of FCTC Article 5.3 in ASEAN 80
Chapter 7: Reducing Tobacco Affordability and Consumption 86

. Prices and affordability of most popular cigarette in ASEAN 85
. Cigarette tax systems in ASEAN 89
. Tobacco tax administration in ASEAN 92
. Tobacco taxation: Higher revenues, better health and benefits the poor 93
- Case studies: Thailand, Singapore and Philippines
Chapter 8: Clearing the Air for a Healthier Environment 100

. 100% smoke-free public places (indoor) policy in ASEAN 99
. Smoke-free settings (indoor and outdoor) based on the national law 101
. Smoke-free airports 102
. Secondhand smoke exposure in ASEAN 103
. Penalties or fees for violating smoke-free policy in ASEAN 105
. Regional smoke-free networks 106
- Smoke-free Cities Asia Pacific Network (SCAN) 106
- Smoke-free Heritage Sites & Cities Alliance (SHA) 107
- Smoke Free Universities Network (SFUN) 110
. Smoke-free tourism: Cambodia and Vietnam 108
. Smoke-free cities model: Philippines 109
. Smoke-free awards: Malaysia and Philippines 112
ii
Table of Contents
Chapter 9: A Picture Is Worth A Thousand Words 114
. Standardized packaging and pictorial Health warnings in ASEAN 113
- Among the world’s largest warning size: Thailand, Brunei, Lao PDR, 116
Myanmar and Singapore
. ASEAN image bank of copyright-free pictorial health warnings 117
. Evolution of pictorial health warnings and standardized packaging in ASEAN 118
. Standardized/plain packaging around the world and in ASEAN 120
. Disclosure of information on relevant constituents and emissions 121
of tobacco products in ASEAN
. Ban on false or misleading descriptors in ASEAN 122
Chapter 10: Pulling the Plug on Tobacco Marketing and Tobacco Philanthropy 124
. Tobacco advertising at point-of-sale in ASEAN 123
. Status of ban on tobacco advertising, promotion and sponsorship in ASEAN 124
. Tobacco marketing channels 125
. Bans on retail display of tobacco products: Brunei, Singapore and Thailand 125
. Curbing tobacco industry CSR activities in ASEAN 126
. ISO 26000 126
Chapter 11: Protecting Future Generations from Nicotine Addiction 128

. Ban sale of single sticks of cigarettes in ASEAN 127
. Youth access to cigarettes and ENDS 128
. Ban kiddie packs (less than 20 sticks per pack) in ASEAN 130
. Status ban of Electronic Smoking Device (ESD) in ASEAN 133
. Tobacco-free generations: Philippines, Singapore, and Thailand 133
Chapter 12: Alternative Livelihood for Tobacco Growers 136

. Tobacco farmers in ASEAN 135
. Kenaf: Malaysia’s sustainable alternative to tobacco 137
. Profitability of other crops vs tobacco: Cambodia, Indonesia and Philippines 137
References 139
iii
Foreword
“With the publication of this 5th edition, the series of Tobacco Control ASEAN
Region Atlases is now established as a valuable source of information on the 10
ASEAN countries. The stunningly simple, colourful, graphic format - based on
sound data - is immediately understandable.”
The 5th edition of the Atlas updates tobacco issues in With the publication of this 5th edition, the series of
ASEAN during a time like no other. Tobacco Control ASEAN Region Atlases is now
established as a valuable source of information on the
The COVID pandemic has dominated the health 10 ASEAN countries. The stunningly simple,
agenda during the last two years. The tobacco colourful, graphic format - based on sound data - is
industry has exploited every moment to use COVID immediately understandable. The series of atlases also
to attempt to shift its image from a vilified business to documents progress (and obstacles) over a time
a trusted health partner, and to make and maximize framework since the first edition in 2013.
contact with policy-makers and health professionals,
contravening WHO FCTC Article 5.3. It has There is bad news and there is good news between the
distributed free masks bearing industry logos, pages: the bad news is that ASEAN countries
ventilators and protective equipment amid a flurry of continue to be a target for tobacco and e-cigarette
publicity. The tobacco companies are in the process market growth. Tobacco industry interference
of producing COVID vaccines, with headlines such as remains the biggest barrier to developing,
‘Tobacco to the rescue.’ implementing, and enforcing strong and effective
tobacco control policies in most ASEAN countries.
Throughout the pandemic, the industry has
interfered with government tobacco control policies The good news is that all countries are implementing
at many levels, continuing to sell cigarettes and make measures to reduce the epidemic, slowly but surely.
profits while stepping-up sales and marketing of vape There is no quick fix, but the Atlas calls on countries
and heated tobacco products. These tactics are rightly in the region to step up action – now – to reduce the
exposed by the STOP campaign, the Tobacco Industry economic and health harm of tobacco.
Interference Indexes, and also now in the ASEAN
Atlas.
The silver lining of COVID is that it has given the

health sector an unprecedented opportunity for
communicable and non-communicable diseases to
find a common cause – with non-communicable
disease risk factors of smoking, obesity and chronic
illness contributing to the COVID epidemic.
Smokers, vapers and waterpipe users are all at Professor Dr Judith Mackay
increased risk of catching COVID and/or increased Director
risk of severe COVID and death. Asian Consultancy on Tobacco Control
iv
Foreword
“The Atlas is a much needed, timely, renewed call to action, urging all of us in
the health and non-health sectors, as well as civil society and academia to act
now to integrate tobacco control into pandemic recovery and broader health,
social and economic development efforts.”
As the COVID-19 pandemic and response enters its responsibilities” to improve its image. Right now, the
third year, we must also continue our work on the tobacco industry is spreading misunderstanding
many other health challenges our Region faces – one about novel and emerging tobacco and nicotine
of the most urgent of which is the tobacco epidemic, products, in order to attract new generations of users
which claims 8 million lives globally and 1.4 trillion to its products and renormalize tobacco use.
US dollars in health expenditures and lost
productivity every year. To protect the gains we have made in tobacco control
and further accelerate progress in the future, now
In the 16 years since the WHO Framework more than ever, countries need to make
Convention on Tobacco Control (WHO FCTC) implementation of the WHO FCTC front and centre
entered into force in 2005, great strides have been of their sustainable development policies and
made. Globally, the prevalence of tobacco use among strategies. The WHO FCTC is the most powerful and
adults aged 15 years and older has been on a steady effective tool we have in the fight against the tobacco
decline. A similar trend has been observed in the epidemic, and tobacco control is an investment in
ASEAN region, as countries continue to adopt sustainable development.
stronger tobacco control policies. For example,
several countries have adopted standardized To support these efforts, the Tobacco Control Atlas:
packaging, and all ten ASEAN countries have now ASEAN Region tracks the progress of tobacco control
implemented pictorial health warnings. Most ASEAN efforts – and closely monitors the activities of the
countries have also taken steps to protect their public tobacco industry – in ASEAN countries. The Atlas is
health policies from tobacco industry interference. an important reference for policymakers, researchers,
and advocates to identify gaps, formulate strategies to
However, we still have a very long way to go. Close to advance tobacco control.
a quarter (22.5%) of adults in this region are regular
smokers; and a staggering 546 billion cigarettes were Congratulations to SEATCA on the launch of the 5 th
sold to children and adults last year in the 10 ASEAN Edition of the Tobacco Control Atlas for the ASEAN
countries. The fight against tobacco is far from over. Region. The Atlas is a much needed, timely, renewed
It is imperative that countries continue to take more call to action, urging all of us in the health and
decisive, innovative, and strategic action to accelerate non-health sectors, as well as civil society and
progress in tobacco control. academia to act now to integrate tobacco control into
pandemic recovery and broader health, social and
We must also stay vigilant in combating the tactics of economic development efforts.
the tobacco industry, which never ceases to market
death and disease, even during the pandemic. The
tobacco industry has long attempted to circumvent Dr Takeshi Kasai
tobacco laws and regulations, and will continue to do Regional Director
so, as well as using the cover of “corporate social WHO Regional Office for the Western Pacific
v
Foreword
“I urge stakeholders in policy, civil society and across sectors in ASEAN and
beyond to make full use of this resource, as together we advance towards the
tobacco endgame, a healthy, and tobacco-free South-East Asia Region for all.”
In the South-East Asia Region and across the world, Amid the COVID-19 response, countries have
tobacco use is a major health and development threat. continued to strengthen implementation of the
The world has nearly 1.3 billion tobacco users. This WHO MPOWER package, drawing on considerable
leads to more than 8 million deaths annually, momentum. In 2018 Thailand became the first
including around 1.2 million from exposure to country in Asia to adopt standardized (plain)
second-hand smoke. Most tobacco-related deaths packaging. DPR Korea, Nepal, India, Thailand,
occur in low- and middle-income countries, which are Timor-Leste and Sri Lanka have banned the use of
often targets of intensive tobacco industry Electronic Nicotine Delivery Systems. The Region
interference and marketing. The WHO South-East continues to contribute to global tobacco control,
Asia Region is home to an estimated 432 million including through the FCTC Global Knowledge Hub
adult tobacco users and accounts for 1.6 million on smokeless tobacco in India; the Knowledge Hub to
tobacco-related deaths annually. The Region is among track tobacco industry interference in public
the top tobacco consuming and tobacco producing policymaking in Thailand; and the Centre for
regions in the world. Combating Tobacco in Sri Lanka.
WHO continues to support countries of the Region To build on these and other successes, I welcome this
to take evidence-based action to reduce tobacco use fifth edition of the Tobacco Control Atlas for the
among all demographic groups, in line with the ASEAN region, produced by the South-East Asia
Region’s Flagship Priority on preventing and Tobacco Control Alliance. As every edition, the Atlas
controlling noncommunicable diseases (NCDs). As provides the Region’s three ASEAN countries –
highlighted in the fourth edition of the WHO global Indonesia, Myanmar and Thailand – an array of
report on trends in prevalence of tobacco use useful statistics, many in vivid graphic formats, which
2000–2025, between 2000 and 2015, estimated will enable them to review progress, identify
tobacco prevalence in the Region declined from opportunities, and accelerate progress towards our
46.6% to 31.2% – the fastest rate of decline among all time-bound targets and goals. I urge stakeholders in
WHO regions. policy, civil society and across sectors in ASEAN and
beyond to make full use of this resource, as together
we advance towards the tobacco endgame, a healthy,
and tobacco-free South-East Asia Region for all.
Dr Poonam Khetrapal Singh

Regional Director
WHO South-East Asia Region
vi
Message
“The Atlas will be a critical resource for policy makers, government agencies,
civil society organisations and other partners of ASEAN Member States in
crafting innovative and effective policies, programmes, interventions, and
partnerships that will strengthen the implement of the WHO FCTC in
ASEAN.”
ASEAN Member States have sustained efforts to I take this opportunity to express our appreciation to
reduce tobacco use and its impact to public health, valuable contributions of the Southeast Asia Tobacco
economy, and society in line with the WHO Control Alliance (SEATCA), a strong technical
Framework Convention on Tobacco Control (FCTC) partner of the ASEAN Health Sector since 2011 in its
and the United Nations 2030 Sustainable efforts to reduce tobacco consumption. We look
Development Goals. ASEAN countries carried out a forwarded to the continued and expanded
wide range of programmes to address tobacco use, cooperation with SEATCA as the ASEAN Health
from raising awareness on the dangers of tobacco use, Sector, through the ASEAN Post-2015 Health
smoke-cessation to smoke-free campaigns, or banning Development Agenda and the ASEAN Health Cluster
tobacco advertisements, marketing, and sponsorships, 1 on Promoting Healthy Lifestyle, determine the
to instituting hefty taxes on the sale of tobacco priority regional initiatives on tobacco control, which
products. is one the sector’s strategic health priorities.
However, tobacco use continues to be a major public I also welcome the publication of the fifth edition of
health issue in the ASEAN region. In addition to the the Tobacco Control Atlas: ASEAN Region. The Atlas
increasing negative impact on the health and lives of will be a critical resource for policy makers,
the people in the region, there persists a market government agencies, civil society organisations and
which is so huge for the tobacco industry to let go. We other partners of ASEAN Member States in crafting
see the tobacco industry employing various strategies innovative and effective policies, programmes,
and tactics – from philanthropy and corporate social interventions, and partnerships that will strengthen
responsibility, use of lobby groups, to confrontational the implement of the WHO FCTC in ASEAN. The
legal challenges, among others – all of which are Atlas is also a crucial reference in further shaping
aimed to subvert, hinder or undermine national regional cooperation in tobacco control as ASEAN
tobacco control efforts. Health Sector finalizes its work programme for the
next five years.
The ASEAN, guided by its vision and by the ASEAN
Socio-Cultural Community Blueprint 2025, envisages I also congratulate SEATCA and all its partners for
a healthy, caring, and sustainable Community. The coming up with this brilliant work.
ASEAN addresses the challenges and risks associated
with tobacco use through regional advocacy and
awareness, guideline development and
implementation, monitoring and reporting of
tobacco control efforts led by the ASEAN Health H.E. Ekkaphab Phanthavong
Sector in cooperation with non-health sectors and Deputy Secretary General of ASEAN
various partners. for ASEAN Socio-cultural Community
vii
Preface
“SEATCA remains committed to stand with

ASEAN countries in this protracted 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.”
This fifth edition of SEATCA’s Tobacco Control SEATCA remains committed to stand with ASEAN
Atlas continues to track national tobacco control countries in this protracted battle waged by the tobacco
progress across the ASEAN region in accordance with industry against public health and to support country
the World Health Organization Framework efforts to fast-track implementation of tobacco control
Convention on Tobacco Control (WHO FCTC), measures that protect and promote health and save lives.
which is the globally recognized minimum standard
for all governments that are serious about reducing We are deeply grateful to all of our country partners from
tobacco use, saving lives, and promoting public all 10 ASEAN countries and TFI/WHO country offices
health. for their ever-valuable contributions, as well as our
SEATCA team, without which this new edition would
All countries are making slow but progressive not be possible.
improvements in the implementation of WHO FCTC
measures despite the COVID-19 pandemic. We hope that, like past editions of the atlas, this fifth one
Certainly, one milestone to highlight since the 4th will be as informative and useful to health advocates and
edition is that three ASEAN countries are the first in partners in ASEAN countries and around the world, and
Asia to require standardized (plain) tobacco we welcome all comments and suggestions for its further
packaging: Thailand (2019), Singapore (2020), and improvement.
Myanmar (full compliance in 2022).
Still, the ASEAN community continues to be a target

of the tobacco industry, not only for its usual harmful
products, but also for its newer electronic smoking
products that are a growing threat to the socio-
political gains made by countries in recent years. It is
quite alarming that e-cigarette use is catching up with
and, in some countries, even exceeded cigarette use Tan Yen Lian, M.A.
among youths. The need to accelerate Knowledge and Information Manager
implementation of tobacco control measures in line SEATCA
with the WHO FCTC remains as urgent as ever, if
countries are to significantly reduce tobacco use and E. Ulysses Dorotheo, MD, FPAO
achieve the UN 2030 Sustainable Development Executive Director
Goals. SEATCA
viii
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
Ms Worrawan Jirathanapiwat, Tobacco Industry Denormalization Program Manager
Ms Jennie Lyn Reyes, Monitoring and Evaluation Manager
Mr Pikasit Sitta, Information Systems Manager
Ms Anisa Ismail, Sustainability Manager
Ms Chris Ann Mel Bugnot, Media and Communications Officer
Ms Supaporn Chiamchit, Operational Officer
ix
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 binti Haji Kassim, Head of Health Promotion Centre, Ministry of Health,
Brunei Darussalam
Dr Siti Rosemawati binti Haji Md Yussof, Senior Medical Officer, Health Promotion Centre,
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, SEATCA Country Coordinator, Indonesia

Mr Mouhamad Bigwanto, SEATCA Country Assistant Coordinator, Indonesia
Mr Dwidjo Susilo, Tobacco Industry Monitoring Focal Point, Indonesia
Lao PDR: Dr Maniphanh Vongphosy, SEATCA Project Coordinator, Lao PDR

Dr Khatthanaphone Phandouangsy, Head Division of Health Promotion and Nutrition,
Hygiene and Health Promotion Department, Ministry of Health, Lao PDR
Mr Douangkeo Thochongliachi, National Professional Officer, WHO TFI 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
Dr Muhamad Hairul Nizam bin Abd Hamid, Senior Principal Assistant Director,
Tobacco Control Unit and FCTC Secretariat, Disease Control Division (NCD), Ministry of Health,
Malaysia
Myanmar: Dr Kyaw Kan Kaung, Deputy Director-General (NCD), Department of Public Health, Ministry of Health,
Myanmar
Dr U Than Sein, President, People’s Health Foundation, Myanmar
Philippines: Health Promotion Bureau, Department of Health

Bureau of International Health Cooperation, Department of Health
Disease Prevention and Control Bureau, Department of Health
Epidemiology Bureau, Department of Health
Fiscal Policy and Planning Office, Department of Finance
Large Taxpayers Service, Bureau of Internal Revenue
HealthJustice Philippines
Singapore: Mr Chan Lit Fai, Assistant Director, Policy and Strategy Development,
Policy Research and Surveillance Division, Health Promotion Board, Singapore
Thailand: Prof Dr Prakit Vathesatogkit, Executive Secretary, Action on Smoking and Health (ASH), Thailand
Dr Chayanan Sittibusaya, Director, Office of Tobacco Products Control Committee,
Ministry of Public Health, Thailand
Mr Chirawat Yoosabai, Deputy Director, Office of Tobacco Products Control Committee,
Ministry of Public Health, Thailand
Dr Sarunya Benjakul Instructor, Department of Health Education and Behavioral Sciences,
Faculty of Public Health, Mahidol University, 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
Ms Le Thi Thu, Program Manager, HealthBridge Foundation of Canada, Vietnam Office
Ms Nguyen Hanh Nguyen, Project Manager, HealthBridge Foundation of Canada, Vietnam Office
Dr Nguyen Tuan Lam, National Professional Officer, WHO Country Office for Vietnam
x
The
Makes produces products that kill around 8 million people worldwide annually.
The old ways and new

Makes products aimed at vulnerable group including teens, women and girls.
Sues governments to undermine, weaken or delay life-saving tobacco control
measures worldwide.
ways to sell harm.

Employs child labour to make tobacco products.
Fake smoke-free promoted by Philip Morris International claimed to be part
of the solution.
Myanmar (2019) Lao PDR (2019)
Tobacco industry players in ASEAN
Laos-China Hongta Other companies % Market Share
Good Luck 6.6
Tobacco Co.
Other 14
Rothmans of Pall Mall companies
Myanmar Pte Ltd 45 52.2
Vietnam (2020) Philippines (2019)
Lao Tobacco Ltd./
Imperial Brands Plc Imperial Philip Morris International Inc British American Other companies
79.4 Brands Plc 3 Tobacco (Philippines) Ltd 2
Imports overall 2.8 7 Other 1
companies
5
JT International
Vietnam (Philippines) Inc
National 26.5
British American Tobacco
Thailand (2020) Tobacco Plc Corp Philip Morris Fortune
28 (VINATABA) Tobacco Corp
57 70.5
Other companies Japan Tobacco
9 International
5
Tobacco
Authority
of Thailand Cambodia (2019)
(TAOT)
64
Philip Morris Other companies
(Thailand) Ltd 17.5 British American
22 Tobacco Cambodia Ltd
25
Japan Tobacco
International Imperial
22.5 Brands Plc
25
Malaysia (2019) Viniton Group
Co Ltd
Other companies 10
6.5
Brunei
Philip Morris British
Darussalam
(Malaysia) American (No tobacco manufacturer and importer)
Sdn Bhd Tobacco Singapore (2019)
13.5 (Malaysia)
Bhd Other companies
JT International Tobacco 56 9
(M) Sdn Bhd
24
Japan Tobacco Philip
International Morris
(Singapore) Pte Ltd Singapore
23 Pte Ltd
44.5
Indonesia (2020) British American Tobacco
(Singapore) Pte Ltd
23.5
Other companies Philip Morris
10.5 International/
HM Sampoerna
BAT/Bentoel 32.6
7.9
Djarum PT
17.5
Gudang Garam
Tbk PT
31.5
3
Chapter 1
Profiting from Deadly Products
In the global tobacco market, transnational tobacco the world’s top 10 cigarette markets in 2020. Indonesia,
companies (TTCs) have been shifting from developed Philippines and Singapore were among the world top 20
countries and targeting markets in poorer, less developed cigarette exporters in 2019. Another four ASEAN countries
countries where tobacco control is not as stringent and (Indonesia, Lao PDR, Philippines and Thailand) were
where tobacco use is significantly high among men and among world’s top tobacco-leaf producing countries in
attractively low among women. In 2020, the tobacco market 2019.
growth in ASEAN is projected to reach a total of 505.65
billion cigarettes sold, primarily in Indonesia, Philippines, In an effort to enlarge their footprints in some ASEAN
Thailand, and Vietnam. countries, TTCs are undertaking mergers and joint
ventures, resulting in increased market control by a few
Four of the world’s five largest TTCs – British American international companies. PMI has bought controlling stakes
Tobacco (BAT), Philip Morris International (PMI), Japan in local cigarette companies in the Philippines and
Tobacco International (JTI) and Imperial Brands (IB) Indonesia. Imperial Brands (IB) (formerly Imperial Tobacco
control the cigarette markets in most countries in ASEAN Group) maintains its majority ownership in Lao Tobacco
such as Cambodia, Indonesia, Lao PDR, Malaysia, Ltd (LTL), its joint venture with the Lao Government.
Philippines, Singapore, Thailand and Vietnam. They have State-owned companies are the leading manufacturers in
also ventured into electronic nicotine delivery systems Thailand (Tobacco Authority of Thailand, the former
(ENDS, also known as e-cigarettes) and heated tobacco Thailand Tobacco Monopoly – TTM) and Vietnam
products (HTPs) to expand their nicotine and tobacco (Vietnam National Tobacco Corp – VINATABA). PMI has
market. The ENDS market value in four ASEAN countries the most (20 out of 39) manufacturing facilities located in
(Indonesia, Malaysia, Philippines and Vietnam) reached ASEAN countries, while JTI, BAT and IB operate six, six
USD 581.5 million in 2019 and projected to grow by 30% and two manufacturing facilities, respectively, in selected
(to USD 756.7 million) in 2023. ASEAN countries.
In 2020, tobacco manufacturers in seven ASEAN countries The tobacco industry has been making billions in profits
(Indonesia, Malaysia, Myanmar, Philippines, Singapore, from selling cigarettes in ASEAN and worldwide with
Thailand and Vietnam) produced 682.47 billion cigarettes. combined profit of the global top four TTCs (PMI, BAT,
Two ASEAN countries (Indonesia and Vietnam) were among JTI, IB) estimated to be USD 21.12 billion in 2020.
Tobacco company shares of global cigarette market, 2019

Djarum PT 1% (55,537)
Five ASEAN tobacco companies in top 15 global cigarette market (million)
Korea Tobacco & Ginseng Corporation
Eastern Company S.A.E 1% (56,793)
1.2% (64,905)
Vietnam National Tobacco Corporation Dhaka Tobacco Industries 0.8% (43,335)
1.3% (66,133) Thailand Tobacco Monopoly
0.3% (17,820)
PT Suryaduta Investama (Gudang Garam Tbk) Others
1.4% (73,549) 8.3% Nojorono Tobacco Indonesia PT
0.2% (12,008)
ITC Limited
1.5% (79,523) Globally, five TTCs
Altria Group Inc (AG) China National Tobacco (China National Tobacco
2% (103,992) Corporation (CNTC) Corporation, British
43% (2,234,050) American Tobacco,
Imperial Brands Plc (IB)
Philip Morris International,
4% (186,110) Japan Tobacco, and
Japan Tobacco Inc (JTI) Imperial Brands) have
8% (389,900) dominated the cigarette
market (80.5% in 2019).
Philip Morris International Inc (PMI)
13% (680,762)
British American Tobacco Plc (BAT)
13% (685,961)
4
Chapter 1: Profiting from Deadly Products
Tobacco Industry profit in global market (2017 – 2020)

50
Profit (USD billion)
48.26
2017 2018 2019 2020
10
7.91 8.06 8.04 8.21

8 7.28
7.19
6.04
6
4 3.54 3.48
3.2 2.93
1.81 1.82 1.92
2 1.29
0
Philip Morris International British American Tobacco Japan Tobacco International Imperial Brands
(PMI) (BAT) (JTI) (IB)
In 2020,
production 39 45 41 38
facilities
Operate in
different 32 43 29 30
countries
Excessive number of cigarette retailers in selected ASEAN countries

Country Total smokers Cigarette retailers, total and per 10,000 smokers Physicians per 10,000 pop
Indonesia 65,700,000 2,400,000 381 4
Malaysia 4,877,697 80,000 164 15
Philippines 16,500,000 694,821 421 6
Singapore 323,000 4,443 138 23
Thailand 10,676,362 527,839 494 8
Vietnam 15,602,400 303,333* 194 8
*Ho Chi Minh City has reportedly more than 70,000 cigarette retailers.
5
Tobacco manufacturing facilities in ASEAN

Philip Morris Japan Tobacco British American Imperial Brands
International (PMI) International (JTI) Tobacco (BAT) (IB)
20 6 6 6
Cambodia Phnom Penh Phnom Penh
Indonesia Bantul Malang Jakarta Selatan* Jakarta Selatan* Jakarta**

Bekasi Mranggen East Java* Malang
Blora Ngoro Bekasi**
Bojonegoro Pandaan
Cepu South Pandaan
Depok Pasuruan
Karawang Probolinggo
Kertosono Surabaya
Lao PDR Vientiane
Malaysia Seremban*** Kuala Lumpur Kuala Lumpur
Myanmar Yangon Yangon
Philippines Tanauan City, Batangas Malolos City, Bulacan

Marikina City Malvar, Batangas
Singapore Singapore
Vietnam Ho Chi Minh city Ho Chi Minh city Ho Chi Minh city Ho Chi Minh city
*Office **Distributor ***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 an 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
Less than 1% of tobacco company shareholders domiciled in ASEAN

Country of shareholder (%)
83.32
United States 55.08
33.73
17.33
7.7
25.57
United Kingdom
44.98
5.03
1.1
Japan 1.01
1.37
73.12
0.15
Luxembourg 5.25
1.74
0.94
4.28
Switzerland
2.59
0.20
1.86
2.40
Germany
5.90
1.83
2.10
Canada 1.14
1.33
0.64
0.015
0.111 Majority of tobacco company shareholders
Malaysia
0.081 are living in high-income countries, while
Less than 0.0001 (JTI) most of the social and economic burdens of
tobacco use falls on low– and middle-
0.009 income countries.
Singapore 0.105
0.085
0.378
Philip Morris International (PMI) Imperial Brands (IB)
Thailand Less than 0.0001 (PMI) British American Tobacco (BAT) Japan Tobacco International (JTI)
Less than 0.0001 (BAT)
7
Big transnational tobacco companies consolidating their power in ASEAN

TTCs Year Acquisition/Merger/Partnership
Philip Morris 2010 Philip Morris Philippines Manufacturing Inc merged with Fortune Tobacco Corp in 2010, creating
International Philip Morris Fortune Tobacco Corp (PMFTC) Inc., which is the largest tobacco company in the
(PMI) Philippines.
2005 Philip Morris International bought 97% stake of the local cigarette manufacturer PT H.M.
Sampoerna for USD 5.2 billion in 2005. It became the largest tobacco company in Indonesia.
British American 2009 BAT acquired 85% stake of the PT Bentoel Internasional Investama Tbk for USD 494 million, the
Tobacco (BAT) 4th largest tobacco company in Indonesia in 2009.
Japan Tobacco 2017 Japan Tobacco Group acquired assets of Mighty Corporation (including its distribution network,
(JT) manufacturing equipment, inventories and intellectual property) for PHP 46.8 billion (USD 936
million) to become the second largest tobacco company in the Philippines.
Japan Tobacco acquired Karyadibya Mahardhika (KDM) and its distributor, PT. Surya Mustika
Nusantara (“SMN”), 100% stake of 2 subsidiaries of Gudang Garam for USD 677 million in
Indonesia.
Imperial Brands 2001 Imperial Tobacco, through its subsidiary, Coralma International (a French company) has a
(IB) controlling stake in Lao Tobacco Ltd (LTL), its joint venture with the Lao Government that gave the
company tax privileges and special benefits for 25 years. LTL is the largest tobacco company in
Lao PDR.
KT&G Korea Tobacco & Ginseng Corporation (KT&G) - KT&G acquired 60% stake of PT Trisakti
Purwosari Makmur, a local cigarette manufacturer for the USD 133 million, the sixth largest
company in Indonesia.
Juul Labs 2019 Juul Labs entered the Philippine market in June 2019 and partnered with Gokongwei-owned
Better For You Corporation (BFY). Juul Labs is 35% owned by Altria, the parent company of Philip
Morris USA.
Juul Labs entered the Indonesian market in July with local partner PT Erajaya Swasembada Tbk,
a distributor of Apple Inc.’s iPhones.
“This transaction is a tremendous strategic fit for our business

that will cement our leadership in South East Asia.”
Matteo Pellegrini, President of Phillip Morris in Asia 2010,
referring to Philippines merger
8
Top 20 global cigarette exporters (2019)

Cigarettes (tonnes)
Lithuana Ukraine Armenia
(41,847) (26,163) (28,481)
Poland
(174,117)
Netherlands Russian Federation
(28,765) (25,061)
Germany
(87,633)
United States Switzerland
(44,335) (23,054) China Korea (51,310)
(33,977)
Portugal
(23,486)
Czechia Philippines
(32,899) (30,279)
Serbia
(26,861) United Arab Emirates
(206,884)
Singapore Indonesia
Romania (60,853) (76,805)
(37,792)
Turkey
(54,501)
Quick The global tobacco market size was valued at USD

Fact 849.09 billion in 2019 and is expected to reach
USD 878.35 billion in 2020.
Top 20 global cigarette importers (2019)

Cigarettes (tonnes) Netherlands Czechia Syrian Arab Republic Iraq
(41,384) (24,905) (28,347) (65,430)
Germany
(59,469)
United Kingdom and
Northen Ireland
(27,367)
France
United States (45,935)
(44,335) China Japan
(22,063) (48,123)
Lybia
(27,617) Thailand
(20,602)
Spain Cambodia
(51,614) Afghanistan (37,435)
Belize (14,496)
(20,761)
Italy United Arab Emirates
(62,940) (37,567) Singapore
(48,715)
Somalia
(24,200)
Saudi Arabia
(25,937)
9
Four ASEAN countries among world’s top tobacco-leaf producing countries (2019)
China 2,610,507
India 804,454
Brazil 769,801
Zimbabwe 257,764
Production (tonnes)
United States 212,260
Export (tonnes)
Indonesia 197,250 Import (tonnes)
Zambia 153,839
Bangladesh 128,597
197,250
Tanzania 116,603 Indonesia 41,317
106,603
Argentina 106,319
66,780
Pakistan 104,355 Thailand 16,227
1,156
Mozambique 102,752
56,706
Lao PDR 10,079
Malawi 102,459
Democratic People’s 51,061
Republic of Korea 90,702
Philippines 39,244
Turkey 70,000 53,686
Thailand 66,780
Lao PDR 56,706
Philippines 51,061
0 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000
Tobacco leaf (tonnes)
10
Indonesia, Lao PDR, Philippines and Thailand: Tobacco leaf production (2015 – 2020)
Production (tonnes)
200,000 Indonesia
193,790
195,482 197,250* 198,739**
181,142
150,000
126,728
100,000
63,040 66,800 57,384 66,651 66,969

66,780 Thailand
61,086 51,024 54,005 56,706 Lao PDR
50,000 56,455 46,571 Philippines
51,946
43,241
35,615
0
2015 2016 2017 2018 2019 2020
*Preliminary data **Forecast data
Top 10 global cigarette markets
(Billion sticks)
2,500
2,275
2,119 2019 2020
2,000
5,183
1,500 4,783
1,000
500
300 258 240
215 230 204
125 115 107 98 107 91 97 89 91 87 87 82
0
China Indonesia United Russia Japan Vietnam Bangladesh Turkey India Egypt Others
States
11
Cigarette production, import and export in ASEAN Countries Countries

imported from exported to
5,000
Cambodia 12,741
(2018)
1,027
356,500
Indonesia
• Germany • Cambodia
2,222 • China • Malaysia
(2019) • Singapore • Singapore
96,204
5,300
Lao PDR
128
(2018)
506
16,460
Malaysia
4,085*
(2019)
10,860*
18,000
Myanmar 2,122
(2018)
3,430
130,001
Philippines • Egypt • Malaysia
59,696* • China • Thailand
(2017) • Bulgaria • Korea
2,945*
14,889
Singapore • Vietnam • Thailand
(2019) 60,811 • Indonesia • Vietnam
• China • Malaysia
48,673
19,000
Thailand 10,047
(2019)
16,489
127,620 Production (million sticks)

Vietnam
10,761 (2018) Export (million sticks)
(2019)
19 Import (million sticks)
12
The global tobacco industry is dominated by five transnational tobacco companies (TTCs), all with a presence in Asia: China
National Tobacco Corporation (CNTC), Philip Morris International (PMI), British American Tobacco (BAT), Japan Tobacco
Inc. (JTI), and Imperial Tobacco Group (ITG). All these TTCs have ventured into electronic nicotine delivery systems (ENDS)
and heated tobacco products (HTPs) and are accessing many countries in Asia as fast-growing markets for expansion.
Tobacco company shares of global ENDS market (2014 – 2019) 26.2
(%) 25 Juul Labs
18.6
12
11.0
British American Tobacco (BAT)
(including RAI from 2017)
10 9.6 9.4
Reynolds American Inc (RAI)
6.3 6.5
4.7 Imperial Brands (IB)

5 4.1 4.0
3.9
3.3 3.7 3.2 Japan Tobacco
3.4 3.1 2.8 International (JTI)
1.6 2.9 2.8 1.8 2.8
1.5 2.5 2.4 2.3 Altria
1.3 0.3
1.1 0.6 0.4 0.3 Philip Morris
0.3 0.9 0.6 0.2 International (PMI)
0
2014 2015 2016 2017 2018 2019
ENDS market size in ASEAN (2015 – 2023)

A total of USD 581.5 million ENDS market value in four ASEAN countries (Indonesia, Malaysia,
(USD million) Philippines and Vietnam) in 2019 and projected to grow by 30% (to USD 756.7 million) in 2023.
800 756.7
720.8 Total
700 677.5
631.4
600 581.5
554.5 527.4
500 466.4
513.9
372.9
400 331.6
286.5 331.1
260.7 264.3 267.1 Indonesia
300 250.8
Malaysia
229.2 259.1 269.1 270.3 270.8
200 155.5 228.1
94.5 192.4 88.7 103 114.5
75.2 Philippines
100 39.5 20.6 50.6 23.7 62.3 26.6 39.8
5.2 20 15.4 18 31.2 30 33.2 36.4
Vietnam
0
2015 2016 2017 2018 2019 2020* 2021* 2022* 2023*
* Forecast values
13
Corporate cover up: PMI, BAT and JTI CSR in ASEAN

Tobacco companies promote themselves as “good corporate citizens” to divert attention from the diseases and other harms
caused by the products they manufacture and sell and to unduly influence and corrupt tobacco regulatory policy development
and implementation.
The tobacco industry has stepped up its corporate social responsibility (CSR) activities across the world during the COVID-19
pandemic. It continues to hand out CSR to create and maintain a positive public view of its business, whitewash the harms
caused by its products, and gain access to high-level officials and policy makers.
To this end, PMI increased its corporate social responsibility (CSR) investment in the ASEAN region from USD 8,753,391
(in 2017) to USD 21,987,966 (in 2020), with the bulk going to the Philippines (USD 13,405,967) and Indonesia (USD
8,007,835). Both countries are vital tobacco markets, where PMI holds 70.5% and 32.6% of the market respectively.
More than half of the total CSR investment was channelled into Philippines to support activities linked to social welfare,
disaster relief, and others. Generally, fewer organizations benefited from PMI’s charitable fund, some of which have been
regular recipients for many years. The amount PMI invested in the Philippines in 2020 is four times more than what it spent
in 2019 (USD 2,927,960).
In additional, PMI also provided in-kind contributions of USD 281,123 to organizations in Indonesia, Malaysia and
Singapore in 2020. These include IT and medical equipment, as well as food, water and sanitation.
What transnational tobacco companies (TTCs) spend on CSR activities is paltry compared to the remuneration paid to their
top executives. André Calantzopoulos, CEO of PMI, alone was paid almost more than double PMI’s total expenditure on CSR
activities in the ASEAN region in 2019.
Tobacco industry’s miniscule CSR spending in ASEAN compared to its profits and remuneration for the CEO
TTCs CEO Remuneration in 2019 2019 profits in global Total expenditure on CSR
(USD) market (USD) activities in ASEAN (USD)
Philip Morris André Calantzopoulos 16.82 M 7.19 B 9,566,715 (2019)
International (PMI)
British American Nicandro Durante 11.05 M 7.28 B No data available

Tobacco (BAT) Jack Bowles
Imperial Brands Alison Cooper 2.84 M 1.29 B No data available

_
Japan Tobacco Masamichi No data 3.20 B 2,609,570 (2016 2019)
International (JTI) Terabatake available
A PMI executive has stated clearly that their corporate giving is not charitable:
"I never use the word corporate philanthropy. That implies that you do
something without any regard to yourself... I don't see any corporation giving
money without a reason."
14
Top 4 ASEAN countries receiving PMI CSR funding (2011 – 2020)

(USD)
Indonesia Malaysia Philippines Thailand
2,252,938 2,457,126 4,792,016
13,405,967
1,406,105 1,876,676 1,764,273 1,870,373 2,320,298 2,927,906
6,224,231
8,007,835
5,972,145
6,037,000
6,181,796
5,994,850
5,852,043
6,500,000
6,424,999
6,252,917
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Distribution of PMI CSR activities (2020)

Empowering communities and Others
women in economic activities USD 232,823
USD 536,503
Education Others
Environment USD 5,562,324 USD 232,823
USD 8,031,109
USD 21,987,966
Environment
USD 5,547,937
Philippines
Social Welfare USD 13,405,967
USD 7,625,207
Economic Development
USD 536,503 Social Welfare
Education USD 7,625,207
Environment USD 5,084,160
Indonesia
USD 2,287,172 USD 8,007,835
15
PMI in-kind contribution (2020)
Stapa Center
(Indonesia)
Ren CI Community Hospital Donated items: IT equipment
(Singapore) USD 4,432
Donated items: food supplies
USD 14,006
MERCY Malaysia
Donated items: medical equipment
USD 281,123 USD 262,685
Quick “More than USD 50 billion of profit per year (USD 10,000 per tobacco
Fact death) enables the tobacco industry’s powerful public relations,
marketing, and scientific arms to present themselves in a bright light,
including donations of cash, protective equipment, ventilators, and
other health support to governments and health-care systems, and
aggressive marketing of new products.”
16
Tobacco industry’s CSR during COVID-19 pandemic in ASEAN

Transnational Tobacco Companies Number of CSR activities during COVID-19 (January 2020 – September 2021)
British American Tobacco 1 Malaysia 1
Philip Morris International 5 Indonesia 5
Japan Tobacco International 11
Malaysia 1 Philippines 2 Cambodia 8
Local Tobacco Companies

Cambodia Texas Tobacco 2
Viniton Group Co., Ltd 1
Indonesia Djarum 4
Djarum and KT&G 1
(Korea Tobacco & Ginseng Corporation)
PT HM Sampoerna 7
Myanmar Traditional Cheroot

Producers Association 1
Philippines LT Group 1
LT Group and Philip Morris 11
Fortune Tobacco Corp (PMFTC)
Philip Morris Fortune Tobacco Corp (PMFTC) 3 37
Jaime V. Ongpin Foundation Inc. (JVOFI)
and PMFTC’s EMBRACE
Thailand Tobacco Authority of Thailand 4
Vietnam Vietnam National Tobacco 2

Corporation (VINATABA)
Saigon Tobacco Company 1
Thang Long Tobacco Company 1
Japan Tobacco International 1
17
Legal challenges of the tobacco industry
to undermine tobacco control in ASEAN
Philippines
15 court cases
• PMPMI, FTC, JTI, Mighty, La Suerte vs DOH re AO 2010-13
requiring graphic health information (5 separate cases filed in
2010).
• PTI vs DOH and FDA re power to regulate tobacco products
• PMFTC vs DOH re tobacco promotions (2 separate cases filed in
2011 and 2012).
• PTI for declaratory relief re outdoor advertising (in 2007)
• Individuals (Anthony M. Clemente and Vrianne I. Lamson)
reportedly paid by PMFTC vs MMDA re smoke-free.
Thailand • PTI vs. City of Balanga re city ordinance making the city's
80-hectare University Town and its three-kilometer radius
3 court cases. In 2013, Philip Morris "tobacco free”.
Thailand and other tobacco companies • PTI vs. City of Balanga re tobacco free generation ordinance.
including BAT and JT filed three separate • Green Puff Electronic Cigarettes Inc. and Ryan Sazon vs DOH,
suits to challenge Thailand’s legislation Manila RTC and Ryan Leopando Sazon vs DOH, Pasig RTC were
increasing pictorial warnings from 55% to filed against D H Administrative rder (A ) No. 2019 0007 that
85% in the Administration court. classified electronic cigarettes as health or consumer products
under the urisdiction of the DA.
Malaysia
5 court cases
filed by Philip Morris Malaysia against the MOH for
• requiring Ministry’s approval for the retail price of
tobacco products,
• rejecting the retail price of its cigarettes, and
• requiring an increase in the selling price of its cigarettes.
• Judicial review by seven Malaysian smokers on a smoking
ban in eateries that was enforced in January 2019.
• Judicial review by British American Tobacco (BAT)
for “mini-cigar”- Dunhill HTL-Cigarillo.
Indonesia
13 court cases
• Six juridicial reviews (2010 - 2012) of the Law No 36/2009 concerning health including • A judicial review (2013) of the Law No 28/2009 concerning regional taxes and regional
tobacco control, pictorial health warnings and smoke-free. levies, related to regional cigarette taxes.
• Two judicial reviews (2011) of the DKI Jakarta Governor Regulation No 88/2010 CS Healthy og a ithout Tobacco ( STT) as sued by tobacco farmers for unla ful
concerning smoking areas. acts of using the ord Tobacco for the name of the organi ation in 2014.
• A judicial review (2011) of the Bogor City Regional Regulation No 12/2009 concerning • A judicial review (2020) of the Regional Regulation of the City of Bogor No 10/2018
No-Smoking Areas and another judicial review (2020) the amendments to the Regional concerning amendments to the Regional Regulation of the City of Bogor No 12/2009
Regulation No 12/2009 concerning the non-smoking area, and the prohibition of displaying concerning the non-smoking area and prohibition of displaying cigarettes at the point of sale.
cigarettes at the point of sale.
• A judicial review (2011) of the Joint Regulations of the Minister of Home Affairs and the
Minister of Health regarding guidelines for implementing a no smoking area in 3 different
files.
18
Lao PDR: Tobacco tax revenue losses

The Lao government continues to lose revenues due to its unfair Investment License Agreement (ILA) with the tobacco
industry. Signed in 2001, the ILA capped ad valorem tobacco tax rates at 15% to 30% of wholesale price until 2026 (25-year
tax break) when the country's tobacco tax rate by law is 50%. If the ILA is not terminated, the Lao government will continue
to suffer more revenue losses till 2026.
Tobacco tax revenues and revenue losses in Lao PDR (2002 – 2019)
(USD million)
90
80 General tax*
37.19
The Lao government lost an
Excise tax collected*
31.25
estimated USD 142.9 million
(LAK 1,429 billion) in
revenue between 2002 and Excise tax losses
2019.
60
8.34
5.7
40
12.39
10.43
12.20
10.85
9.36
39.59
39.47
5.01
4.42 - 3.38 - 1.04
3.09
3.57 - 1.68 - 1.89
3.57 - 1.75 - 1.83

2.81 - 1.12 - 1.68
2.94 - 1.32 - 1.62
2.94 - 1.37 - 1.57
10.99
7.95
9.92
8.13
1.53 - 0.94 - 0.58
9.5
1.26 - 0.85 - 0.4
1.29 - 0.79 - 0.5
20
9.46
9.21
20.35
20.35
20.35
20.35
20.35
14.46
12.29
0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
* General tax refers to the overall tobacco tax revenue that the Lao Government is supposed to collect (but failed to do so),
while the excise tax collected refers to the actual tobacco tax revenue that the Lao Government is able to collect.
Lao PDR Tobacco Control Fund revenue loss (2014 – 2019)

50 The Lao government lost an
(LAK million)
45
44.27 42.52 estimated USD 20.33 million
(LAK 180.21 billion) between
40
2014 and 2019 from uncollected
35 revenue (2% of profit tax and
30 26.31 LAK 200/ pack surcharge taxes
25 22.37 22.37 22.37 from domestic tobacco
companies such as Lao Tobacco
20
Ltd) for Tobacco Control Fund
15 (TCF). A significant loss in
10 revenue collection for TCF to
5 support tobacco control
0 programs and strengthening
2014 2015 2016 2017 2018 2019 health care system in the country.
19
Tobacco Industry front groups and lobby groups to fight tobacco control
The tobacco industry* rallies and funds front groups to fight tobacco control measures at both international and national level.
The tobacco industry refers to (a) any tobacco or tobacco product (including electronic smoking devices (ESD)) manufacturer,
processor, wholesale distributor, importer , (b) any parent, affiliate, branch, or subsidiary of a tobacco or tobacco product
(including ESD) manufacturer, wholesale distributor, importer, retailer, or (c) any individual or entity, such as, but not limited
to an interest group, think tank, advocacy organization, lawyer, law firm, scientist, lobbyist, public relations, and/or advertising
agency, business, or foundation, that represents or works to promote the interests of the tobacco and nicotine industry. 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 8, 9, 10, 17 and 18.
Other front groups include retailers and trade associations, coffee shop associations or research groups, which challenge
tobacco control legislation.
Country Front groups and lobby groups in ASEAN

Regional/ International Tobacco Growers Association (ITGA)
Farmers
groups
International
Indonesia Asosiasi Petani Tembakau Indonesia (APTI) - Indonesia Tobacco Farmers Association
Asosiasi Petani Cengkeh Indonesia (APCI) - Indonesian Clove Farmers Association
Paguyuban Petani Pedagang Tembakau Magelang (P3TM) - Association of Tobacco Farmers and Traders of Magelang
Philippines Philippine Tobacco Growers Association (PTGA)
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)
Associations
Manufacturer
Indonesia Aliansi Masyarakat Tembakau Indonesia (AMTI) - Indonesia Tobacco Society Alliance
Gabungan Produsen Rokok Putih Indonesia (GAPRINDO) - The Association of Indonesia White Cigarette Producers
Gabungan Perserikatan Pabrik Rokok Indonesia (GAPPRI) - The union of Indonesia Cigarette (kretek) Industries
Paguyuban Mitra Produksi Sigaret Indonesia (MPSI) - Cigarette Manufacturing Association
Gabungan Perusahaan Rokok (GAPERO) - Association of Cigarette Companies
Persatuan Perusahaan Rokok Kudus (PPRK) - Cigarette Company Association of Kudus
Myanmar Myanmar Cigarette Producers’ Association
Myanmar Association of Cheroot Making Industries
Philippines Philippine Tobacco Institute (PTI)
Federation of Philippine Industries (FPI)
Philippine E-cigarette Industry Association (PECIA)
Businessmen
Singapore Tobacco Association (Singapore) Retailers
Lao PDR Lao Tobacco Ltd

State-owned
company
/ State agency
Philippines National Tobacco Administration (NTA)

Farmers
Thailand Tobacco Authority of Thailand (TAOT)
Vietnam Vietnam National Tobacco Corporation (VINATABA)
continued
20

Regional Asia Pacific Travel Retail Association (Singapore)
Retailer groups
Cambodia Dufry (Cambodia) Ltd

Indonesia Forum Masyarakat Industri Rokok Indonesia (FORMASI) - Indonesian Forum of Tobacco Industry Community
Malaysia Malaysia Retail Electronic Cigarette Association (MRECA)
Philippines Peoples’ Coalition Against Regressive Taxation (PCART)
Philippine Association of Supermarkets Inc. (PASI)
Singapore Singapore Retailers Association
DFS Venture Singapore
Informal group of licensed tobacco retailers
Vietnam Association of Vietnam Retailers (AVR)
Regional US-ASEAN Business Council (US-ABC)
Business
groups
EU-ASEAN Business Council

ASEAN Intellectual Property Association (ASEAN-IPA)
Property Rights Alliance (PRA)
International Trademark Association (INTA)
American Chamber of Commerce
European Chamber of Commerce
Indonesia Forum Komunikasi Pengusaha Rokok Kecil (FKPRK) - Communication Forum of Small Cigarette Businessmen
Asosiasi Personal Vaporizer Indonesia (APVI) - Indonesian Association of Personal Vaporizer
Asosiasi Vaper Indonesia (AVI) - Indonesia Vapers Association
Malaysia International Chamber of Commerce Malaysia
Malaysian International Chamber of Commerce and Industry
Malaysia-Singapore Coffee Shop Proprietors General Association (MSCSPGA)
Federation of Sundry Goods Merchants Associations of Malaysia
Malaysia E-Vaporisers and Tobacco Alternative Association (MEVTA)
Malaysian Vape Chamber of Commerce (MVCC)
Malaysian Organization of Vape Entity (MOVE)
Philippines Philippine Aromatic Tobacco Development Association, Inc. (PATDA)
Trade Union Congress of the Philippines (TUCP)
American Chamber of Commerce of the Philippines, Inc.
Federation of Philippine Industries
Singapore Singapore International Chamber of Commerce
European Chamber of Commerce, Intellectual Property Rights Committee
Amcor Specialty Cartons (of Amcor Group) (Singapore/ Switzerland)
GD Machinery Southeast Asia Pte Ltd (a COEASIA company) (Packaging industry)
Design Bridge (Design/advertising agency)
Thailand Thai Tobacco Trade Association (TTTA)
Vietnam Vietnam Chamber of Commerce and Industry (VCCI)
continued
21

Regional / Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA)
Consumer/
astroturf groups
international International Network of Nicotine Consumer Organisations (INNCO)
Indonesia Komunitas Perokok Bijak (KOJAK) - Wise Smokers Community
Koalisi Nasional Penyelamat Kretek (KNPK) - National Coalition for the Rescue of Kretek
Yayasan Pemerhati Kesehatan Publik (YPKP) - Public Health Observer Foundation
Koalisi Indonesia Bebas Tar (KABAR) - The Indonesia Tar-Free Coalition
Philippines Proyosi Inc / Nicotine Consumers Union of the Philippines
Harm Reduction Alliance of the Philippines
The Vapers Philippines
Thailand End Cigarette Smoke Thailand Group (ECST)
Thai Smokers Group (TSG)
Indonesia Federasi Serikat Pekerja Rokok, Tembakau, Makanan Minuman (FSP RTMM-SPSI) -
Labor/
Legal workers group
Federation of Trade Unions of Cigarette, Tobacco, Food and Beverages

Thailand Tobacco Authority of Thailand Workers Union
Regional / Factasia.org (HK-based)

Think tanks/
international Competitive Enterprise Institute (US-based)

R Street Institute (US-based)
Lao PDR Lao Law & Consultancy Group
Malaysia Institute for Democracy and Economic Affairs (IDEAS)
Malaysia Society for Harm Reduction (MSHR)
Philippines Minimal Government Thinkers
Regional/ JTI Foundation
CSR group
Foundation/
international Fundacion Altadis (Imperial Brands)

Indonesia Putera Sampoerna Foundation
Djarum Foundation
Malaysia BAT Malaysia Foundation
Philippines American Chamber Foundation Philippines
Jaime V. Ongpin Foundation
Tan Yan Kee Foundation
Wong Chu King Foundation
Synergeia Foundation, Inc
22
Tobacco is a
GLOBAL THREAT
More than Smokers worldwide

• Adult (aged 15 years and above) • Youth (aged 13–15)
1 Billion Men - 847 million

Women - 153 million
Boys and girls - 24 million
Lives lost from tobacco use annually

More than 7 million deaths
result from direct tobacco use More than
1.2 million non-smokers are killed
due to exposure to secondhand smoke
8 Million
Tobacco is a SILENT KILLER that

contributes to significant MORTALITY,
ILLNESSES and SUFFERING worldwide
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 Million
Tobacco use not only DAMAGES HEALTH but also

WORSENS POVERTY and causes DEVASTATING social,
economic and environmental HARMS
Myanmar (2018)
20.4%
Adult smoking prevalence in ASEAN
Lao PDR (2015)
36.4% 4.4% 27.9%
Male Female
Total % of adult smoking prevalence
50.8% 7.1% <15
_
15 25
>25
Vietnam (2015)
22.5%
45.3% 1.1%
Thailand (2017) Philippines (2015)

19.1% 23.8%
37.7% 1.7% 41.9% 5.8%
Cambodia (2014)
16.9%
Malaysia (2019)
21.3%
32.9% 2.4%
40.5% 1.2%
Brunei
Singapore* (2019) Darussalam (2016)
10.6% 19.9%
18.4% 3.2% 36.3% 3.7%
Indonesia (2018)
33.8%
62.9% 4.8%
MOST LEAST In ASEAN, male smoking prevalence is

33.8% 10.6% highest in Indonesia (62.9%) and lowest
in Singapore (18.4%). Female smoking
of the Indonesian of the Singaporean
population smoke population smoke rates are particularly high (between 4.4%
and 7.1%) in Indonesia, Lao PDR,
Myanmar and Philippines.
*Daily smokers aged 18 to 74 years.
25
Chapter 2
Nicotine and Tobacco Addiction
Globally, more than one billion people use tobacco with Among ASEAN countries, adult male smoking prevalence is
adult male smokers (1,091 million) significantly highest in Indonesia (62.9%) and lowest in Singapore
outnumbering women (230 million). This alarming number (18.4%). Adult female smoking rates are particularly high
represents about one-third of the global population aged 15 (ranging between 4.4% and 7.1%) in Indonesia, Lao PDR,
and above. It has grown substantially in low- Myanmar and Philippines.
and-middle-income countries, constituting over 80% world’s
tobacco users. In the ASEAN region, there are currently 124 Youth smokers are estimated to be around 24 million
million (22.5%) adult smokers, half of whom live in worldwide. Of these, the South East Asian (6.4 million or
Indonesia (65.7 million). 27%) and Western Pacific (4.7 million or 19.9%) regions
have the largest number of youth cigarette smokers. In
This highly additive product is commonly used by different ASEAN, youth smoking prevalence is high (ranging between
segments of the population including vulnerable groups 11.3% and 19.2%) particularly in Indonesia, Malaysia,
such as women, youth, and children. About 6.5 trillion Philippines and Thailand.
cigarettes are sold each year, estimated 18 billion cigarettes
are smoked every day worldwide (1.457 billion sticks in In addition to smoking, an increasing exposure and
ASEAN). In 2020, an estimated 505 billion cigarettes were prevalence of electronic nicotine delivery systems (ENDS,
sold in ASEAN countries with 92% primarily consumed in also known as e-cigarettes) and and heated tobacco products
Indonesia, Philippines, Thailand, and Vietnam. Due to the (HTPs) use among youths in ASEAN further contribute to
expansion of the world’s population and dynamic economic nicotine addiction. The prevalence of ENDS among youth is
growth, the number of smokers is expected to reach at least high (ranging between 9.8% and 13.3%) particularly in
2 billion people by 2030. Brunei, Indonesia, Malaysia and Philippines.
Reducing the prevalence of tobacco use (smoked and smokeless tobacco)

Country National target (%) *Global target (%)
Brunei 13.93% (30% relative reduction in prevalence of current tobacco 12.88% (30% relative reduction from 18.4% in 2011)
use (19.9%) in adults by 2023, set in 2019)
Cambodia No target available 13.65% (30% relative reduction from 19.5% in 2011)
Indonesia
Lao PDR
10 – 18 years old: 8.7% in 2024 (no target for adults)
17.85% (30% relative reduction in adult smoking prevalence
in 2012 (25.5%) by 2025, set in 2015)
24.01% (30% relative reduction from 34.3% in 2010)
Same as national target -30%
Malaysia 19.63% (15% relative reduction in adult smoking prevalence 17.22% (30% relative reduction from 24.6% in 2011) 2025
(23.1%) by 2025 set in 2015)
Myanmar 24.8% and 23.5% (5% and 10% relative reduction in prevalence 15.4% (30% relative reduction from 22% in 2009) A 30% relative
of current tobacco use (26.1%) in persons aged 15+ years by reduction in
2021 and 2025 respectively, set in 2017) prevalence of
current tobacco
Philippines 15% - 18% adult smoking prevalence by 2022 20.8% (30% relative reduction from 29.7% in 2009) use in persons
aged 15+ years
Singapore <10% adult smoking prevalence by 2020 10% (30% relative reduction from 14.3% in 2010) by 2025/(2010
baseline).
Thailand 17.59% (15% relative reduction in prevalence of current tobacco 14.49% (30% relative reduction from 20.7% in 2009)
use (20.7%) in persons aged 15+ years by 2025, set in 2010)
Vietnam 28.54% (37% relative reduction in prevalence 16.66% (30% relative reduction from 23.8% in 2010)
of adult male smokers (45.3%)
*A 30% relative reduction in prevalence of current tobacco use in persons aged 15+years by 2025 (2020 baseline).
26
Chapter 2: Nicotine and Tobacco Addiction
Global estimate of smokers* by WHO region in 2020

Africa 10%
1,091 million
62 million
235 million
South-East Asia 15.9%
241 million
Western Pacific 23.3%
About 1.3 billion tobacco
384 million users aged 15 years and
Americas 15% above worldwide – 1.07
billion smokers and 367
118 million million smokeless tobacco
users.
Europe 25.3% Eastern Mediterranean 16.9%
About 80% of the world’s
181 million 84 million smokers live in low- and
middle-income countries
*Projection of smoking prevalence and number of smokers. and 226 millions of them
are living in poverty.
ASEAN has 10% of world’s smokers
22.5% of adults in ASEAN has 124.3 million adult smokers,

half of whom live in Indonesia.
ASEAN smoke Total ASEAN population: 667,304,000 (2020)
Quick
Fact About 1.3 billion tobacco users aged 15 years and above worldwide –
1.07 billion smokers and 367 million smokeless tobacco users.
About 80% of the world’s smokers live in low- and middle-income

countries and 226 millions of them are living in poverty.
27
Adult smoking and ENDS use

Numbers don’t lie: Percentage of adult male and female smokers and ENDS users
Adult Smoking (%) ENDS use (%)
31.5 Global*
5.2 (2020)
30.5 WHO SEARO*
1.3 (2020)
44.0 WHO WPRO*
2.6 (2020)
29.5
36.3 Brunei
3.7 (2016) 4.3
32.9 Cambodia
62.9 2.4 (2014)
Indonesia 2.8
4.8 (2018) 2.7
50.8 Lao PDR
7.1 (2015)
40.5 Malaysia 9.4
1.2 (2019) 0.3
36.4 Myanmar
4.4 (2018)
41.9 Philippines 1.3
5.8 (2015) 0.2
18.4 Singapore**
3.2 (2019)
37.7 Thailand
1.7 (2017)
45.3 Vietnam 0.4
1.1 (2015) 0.1 Male Female
*Projected 2020 prevalence (%) for current tobacco smoking prevalence, age-standardized average.
**Daily smokers aged 18 to 74 years.
Quick
Fact Smoking is associated with an increased risk of suffering from a wider
range of COVID-19 symptoms and smokers are more likely to visit
hospital than non-smokers.
28
Numbers don’t lie: Adult smokers and ENDS users in ASEAN
Adult smoking (%) ENDS use (%)
1,068,000,000 Global*
18.4 (2020)
241,000,000 WHO SEARO*
15.9 (2020)
384,000,000 WHO WPRO*
23.3 (2020)
39,037 Brunei 16.7
19.9 (2016)
1,680,867 Cambodia
16.9 (2014)
65,700,000 Indonesia
(2018) 2.7 (254,260)
33.8
824,016 Lao PDR
27.9 (2015)
4,877,697 Malaysia
4.9 (1,126,073)
21.3 (2019)
8,100,000 Myanmar
20.4 (2018)
16,500,000 Philippines
(2015) 0.8 (180,000)
23.8
323,000 Singapore* Total number of adult smoking
10.6 (2019)
Adult smoking prevalence (%)
10,676,362 Thailand
19.1 (2017) Total adult ENDS use prevalence (%)
15,602,400 Vietnam
(2015) 0.2 (138,519)
22.5
*Projected 2020 prevalence (%) for current tobacco smoking prevalence, age-standardized average.
Regular smokers and ENDS users by gender (Global) Prevalence of current dual users of ENDS and cigarettes
Malaysia (2016) Total 2.3% | 445,458
29% 10% Regular smokers and ENDS users by generations (Global)
25% Generation Y 10%
20% 7% 30% Generation X 10%

23% Boomers 5%
10% Silent 1%
generations
29
Quick
Fact The World Health Organization (WHO) has warned that all forms of tobacco, including heated
tobacco products (HTPs), are harmful. The Conference of Parties to the WHO FCTC
recommends that HTPs be regulated as tobacco products.
Prevalence and number of ever-tried adult ENDS users in ASEAN*

ENDS users (%) Total (%)
11.9
Malaysia
(2016)
2,266,827
4.5 Philippines
2.8
Male
1.1 (2015)
1,753,232 Female
2 Vietnam Total
(2015) 1.1
0.2
761,857 Total number
*No data available in Cambodia, Indonesia, Lao PDR, Myanmar, Singapore and Thailand.
30
_
Cigarette per capita annual consumption in ASEAN (2015 2020)
2,000 By contrast, in high-income and European countries annual consumption declined

by over 1,000 cigarettes per adult after 2003, whereas in low- and middle-income and
Asian countries annual consumption increased by over 500 cigarettes per adult.
1,707
1,658
1,589 1,562
1,503
1,500 1,445
1,389 Vietnam
1,309 1,334 1,445
1,430
Indonesia
1,304 1,276
1,124
1,039
995
1,000 939
874
Philippines
764 789 768
725 701 706
763 703 709
688 Cambodia
637 715 704 570 646 Lao PDR
557 660 565 545
578 575 Thailand
534 473 539
500 541 507 Singapore
415 Myanmar
488
381 450 449
398 378
351 Malaysia
283 266
0
2015 2016 2017 2018 2019 2020
31
Number of cigarettes smoked daily by adults in ASEAN
1.457 billion sticks are

smoked daily by adults
840,960,000 Total number of cigarettes smoked by adults daily in ASEAN.
Average number of cigarettes smoked daily
213,752,880
181,500,000
106,763,620
60,483,443
355,237 25,885,352 10,959,413 12,150,000 3,876,000
9.1 15.4 12.8 13.3 12.4 1.5 1 12* 10 13.7

Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Vietnam
(2016) (2014) (2018) (2015) (2019) (2018) (2015) (2019) (2017) (2015)
*Daily smokers aged 18 to 74 years.
Quick Smoking causes thousands of DNA mutations, such that every 15 cigarettes smoked causes a genetic
Fact mutation leading to the development of lung cancer.
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
0.2 3.8 0.1 6.5 2.8*
0.1
Cambodia Indonesia Lao PDR Malaysia Philippines Singapore Thailand Vietnam
(2014) (2011) (2015) (2011) (2015) (2013) (2017) (2015)
Grocery store Convenience 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.
32
_
Cigarette sales volumes in ASEAN region (2015 2023)
Cigarette sales volumes are highest in Indonesia, Philippines, Thailand, and Vietnam
350
320 315.6 307.4 307 300.2 299.7 302.8 305
300 Indonesia
250 258.4
(Billion sticks)
200
150
101.08 105 107 108 108.5 108.3 108
93.35 96.16 Vietnam
100
74.9 73.25 70.55 67 65.8 64.75
90.2 63.9
79.3 Philippines
50
43 Thailand
37.5 36.44 31.01 33 33.5 32.75 32.2 31.7
0
2015 2016 2017 2018 2019* 2020* 2021* 2022* 2023* * Forecast sales
Quick In ASEAN, an estimated Over six trillion cancer sticks with

Fact 505.65 billion cancer sticks highly addictive nicotine are
were sold in 2020. produced annually worldwide.
Cigarette sales volumes in Cambodia, Lao PDR, Malaysia, Myanmar and Singapore
20 19.31 18.9 19.2
18.48 18.2 18.6 Myanmar
18
16
15 14.5
12.1
(Billion sticks)
10 9.2 8.9
8.4 8.15 8.27 8.4 8.53
7.6 8 Cambodia
7.3
7.8 8 6.6 6.4 6.25 6.1
6.9 Malaysia
5 3.61 3.59 3.45
3.42 3.4 3.2 3.3 3.35 3.4
Lao PDR
2.82 2.83 2.75 2.75 Singapore
2.76 2.6 2.53 2.47 2.41
0
2015 2016 2017 2018 2019* 2020* 2021* 2022* 2023* * Forecast sales
33
Number and percentage of adults who use smokeless tobacco in ASEAN

7.8%
3.3% Global 5.6% (302,500,000)
24%
11.5% WHO SEARO 17.9% (247,400,000)
Smokeless
0.5% WHO WPRO 0.4% (5,000,000)
tobacco use 0.2%
highest in
Myanmar (43.2%), 1.7% Brunei
Malaysia (6.5%), 2.1% (2016) 1.9% (3,727)
Cambodia (4.9%),
and
Lao PDR (4.3%). 0.8% Cambodia
8.6% (2014) 4.9% (487,317)
2.22% Indonesia
(2018) 2.5% (4,862,500)
2.8%
0.5% Lao PDR

(2015) 4.3% (149,952)
8.6%
12.1% Malaysia
0.7% (2019) 6.5% (1,496,276)
62.2%
Myanmar 43.2% (8,758)
24.1% (2014)
2.7% Philippines
0.8% (2015) 1.7% (1,164,966)
1.5% Thailand Male (%)

2.7% (2017) 2.1% (1,196,383)
Female (%)
0.8% Vietnam Total (%) Total number of
2.0% (2015) 1.4% (954,000)
adult use smokeless tobacco
Quick
About 303 million people globally (from 133 countries), aged 15
Fact years and older, currently use smokeless tobacco. Of these, 248
million smokeless tobacco users live in the WHO South-East Asia
region, primarily in India.
More than 85% of the smokeless tobacco-related burden was in South and Southeast Asia
and the risk estimates for cancers were highest in this region. In 2017, at least 2.5 million
DALYs and 90,791 lives were lost across the globe due to oral, pharyngeal and oesophageal
cancers that can be attributed to smokeless tobacco.
34
Quitting tobacco use

Percentage of current smokers (aged>15 years old) who intend to quit within next 12 months*
(%) 80
76.7
70 Male Female Total
60
48.9 45.8
50 48.8
40
30
20.5
20 19.6 19.7
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 Philippines Singapore Thailand Vietnam
(2014) (2011) (2015) (2015) (2019**) (2011) (2015)
*No data available in Brunei, Malaysia and Myanmar. **18-74 years old.
Percentage of current smokers who attempted to quit in the past 12 months

(%) 62.7
62.5 62.6 Male Female Total
58.9 57.1
48.9 52.5 51.5 52.2
48.6 48 45.3
44.6 44.8
43.7
42 32.8
39.8 39.6
29.8 30.4 15.9

29
27.2 23.620.8
20.7
8.0
4.1
0.5
(2016) (2014) (2011) (2015) (2019) (2014) (2015) (2019*) (2017) (2015)
*18-74 years old.
35
Health benefits in quitting for all tobacco users
15 years
after quitting
10 years smoking
after quitting
5-15 years smoking
after quitting the risk of
1–9 1 year smoking coronary
after quitting the risk of heart disease
months smoking lung cancer is that of a
after quitting the risk of falls to about
2-12 weeks smoking stroke is half that a person who
after quitting the risk of reduced of a smoker, never smoked.
Within 12 hours smoking coronary to that of a and the risk
after quitting coughing heart disease of cancer of
20 minutes smoking and shortness is about half
non-smoker.
the mouth,
after quitting the circulation of breath throat,
smoking improves that of a
the carbon decrease. smoker. oesophagus,
monoxide and the lung bladder,
the heart rate level in the function cervix and
and blood blood drops increases. pancreas
pressure drop. to normal. decreases.
Quick Years gained by quitting smoking by age

Fact Smoking cessation is beneficial at
any age. It improves health status Benefits in comparison with those who continued:
and enhances quality of life as At about 30 gain almost 10 years of life
well as reduces the risk of
premature death and many
adverse health effects, including At about 40 gain 9 years of life
reproductive health outcomes,
cardiovascular diseases, chronic At about 50 gain 6 years of life
obstructive pulmonary disease
(COPD), and cancer. At about 60 gain 3 years of life
Cessation support (national toll-free tobacco quitline service)

in selected ASEAN countries
Country National toll-free tobacco quitline service
Indonesia Layanan Berhenti Merokok (0800-177-6565)
Malaysia Infoline: 03-8883 4400
Philippines Quit Smoking: Call DOH Quitline 1558 (formerly 165-364)
Singapore QUITLINE 1800 438 2000
Thailand Quitline 1600
36
Myanmar (2016)
8.3%
Lao PDR (2016) Youth*smoking prevalence in ASEAN
17.0% 1.5% 6.4%
Boys Girls
10.7% 2.1% Total % of youth smoking prevalence
<5
_
5 10
_
10 15
>15
Vietnam***(2019)
2.6%
4.4% 1.0%
Philippines (2019)
10%
Thailand (2015)
11.3% 15.3% 5.1%
17.2% 5.2%
Cambodia** (2016)
2.4%
2.9% 1.9%
Malaysia*** (2017) Brunei

13.2% Darussalam (2019)
6.1%
20.6% 5.7%
9.6% 2.2%
Singapore****
_
(2014 2016)
4%
Indonesia (2019)
19.2%
38.3% 2.4%
*Percentage of youths (13-15 years) 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.
***The data is based on youth aged between 13 and 17.
**** Youth smoking prevalence (4%) is a consolidated figure from three different surveys among youth aged 13-20 between 2014 and 2016.
37
Youth Smoking
_
Numbers don’t lie: Percentage of smoking among boys and girls (13 15 years)* in ASEAN
Boys (%) Girls (%)
The highest
average rate 8.9 Global 3.8
(10.5%) for Around 24 million
boys’ cigarette 8.8 WHO SEARO 2.2 youth aged 13-15
smoking is in the (17 million boys
Western Pacific 10.5 WHO WPRO 2.4 and 7 million girls)
among the WHO globally report
regions. 9.6 Brunei (2019) 2.2 current smoking
of cigarettes.
2.9 Cambodia (2016)** 1.9
38.3 Indonesia (2019) 2.4
10.7 Lao PDR (2016) 2.1
20.6 Malaysia (2017)*** 5.7
17 Myanmar (2016) 1.5
15.3 Philippines (2019) 5.1
No data available Singapore (2014-2016)**** No data available
17.2 Thailand (2015) 5.2
4.4 Vietnam (2019)*** 1
*Percentage of students who smoked cigarettes on one or more days in the past 30 days. ** Data is based on current use of any tobacco product during the past 30 days.
***The data is based on youth aged between 13 and 17. **** Youth smoking prevalence (4%) is a consolidated figure from three different surveys among youth aged 13-20 between 2014 and 2016.
Quick
Fact The South East Asian (6.4 million or 27%)
and Western Pacific (4.7 million or 19.9%)
regions have the largest number of youth
cigarette smokers of the global total (23.6
million) respectively.
"They represent tomorrow's cigarette business. . . As

this 14-24 age group matures, they will account for a
key share of the total cigarette volume -- for at least
the next 25 years."
1974 R.J. Reynolds Tobacco Co.
marketing plan presented to the company's board of directors.
Bates No. 501421310-1335
38
Youth smoking initiation

Early initiation of youth ever-smokers* in ASEAN
Country Boy (%) Girl (%) Total (%)
Brunei**(2019) 20.7 6.4 13.9
Cambodia No data available
Indonesia** (2019) 37.9 37.5 37.9
Lao PDR (2011) 28.6 _ 30.9 Globally, 24 million youth
Malaysia**(2017) 69.9 56.7 68.4 aged 13-15 smoke, and
13 million use smokeless
Myanmar (2016) 15.2 28.2 17.2 tobacco.
Philippines***(2015) 10.7 14.5 12
Singapore No data available
Thailand (2015) 16.8 9.2 14.5
Vietnam (2014) 16.4 24.4 17.7
*Percentage of ever smokers who first smoked before the age of 10 years
**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.
Average age of adults smoking initiation (daily smokers) in ASEAN
15-20 20 20 Most smokers in

18 18.8
17.4 17.2 17.5 ASEAN started
17.1 16.8 smoking in their
teens.
(2016) (2014) (2018) (2015) (2011) (2014) (2015) (2019) (2017) (2015)
39
Intentions of non-smoking youths to start smoking in the next year

Intentions to start smoking (%)
Brunei (2019) 14.8
Indonesia (2016) 5.6
Indonesia (2019) 6.7
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
Note: Years of the Global Youth Tobacco Survey (GYTS) differ between countries.
No data available in Singapore.
40
Numbers don’t lie: Percentage of youth smokers* and ENDS users in ASEAN
Smoking (%) ENDS use (%)
9.6 19
2.2 Brunei 7.1
6.1 (2019) 13.3
2.9 2.1
1.9 Cambodia** 2.5
2.4 (2016) 2.3
38.3
2.4 Indonesia*** 10.9
19.2 (2018)
10.7 5
2.1 Lao PDR 3.7
6.4 (2016) 4.3
20.6 17
5.7 Malaysia**** 2.8
13.2 (2017) 9.8
17 Myanmar
1.5 (2016)
8.3
15.3 20.9
5.1 Philippines 7.5
10 (2019) 14.1
4 Singapore*****
(2014-2016)
17.2 Thailand 4.7

5.2 (2015) 1.9
11.3 3.3 Male
4.4 Vietnam**** 3.6 Female
1 1.5
2.6 (2019) 2.6 Total
* 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.
*** Indonesian youth aged 10-18 years old ****The data is based on youth aged between 13 and 17.
***** Youth smoking prevalence (4%) is a consolidated figure from three different surveys among youth aged 13-20 between 2014 and 2016.
Quick
Fact Globally, the number of youths aged 13–15 years, who smoke, is estimated to be around 24 million, and
13 million use smokeless tobacco products.
41
Prevalence of ever tried and initiation age using ENDS in ASEAN*

Ever tried (%) Initiation before the age of 14 years
31 20.8
Brunei
14.4 (2019) 9.7
23.1 15.5 Male
Female
35.2
Philippines Total
14.8 (2019)
24.6
42.9
Malaysia
(2017) 38.1
42.2
*No data available in Cambodia, Indonesia, Lao PDR, Myanmar, Singapore, Thailand and Vietnam.
Quick
Electronic nicotine delivery systems (ENDS) use is associated with a higher risk of cigarette
Fact smoking among adolescents who had no prior intention of taking up conventional smoking. They
are more than four times more likely to start smoking cigarettes one year later compared to those
who did not use ENDS.
Prevalence of current youth dual users of ENDS and cigarettes in ASEAN*

(%) 10
9.8 Boys
8
8 Girls Quick Electronic nicotine delivery
Total Fact systems (ENDS) are
associated with adolescents
starting to smoke tobacco
6
5.2 cigarettes; adolescents who
5 use ENDS are three to five
times more likely to start
4 smoking tobacco cigarettes
compared to those who
never used ENDS.
2 1.8
0.9
0 *No data available in Cambodia, Indonesia, Lao PDR, Myanmar, Philippines,

Brunei Malaysia Singapore, Thailand and Vietnam.
(2019) (2016)
42
Smoking initiation trend among Indonesian between 1995 and 2018
• New smokers aged 10-14 increased by

(%) 54.6 63.7 43.3 52.1 2.5 times (256%) in 24 years
58.9 50.7 56.9 (1995 – 2018).
• New smokers aged 15-19 decreased by
95% between 1995 and 2018.
• There is a shifting of new smokers to
younger age group.
25.8 17.2 14.6 14.8

23.9 19 16.3
9 12.6 17.5 23.1
9.5 16 17.3 3.8 1.8 18.6 3.3
2.6 6.9 3.6
6.3 4.8 3.1 5.5 4.3 4.4 4.2
0.6 0.4 1.7 1.9 1.7 1.5 2.5
_ _ _ _ _
59 10 14 15 19 20 24 25 29 >30
Age of smoking initiation
1995 2001 2004 2007 2010 2013 2018
Recruit New
DEATHS FROM Smokers
•16.8 million new Indonesian
TOBACCO smokers (10-19 years old)/year
• 290,444 Indonesians/year •46,027 youth smokers
• 795.7 Indonesians/day (below 19 years)/day
Quick Indonesia has one of the highest smoking rates in the world where 63% of
Fact adult males and 38.3% of youths (aged between 10 and 18) smoke.
43
Youth susceptibility to tobacco advertising and promotion in ASEAN
Tobacco advertisement or promotion at point-of-sale seen by youth

Youth who saw anyone using tobacco on television, videos, or movies
Youth who have object with a tobacco brand on it
Brunei (2019) 19.6 64.8 6.3
Indonesia (2016) 17.7 65 14
Indonesia (2019) 65.2 56.8 10.5
Lao PDR (2016) 35.2 61.9 7.1
Malaysia (2016) 37.4 77.2 4.7
Myanmar (2016) 42.3 83.4 5.6
Philippines (2019) 36.1 66.6 8.4
Thailand (2015) 35.5 77.4 10.5
Vietnam (2014) 27.9 77.8 7.1 (%)
*All forms of tobacco advertising or promotion are prohibited in Singapore.
Percentage of youths offered free cigarettes by a tobacco company representative in ASEAN
Malaysia (2016) 2.5% Brunei (2019) 3.2%

Vietnam (2014) 3.1%
Indonesia (2019) 6%
Myanmar (2016) 5.9%
Philippines (2019) 11%

Cambodia (2016) 8%
Lao PDR (2016) 3.9% Thailand (2015) 7.3%
44
Average monthly expenditure for
manufactured cigarettes (in USD)
Myanmar* among smokers ≥ 15 years old
Lao PDR (2015) Average monthly expenditure for manufactured cigarette (USD)
12.9 (LAK 106,528) <10
_
10 15
_
16 20
>20
Vietnam (2015)
10.3 (VND 221,400)
Thailand (2017) Philippines (2015)

16.8 (THB 546) 14.96 (PHP 678.40)
Cambodia (2014)
9.7 (KHR 38,800) Brunei
Darussalam*
Malaysia (2011)
55.9 (MYR 178.8)
Singapore (2019)
21.6 (SGD 29.1)
Indonesia (2020)
5.05 (IDR 73,442)
*No data available on average monthly expenditure for manufactured cigarette.
45
Chapter 3
Tobacco use is inextricably linked to poverty. Tobacco

Basic Needs Sacrificed smokers to spend a large proportion of their income on
consumption varies according to socioeconomic group, but tobacco diverting limited family resources from spending on
in most countries, those who tend to consume tobacco the basic necessities such as food, health care, shelter, and
most are the poor and the poorest and men with low education. Tobacco also exacerbates poverty among families
education than their more affluent and higher education of tobacco users, who are at high risk of falling seriously ill
counterparts. This inequality in smoking implies wide from tobacco-related diseases and dying prematurely,
disparities in the health status of different socioeconomic thereby imposing heavy health care costs on families and
groups in many countries. depriving them of much-needed household income. It
contributes to a disproportionate burden of disease and
In many ways tobacco perpetuates the vicious cycle of death among the poor.
poverty that many smokers are in. Nicotine addiction drives
Quick Globally, around Smoking prevalence was strongly linked to the

Fact 226 million level of educational attainment. In most
adult tobacco users countries, smoking and other forms of tobacco
live in poverty. use are much higher among the poor.
Poverty and inequality

Education level of adult smokers in ASEAN
Education level
(%) 50 48.2 Less than primary Primary
Secondary (lower/secondary) College or above
32.9 (lower) 35.4 (lower)
24.6
40 36.9
35.8 35.4 (high) 17.6 (upper)
32.9 33.9
32.9 33.3
29.7 (lower)
30
26.7 (high)
24.7 24.3 24.6 24.7*
22.1 22.5 22.7
20.5 19.9
20 18.5 18.4
15.7
14.2 13
9.1 10
10 8.4
0
Brunei Cambodia Indonesia Lao PDR Malaysia Philippines Thailand Vietnam
(2016) (2014) (2018) (2015) (2019) (2015) (2017) (2015)
* The percentage of primary and less than primary.
46
Chapter 3: Basic Needs Sacrificed
Tobacco expenditure and basic needs (USD)

1.2 4.9 2.6 1.6 23.0 19.5
(IDR 12,328) (IDR 51,586) (PHP 141) (PHP 87) (SGD 31.1) (SGD 26.5)
1.9
(IDR 20,215)
13.2 1.3
(IDR 137,652) Indonesia Philippines (PHP 71) Singapore
(2013) (2003) (2017/2018)
13.1 2.6 172.4
83.8 (PHP 684) (PHP 141) (SGD 234.6)
(IDR 874,127)
137.3
Poorest households expenditure on (SGD 186.9)
Tobacco Education Health Clothing Others
Quick Among poor families in urban slum Paternal smoking diverts household money
Fact areas of Indonesia, households where the from food to tobacco (22% of weekly per
father was a smoker are at greater risk of capita household expenditures) and
household food insecurity. exacerbates child malnutrition.
Price of most popular cigarette brands (per pack) relative to quantity of rice (kg) and eggs in ASEAN
Country Most Popular Cigarette Brand Quantity of
Brand name Price
Rice (kg) Eggs (pieces)
Local currency USD
Brunei Djarum Super* BND 4.10 5.11 5.8 35
Cambodia Fine KHR 4,000 1.00 2 8
Indonesia A Mild (16 sticks) IDR 25,500 1.75 2.3 18
Lao PDR Adeng LAK 8,000 0.85 0.96 1.05
Malaysia Dunhill MYR 17.40 4.20 11.7 79
Myanmar Red Ruby MMK 2,500 1.79 1.25 17
Philippines Fortune PHP 111 2.29 3.01 17
Singapore Marlboro SGD 14 10.42 5.08 60
Thailand SMS THB 60 1.92 3.15 19.35
Vietnam Thang Long VND 10,000 0.43 0.78 5
* 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.
47
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 tons of
(2016) in rural areas high quality 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
average expenditure the average expenditure the average expenditure
on meat on milk and eggs on fish and vegetables
or or
7 times 11 times
the average expenditure the average expenditure
on education on health
Quick
Fact
Annual expenditure of
current smokers on cigarettes is USD 179.55
(PHP 8,140.80) per smoker in 2015. In low-income
Rice or Fish countries, sometimes
(PHP 36.93/kilo) (PHP 163.92/kilo) more than 10% of
220 kilos/year 50 kilos/year
household income
is spent on tobacco
products – meaning
less money for food,
or Green Leafy or Egg education and
(PHP 40.71/kilo) (PHP 6.73 per piece) healthcare.
200 kilos/year 1,210 pieces of eggs
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
48
Annual deaths attributed to major
tobacco-related diseases in ASEAN
Myanmar
41,696 <1,000
Lao PDR _
1,001 50,000
6,461 _
50,001 100,000
>100,001
Vietnam
40,000
Thailand
72,656 Philippines
98,893
Cambodia
Brunei
15,000 Darussalam
290
Malaysia
28,671
Singapore
2,756
Indonesia
261,599
Quick More than half a million people On average smokers lose 15 years of their
Fact die from tobacco-related diseases life. Millions of people stop smoking by
annually in ASEAN. dying.
49
Chapter 4
Burden of Death,
When used as intended by the manufacturer, tobacco is the
Disease and Disability
Tobacco also imposes a heavy economic burden on society
only legal product that kills up to two thirds of its regular and government through increased health care costs and
users, currently killing more than 8 million people globally human productivity losses. The economic and societal costs
each year, including about 1.2 million non-smokers, who of tobacco-related diseases are staggering and cost an
lose their lives due to exposure to secondhand smoke. All estimated USD 1.4 trillion annual expenditure in
forms of tobacco are harmful, and there is no safe level of tobacco-related healthcare costs and in lost productivity due
exposure to tobacco. As such, tobacco use is the biggest to illnesses and early deaths. Forty percent (40%) of the
public health threat continues to be the world’s single largest global cost of smoking occurred in low- and middle-income
preventable cause of diseases, harming almost every organ of countries. Most ASEAN governments already spend
the body. significant amounts of their budgets for direct and indirect
tobacco-related health care costs that are many times higher
Given the current trends of the tobacco epidemic being than revenue gained from tobacco.
exported from high-income countries to low-and
middle-income countries, it is estimated that tobacco use will Tobacco is a key risk factor for many noncommunicable
kill more than 8 million people annually by 2030, with 80% diseases and reduction in tobacco use is critical to reducing
of these premature deaths in low-and middle-income the NCDs burden, which account for 71% (41 million
countries. In the ASEAN region, tobacco already causes people) of deaths globally, including 15 million people aged
more than half a million deaths every year. between 30 and 69 years.
Tobacco – Global agent of death

~500
500
Millions of smoking-related deaths
Total twentieth Total twenty-first century: 1 billion Tobacco will kill 1 Billion people
400 century: in the 21st century About half of
0.1 billion ~300 these deaths will occur before 70
300 years of age.
Tobacco use killed about 100

200 ~150 million people worldwide in the
20th century, and remains a
100 serious and growing concern that
100 it will claim an estimated 1 billion
or more lives in the 21st century
0 unless urgent action is taken.
_ _ _ _
1900 1999 2000 2024 2025 2049 2050 2099
Time period
Quick On the basis of current consumption patterns, approximately 450 million adults
Fact will be killed by smoking between 2000 and 2050. At least half of these adults will
die between 30 and 69 years of age, losing decades of productive life.
50
Chapter 4: Burden of Death, Disease and Disability
Global leading causes of death and disability

Disease of injury Rank
6.8 1
Ischaemic heart disease 7.8 1
8.9 1
5.5 2
Stroke 5.8 2
6.2 2
3 5
Chronic obstructive pulmonary 2.9 3
3.2 3
3.1 4
Lower respiratory infections 2.6 4
2.6 4
3.2 3
Neonatal conditions 2.5 5
2 5
1.2 9
Trachea, bronchus, lung cancers 1.5 7
1.8 6
0.584 20
Alzheimer disease and other dementias 1 14
1.6 7
2.6 6
Diarrhoeal diseases 1.9 6
1.5 8
0.878 12
Diabetes mellitus 1.1 11
1.5 9
0.814 13
Kidney diseases 1.1 13
1.3 10
1.1 11
Cirrhosis of the liver 1.2 10
1.3 11
1.2 10
Road injury 1.3 9
1.3 12
1.7 7
Tuberculosis 1.4 8
1.2 2000 2010 2019 13
0 2 4 6 8 10
Total deaths (million)
Quick At the global level, 7 of the top 10 causes of death in 2019 are noncommunicable
Fact diseases. There were 55.4 million deaths and 2.5 billion healthy years of life lost
worldwide. Ischaemic heart disease caused the most deaths and was responsible for
16% of total deaths. Since 2000, it has seen the largest increase in deaths, rising by
more than 2 million to nearly 9 million deaths in 2019.
Today’s tobacco users will make up the majority of future tobacco-related deaths,
which will disproportionately affect low- and middle-income countries.
51
Risks associated with the highest number of deaths worldwide for both sexes combined, all ages, in 2019
Total deaths (million)
Kidney dysfunction Child and maternal malnutrition
3.16 ( 1.63 1.53) 2.94 ( 1.58 1.36)
Alcohol use
High LDL cholesterol 2.44 ( 2.07 0.37)
4.4 ( 2.36 2.04)
High systolic blood pressure
10.8 ( 5.6 5.25)
High body-mass index
5.02 ( 2.48 2.54) Tobacco
8.71 ( 6.56 2.15)
High fasting plasma glucose
6.5 ( 3.41 3.09) Dietary risks
(e.g., low fruit, high salt)
Air pollution 7.94 ( 4.47 3.48)
6.67 ( 3.75 2.92)
Leading causes of DALYs* or health loss globally for both sexes combined, all ages, in 2019
Neonatal disorders
1 Ischaemic heart disease Low-income and
2
Rank
Stroke middle-income
countries account for
3 Lower respiratory infections 62·6% of the global
4 Diarrhoeal diseases burden of COPD and
5 lung cancer, and this
Chronic obstructive pulmonary disease (COPD) share is likely to
6 Road injuries increase sharply over
7 coming decades due to
Diabetes ageing populations
8 Low back pain and less successful
9 tobacco and
Congenital birth defects air pollution control.
10
*Disability-adjusted life-years (DALYs) .
Quick Several of the risk factors and non-communicable diseases (NCDs), including obesity, diabetes,
Fact and cardiovascular disease, are associated with increased risk of serious illness and death from
COVID-19.
Tobacco use is a leading common risk factor for non-communicable diseases.
41 million people kill each year, equivalent to 71% of all deaths globally, including 15 million
people aged between 30 and 69 years.
52
Direct and indirect tobacco-related health care costs in ASEAN

Total number of adult smokers
Brunei
(2012) BND 190 million (USD 155.483 million) 39,037
of direct and indirect economic cost for overall tobacco-related diseases
(0.9 % of Brunei’s 2012 GDP).
Cambodia
(2017) KHR 2.71 trillion (USD 660 million) 1,680,867
total economic costs of tobacco use for 31 tobacco-related diseases
(3.0% Cambodia’s 2017 GDP).
Indonesia
(2017) IDR 531.8 trillion (USD 39.4 billion) 65,700,000
of direct and indirect smoking cost for 21 tobacco-related diseases
(2.15% of Indonesia’s 2017 GDP).
Lao PDR
(2017) LAK 3.54 trillion (USD 427.8 million) 824,016
(2.3% of Lao PDR’s 2017 GDP).
Malaysia
(2012) MYR 15.785 billion (USD 5.175 billion) 4,877,697
(1.7% of Malaysia’s 2012 GDP).
Myanmar
(2016) MMK 2.62 trillion (USD 1.919 billion) 8,100,000
(3.3% of Myanmar’s 2016 GDP).
Philippines
(2012) PHP 269.326 billion (USD 6.568 billion) 16,500,000
(2.5% of Philippines’s 2012 GDP).
Singapore SGD 609.37 million (USD 479.8 million) 323,000

(2014)
of direct and indirect smoking cost for 4 tobacco-related diseases
(0.19% of Singapore’s 2014 GDP).
Thailand
(2017) THB 87.25 billion (USD 2.6 billion) 10,676,362
of direct and indirect economic cost for tobacco-related diseases
(0.56% of Thailand’s GDP or 15% of total health expenditure in 2017).
Vietnam 15,602,400
(2011) VND 24, 679.9 billion (USD 1.1732 billion)
of direct and indirect cost for 5 tobacco-related diseases
(0.97% of Vietnam’s 2011 GDP).
Tobacco-related health care costs (billion)
53
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

Cardiovascular diseases
of total global healthcare
expenditure 1.436 Respiratory diseases
Lower respiratory infections
Trillion Tuberculosis
USD 357 Billion (2012)*
Indirect cost of morbidities caused
by smoking
1.8%
world GDP
40%
of the total economic costs are incurred in LMICs
* Total economic cost of smoking (from health expenditures and productivity losses together).
The numbers of lives behind these costs include:
2.1 Million 13.6 Million

deaths caused by years lost due to disability
smoking among adults ages 30 to 69
40%
of USD 1.436
Trillion
18 Million 26.8 Million
years of labor lost years of lost labor due to
due to death smoking-related diseases
Quick Global annual costs from tobacco use are USD 1.4 trillion in healthcare
Fact expenditure and lost productivity from illness and premature death.
40% of the USD 1.436 trillion global cost of smoking occurred in low- and
middle-income countries.
54
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
Brunei Cambodia Lao PDR Myanmar 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
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 warnings 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 advertising, promotion and sponsorship
WHO FCTC Article 26: Financial resources
Lao PDR 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, 182 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.
57
Higher taxes 100% smoke-free TAPS ban
Standardized packaging
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
and standardized/plain packaging 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
58
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 12 No more licensed tobacco retailer
Tobacco control milestones
warnings on cigarette packs (S49/05) passed Tobacco Control established (since May 2014)
2 All government building declared • Sale of single sticks of Pictorial health warnings (PHWs) Smoking cessation clinics expanded
smoke-free cigarettes ban implemented to all health centers nationwide and
(Top 50% front and back) one hospital
200% increase in tobacco tax • Kiddie pack
(less than 20-stick) ban 10 New tobacco tax and price 13 Increased in licensing fee for importer
3 Royal Brunei Airlines became (Cigarettes – BND 0.25 per stick) and retailer
smoke-free Smoking cessation clinics
established Pack display ban 14 Increased in tobacco tax by 100%
4 Schools declared smoke-free
7 Tobacco Regulations 2007 Additional requirements for (Cigarettes – BND 0.50 per stick)
5 Ratified WHO FCTC (3 June) enacted tobacco retail license
15 Prime Minister’s Office circular for
Haram fatwa on smoking issued 8 Tobacco Control Unit 11 100% smoke-free airport civil servants on involvement with
established tobacco industries was endorsed
Expansion of smoke-free areas and distributed
Tobacco retail licensing
enforced PHWs (2nd rotation) – warning size
increased to 75%
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 15
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 2018 2019
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 circular on prohibition of involvement with the tobacco industry that applies to all government agencies.
Article 6 Tobacco tax burden as % or retail price (62%)
No licensed tobacco importers and retailers in Brunei since May 2014
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 Pictorial health warnings (Top 75% front and back) in 2008 and 2nd rotation in 2012 • False or misleading descriptors (No ban)
Article 13 Ban on direct tobacco advertising, promotion and sponsorship • Advertising at POS ban • Pack display ban • Sale of cigarette in single sticks ban • Sale of all
types of heated tobacco products, electronic cigarettes, shisha and water pipe ban • Cross border advertising (partial ban) • TAPS via internet (no ban)
• Person-to-person sale (no ban)
Article 16 Less than 20-stick pack ban • Required clear indicator inside POS about the prohibition of tobacco sales to minors
• Required Sellers request for appropriate evidence prohibition of tobacco sales to minors of having reached full legal age
Article 26 Health Promotion Centre (operational budget), Ministry of Health, Brunei
Total budget: USD 189,107 (BND 250,000) for 2019-2020
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
59
Cambodia WHO FCTC Ratification: 15 Nov 2005 | Tobacco Control Law Enacted: Tobacco Control Law 2015
1 Regulation on banning smoking 5 Comprehensive ban of TAPS via internet ban 10 PHWs (2nd rotation)
in educational, health, religious tobacco advertising,

and tourism facilities and some promotion and sponsorship Point-of-sale (POS) advertising ban 490 Tobacco Control Inspection
workplaces but not binding (TAPS) (Sub-decree) Officers established
POS pack display Strategic plan on tobacco
2 Inter-ministerial committee on Expansion of smoke free (Allow 1 pack per brand) education and reduction_
education and reduction of workplaces (Prakas) phase 2 adopted (2021 2026)
tobacco use established False or misleading descriptors ban
6 Sales and imports of shisha 11 PHWs (3rd rotation)
Strategic plan on tobacco and e-cigarette ban 8 Pictorial health warnings (PHWs)
education and reduction phase 1 implemented (Top 55% front and back) Ban all forms of partnerships
_ with tobacco industry among
developed (2001 2005) Smoking ban at workplaces educational facilities
and public places (Circular) Smoking ban at workplaces
3 Ratified WHO FCTC and public places (Sub-decree) Ban the use, sale, and importation
7 Tobacco Control Law passed of HTPs (in addition to a ban on
4 Sub-decree on textual health 9 Tobacco control committee e-cigarette and shisha since 2014)
warning on cigarette packages Kiddie pack (less than established
20-stick) ban Sub-decree on establishment and
functioning of the CFTC legislated
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 11
2000 2001 2002 2003 2004 2005a 2006 2007 2008 2009 2010 2011b 2012 2013 2014b 2015 2016 2017 2018 2019 2020 2021
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 Principles of Article 5.3 in the Sub-decree on establishment and functioning of the committee for Tobacco Control (CFTC)
• Circular of the Ministry of Education, Youth, and Sport bans all forms of partnerships with tobacco industry among educational facilities.
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 in
Indoor smoking room allowed in
Outdoor smoking anywhere allowed in
Article 11 Pictorial health warnings (Top 55% front and back) in 2016 and 2nd and 3rd rotation in 2018 and 2021 • False or misleading descriptors ban
Article 13 Ban on direct tobacco advertising, promotion and sponsorship • Advertising at POS ban • Cross border advertising ban • Person-to-person sale ban
• TAPS via internet ban • Sale of cigarette in single sticks ban • Sale of all types of electronic cigarettes, heated tobacco products, shisha and water pipe ban
• Corporate social responsibility (Ban cigarette brand name only) • Pack display (Allow 1 pack per brand)
Article 16 Less than 20-stick pack ban • Not required clear indicator inside POS about the prohibition of tobacco sales to minors
• Not required sellers request for appropriate evidence prohibition of tobacco sales to minors of having reached full legal age
Article 26 No governmental funding mechanisms for tobacco control
60
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 PHWs (2nd rotation)
warning of 5 health related or misleading descriptors on of interest with the tobacco

diseases on cigarette packs and cigarette packs industry in the Ministry of Health 8 Proposed government
smoke-free public places policy regulation (PP) revision is
4 Pictorial health warnings 6 Point-of-sale (POS) pack display underway to include PHW
2 Local SF Area (KTR) became (PHWs) implemented ban in Bogor SF Regulation enlargement to 90%,
the key TC policy measure to (Top 40% front and back) No 12/2009 began implemented banning outdoor and online
be spread out nationwide and it has been expanded to advertisements and regulating
14 other cities. novel tobacco and nicotine
product.
Adult smoking prevalence in Indonesia

(%)
65.6 65.8
62.2 63.1 66 62.9 Male
53.4
34.4 34.3 36.3

27 31.5 34.2
33.8 Adult
5.2 6.7
4.5 4.1 4.8
1.7 1.3 Female
1 2 3 4 5 6 7 8
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 2020
Key measures Indonesia: Progress in WHO FCTC implementation*

Article 5.2 Ministry of Health (MOH) Focal Point
Article 5.3 Ministerial regulation (code of conduct) or guidelines apply to its Ministry of Health only
Article 6 Has regular adjustment processes or procedures for annual evaluation of tobacco tax levels • Tobacco tax burden as % of retail price (63.5%)
• No licensing of tobacco retailers
Article 8 By local ordinance: 100% smoke-free indoor in
By local ordinance: Indoor smoking room is not allowed in
Article 11 Pictorial health warnings (Top 40% front and back) in 2004 and 2nd rotation in 2018 • False or misleading descriptors ban
Article 13 POS pack display ban is expanded to several cities
• Some cities applied direct/outdoor tobacco advertisement. This provision is included in the draft national regulation of PP 109/2012 revision
• Corporate social responsibility (Ban logo, brand image and publicity only) • No ban on cross border advertising, person-to-person sale, sale of cigarette in single
sticks and sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Article 16 No ban on less than 20-stick pack • Not required clear indicator inside POS about the prohibition of tobacco sales to minors.*
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) • Starting from 2019, some 75% of the 50% allocation for health should be allocated for national health insurance (JKN) program.
*Indonesia is a non-Party to the WHO FCTC but has implemented some of FCTC measures.
61
Lao PDR WHO FCTC Ratification: 6 Sep 2006 | Tobacco Control Law Enacted: Tobacco Control Law (2009)
1 National Tobacco Control Policy 3 Ratified WHO FCTC 6 Specific Tax increased to 10 MOH code of conduct on
approved by the Health Minister 500 LAK per pack article 5.3 between health
• Increase tobacco tax Minister of Health Regulation sector and tobacco industry
• Control cigarettes smuggling required 30% text warning 7 Lao PDR Tobacco Control Fund
• Ban on tobacco advertising established Prime Minister Ordering bans
4 Tobacco Control Law legislated on sale of all types of heated
• Smoke free tobacco products, electronic
• Ban selling cigarettes to minor Sale of single sticks of cigarettes ban 8 Excise tax rate 45% of wholesale cigarettes, shisha and water
(<18) (Excise Tax Law 2015) pipe
• Health Education on tobacco Kiddie packs
harms (less than 20 sticks per pack) ban 9 Pictorial health warnings Specific Tax increased to
• Government budget support 5 TAPS ban implemented 600 LAK per pack
• Establish the National Tobacco (Top 75% front and back)
Control Committee TAPS via internet ban 11 Prime Minister Decree
Corporate Social Responsibility penalties on implementation
2 Established Tobacco Control False or misleading descriptors ban (CSR) ban of Tobacco Control Law and
Task Force Committee (10 Regulations
representatives from Ministries) 100 LAK per pack of Specific Tax
Excise tax rate increased
to 50% of wholesale
(Excise Tax Law 2019)
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 10 11
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Key measures Lao PDR: Progress in WHO FCTC implementation

Article 5.2 National Tobacco Control Committee
Article 5.3 MOH code of conduct apply to health sector only
Article 6 Tobacco tax burden as % or retail price (18.8%)
Article 8 100% smoke-free indoor in
All indoor public places are smoke-free • Penalty to all smoke-free violations
Article 11 Pictorial health warnings (Top 75% front and back) in 2016 • False or misleading descriptors ban
Article 13 Ban on direct tobacco advertising, promotion and sponsorship • Advertising at POS ban • Corporate social responsibility ban • Cross border advertising ban
• Person-to-person sale ban • TAPS via internet ban • Sale of cigarette in single sticks ban • Pack display (allow 1 pack per brand)
• Ban on sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Article 16 Less than 20-stick pack ban • Not required clear indicator inside POS about the prohibition of tobacco sales to minors
Article 26 Lao PDR Tobacco Control Fund
Total budget: USD 117,740 (LAK 1,004,912,730) for 2018
62
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 (PHWs) 6 Expansion of smoke-free places
Regulation 2004 under the implemented - Top 40% front and (23 places)
Food Act 1983 3 Malaysian Health Promotion 60% back
• Direct and indirect tobacco, Board (MySihat) established Expansion of smoke-free cities
advertising, promotion and and abolished in 2018 False or misleading descriptors ban (5 cities)
sponsorship ban
• TAPS via internet ban 7 Minimum retail price for cigarette
5 PHWs (2nd rotation) - Top 50% increased to MYR 12 (USD 2.90)
• Kiddie pack (less than 20 front and 60% back
sticks per pack) ban* PHWs apply on all tobacco
• Sales of single stick ban products
* The kiddie pack ban was delayed and came into

force in 2010.
Adult smoking prevalence in Malaysia (Aged 18 years and over)

(%)
49.1
48.8
46.6
45.1 40.5 Male
24.7 24.6 24
22.8 21.3
Adult
3.5
1.9 1.4 1.2
1.1 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 2019 2020
Key measures Malaysia: Progress in WHO FCTC implementation

Article 5.2 Framework Convention on Tobacco Control (FCTC) Secretariat
Article 5.3 No code of conduct
Article 8 100% smoke-free indoor in Outdoor smoking area within public places allowed in
Indoor smoking room allowed in Outdoor smoking anywhere allowed in
Indoor smoking anywhere allowed in Penalties or compound for violating smoke-free
Article 11 Pictorial health warnings (Top 40% front and 60% back) in 2009 and 2nd rotation in 2014 (Top 50% front and 60% back)
• False or misleading descriptors ban
Article 13 Ban on direct tobacco advertising, promotion and sponsorship • Advertising at POS ban • Person-to-person sale ban • TAPS via internet ban
• Sale of cigarette in single sticks ban • Cross border advertising (Partial ban) • Corporate social responsibility ban
• No ban on pack display and sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Article 26 Malaysian Health Promotion Board (MySihat)
Total budget: USD 1.91 million (MYR 7.5 million) for 2018
Transportation (public) Universities Workplaces/offices Workplaces/offices (open area) Parks & playgrounds Sport complexes Casino
63
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, 5 Total ban of tobacco 7 Tobacco use in all government 10 2nd rotation of PHWs (2017 2018)
all basic education schools and advertising, promotion and offices’ compounds and _
sports fields and ground as sponsorship buildings is prohibited 11 3rd rotation of PHWs (2018 2019)
tobacco free – directive by the president
Restriction of access to tobacco _
2 Prohibition of TAPS from all office 12 4th rotation of PHWs (2019 2020)
products by legal minors
electronic media, billboards, _
print media Sales of single stick ban 8 Notification on posting signage 13 5th rotation of PHWs (2020 2021)
for no smoking area issued
3 Training of health personnel for Text warning on tobacco 14 Standardized Packaging
tobacco control activities product packages 9 Pictorial health warnings Notification on tobacco products
implemented approved, 6th rotation of PHWs,
4 Ratified WHO FCTC 6 Offer cessation service (Top 75% front and back) effective on 10 April 2022
on all tobacco
_ products
5 The Control of Smoking and 7 Central Tobacco Control (2016 2017)
Consumption of Tobacco Committee established chaired
Product Law legislated by Union Health Minister and False or misleading descriptors
members include the Deputy ban
Smoking prohibited in Ministers and Senior officials
from Health Ministry and other
related ministries
Adult smoking prevalence in Myanmar (Aged 15 years and over)

(%)
44.8
Male 43.8
36.4
26.1
22
Adult
20.4
7.8 8.4
Female
4.4
1 2 3 4 5 6 7 8 9 10 11 12 13 14
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Key measures Myanmar: Progress in WHO FCTC implementation

Article 5.2 Central Tobacco Control Committee
Article 5.3 Guidelines on contact with cigar and tobacco product manufacturer, distributor, seller or related person apply to Ministry of Health only
Article 6 Has regular adjustment processes or procedures for periodic revaluation of tobacco tax levels • Tobacco tax burden as % or retail price (50 – 60%)
Penalties or compound for violating smoke-free Indoor smoking room allowed in
Article 11 Pictorial health warnings (Top 75% front and back) in 2016 and 2nd rotation (2017), 3rd (2018), 4th (2019), 5th (2020) and 6th (2021)
False or misleading descriptors ban
Article 13 Ban on direct tobacco advertising, promotion and sponsorship • Cross border advertising ban
• Person-to-person sale ban • TAPS via internet ban • Sale of cigarette in single sticks ban
• No ban on advertising at point-of-sale, corporate social responsibility, pack display and sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Article 16 Required clear indicator inside POS about the prohibition of tobacco sales to minors • Less than 20-stick pack (No ban)
Article 26 No governmental funding mechanism for tobacco control
64
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 5 RA 10351 Sin Tax Law 8 RA 10963 TRAIN Law 10 RA 11346 (additional increase in
(Republic Act 9211) legislated legislated legislated (additional increase excise taxes for tobacco; levied
in excise taxes for tobacco new taxes on ENDS and heated
2 Ratified WHO FCTC 6 RA 10643 Graphic Health products) tobacco products)
Warning on Tobacco Products DOH AO 2019-0009 (3rd set of
3 TAPS via Internet ban Law legislated Executive Order 26 “Smoke pictorial health warnings)
Free Environment”
4 Joint _Memorandum Circular AO-2014-0008 FDA Rules and 11 Executive Order 106 “Smoke-Free,
2010 01 between DOH and Regulations on ENDS 9 2nd rotation of PHWs Vape-Free Environment”
CSC for protecting the (Bottom 50% front and back)
bureaucracy against tobacco 7 Pictorial health warnings RA 11467 (additional increase in
industry interference implemented excise taxes for ENDS and heated
(Bottom 50% front and back) tobacco products)
False or misleading descriptors AO 2020-0055 (Regulation on

Vapor Products and Heated
ban Tobacco Products under the FDA)
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 10 11
2000 2001a 2002 2003b 2004 2005 2006 2007 2008 2009c 2010 2011 2012 2013 2014 2015c 2016 2017 2018 2019 2020
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 • Tobacco tax burden as % or retail price (71.3%)
Article 11 Pictorial health warnings (Bottom 50% front and back) in 2016, 2nd rotation (2018) and 3rd rotation (2020)
Article 13 Direct tobacco advertising ban • TAPS via internet ban • Partial ban on tobacco promotion and sponsorship
• No ban on advertising at point-of-sale, corporate social responsibility, pack display, cross border advertising, person-to-person sale, sale of cigarette in single sticks
and sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Article 16 Required clear indicator inside POS about the prohibition of tobacco sales to minors • No ban on less than 20-stick pack
• Required sellers request for appropriate evidence prohibition of tobacco sales to minors of having reached full legal age
Article 26 Incremental sin tax revenue for health (85% of the increment for Universal Health Care or Department of Health Budget)
65
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 TAPS via internet ban 3 Ratified WHO FCTC 5 3rd rotation of PHWs 9 Minimum Legal Age for the
(Top 50% front and back) purchase, use and possession

Singapore Health Promotion Board Tobacco (Control of of tobacco increased to 19
established Advertisements and Sale) Act False or misleading descriptors ban
10 Minimum Legal Age for the
2 Sales of single stick ban purchase, use and possession
Pictorial health warnings 6 Emerging Tobacco Products of tobacco increased to 20
implemented (Smokeless cigars, smokeless
Kiddie packs (Top 50% front and back) cigarillos and smokeless cigarettes; Standardised packaging for all
(less than 20 sticks per pack) ban dissolvable tobacco or nicotine) ban tobacco products, 4th rotation
4 2nd rotation of PHWs of PHWs and increased warning
(Top 50% front and back) 7 Point of Sale pack display ban size to 75%, effective on
1 July 2020
8 Ban on the possession and 11 Minimum Legal Age for the
use of e-cigarettes purchase, use and possession
of tobacco increased to 21
Adult smoking prevalence in Singapore (Aged 18 - 69 years)

33.2
27.1 24.3 23.7 24.7

21.8 23.1
18.3
21.1
15.2
13.8 13.6 14.3 13.3 18.4
12.6
12
4.2 10.6
3.2 3.6 3.5 3.7 3.8
3.1 3.4 3.2
1 2 3 4 5 6 7 8 9 10 11
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 2019 2020 2021
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 • Tobacco tax burden as % or retail price (67.5%)
Article 11 Pictorial health warnings (Top 50% front and back) in 2004, 2nd rotation in 2006, 3rd rotation in 2013.
• Standardized packaging and increased warning size of 75% (4th rotation) in 2020 • False or misleading descriptors ban
Article 13 Ban on direct tobacco advertising, promotion and sponsorship • Advertising at POS ban • Pack display ban • Cross border advertising ban
• Person-to-person sale ban • TAPS via internet ban • Sale of cigarette in single sticks ban
• Sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe ban • Corporate social responsibility (Ban on publicity only)
• Required sellers request for appropriate evidence prohibition of tobacco sales to minors of having reached full legal age
Article 26 Singapore Health Promotion Board
Total budget: USD 261.71 million (SGD 352 million) for 2019
66
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 Tobacco Control Office in MOPH 8 2nd rotation of PHWs 15 Excise tax 90% of factory price 17 Appearance and methods for
(Top 55% front and back) displaying no-smoking signs

2 Tobacco Products Control Act and 16 Tobacco Products Control Act 2017 and smoking area signs
Nonsmoker’s Health Protection Act False or misleading descriptors ban • Minimum age requirements
(20 years old) Identification of types or
3 Ban smoking scene on television Excise tax 79% of factory price • Minimum age for purchase names of public places, work
(18 years old) places and vehicles, entirely
4 ThaiHealth established 9 Smoking ban in pub/bar/discotheques • Restrictions on sale and or in part, as non-smoking
promotions (including CSR) areas or smoking areas in
Excise tax 75% of factory price 10 Excise tax 85% of factory price • Disclosure and reporting non-smoking areas
5 Ratified WHO FCTC 11 3rd rotation of PHWs 17 Criteria, methods and conditions on 18 Standardized packaging for
(Top 55% front and back) • display of text or message that may cigarette and 5th rotation
6 Pictorial health warnings implemented mislead or motivate consumption on PHWs, effective on
(Top 50% front and back) 12 Excise tax 87% of factory price labels of cigarette, cigar, tobacco or 10 September 2019
POS pack display ban 13 4th rotation of PHWs blended/flavoured tobacco 19 Standardized packaging thfor
(Top 85% front and back) • display of names, prices and points shredded tobacco and 5
7 Excise tax 80% of factory price of sale of tobacco products rotation PHWs
14 Sales and imports of shisha
and E-cigarette ban 20 6th rotation of PHWs
59.3 Adult smoking prevalence in Thailand (Aged 15 years and over)

54.5 (%)
48.4
43.7 40.5
32 41.7 41.7 39 39.3
28.8 40.5
25.5 37.7 Male
23
21.2 20.7 21.4 20.7
19.9 19.9
5 19.1 Adult
3.5
3 2.2 1.8
2.6 2.1
1.9 2 1.7
Female
2.1
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1991 1992 1996 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2022
Key measures Thailand: Progress in WHO FCTC implementation

Article 5.2 National Committee for tobacco Control
Article 5.3 Ministerial regulation (code of conduct) or guidelines only apply to its Ministry of Health
Article 6 Has regular adjustment processes or procedures for periodic revaluation of tobacco tax levels • Tobacco tax burden as % or retail price (78.6%)
• Licensing of tobacco retailers
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 9&10 The testing and measuring of tobacco products and regulation. • Reducing tobacco-attractiveness of tobacco products and reducing overall toxicity.
Article 11 Pictorial health warnings (Top 50% front and back) in 2005, 2nd rotation (55% PHWs) in 2007, 3rd rotation in 2010, 4th rotation (85% PHWs) in 2014)
• Standardized packaging, 5th rotation of PHWs (2019) and 6th rotation of PHWs (2022) • False or misleading descriptors ban
Article 12 Propose measures to increase the effectiveness of education, communication, training efforts that raise public awareness of matters related to tobacco control.
Article 13 Ban on direct tobacco advertising, promotion and sponsorship • Advertising at POS ban • Corporate social responsibility ban • Pack display ban
• Person-to-person sale ban • TAPS via internet ban • Sale of cigarette in single sticks ban • Sale of all types of heated tobacco products, electronic cigarettes,
shisha and water pipe ban • Cross border advertising (Overseas live telecast allowed)
Article 16 Less than 20-stick pack ban • Required sellers request for appropriate evidence prohibition of tobacco sales to minors of having reached full legal age
• Not required clear indicator inside POS about the prohibition of tobacco sales to minors
Article 26 Thai Health Promotion Foundation (ThaiHealth)
Total budget: USD 118.65 million (THB 3,550 million) for 2020
67
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 established 5 Revision of Law on Excise Tax passed (tobacco excise tax
Prevention and Control (2000 2010) rate increased to 70% effective on 1 Jan 2016 and 75%
approved by the Prime Minister Pictorial health warnings implemented on 1 Jan 2019)
(Top 50% front and back)
2 Ratified WHO FCTC 6 Kiddie packs (less than 20 sticks per pack) ban
3 Tobacco Control Law legislated 7 Restricting the use of tobacco in theatrical and film works
POS advertising ban (Display of any 1 pack,
box or carton per brand) 8 Prohibition of smoking and drinking alcohol at schools
TAPS via Internet ban 9 Penalties increased for violations on smoke-free policy,
TAPS, display cigarette packs at POS, sell/provide
National Strategy on Tobacco Harm cigarette to people under 18 years old
Prevention and Control till 2020 approved
by the Prime Minister New penalty for violating health warning on tobacco
packaging and labelling
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 7 8 9
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Key measures Vietnam: Progress in WHO FCTC implementation

Article 5.2 Vietnam Tobacco Control Fund (VNTCF)
Article 5.3 No code of conduct
Licensing of tobacco retailers
Indoor smoking room allowed in Outdoor smoking anywhere allowed in
Penalties or compound for violating smoke-free
Article 11 Pictorial health warnings (Top 50% front and back) in 2013 • False or misleading descriptors ban
Article 13 Ban on direct tobacco advertising, and promotion • Advertising at POS ban • Person-to-person sale ban • TAPS via internet ban • Partial ban on tobacco
sponsorship and cross border advertising • Corporate social responsibility (Ban on publicity only) • Pack display (Allow 1 pack/carton per brand) • No ban on
sale of cigarette in single sticks • No ban on sale of all types of heated tobacco products, electronic cigarettes, shisha and water pipe
Article 26 Vietnam Tobacco Control Fund
Total budget: USD 16.256 million (VND 375,030 million) for 2020
68
Human resource for tobacco control in ASEAN
Myanmar
3 18
Number of government staff (MOH) working on tobacco control
1
Full-time Part-time
2,700,000
Lao PDR Number of NGOs working on tobacco control
2 Number of smokers per one full time tobacco control staff
2 ≤100,000
412,008*** _
100,001 300,000
_
300,001 500,000
_
500,001 700,000
Vietnam >700,001
27 3
6
577,867
Philippines
Thailand
46****
35 15
20***** 358,696
305,038
Cambodia
Brunei
6 5 Darussalam
2
280,145 12 30
3,253
Malaysia
10
23
487,770
Singapore
29
2
11,138
Indonesia
13* 21**
101
5,053,846
* Full-time tobacco control staff from Food and Drugs Association (FDA) Indonesia.
** Part-time tobacco control staff from Ministry of Health Indonesia.
***The ratio estimate based on number of part-time tobacco control staff.
****Department of Health officers from Substance Abuse Prevention Unit (include tobacco control) and health promotion officers across the region in the Philippines.
*****About half of the NGOs are not solely working on tobacco control issues but on other health-related ones as well.
69
Chapter 5
Human and Financial Resources
for Tobacco Control
Knowledgeable and skilled human resources and effective Generally many countries still lack the necessary structural,
multi-sectoral collaboration at different levels of human, financial, and technical resources to implement
government and society are necessary for effective cost-effective and sustainable tobacco control programmes.
development and implementation of a wide range of Few national governments in ASEAN have a sufficient
tobacco control activities. To this end, the WHO FCTC number of staff working full-time on tobacco control. Both
requires Parties to establish or reinforce and finance a Singapore and Thailand have strong tobacco control
national coordinating mechanism or focal point in order to policies in place with support from a significant number of
develop, implement, periodically update, and review national level tobacco control staff, while other countries in
comprehensive multi-sectoral national tobacco control the region need to build national capacity (human,
strategies, plans and programmes (Articles 5.1 and 5.2). financial, and technical) to carry out effective and
sustainable tobacco control programmes to combat the
tobacco epidemic.
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 Department of Health (Health Promotion Bureau, Disease Prevention and Control Bureau, Yes
Bureau of International Health Cooperation) and the Food and Drug Administration
Singapore Health Promotion Board Yes
Thailand National Tobacco Products Control Committee Yes
Vietnam Vietnam Tobacco Control Fund (VNTCF) Yes
*The focal point is supported by health promotion unit of Ministry of Health.
** Local Government mechanism through Local Tobacco Tax and Excise Sharing Fund.
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 activi-
ties to meet the objectives of the convention.
70
The way forward: Innovative national financing solutions
In many countries tobacco control is often not a national priority. Consequently, domestic resources for WHO FCTC
implementation are far from secure and must compete with other programmes for government funding. An effective way to
address this is the introduction of dedicated surcharge taxes on tobacco and alcohol, which can aid in reducing consumption
of these harmful products and, more importantly, provide a more secure funding stream for health promotion and tobacco
control programmes.
Four out of ten ASEAN countries have established health promotion or tobacco control funds through surcharged taxes
(Thailand, Lao PDR and Vietnam) and treasury budget (Singapore).
Myanmar Tobacco control and health budgets in ASEAN

(2016)
7,385 (MMK 10.08 million) Lao PDR Tobacco control (USD)
0.00014 (MMK 0.19) (2018) < 0.1 million
_
117,740 (LAK 1,004,912,730) 0.1 1 mil
0.017 (LAK 142.3) >1 million
Tobacco control (USD per capita)
Health (USD)
Vietnam
(2020) Health (USD per capita)
16.256 million (VND 375,030 million)

0.17 (VND 3,853)
Philippines
(2021)
Thailand 4.33 billion (PHP 210.2 billion)
(2019) 39.51 (PHP 1,918)
12.6 million
(THB 375 million)
0.18 (THB 5.39)
Brunei
9.822 billion Darussalam
(THB 292.39 billion) Cambodia (2019/2020)
141.1 (THB 4,199) (2018)
11,074 (BND 14,640)*
24,128 (KHR 99 million) 0.025 (BND 0.034)
0.0015 (KHR 6.09) 292.61 million (BND 386,834,340)
672.67 (BND 889.27)
Malaysia
(2021)
120,627 (MYR 500,000)
0.0037 (MYR 0.015)
7.696 billion (MYR 31.9 billion)
237.8 (MYR 985.6)
Quick Health is still not given enough
Indonesia
Singapore
(2019)
Fact priority by government. In
(2020) low-income countries, health
261.71 million**(SGD 352 million) expenditure fell as a share of
7.9627 billion (IDR 111.7 trillion) 45.1 (SGD 60.7) government spending, from
29,112 (IDR 408,375) 8.42 billion (SGD 11.32 billion) 7.9% in 2000 to 6.8% in 2016.
1,451 (SGD 1,951) They became increasingly
reliant on official development
assistance for health.
*The budget use for tobacco related programmes come from the operational budget of Health Promotion Centre, Brunei.
**Budget of USD 261.71 million (SGD 352 million) is for all health promotion programmes and not solely for tobacco control.
71
Tobacco control is under-funded
180 178.94 Governments collect more than USD 250 billion in

(USD per capita)
Per capita excise tax revenue total tobacco excise tax revenues each year worldwide,
160 from tobacco products but spend only around USD 1 billion combined on
Per capita public spending tobacco control – with 95% of this spent by
140 on tobacco control high-income countries.
120
100 Quick Too few resources applied to tobacco control
Fact in low- and middle-income countries.
80
60 Fund currently available from public
spending and foreign assistance: USD 0.019
per capita.
40 34.53
20 Fund needed to implement tobacco control
1.14 0.01 2.39 0.004 “Best Buys” measures: USD 0.11 per capita.
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.
Development assistance for health by programme area for non-communicable diseases

(USD billion)
Unallocable Other infectious diseases
Programme area 93.14 2,402.22
Non-communicable
diseases
Tuberculosis Other health Human resources
1,663.44 focus areas HIV/AIDS 118.30
4,965.44 9,479.42
Health systems
USD USD
strengthening
40,557.47
HSS/ 58.25
SWAPS Others
337.12
735.00
Reproductive and
5,583.40
Billion Billion
(2019)*
Mental health
maternal health (2019)* 155.09
4,840.55
Newborn and Tobacco
child health 66.23
Malaria 8,464.79
2,330.08
*2019 estimates (in USD billion) are preliminary.
All figures are in millions of 2019 US dollars. Development assistance for health
includes both financial and in-kind contributions for activities aimed at improving
Quick The global tobacco control funding gap is currently
health in low- and middle-income countries. This table disaggregates development
assistance for health earmarked for HIV/AIDS; maternal, newborn, and child health;
Fact estimated at USD 27.4 billion.
malaria; tuberculosis; other infectious diseases; non-communicable diseases; and The current average annual amount of domestic
health systems strengthening and sector-wide approaches. "Other health focus funding for tobacco control per country is USD 15
areas" captures development assistance for health for which we have health focus
area information but which is not identified as being allocated to any of the health million, half of what’s needed to scale-up the FCTC
focus areas listed. Contributions from remaining channels are shown as unallocable policies implementation.
by disease.
72
Earmarked taxes: A global view
Iceland
Estonia*
Ireland* Lithuania
Switzerland*
Mongolia
United States of America Republic of Korea*
Morocco Iran
Algeria Nepal
Egypt Thailand* Lao PDR
Guatemala India
Mauritania Philippines
El Salvador Jamaica Cabo Verde Chad
Costa Rica Bangladesh Vietnam*
Panama Venezuela Benin
Colombia Palau
Côte d'Ivoire
Gabon Maldives
Comoros Indonesia
Around 39 countries Paraguay Botswana

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
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 3 rd 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
Quick In low income countries, health expenditure fell as a share of government spending, from 7.9% in
Fact 2000 to 6.8% in 2016.
In low income countries, average government spending per head increased from USD7 in 2000 to
just USD9 in 2016.
In lower middle income countries, government health spending as a share of general expenditure
grew in real terms from only 7.6% in 2000 to 8.3% in 2016. In low income countries, health
expenditure fell as a share of government spending, from 7.9% in 2000 to 6.8% in 2016.
73
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 115,942 (BND 160,000)* (2017-2018)

189,107 (BND 250,000)* (2019-2020)
Singapore Health Promotion Board 2001 183.33 million (SGD 253 million)** (2017)
185.61 million (SGD 245 million)** (2018)
261.71 million (SGD 352 million)** (2019)
Philippines Department of Health budget 2012 85% of incremental sin tax revenue earmarked for health
(RA 10351) • 80% for Universal health coverage
Philippine Health Insurance Corporation • 20% for medical assistance and health enhancement
facilities programme
2019 Tobacco products
(RA 11467) 50% of the total revenues collected are earmarked for health
• 80% for Universal health coverage
• 20% for medical assistance and health enhancement
facilities programme
Heated tobacco products (HTPs) and vapor products
100% of the total revenues collected from the excise taxes
on HTPs (and vapor products)
• 60% for universal health coverage
• 20% for medical assistance and health facilities
enhancement programme
• 20% for Sustainable Development Goals (SDGs)
Lao PDR Tobacco Control Fund 2013 2% profit tax plus LAK 200 (per pack)
116,700 (LAK 945,266,000)*** (2017)
Earmarked Surcharge Tax
117,740 (LAK 1,004,912,730)*** (2018)

Thai Health Promotion Foundation 2001 2% surcharge levied on excise tax from alcohol and tobacco
(ThaiHealth) 121.12 million (THB 4,275.7 million) (2016)
128.97 million (THB 4,372.1 million) (2017)
118.65 million (THB 3,550 million) (2020)
Vietnam Tobacco Control Fund 2013 1% excise tax, effective 1st May 2013;
1.5% from 1st May 2016; and
2% from 1st May 2019
11.263 million (VND 260,970 million) (2019)
16.256 million (VND 375,030 million) (2020)
Malaysian Health Promotion Board 2006 1.65 million (MYR 7.1 million) (2017)
National Treasury
Allocation
(MySihat)**** 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 and not solely for tobacco control.
***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.
**** In June 2018, Health Minister Dr Dzulkefly Ahmad announced a cabinet decision to abolish MySihat as part of the government’s rationalisation plan.
*****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 National Health
Insurance (Jaminan Kesehatan Nasional (JKN)) program, 25% for health services and law enforcement).
74
Chapter 5: Human and Financial Resources for Tobacco Control
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 Promotion Autonomous Board of Governors Cabinet and to
Foundation (ThaiHealth) agency and chaired by both houses of
(2001) Prime Minister Parliament
Singapore Health Statutory Board Board of Directors Minister of Health
Promotion Board (2001) under MOH and chaired by and Parliament
independent
Chairman
Vietnam Tobacco Control Semi-autonomous Inter-sectoral Government and
Fund (2013) agency and a unit Management Board National Assembly
in MOH chaired by Minister
of Health
Lao PDR Tobacco Control Unit in MOH Tobacco Control National Tobacco
Fund (2013) Fund Council Control Committee
(National Tobacco and Government
Control Committee)
_
Thailand: Annual budget for health (2010 2020) ThaiHealth budget as
percentage of combined
1.93 1.80 1.78 1.83 1.84 1.83 1.49 1.45 1.48 1.43 1.08 MoPH budget + Fund for
National Health Security (%)
350,000
( Baht million)
MoPH+Fund for the

300,516.7 327,616.15 National Health Security
300,000 286,694.3 318,326.38
310,244.95
250,000
221,279.60
208,532.70
199,810.90 224,621.90
200,000 187,962.40 190,366.0 Fund for the
181,584.1
169,752.4 175,559.8 National Health Security
161,010.20 163,152.2
150,000
Ministry of Public Health
108,744.50 115,176.70 114,963.60 134,685.15 136,742.28 137,250.15 (MoPH)
101,057.90 107,814.10 130.764.3
89,384.80 123,542.1
100,000 109,658.30
99,788.20 106,102.90
86,904.50 91,996.80
71,625.40
50,000
3,110.3 3,391.77 3,561.27 3,811.55 4,064.74 4,111.31 4,275.7 4,372.1 4,610.5 4,560.7 3,550
ThaiHealth
0 Fiscal Year
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
75
_
Thaihealth funding for selected major NCDs risks reduction programmes (2017 2020)
25
(USD million)
24.5 23.6
22.6
21.9
20 Health Literacy
Promotion + Healthy
18 19.3 Media System and
16.9 Spiritual Health
Pathway Promotion
15
14.1 Healthy Community
Strengthening
11.5
11.2 10.5
11.5
10 9.9
8.4 9.9
7.8 8.3 8.3 Alcohol
7.6 7.1 6.7 7.9 Tobacco
7.1 6.7 Traffic accident
6.4
5 5.4 4.8 Physical activity
4.2 Diet/ Nutrition
0
2017 2018 2019 2020
VNTCF: Fund distribution for tobacco control programmes (2019/2020)

4.4%
5.4% supporting the cost of administration and performance of VNTCF
improving and strengthening tobacco cessation service
quit line and consultancy service in all health settings
0.6%
contingence
1.4%
capacity building on network of 37%
tobacco control collaborators awareness raising among policy
makers and the public on the tobacco
5.3% harms and tobacco control law
implementing research serving for
tobacco control programs
43.9%
2% disseminating smoke-free models in
strengthen inspection and supervision state agencies and provinces/cities
of the Tobacco Control Law
Between 2019 and 2020, 100 grantees were funded by VNTCF with a total funding of USD 27.568
million (VND 636,000 million) distributed among 23 ministries, mass organization agencies, 63
provinces/cities agencies, 4 tourism cities and 10 hospitals. The projects supported mainly on
communication campaigns related to tobacco prevention and control, smoke-free development, and
capacity building for law enforcement.
76
Myanmar
Yes
Guidelines on contact with
Implementation of FCTC Article 5.3 in ASEAN
cigar and tobacco product
manufacturer, distributor, Lao PDR Code of conduct, guidelines, or other policy
seller or related person
apply to Ministry of Health Yes Preventive measures
only. Tobacco control code of conduct
between health sector and Limited to issuing authority
tobacco industry for health Apply to the whole bureaucracy
professional apply to Ministry of
Heath only.
Vietnam* Philippines
No
Yes
Implementation of code of
conduct (Joint Memorandum
Thailand Circular 2010-01 (JMC)) that is
enforced by the whole of
Yes government.
The ministerial regulation
(code of conduct) or
guidelines only apply to
its Ministry of Health.
Cambodia
Brunei
Yes Darussalam*
The circular of the Ministry of Education, Youth, and
Sport bans all forms of partnerships with tobacco Yes
industry among educational facilities. The code of conduct circular on
prohibition of involvement with
Malaysia The Sub-decree on establishment and functioning of the tobacco industry that applies
the Committee for Tobacco Control (CFTC) has to all government agencies.
No incorporated principles of Article 5.3.
Singapore
Yes
Implementation of internal
code of conduct that is
enforced by the whole
government.
Indonesia
Yes
The ministerial regulation (code of conduct) or guidelines only apply to its Ministry of Health.
The Minister of Education and Culture guidelines rejecting any form of partnerships with
tobacco industry and supporting tobacco-free school premises.
*In 2017, Ministry of Health issued an Official Letter cautioning all ministries and local government
offices on non-cooperation with PMI-funded Foundation for a Smoke-free World (FSFW) and in 2019.
MOH also issued a circular that aims to safeguard the drafting process for policies and legal
documents to reduce interference from other units with conflicts of interests.
77
Chapter 6
Insulating Public Health Policies
from Industry Interference
The tobacco industry is not like any other business. Despite Article 5.3 of the WHO FCTC requires Parties, when setting
selling a highly addictive and inherently defective product and implementing their public health policies with respect
that kills up to two thirds of its consumers, it continues to to tobacco control, to protect these policies from commercial
escape commensurately stringent regulation of its business and other vested interests of the tobacco industry in
and products by interfering at all levels of tobacco control accordance with national law. By unanimously adopting the
policy development and implementation. Through both WHO FCTC Article 5.3 Guidelines at the third session of
overt and covert means, the industry uses its massive the Conference of the Parties (COP3) in 2008, Parties to the
resources to deter and thwart governments' efforts from treaty formally recognized the irreconcilable conflict
implementing effective tobacco control measures and between the tobacco industry’s interests and public health
protecting public health policies. Tobacco industry policy interests.
interference remains a major problem in the ASEAN region
as in other parts of the world. Within ASEAN, eight countries (Brunei, Cambodia,
Indonesia, Lao PDR, Myanmar, Philippines, Singapore and
The tobacco industry employs an extensive range of Thailand) have taken concrete steps to protect their public
unethical and intentionally orchestrated tactics and health policies from tobacco industry interference by
strategies, at both the country level and internationally, to developing a policy, guidelines, or a code of conduct to
directly and indirectly challenge, defeat, discredit, dilute, prevent unnecessary interactions with the industry and
obstruct, delay and circumvent implementation of effective ensure transparency of any interactions that do occur, while
tobacco control measures. These include political lobbying Malaysia and Vietnam still have to institute similar
to manipulate and hijack the political and legislative process preventive measures in line with the Article 5.3 Guidelines.
through drafting and distributing industry-friendly Only Brunei, Philippines and Singapore introduce a
legislation, providing incentives to government officials and whole-of-government code of conduct or policy that
politicians to take a pro-industry position, and hiring former prohibits unnecessary government interactions with the
prominent government officials or appointing them to be tobacco industry.
tobacco industry spokespersons or board members. Other
tactics include intimidating governments and individuals Regardless of such actions taken, there has been increasing
with litigation or threat of legal suit, mobilizing front groups industry interference in many countries, and this is expected
to advance its cause, and making false claims and spreading to continue into the future. Hence there remains much
half-truths and misinformation through position papers, room to institute or strengthen mechanisms at the highest
news items, posters, and paid ads. levels to prevent or reduce such industry interference in
tobacco control.
Tobacco companies’ timeline of public deception

For decades, the tobacco industry has deceived the public for purposes of gaining more profit.
1950s 1960s 1970s 1980s 1990s

Harms of smoking Addictiveness of Link of smoking to cancer Harms of Dangers of tobacco’s youth
Concealed evidence smoking and nicotine Spent enormous amount of secoundhand smoke smoking prevention campaigns
that cigarettes Concealed evidence that resources on disinformation Hired “independent’ Aimed programs not at reducing
cause cancer while cigarettes are highly campaigns and propaganda scientists to support youth smoking but at harnessing
marketing products addictive and in the 90s, to negate and deflect the industry studies and “positive feelings” for tobacco
as safe swore under oath to science clearly linking questioned smoke-free companies
deny it smoking to cancer policies
2000s
Benefits of smoking “light” and “mild” Supporting WHO FCTC
Misled the public that products are safer, use light/mild cigarettes to leverage Falsely claimed that it is supportive of the WHO FCTC but in its internal
on smokers’ health concern to increase sales, and even designed new products documents, called the measures compliant with FCTC as “extreme”
that increase nicotine intake
78
Chapter 6: Insulating Public Health Policies from Industry Interference
Global Center for Good Governance in Tobacco Control (GGTC)

The Global Center for Good Governance in Tobacco Control was designated
by the FCTC Secretariat to serve as the Knowledge Hub for Article 5.3 to
support implementation of the Convention’s obligation on protecting
against tobacco industry. In 2019, the Knowledge Hub for Article 5.3
(GGTC) provided technical support to at least 12 countries in 8 regions to
advance Article 5.3 implementation: Setting up Tobacco Industry
Observatories and disseminating tools to counter tobacco industry tactics.
Monitoring center
The Monitoring Centers in Egypt, Ukraine, and Bangladesh joined the

network of Observatories and Monitoring Centers established to
monitor and identify tobacco industry tactics all over the world.
Observatory Monitoring
PROGGA
progga.org
Life Advocacy Centre
center-life.org
Egypt Tobacco Control Observatory Southeast Asia Tobacco

egypttobaccoobservatory.com Control Alliance (SEATCA)
tobaccowatch.seatca.org
Africa Tobacco Control

Consortium (ATCC)
Centre for Studies on Tobacco atca-africa.org Centre for Combating
and Health, National School of Tobacco (CCT),
Public Health Sergio Arouca da Faculty of Medicine
Fiocruz (Cetab/Ensp/Fiocruz)* Africa Centre for Tobacco Industry University of Colombo
observatoriotabaco.ensp.fiocruz.br Monitoring & Policy Research (ATIM), tobaccounmasked.com
Sefako Makgatho Health Sciences University
atim.co.za
Quick International Organizations such as the UN Economic and Social Council (ECOSOC), United
Fact Nations Global Compact (UNGC) WHO, United Nations (UN) and United Nations Development
Programme (UNDP) and UNESCO, have adopted or developed policies to be consistent with or
to support the Implementation of WHO FCTC Article 5.3. It aims to address tobacco industry
interference, and have the legal personality and medium to influence governments and
international bodies.
...................................................................
Globally, there are 36 countries have adopted good practices and measures to
prevent tobacco industry interference in the development and implementation of
public health policies with respect to tobacco control in accordance with the
recommendations provided by the Article 5.3 Guidelines.
79
Implementation of FCTC Article 5.3 in ASEAN

Industry interference in policy development
The tobacco industry (TI) works to defeat, dilute, and delay effective tobacco control policy. They participate in different
stages of policy development in order to undermine any stringent measure a government may propose.
Brunei Cambodia Myanmar Thailand

Brunei, Cambodia, and Thailand do not accept or endorse policy or legislative drafts by or in collaboration with
the tobacco industry, nor invite the tobacco industry to sit at meetings where policies are decided.
Brunei, Cambodia, Myanmar, and Thailand do not allow the TI to sit in inter-ministerial or committee meetings
on implementing the FCTC.
Industry-related CSR activities

Tobacco companies are re-branding themselves as “socially responsible” and a “legitimate partner” for social and development
causes. 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.
The industry engages with non-health government sectors such as sports, education, environment, welfare and development,
and law enforcement to whitewash its business agenda and dissociate its corporate image from the health harms caused by the
products it manufactures and sells.
Brunei Cambodia Lao PDR Myanmar Singapore Thailand Vietnam

Among ASEAN countries, only Brunei, Lao PDR, Myanmar, and Thailand have banned all tobacco-related CSR
activities, while Cambodia, Singapore, and Vietnam have banned the publicity of these activities.
Benefits to the tobacco industry

Except in Brunei and Vietnam, the tobacco industry continues to receive benefits in a variety of ways in most countries
because their governments still associate economic value in the tobacco industry’s business portfolio. Because of this
preconception, the tobacco industry gains political capital to influence policies to its advantage.
Cambodia Indonesia Malaysia Thailand

Delay in implementation of stronger tobacco control measures was accommodated in
Cambodia deferred the adoption of the Joint Prakas between the MOF and MOH to implement the Tobacco
Control Law’s penalties (fines).
Indonesia cancelled the scheduled 2019 tobacco tax increases and revoked the tobacco excise simplification
roadmap.
Malaysia deferred tax increases for 2019, introduction of standardized packaging, imposing retail licenses for
tobacco product sellers, and banning all ENDS and electronic non-nicotine delivery system (ENNDS)) pending
since 2016.
Thailand deferred to 2021 the excise tax increase from 20% to 40% scheduled in 2019.
80
Forms of unnecessary interaction

Unnecessary interactions between government personnel and the tobacco industry still occur. With the exception of Brunei,
all countries have documentation of such interactions that include senior government officials attending social functions with
or accepting assistance and offers of partnerships from the tobacco industry.
Cambodia Indonesia Lao PDR Malaysia Philippines Thailand Vietnam

Unnecessary interactions
• Attending social functions and junkets
Malaysia Deputy Minister of International Trade and Industry attended an event by the American Malaysian
Chamber of Commerce (AmCham) - PMI was a major sponsor.
During the 74th UN General Assembly, the US-ASEAN Business Council (US-ABC) (PMI sits on its Board) and
the US Chamber of Commerce held separate dinner receptions for the Prime Minister of Malaysia and Thailand
together with their entourage of high-level officials.
A group of Philippines legislators, including the chairs of the Committee on Health and Committee on Trade and
Industry in the House of Representatives, went on a study tour to the UK. They met a Member of Parliament,
David Amess who is a supporter of PMI’s “Unsmoke Your World” campaign: and visited an IQOS shop escorted
by PMFTC’s Manager of Fiscal and Government Relations.
In Vietnam, anniversary celebrations of Vinataba and other tobacco companies are attended by senior officials
from the MOIT, Central Communist Party, and Commission for the Management of State Capital at Enterprises.
• Accepting assistance and offers of partnerships

Cambodia Minister of Information met with the Chair of China Huaxin Group to discuss a tobacco farming
investment worth USD 2 billion.
Indonesia, Lao PDR, Malaysia, Philippines, and Vietnam have accepted assistance from the tobacco industry to
conduct anti-smuggling activities in the country.
Greater transparency needed

Most governments have no procedures in place for the disclosure of meetings and interactions with the tobacco industry or
about entities, affiliates organizations and individuals acting on the industry’s behalf such as lobbyists. While the tobacco
industry can communicate with the government regarding its business, systematic recordkeeping to document what transpires
or how the industry’s agenda might impact policy (such as when the meetings take place, their purposes, or the contents and
outcomes of such meetings) remains lacking.
Malaysia Myanmar Philippines Thailand 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 full information about
meetings of other agencies with the tobacco industry. For example, while there are social media sightings and
anecdotal information of different interactions between the tobacco industry and government agencies, the CSC
reports that it has not received any documents or disclosure of any meetings or interactions as required by the JMC.
Governments of Malaysia, Thailand, and Vietnam continue to interact (either in closed-door meetings or open
interactions in) with the tobacco industry; however, details of these interactions are not accessible or made
transparent to the public.
continued
81
Myanmar Philippines
There are certain domestic laws/regulations in all countries that require the tobacco industry to register aspects of
its business operations (such as manufacturing, trading, revenues) in order to operate. For example, in Myanmar,
a Special Goods Tax Law requires all manufacturing facilities and distribution chains to register with the
government, while in the Philippines, corporate and business entities are also required to register with the BIR and
Securities and Exchange Commission (SEC) to operate.
Conflicts of interest
Brunei Lao PDR Vietnam

One way the tobacco industry gains influence with governments is by subscribing to a patronage system –
exchanging contributions for candidates, parties, and their election campaigns for political support. Brunei
prohibits political contributions from the tobacco industry and political campaigns do not take place in Lao PDR
and Vietnam because of their unitary/single party governments.
Philippines Thailand
In the Philippines (through individuals including industry representatives) and Thailand (with certain monetary
limits) the tobacco industry is still allowed to give political contributions.
Cambodia Indonesia Lao PDR Philippines Thailand Vietnam

Another way the tobacco industry influences public policy and creates conflict of interest situations is through the
“revolving door”, where politicians or civil servants take up jobs as lobbyists or consultants in the area of their
former public service or where former private sector employees accept government positions that regulate the sector
they were once a part of. Revolving doors may undermine trust in governments because of the potential for real or
perceived conflicts of interests regarding matters of the state.
Country Current/ former public service/ private sector employees Position/part of

Cambodia President of the LYP Group (owner of cigarette company Hero King) Senator
Indonesia Director of Beverage Industry, Tobacco Products and Refresher Materials, Indonesian Cigarette Manufacturers’
and the Head of Data and Information Center Association (GAPPRI)
Lao PDR Vice Minister of Ministry of Industry and Commerce (MOIC) Chair of the LTL Board
MOF and MOIC representatives Board of Management
Philippines Former Chief Justice and former Governor of the Philippine Central Bank Board of Trustees of Tan Yan Kee Foundation
Thailand CEO of Tobacco Authority of Thailand (TOAT) Government official
Vietnam Ministry of Industry and Trade (MOIT) officials Vinataba
82
Preventive measures
Article 5.3 details guidelines to protect against interference, not only by the tobacco industry but also by entities working in
its behalf. Two elements are essential for achieving this outcome: a) governments need information about the industry’s
activities and practices to ensure transparency and accountability; and b) a code of conduct for the bureaucracy prescribing
the standards they should comply with in their interactions with the tobacco industry or its representatives.
Brunei Cambodia Indonesia Malaysia Myanmar Philippines Thailand Vietnam

Brunei, Philippines, and Thailand are leading the way in implementing a code of conduct for the bureaucracy
prescribing the standards they should comply with in their interactions with the tobacco industry or its
representatives.
Cambodia, Indonesia, Malaysia, Myanmar, Philippines, 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.
Country Preventive measures limited to issuing authority Position/part of
Brunei Prime Minister Circular (code of conduct) –

Prohibition of involvement of the tobacco
industry and smoking in government premises
Prevention of Corruption Act*
Cambodia Ministry of Education, Youth, and Sport Circular on ban all forms of Law on Anti-Corruption*
partnerships with tobacco industry among educational facilities including
ban the use, advertisement, and display and sale of tobacco and alcohol
products within campuses of public and private educational facilities
Indonesia Ministry of Health Guidelines for Managing Conflicts of Interest with the Ministry of Administrative and Bureaucratic
Tobacco Industry within the Health Ministry Reforms Guidelines for Managing Conflict of
Interest*
Several anti-corruption laws*
Lao PDR Ministry of Health Tobacco Control Code of Conduct between Law on Anti-corruption*
Government Health Sector and Tobacco Industry
Malaysia Anti-corruption Commission Act*
Myanmar Ministry of Health and Sports Guidelines on contact with cigar and Anti-corruption Code of Ethics for Companies
tobacco product manufacturer, distributor, seller or related person and Corporate Bodies*
continued
83
Philippines Thailand Vietnam
Country Preventive measures limited to issuing authority Position/part of
Philippines • Department of Education (DepEd) Order No. 6, s. 2012 – Civil Service Commission-Department of Health
guidelines against tobacco industry interference Joint Memorandum Circular (JMC) 2010-01
• Department of Labor and Employment (DOLE) Memorandum
(30 April 2012) – reiterates the JMC Code of Conduct and Ethical Standards for
• Bureau of Internal Revenue (BIR) Memorandum Order No. 16-2012 - Public Officials and Employees*
restricts interactions with the tobacco industry
• Department of Foreign Affairs (DFA) Memorandum (24 May 2013) – Anti-graft and Corrupt Practices Act*
directs compliance with the JMC
• Metro Manila Development Authority (MMDA) Memorandum
(20 August 2013) – amends the Code of Conduct to include protection
against tobacco industry interference
• Department of Social Welfare and Development (DSWD) Administrative
Order No. 11-2019 - guidelines against tobacco industry interference
• Food and Drug Administration (FDA) Advisory No. 2019-501 -
reminds public physicians to follow the JMC and avoid interaction
with the tobacco and electronic nicotine delivery systems (ENDS)
industry
Thailand Ministry of Public Health Guidelines on Interaction with Tobacco Office of Civil Service Commission Regulation
Entrepreneurs and Related Persons
Several anti-corruption laws*
Vietnam Ministry of Health Official Letter to other

ministries, mass organizations, and the people's
committees of the provinces and municipality
on non-cooperation with Smoke-free World
Foundation funded by PMI
Anti-corruption Law*
* Not specific to the tobacco industry.
Quick Foundation for a Smoke-Free World (FSFW) and its relationship with the tobacco industry
Fact In 2017, Philip Morris International (PMI) announced its financial support (USD 960 million for
12 years) for the establishment of the Foundation for a Smoke-Free World (FSFW), whose
purported goal is to “eliminate smoking.” This wholly PMI-funded foundation presents itself as a
tobacco control organization, but, unsurprisingly, its definition of “smoke-free” is fully aligned
with PMI’s “smokefree future” -- not eliminating tobacco use but switching smokers to so-called
less harmful alternatives like electronic nicotine delivery systems (ENDS, also known as
e-cigarettes).
For more detailed information, please visit http://tobaccowatch.seatca.org and refer to Tobacco Industry Interference Index
(2020); 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).
84
Myanmar
Prices of most popular cigarette brands in ASEAN
Red Ruby 1.79 (MMK 2,500)
Most popular foreign brand (USD/pack)
Marlboro 3.21 (MMK 4,500)
Lao PDR
Most popular local brand (USD/pack)
Adeng 0.85 (LAK 8,000) Less than USD 1
Marlboro 1.60 (LAK 15,000)
USD 1–USD 2.90
USD 3–USD 4.90
USD 5 and above*
Vietnam
Thang Long 0.43 (VND 10,000)
State Express 555 Gold 1.37 (VND 31,500)
Thailand
Philippines
SMS 1.92 (THB 60) Fortune 2.29 (PHP 111)
L&M 1.92 (THB 60) Marlboro 3.19 (PHP 155)
Cambodia
Brunei
ARA 0.62 (KHR 2,500) Darussalam
FINE 1.00 (KHR 4,000)
Djarum Super**
5.11 (BND 4.10)
Malaysia
Dunhill 4.2 (MYR 17.4)
Dunhill 4.2 (MYR 17.4)
Singapore
Marlboro 10.42 (SGD 14)
Three countries (Cambodia, Lao PDR and

Indonesia Vietnam) have the lowest cigarette price (less
than USD 1 per pack).
A Mild [16 sticks] 1.75 (IDR 25,500)
Marlboro [20 stciks] 2.06 (IDR 29,900) Only Singapore has the highest cigarette price
(more than USD 10 per pack).
* Djarum Super (Brunei) and Marlboro (Singapore) are most popular foreign brand.
** 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.
85
Chapter 7
Reducing Tobacco Affordability
and Consumption
Excise tax increases that significantly raise tobacco product continually reduce affordability of tobacco products. This
prices and reduce their affordability are among the most also means strengthening tobacco tax administration
effective fiscal measures to reduce tobacco consumption (licensing, warehousing, anti-forestalling, fiscal markings,
(and thereby its adverse health consequences) by and enforcement), considering dedicating tobacco tax
discouraging purchase of tobacco products, thereby revenues to tobacco control programmes, and prohibiting or
encouraging tobacco cessation and preventing tobacco restricting tax/duty-free sales of tobacco products.
uptake among various segments of the population, in
particular price-sensitive young people and the poor. This chapter provides an overview of the tobacco tax
Tobacco taxes can therefore have large aggregate benefits for situation in ASEAN countries, where tax policies have been
public health and socio-economic development, primarily strengthened in some countries, but require more
through healthier and more productive populations and improvements in others. Thailand has the highest tax
reduced healthcare costs, reducing poverty, and providing a burden as a percentage of retail price (78.6%), followed
reliable source of government revenues. For these reasons, closely by Philippines (71.3%) and Singapore (67.5%). These
tobacco tax increases are described as a win-win policy countries are good examples where tax increases have
measure, i.e. a highly cost-effective WHO “best buy” public contributed to a decline in smoking prevalence rates
health intervention and a reliable source of domestic alongside higher tobacco tax revenues. Most countries also
financing. do not have any long-term tobacco tax policies with regularly
evaluated fiscal and public health targets. Cigarette prices
The World Bank has recommended that the total tax burden remain affordable and relatively low throughout the region,
should be 66% to 80% of the retail price, and more recently, particularly in Cambodia, Lao PDR, and Vietnam (less than
the WHO has recommended that at least 70% of retail price USD 1 per pack) where regular tax increases are needed to
should be excise. The current global guidance for tobacco keep pace with economic and income growth.
taxation, however, remains to be WHO FCTC Article 6 and
its implementation guidelines (adopted by the WHO FCTC In the case of Lao PDR, the government’s lopsided
COP in 2014), which recommend that governments should Investment License Agreement (2001-2026) with Imperial
adopt long-term tax and price policies that meet both their Brands prevents the Lao government from benefiting, as the
public health and fiscal needs. government continues to lose millions in tobacco tax
revenues (see page 19) while being unable to reduce tobacco
This means applying specific or mixed (specific and ad use.
valorem) taxes on all tobacco products, taxing all tobacco
products in a similar way (to reduce the potential for product
substitution), and regularly increasing tax rates so as to
Quick Generally, cigarette prices remain affordable and relatively low throughout the
Fact region, but particularly in Cambodia, Lao PDR, and Vietnam (less than USD 1 per
pack) where regular tax increases are needed to keep pace with economic and income
growth.
86
Cigarette affordability: Affordability of the most sold brand of cigarettes (2020), globally
In most countries,
cigarettes are still
affordable.
Myanmar 5.84%
Thailand 2.69%
% of GDP per capita Lao PDR 2.88%
required to purchase
2000 cigarettes of the Vietnam 2.63%
most sold brand Philippines 5.95%
<1 Indonesia 5.19%
1–5
5.1–10 Singapore 1.74%
10.1–15 Malaysia 4.08%
15.1–20 Cambodia 3.25%
20.1–25
>25
Cigarette affordability: Relative Income Prices (RIP)*of cigarettes in ASEAN

16.25
16
• The lower the RIP, the more
affordable cigarettes are.
11.56
• Cigarettes have become more
11.43 affordable in ASEAN countries between
2000-2018, a significant decline in RIP
(apply for the most popular brand) since
10 early 2000. This was more drastic in Lao
PDR and Vietnam.
• Although the RIP in the Philippines

8.12
showed sharply reduced affordability
7.69
from 2013-2016 as a result of the 2012
Sin Tax Reform, affordability has
gradually increased since 2018.
5.82
4.8
5 4.67
4.14 4.26 Myanmar
3.87 3.94 Indonesia
3.93 3.35 Lao PDR
3.85 3.19 Philippines
3.09 Vietnam
2.83 3.04 Cambodia
2.03 1.83 2.43 Thailand
1.64 Brunei
1.62 Singapore
1.41
0.4 0.51
0
2000 2002 2004 2006 2008 2010 2012 2014 2016 2018 2019
* Relative Income Price (RIP) refers to percentage of per capita GDP required to purchase 100 packs of cigarettes.
87
Prices of most popular cigarette brand

(USD)
12
Marlboro
Most popular local brand 10.42
Most popular foreign brand 10
10 Price that stop youth from smoking*
8 State
Express
Djarum FINE Marlboro Marlboro Marlboro Marlboro L&M 555 Gold
Super** 1.00 2.13 1.6 3.21 3.19 1.93 1.37
6
5.11 5***
Dunhill Dunhill
4.2 4.2
4
Red Fortune >3
2.5 A-Mild Ruby 2.29 SMS
1.75 1.79 1.92
2 Adeng Thang
ARA >1.1 Long
0.62 0.85
0.43
0
*Findings from youth opinion survey on cigarette prices in five ASEAN countries conducted in 2017. Respondents were aged 13-24 years.
** Djarum Super was the most popular brand prior to 2014. There are no licensed tobacco importers and retailers in Brunei since May 2014.
***The study was conducted among Indonesians aged between 14 -78.
Tobacco tax burden as percentage of cigarette retail price in ASEAN

(%)
80 78.6
71.3 Thailand currently has
70 67.5 the highest tax burden
62 63.5 as a percentage of retail
58.6 50–60
60 price (78.6%), followed
closely by Philippines
(71.3%) and Singapore
50 (67.5%).
40 36.7
25–31.1
30
18.8
20
10
0
Brunei* Cambodia Indonesia Lao PDR Malaysia** Myanmar Philippines Singapore** Thailand Vietnam
* There are no licensed tobacco importers and retailers in Brunei since May 2014. Hence, there are no cigarettes being sold legally in the country.
**The estimate was calculated based on premium cigarette brand.
88
Cigarette tax systems in ASEAN
Country Excise rate VAT Import tariffs Others
Brunei BND 0.50/stick None None N/A
Specific Tax
Indonesia IDR 110–865/stick (10 tiers) 9.1% 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 N/A
Myanmar MMK 9–26/stick N/A 30% on CIF 5% commercial tax for import, sale
(4 tiers) and export of tobacco and tobacco
products
1% special excise duty, income tax
and import duties are also charged
on raw tobacco and materials for
cigarettes
Philippines PHP 50.00/pack on 1 January 2021; 12% 0%–10%
PHP 55.00/pack on 1 January 2022;
PHP 60.00/pack on 1 January 2023;
and 5% annual increase beginning on
1 January 2024
Singapore SGD 0.427/stick 7% None
Lao PDR** 15%–30% of production cost 10% Flat rate of USD 0.40/pack Royalty fee 5% of production cost
Mixed System
plus LAK 600/pack additional

specific tax (in practice) Compulsory contribution to Lao PDR
Tobacco Control Fund: 2% of profit
50% of wholesale price plus tax and LAK 200/pack
LAK 600/pack additional specific
tax (by law)
Thailand 20% Ad valorem rate of 7% Exempted but other local taxes Provincial Administration
suggested retail price (SRP) less are applied Organization tax of THB 1.86/pack
than/equal to 60 THB/pack and
1.2 THB/stick*** ThaiHealth tax at 2% of excise tax
40% Ad valorem rate of SRP TV tax at 1.5% of excise tax
more than 60 THB/pack and THB Sport tax at 2% of excise tax
1.2/stick***
Interior tax at 10% of excise
Senior citizen fund tax at 2% of excise
Cambodia 20% of 90% of invoice price 10% 7%–35% plus Public lighting tax 3% of invoice value,
Ad Valorem Tax
10% import VAT Profit tax 20% of profit, Turnover tax

2% of invoice value
Vietnam 75%of ex-factory price 10% 30-135% Compulsory contribution to Vietnam
Tobacco Control Fund:
30% applies on tobacco materials 1% of taxable price (1 May 2013);
including tobacco leaves and other 1.5% of taxable price (1 May 2016);
materials 2% of taxable price (1 May 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. Lao Tobacco Company (LTC) stops paying specific tax LAK 600 per pack since September 2019.
***These rates have been applied from 16 September 2017 to present. A single rate of 40% of SRP and THB 1.2/stick was scheduled to be applied from 1 October 2019 onwards; however,
because of tobacco industry opposition, enforcement was postponed indefinitely.
89
Implementation of FCTC Article 6 Guidelines While some countries

• Have regular adjustment processes or procedures for periodic revaluation of tobacco tax levels. have made significant
progress in implementing
tobacco tax policies, the
region as whole is
advancing very slowly.
Indonesia Myanmar Philippines Singapore
• Have long-term policies on the tobacco taxation structure with regular monitoring and adjustments.
Lao PDR Myanmar Philippines Thailand
• Have had tax increases that are discouraging consumption.
Brunei Indonesia Philippines Singapore Thailand
• Dedicate tobacco tax revenues to tobacco control/health promotion programmes.
Lao PDR Thailand Vietnam
• Have a procedure/policy that protects tobacco tax and price policies from commercial and other vested interests of the tobacco industry.
Brunei Philippines
Quick In Malaysia, an excise duty of 10% on all smoking devices—both electronic and non-electronic
Fact cigarettes including vape, electronic heated tobacco products, and traditional tobacco devices
such as hookah/shisha and smoking pipes; while excise duty of MYR 0.40 (USD 0.10) per
milliliter imposed on non-nicotine liquid used in electronic cigarettes (vape juice), effective on
1 January 2021.
In Malaysia, there was no tax increase on tobacco following statements from the tobacco
industry that it will worsen smuggling. The last tax increased was in 2015.
In Indonesia, while value-added tax (VAT) for all consumer products is 10%, cigarettes
have been given a discount for many years at only 8.4%. In 2015, the VAT for tobacco
was raised slightly to 8.7%, which is still not the full amount. The government
continues to accommodate demands from the tobacco industry to provide more time
for implementation or delay the regulation of tobacco control as seen in not acceding
to the FCTC.
Thailand has also awarded tax exemption for native tobacco leaves, while Cambodia export tax was exempted for
registered farmers producing more than 3,000 tons of tobacco leaf.
Vietnam government accommodated requests from the tobacco industry, which argued for lower tax rate and
delayed the date of its implementation by one (1) year.
90
Chapter 7: Reducing Tobacco Affordability and Consumption
Tobacco tax administration in ASEAN
Philippines
Singapore
Cambodia
Indonesia
Myanmar
Malaysia
Thailand
Lao PDR
Vietnam
Brunei*
Authorization/licensing
Requires a license or control system on the manufacture N/A

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. N/A
Requires license for 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.
Quick Thailand enforces a license or control system on the whole tobacco supply chain. All
Fact other countries in ASEAN require licensing for only some parts of the supply chain,
thereby allowing loopholes for tax evasion and illicit trade.
Licensing of tobacco retailers in ASEAN

Country Cost of license (USD/year) Country Cost of license (USD/year)
_ _
Brunei* 222 (BND 300) _ 2008 Singapore** 272.73 (SGD 360) _ 2010
444 (BND 600) 2015 297.62 (SGD 400) 2016
Cambodia No Thailand 3.20 – 16.0 (THB 100 – 500)***
Indonesia No Vietnam Fee for assessment and recognition:
In city and urban level: 52 (VND 1,200,000)
Lao PDR No In district level: 26 (VND 600,000)
Malaysia No Fee for licensing:
In city and urban level: 8.67 (VND 200,000)
Myanmar No In district level: 4.33 (VND 100,000)
Philippines No
* 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
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.
***Two types of tobacco retail licensing (VAT- THB 500) and (Non VAT- THB 100) registrant retailers.
In Malaysia, a public consultation on licensing of cigarette retailers was carried out

early in the year but following protests from retailer groups there was no decision.
91
Tax all tobacco products: No duty-free allowance

Duty-free allowance in the region Country
No duty-free concession on all tobacco products Brunei (since 2011)
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, 100 cigars or 250 gm of tobacco Myanmar
400 cigarettes Philippines*
No duty-free concession on all tobacco products Singapore (since 1991)
200 cigarettes or 250 gm of tobacco or all types of combined Thailand
200 cigarettes or 20 cigars or 250 gm of shredded tobacco Vietnam
* Malaysia has imposed excise tax on tobacco products sold at duty-free shops beginning in 2021, while the Philippines, whose tax on duty-free tobacco began in 2013.
Quick All countries should follow the lead of Brunei Darussalam and Singapore that
Fact prohibit duty-free tobacco sales or of Malaysia and the Philippines that impose excise
tax on duty-free products.
Lost funds in tobacco tax revenue gap in 2 years (cigarettes) in selected ASEAN countries
Cambodia
_ 198.2 (KHR 811.9 billion)
(2019 2020)
Indonesia
_
(2020 2021) 3,460 (IDR 51.78 trillion)
Lao
_ PDR
(2019 2020) 19.6 (LAK 185.64 billion) If the governments of Cambodia,
Indonesia, Lao PDR, Myanmar and
Vietnam implemented the recommended
Myanmar
_ 309.5 (MMK 440.18 billion) tax changes, 1.3 million premature
(2019 2020) deaths could be prevented and additional
USD 4.81 billion in tax revenue would
Vietnam have been collected in these 5 countries
_ 825 (VND 19 trillion) in the last 2 years alone.
(2020 2021)
0 500 1000 1500 2000 2500 3000 3500

Revenue loss (USD million)
92
Thailand: Higher tax rates, higher revenues, and reduced smoking prevalence
Thailand raised its cigarette excise rates 11 times (from 55% to 87% of factory price)between 1991 and 2012, which resulted
in an almost fourfold gain in revenues from THB 15.89 billion (USD 530 million) to THB 59.91 billion (USD 1,997 million)
over the same period. At the same time, overall smoking prevalence dropped from 32% (1991) to 21.4% (2011).
The Thai government has further increased the tax rate to 90% in early 2016, aimed at reducing number of smokers and raising
tax revenue by about THB15 billion per annum.
In September 2017, a new tax structure and rate on tobacco came into force to further reduce cigarette affordability in
Thailand.
Excise tax on cigarette in Thailand

(USD million) 2,463 (%)
2400 2,415
2,262 2,191 2,287 2,285
2,171 2,247
2200 2,130
2,135 2,328 2,110 2,187
2,038 2,003 2,091 2,181 2,019 2,097
1,942 1,958
2000 1,904 1,997 100
1,983 1,826 1,837 1,907 2,033
1,7901,800 1,963
1,727 87 87 87 87 90 90 1,742
1800 1,793 90
1,810
1,716 80 80 85 85 85
79 1,706
1600 75 75 75 75 75 1,779 1,682 80
1,473
70 71.5
1400 68 68 1,323 1,384 1,348
1,119 1,211 70
60 62
1200 55 55 55 1,188 60
992 1,042
1000 988
937 50
890
803
800 40
32 667 691
28.8
600 530 515 512 25.5 30
23 21.1 21.4
20.7 19.9 19.9 19.1
400 20
200 10
1991 1992 1993 1994 1995 1996 1997 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017*2018*2019*2020*
_
Fiscal year (Oct Sept)
Excise rate (% of factory price)
_
2018 2020 Sale (million packs) Smoking prevalence (%)
SRP Ad Valorem Specific
(% of SRP) (THB/Sticks) Tax revenue (USD million)
USD 1 = THB 30
SRP≤60 20% 1.2
Source: Excise Tax Department, Ministry of Finance, Thailand, 2020.
THB/Packs
* These rates have been applied from 16 September 2017 to present. A single rate of 40% of SRP and THB 1.2/stick was
SRP>60 40% 1.2 scheduled to be applied from 1 October 2019 onwards; however, because of tobacco industry opposition, enforcement was
THB/Packs postponed indefinitely.
93
Singapore: Highest tobacco tax burden in ASEAN

Concerned by slight increase in smoking prevalence from 2004 to 2010 and noting that the last tobacco excise tax increase
was in 2005, the Singapore government decided to increase tax by 10% in 2014.
_
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 0.388 per stick of < 1g 13.00 -
2016 0.388 per stick of < 1g 13.00 -
2017 0.388 per stick of < 1g 13.00 -
2018 0.427 per stick of < 1g 14.00 12.0 (2017)
2019 0.427 per stick of < 1g 14.00 10.6 (2019)
2020 0.427 per stick of < 1g 14.00 No data available
Quick
Fact Up to March 2003, excise duty on cigarettes was by weight per kilogram of tobacco. From July
2003, excise duty on cigarettes was revised to a unit-based (per stick) system. This change to a
unit-based system was in response to the emergence in 2000 of low-priced cigarettes that had less
tobacco content and less weight per cigarette and which, due to their price, were attracting 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).
For unmanufactured tobacco and cut tobacco, the excise duty is SGD 388 per kg. For beedies,
ang hoon, and smokeless tobacco, the excise duty is SGD 329 per kg. For all other tobacco
products, the excise duty is SGD 427 per kg. An additional 7% goods and services tax (GST) - on
the cost, insurance and freight incurred plus tobacco tax - is imposed on top of the excise duties.
94
Philippines: Impact of sin tax law

Fiscal gain: Strengthened, more efficient tax administration
Tax structure simplified and higher tax rates 60
(PHP) 55 (unitary)
60 (unitary)
50
Tier 1: Net Retail Price (More than PHP 11.50) (unitary)
50 45
Tier 2: Net Retail Price (PHP 11.50 and below) (unitary)
35.00
_
40 (July Dec.)
30 35
(unitary) 5% annual
Excise tax
28 29 (unitary) indexation
30 Premium 28.3 27 32.50
25 _
(Jan June)
21 (unitary)
25
20 17
12
High 12
10
Medium 7.56
Low 2.72
0
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 Beyond
(Old system) RA 10351 (TRAIN Law) RA 10351
Fiscal gain: Regular Adjustment to Tobacco Excise Tax Rates have resulted to an increase in government revenue
Reforms in the tobacco excise tax system have increased government revenues over time (2012–2020)
(USD billion)
3 2.811
(PHP 139.496)
2.374 Total tobacco

2.5 (PHP 125.063) 2.654 Excise tax revenue
2.198 (PHP 137.480)
(PHP 100.107)
1.989
(PHP 94.506)
2
Tax revenues
1.658
(PHP 70.392) 1.925
(PHP 97.029)
1.7 Incremental revenue
1.5 (PHP 75.509) 1.225 of tobacco
(PHP 55.744)
1.421
0.985 (PHP 73.629)
(PHP 41.842) 1.229
1 (PHP 64.773)
0.676 0.887 0.918 0.980
(PHP 28.550) (PHP 39.394) (PHP 43.632) (PHP 49.396)
0.5
2012 2013 2014 2015 2016 2017 2018 2019 2020*
*Projection by the Department of Finance.
95
Fiscal gain: Increase in resources to achieve Universal Health Care
Share of health sector (80% of the incremental revenue for both tobacco and alcohol excise taxes)
(USD billion) 1.965
2 (PHP 101.810)
1.726 Total incremental for

(PHP 90.900) tobacco and alcohol
1.413
1.5 1.377 (PHP 71.240)
(PHP 62.685)
Incremental revenue
1.247
(PHP 59.232)
1.138
(PHP 58.973)
1.053 0.958 0.994 0.981
(PHP 44.716) (PHP 42.553) (PHP 45.272) (PHP 51.684) Tobacco only
1
0.833 0.745
(PHP 35.384) (PHP 35.402***)
0.774
0.715 (PHP 39.052)
(PHP 31.763**)
0.5
2012* 2013 2014 2015 2016 2017 2018 2019
* Prior to the Sin Tax Law of 2012, there is no provision in the Internal Revenue Code of the Philippines that Health will directly benefit from the incremental revenue
of tobacco and alcohol. The Sin Tax Law was passed in 2012. It took effect only in 2013.
** For 2014-2015, the primary reason in the decline is the so-called frontloading practice of the tobacco industry wherein they produce so much so that they will
escape the higher tax rate the following year. Another reason is that the tobacco tax stamp is not yet mandatory so there are leakages in this period.
***For 2016, this is when Mighty Corporation was caught to be using fake tax stamps thus doing tax evasion.
Share of tobacco-growing provinces and funds for alternative livelihood of tobacco farmers
(USD billion)
0.3 0.282
(PHP 14.655)
0.25 Share of Tobacco

(PHP 10.343) Planting Provinces*
0.25 0.23 (15% of the
(PHP 10.471) 0.248 incremental revenue
(PHP 13.089) from tobacco taxes)
0.2
0.152
(PHP 6.457) 0.171 0.173
0.15 (PHP 7.630) (PHP 8.230)
0.138
(PHP 5.849)
0.1
2012 2013 2014 2015 2016 2017 2018 2019
* There are 2 other Laws that mandate the government to allocate funds for tobacco-growing provinces. These 2 Laws date back in the mid-90’s.The purpose of the
share of tobacco-growing provinces is to compensate for farmers who lost their livelihood or encourage them to shift to alternative livelihood activities.
96
Public health gain: Reduction in smoking prevalence (1998–2015)

(%)
80
70 Since the passage of

63.7 Sin Tax Law (2012),
59.1 Never smoker
60 smoking among youth
54.5 55 54.3 decreased to 5.5%
from 6.8% in 2013.
50
2012 sin tax
reform law
40 34.8 passed
32.7 31
30 25.4
23.3
Current smoker
20 14.7 15.5
12.8 13
10.2 Former smoker
10
0
1998 2003 2008 2013 2015
Public health gain: Department of Health budget between 2010 and 2020
(PHP billion)
200
166.7 171.9
165
148.5
150
Sin Tax 122.6
Reform
100 87 The Department of Health

83.7 budget increased by 308%
from PHP 42.15 billion in
53.2 2012 to PHP 171.9 billion
42.15 in 2020.
50
31.83
24.65
0
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
97
Public health gain: Win for the poor
(PHP billion)
60 58.73
53.2 54.73
50 48
43.9
40 37.1
35.2
30
The share of health from

20 sin tax was able to subsidize
12.5 the annual social health
12.6 insurance coverage of
10 approximately 34.4 million
3.5 4.5 5 5 3.5
2.9 members that include their
0.5 0.5 0.5 0.5 0.8
dependents in 2019.
0
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Note: Starting 2019, 100% of Filipinos have PhilHealth coverage due to the passage of the Universal Health Care Law or Republic Act No. 11223.
Philippines: Distribution of incremental sin tax revenue for health

(PHP billion)
100 93.57 Total incremental sin tax
95.27** 90.90
revenue for health
80 76.33 71.24 74.86 80% - allocation for Universal

72.72
69.40** Health Care (UHC), Millennium
Development Goals (MDGs),
56.99 and Health Awareness
60
55.62 Free health insurance provided to
the poorest 40% of the population.
40 A premium/subsidy of PHP 3,600
33.74 or USD 72, per family.
30.49
27.30 26.97 18.94 18.18 18.71 20% - Allocation for Medical

20 13.75 14.25 Assistance and Health Facilities
6.77 Enhancement Programme (HFEP)
3.19
2014 2015 2016 2017 2018 2019 2020

* The allocation is derived from the total Excise Tax Revenue (Tobacco and Alcohol). The health sector was able to benefit from sin taxes only from 2014.
For more detailed information, please visit https://tobaccotax.seatca.org/ and refer to SEATCA Tobacco Tax Index:
Implementation of WHO Framework Convention on Tobacco Control Article 6 in ASEAN Countries (2021).
98
100% smoke-free public places (indoor) policy in ASEAN
Airport Bars/Pubs Education
Myanmar** Facilities
Health care Hotel Public
Lao PDR Facilities Transportation
Universities Government Workplaces
Offices
With smoking room Allows smoking anywhere
100% smoke-free indoor air-conditioned restaurant
100% smoke-free indoor non-air conditioned restaurant
Vietnam Allows designated smoking room inside the restaurant
Thailand
Philippines
Cambodia
Brunei
Darussalam*
Malaysia
Singapore
Quick
Indonesia Brunei: Non-smoking zones include areas within
Fact a distance of 6 meters from the perimeter of the
buildings.
Philippines: No designated smoking areas allowed

within 10 meters of places where people pass or
congregate.
* Brunei: No bars or pubs.

** Myanmar: Designated smoking areas are allowed in public trains and public water transportation under the national
tobacco control law but the Ministerial Notifications (2014) prohibits smoking in those forms of transportations.
99
Chapter 8
Clearing the Air
for a Healthier Environment
Secondhand smoke (SHS) kills, and WHO and other health As recommended in the WHO FCTC Article 8 Guidelines,
authorities have declared that there is no safe level of only a 100% smoke-free environment can effectively protect
exposure to SHS. Non-smokers exposed to SHS are equally at persons from exposure to tobacco smoke and the health
risk of tobacco-related diseases and premature death as those hazards of smoking. Public smoking bans also encourage
who actively smoke. Globally, more than a third of all people smokers to quit and discourage youth smoking.
are regularly exposed to SHS. SHS exposure commonly
occurs in homes and workplaces, but exposure also occurs in With growing public awareness and support for smoke-free
many public places including in restaurants, bars, markets, environments, an increasing number of countries have taken
airports, public transportation, and even health and steps to protect people from the dangers of tobacco smoke by
education facilities. It is estimated that around 1.2 million enacting laws that ban smoking in all public places and create
premature deaths annually are due to exposure to SHS smoke-free environments. The ban covers all forms of
causing heart disease, stroke, cancer, acute asthma, and tobacco products including waterpipes and e-cigarettes and
others. Even brief exposure can cause immediate and serious heated tobacco products.
health harms.
This chapter describes the progress achieved by ASEAN
All people, regardless of age, gender, or socio-economic countries to enforce comprehensive smoke-free laws
status, deserve protection of their health, and involuntary prohibiting smoking in various public settings. Related
exposure to SHS may be considered a violation of the basic initiatives include smoke-free cities, smoke-free world
human right to life and smoking around children as a form of heritage sites, and smoke-free universities with the aim of
child abuse. attaining a smoke-free ASEAN.
Enjoy ASEAN food in smoke-free environments

100% smoke-free indoor 100% smoke-free indoor Allows designated smoking
Country air-conditioned restaurant non-air conditioned restaurant room inside the restaurant
Brunei
Cambodia
Indonesia
Lao PDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Vietnam
100
Chapter 8: Clearing the Air for a Healthier Environment
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. ** Myanmar: Designated smoking areas are allowed in public trains and public water transportation under the national tobacco control law but the Ministerial Notifications
(2014) prohibits smoking in those forms of transportations.
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
*In Singapore, since 30 June 2017, new smoking areas have not been approved for bars and pubs but existing smoking areas are all allowed to remain until the business operators cease operations.
** In Vietnam, sports complex may have designated smoking areas with the exception of childcare facilities and recreational facilities for children which should be 100% smoke-free.
101
Smoke-free airports
28 smoke-free airports among the world’s 50 busiest airports*
Denver International, Chicago O’Hare International,
Colorado, USA (DEN) Illinois, USA (ORD) London Heathrow,
Toronto Pearson International, UK (LON)
Seattle-Tacoma International, Canada (YYZ) London Gatwick,
Washington, USA (SEA) UK (LGW) Sheremetyevo International Airport,
Newark Liberty International, Moscow, Russia (SVO)
San Francisco International,
California, USA (SFO) New Jersey, USA (EWR)
New York JFK, USA (JFK) Barcelona-El Prat, Istanbul Ataturk, Turkey (IST) Beijing Capital International, China (PEK)
Los Angeles International,
California, USA (LAX) Charlotte Douglas International, Madrid Barajas, Spain (BCN)
North Carolina, USA (CLT) Spain (MAD) Shanghai Pudong International, Shanghai Hongqiao International,
Dallas/Fort Worth China (PVG) China (SHA)
International, USA (DFW) Orlando International, Shenzhen Bao’an International Airport,
Florida, USA (MCO) China (SZX)
Phoenix Sky Harbor International,
Arizona (PHX) Miami International, Suvarnhabumi Airport, Bangkok,
Florida, USA (MIA) Thailand (BKK)
Houston George Bush Intercontinental,
Texas, USA (IAH) Hartsfield-Jackson Atlanta
International Airport (ATL)
Mexico City Benito Juarez
International, Mexico (MEX)
Sydney Kingsford-Smith,
Australia (SYD)
* Ranking based on passenger traffic, 2017.
Smoke-free airports in ASEAN

Lao PDR
All domestic and international airports in Lao PDR are 100% smoke-free.
Philippines
Ninoy Aquino International Airport (MNL) is
100% smoke-free indoors (since July 2019).
Thailand
All Thai airports including Bangkok’s
Suvarnhabumi Airport (BKK) and Don
Mueang* are 100% smoke-free. Francisco Bangoy International Airport (DVO),
Davao City is 100% smoke-free since 2012.
Brunei
Brunei International Airport (BWN) is 100% smoke-free.
No designated smoking room at the Airport Terminal
and all office premises, effective 1st March, 2012.
*Suvarnhabumi Airport (BKK) and Don Mueang closed all smoking rooms in February 2019 in compliance with the Tobacco Products Control Act 2017.
Smoking is prohibited within 5 meters of airport entrances and walkways.
102
Secondhand smoke exposure in ASEAN

Percentage of youth exposed to secondhand smoke inside and outside the home
(%)
80
70 In home Outside Home 66.5

66.2
60 57.8
52.4 51.2
50 47.1
44.5*
41.7
40 38.5 37.8 38.6
35.2 33.8
32.5 33.2
28.4 29.3
30
24.3
20
10
0
Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Thailand Vietnam
(2019) (2016) (2019) (2016) (2016) (2016) (2019) (2015) (2014)
*Exposed to tobacco smoke inside enclosed public places.
Percentage of youth exposed to people smoking in their presence in ASEAN*

(%)
80
72.4 77.7**
Quick Almost 1.5 billion
Fact people in 55 countries
60 protected by
smoke-free legislation.
42 39.5
Comprehensive
40 smoke-free legislation
is currently in place
for almost 1.5 billion
people in 55 countries.
20
1 in 2 children
is exposed to
secondhand smoke.
0
Brunei Indonesia Malaysia Thailand
(2019) (2018) (2017) (2015)
*No data available for Cambodia, Lao PDR, Myanmar, Philippines, Singapore and Vietnam. **Percentage of youth aged 10-18 who were exposed to people smoking in their presence.
103
Common places with secondhand smoke exposure in ASEAN
(%)
100
87
85
80.7
80 75.8 78
70
65.6 63.1
63
59.9
60 33.6 57.5 56.2
48 49.4 51
21.9 19.4
41.4 42.6
40 39.1 37.6 38.2
34.1
31 31 31.5 30.9
27.2 27.5 25.8
21.7 21.6 8.5 21.5
18 18.4
(air-conditioned)
20
11.8 13.6 11.5
8.2
4.2
0
Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Thailand Vietnam
(2014) (2014) (2011) (2015) (2019) (2014) (2015) (2017) (2015)
At workplace At home Inside restaurant Public transportation Government buildings Health facilities
*89.1% reported expose at Bar/café/ teashops.
Countries with smoke-free places and places with smoking rooms in ASEAN
Bars/Pubs 4 5 - IDN, MYS, PHL, SGP, VNM. 1-BRN
Airports 5 5 - KHM, IDN, MYS, SGP, VNM.
Hotels 5 5 - IDN, MYS, PHIL, SGP, VNM.
Restaurants 8 2 - IDN, PHIL.
Workplaces/Offices 7 3 - IDN, PHIL, SGP.

Transportation (Public) 8 2-MMR, VNM.
Shops/Shopping Complexes 8 2 - IND, PHL.
Universities 10
Healthcare Facilities 10
Educational Facilities 10
Transport Terminals 10 Smoke-free places
Places with smoking areas
0 2 4 6 8 10
Number of countries
Brunei (BRN) • Cambodia (KHM) • Indonesia (IDN) • Malaysia (MYS) • Myanmar (MMR) • Philippines (PHL) • Singapore (SGP) • Vietnam (VNM)
Quick Nicotine is highly addictive and exposure to nicotine in adolescents, in particular, can have
Fact long-lasting, damaging effects, noting that it could affect brain development. ENDS involves the
inhalation of a nicotine-infused aerosol.
104
Penalties
Countries that allow the issuance of compound fees to smoke-free violators
Country Compound fees (USD)
Smokers Establishment
Brunei 224 - 374 (BND 300 - 500) 374 (BND 500)
Malaysia 50% from the total fine up to 1,206 (MYR 5,000) 50% from the total fine up to 362 or 603 (MYR 1,500 or MYR 2,500)
Singapore 1st Offense 149 (SGD 200) 1st Offense 149 (SGD 200)
Succeeding offenses 372 (SGD 500) Succeeding offenses 372 (SGD 500)
Penalties for violating smoke-free policy in ASEAN

Country Penalties (USD)
Smokers Establishments
Brunei 747 (BND 1,000) 747 – 1,494 (BND 1,000 – 2,000)
Cambodia 5 (KHR 20,000) 12.3 (KHR 50,000)
Indonesia Maximum limit of fines: 3,438 (IDR 50 million) 106.7 – 533.3 (LAK 1,000,000 – 5,000,000)**
Lao PDR 21.3 – 42.7 (LAK 200,000 – 400,000)* 106.7 – 533.3 (LAK 1,000,000 – 5,000,000)**
Malaysia 2,413 (MYR 10,000) or imprisonment not exceeding 2 years 724 (MYR 3,000) or imprisonment not exceeding
6 months (not displaying no smoking signage)
1,206 (MYR 5,000) or imprisonment not exceeding
1 year (failing to ensure no people smoke in the premise)
Myanmar 0.71 – 3.57 (MMK 1,000 – 5,000) 1st Offense 0.71 – 2.14 (MMK 1,000 – 3,000)
Succeeding Offenses 2.69 – 8.98 (MMK 3,772 – 12,572) Succeeding offenses 2.14 – 7.14 (MMK 3,000 – 10,000)
Philippines 10.3 – 206 (PHP 500 - 10,000) 10.3 – 206 (PHP 500 - 10,000)
Singapore 744 (up to SG 1,000) 1st Offense 744 (SG 1,000)
Succeeding offenses 1,488 (up to SG 2,000)
Thailand 160 (THB 5,000) 1,600 (THB 50,000)
Vietnam 8.7 – 21.7 (VND 200,000 – 500,000) 130 – 2,600 (VND 3 – 60 million)
*1st offence shall be disciplined and warned; 2nd offence LAK 200,000; 3rd or succeeding offences LAK 400,000.
** None ‘no-smoking sign’, 1st offence shall be disciplined and warned; 2nd offence LAK 1,000,000; 3rd or succeeding offences LAK 2,000,000. Ignored or negligence somebody
smoking in the establishment, 1st offence shall be disciplined and warned; 2nd offence LAK 1,000,000; 3rd and succeeding offences LAK 5,000,000.
Government toll-free telephone complaint hotline or similar system to report violations

Country Toll-free telephone complaint hotline Provided by
Brunei +67 37192005 Health Enforcement Unit, Ministry of Health
(any violations to smoke-free law)
Singapore + 66 842036 or 66842037 Health Science Authority (HSA)
(any tobacco related offences)
Thailand 1442
(any complaints including issues related to tobacco and violence offences) Department of Disease Control, Ministry of Public Health
105
Regional smoke-free networks

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, municipalities, provinces, states and
districts in the Asia Pacific countries that support each other to achieve the goal of
making their countries 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
Photo of Philippines President Rodrigo Duterte taken
importance of creating and adopting strong smoke-free policies to make cities healthy
in 2013 while he was the Mayor of Davao City.
and liveable.
In 2015, the mayors and governors signed the pledge of commitment 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.
Siem Reap, Cambodia (2019)
Hoi An, Vietnam (2018)
Penang, Malaysia (2017)
Krabi, Thailand (2016)
Iloilo, Philippines (2015)
Balanga City, Philippines (2014)

Davao City, Philippines (2013)
106
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
107
Smoke-free tourism in ASEAN
Cambodia: Smoke-free award
The Ministry of Tourism in collaboration with the Ministry of
Health has launched a ‘Smoke-Free Environment Compliance
Awards’ initiative in 2019. The award aims to give recognition and
encourage good compliance of smoke-free environments in the
tourism sector in tandem with the smoke-free regulation
particularly among the eatery establishments (restaurants, cafeteria,
and food court) and accommodations (hotels, guesthouses, and
homestays). At present, 378 tourism establishments have received
the smoke-free environment compliance awards (a trophy and a
certificate of appreciation) by the Ministry of Tourism.
The initiative started with tourism-active provinces including

Kampong Cham, Siem Reap and Battambang. About 37
hotels/guesthouses and 26 restaurants across the three provinces
were eligible to receive the ‘Smoke-free Environment Compliance
Award” in the tourism sector for 2019-2020.
The initiative has extended to other provinces with
a higher number of awardees of 138 hotels/
guesthouses and 97 restaurants attaining the
excellent smoke-free compliance in the context of
COVID-19 crisis and receiving the 2020 Smoke-Free Smoke-free environment compliance awardees for 2019–2021
Environment Compliance Award in the tourism
sector. No smoking stickers were also provided to Provinces Number of awardees Year
hotels/guesthouses and restaurants to support the Hotels/guesthouses Restaurants
smoke-free initiative. The awardees were from
Kampong Speu, Pursat, Kep, Kampot, Prey Veng, Kampong Cham, Siem Reap, Battambang 37 26 2019
Svay Rieng, Kampong Chhnang, Takeo, Tboung
Khmum and Kratie provinces. Kampong Speu, Pursat, Kep, Kampot, 138 97 2020
Prey Veng, Svay Rieng, Kampong Chhnang,
In 2021, about 46 hotels/guesthouses and 34 Takeo, Tboung Khmum, Kratie
restaurants have received the award for good
compliance with smoke-free environments in the Kampong Thom, Preah Vihear, Steung Treng 46 34 2021
tourism sector and prevention of COVID-19. The
awardees came from Kampong Thom, Preah Vihear
and Steung Treng provinces.
Vietnam: Non-smoking tourism city model

Vietnam has initiated a non-smoking tourism city model in
Hoi An, Hue, Nha Trang and Ha Long cities. No-smoking
signages were displayed in non-smoking areas particularly at
tourist attraction areas, hotels, and restaurants. Besides
providing a non-smoking working environment, the
restaurants and hotels also enforce penalties for those who
smoke in workplaces and public places, as well as promote
smoke-free policy to the locals and tourists.
Hanoi was promoted as a model for “food-safe and

non-smoking restaurants and hotels” in 2017. About 200
hotels and restaurants had participated in the non-smoking
campaign and committed to comply with smoke-free policy
according to the Law on Prevention of the Harm of Tobacco.
In September 2019, there were 30 non-smoking cultural,

tourist, and relic sites in Hoan Kiem District, Hanoi City.
No smoking signages were put up to warn the locals or
tourists to comply with the smoke-free policy.
108
Smoke-free cities model: Philippines

Davao City was 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 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 within 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 a three (3)
kilometer radius from the university town area are prohibited
as stipulated in the Ordinance No. 09 S 2016.
......................................................
Baguio City is a 100% smoke-free City in the Philippines. Ordinance No. 34 s.
2017 makes it unlawful for any person to smoke or allow smoking in public
utility vehicles, government-owned vehicles or any other means of public
transport for passengers, accommodation and entertainment establishments,
public buildings, public places, enclosed public places or any enclosed area
outside of one’s private residence or private place of work, except in duly
designated smoking areas Those allowing or abetting or tolerating the
aforementioned violations will be fined PHP 1,000 for the first offense, PHP
2,000 for the second offense and PHP 3,000 for the third offense.
In 2020, Baguio City reported a total of PHP 2.815 million collection from
establishments and individual violators of the smoke-free ordinance.
109
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 included
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
included the University of Medicine (Magway), the University of Dentistry
(Yangon) and the University of Traditional Medicine (Mandalay).
All medical related universities have been

smoke-free since 2018. Major universities in
all capital cities of regions and states have
also been smoke-free since 2019. About
25% of the universities are implementing
100% smoke-free policy.
Thailand
Ministry of Higher Education, Science, Research and Innovation has established a smoke-free universities network
with a total of 164 members. The network aims to support the strengthening the implementation of smoke-free
university.
Smoke-Free Sports in ASEAN

Country
Vietnam Smoke-free 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 Smoke-Free 26th Southeast Asian (SEA) Games, held in Jakarta, 11–22 November 2011
Lao PDR Smoke-Free 25th Southeast Asian (SEA) Games, held in Vientiane City, 9–18 December 2009
Malaysia Smoke-Free Paralympic Games held on 15–19 August 2009
Thailand Smoke-Free 24th Southeast Asian (SEA) Games, held in Nathon Ratchasima (Korat), 6–15 December 2007
Philippines Smoke-Free 23rd Southeast Asian (SEA) Games, held in Manila, 27 November to 5 December 2005
Smoke-free, Vape-Free 30th Southeast Asian (SEA) Games, held in Manila, 30 November to 11 December 2019
Vietnam Smoke-Free 22nd Southeast Asian (SEA) Games, held in Hanoi, 5–13 December 2003
110
Enforcement infrastructure at the national level

Components of the enforcement Brunei Cambodia* Indonesia** Lao PDR Malaysia Myanmar Philippines Singapore Thailand Vietnam
infrastructure that should be
included in the law
Authorities responsible
for enforcement
System for monitoring compliance

and for prosecuting violations
Process for inspection of

businesses for compliance
National coordinating mechanism

to ensure a consistent approach
on monitoring nationwide
Overall Enforcement Plan
Regular Inspections
Authorizes inspectors to enter

the premises and to collect
samples and gather evidence
Prohibits businesses from
obstructing the inspectors
in their work
Funding Mechanism
Yes Partial No * Cambodia is in the process of developing regulations related to enforcement.

** All enforcement infrastructure and activities are based on Local Smoke-free Regulations legislated by the local government.
Strategies for enforcement

Soft enforcement upon the

law’s entrance into force
Information drive for

business establishments
Swift & decisive action

to penalize violators
Yes Partial No
111
Smoke-free awards
Malaysia: Blue Ribbons 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
awards were given to individuals, groups, institutions, communities,
government agencies and other stakeholders who have shown
excellence in tobacco control leadership. MySihat has also been
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 Awards

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 push for full implementation of World Health
Organization's Framework Convention on Tobacco Control (WHO FCTC). The
awards started in 2010 through giving recognition to 100% tobacco-free cities,
municipalities, government offices and health facilities strictly enforcing tobacco
control measures. The DOH Health Promotion and Communication Service
manages the awards.
SMOKE-FREE METER
S MOKE-FREE ENCLOSED PLACES (Law/Policy)
T ASK FORCE /WORKING GROUP
O RGANIZATIONS
P OLITICAL WILL
S TRATEGIES
M ASS MEDIA CAMPAIGN/MONITORING
O UTDOOR ADVERTISEMENTS
K EY MESSAGES
I MPLEMENTATION/INSPECTION
N EVER NEGOTIATE WITH TOBACCO INDUSTRY
G OVERNMENT SUPPORT
For more detailed information, please visit http://smokefreeasean.seatca.org and refer Smoke-free Index:
Implementation of Article 8 of the WHO Framework Convention on Tobacco Control in ASEAN Countries, 2020.
112
Myanmar
(since 2016 (PHWs), 2022 (SP))*
Standardized packaging (SP) and
3rd standardized
Lao PDR
pictorial health warnings (PHWs) in ASEAN
packaging in ASEAN
(since 2016)**
Pictorial health warning size
85% and above
75% _
75% 75% 84%
_
50% 74%
75% front and back Less than 50%
Philippines
75% front and back (since 2016)***
Vietnam
(since 2013)
50% 50%
50% front and back

(bottom)
50% front and back
Thailand
(since 2005 (PHWs),
since 2019 (SP))*****
Brunei Darussalam
1st standardized Cambodia (since 2008)
packaging in ASEAN (since 2016)****
Malaysia 55% 75%

85%
(since 2009)
85% front and back 50% 75% front and back

55% front and back
50% front; 60% back

Singapore
(since 2004 (PHWs),
since 2020 (SP))******
Indonesia
(since 2014) 2nd standardized
packaging in ASEAN
40%
75%
40% front and back 75% front and back
( ) Year of PHWs implementation

* Myanmar was the third ASEAN country after Thailand and Singapore to implement standardized packaging, effective by 12 April 2022
** The actual implementation date 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.
*** The implementation of 4th rotation of Philippines PHWs effective by March 2022.
****The implementation of 3rd rotation of Cambodia PHWs effective on 1 August 2021 was delayed to 1 December 2021 due to strong tobacco industry interference.
*****Thailand was the first country in ASEAN to implement standardized packaging, effective by 10 September 2019.
****** Singapore ranked second country in ASEAN to implement standardized packaging, effective by 1 July 2020.
113
Chapter 9
A Picture Is Worth A Thousand Words
Tobacco packaging serves as the most cost-effective The Article 11 Guidelines also recommend standardized
communications channel for governments to convey health (plain) packaging, which enhances visibility of the PHWs and
risks associated with tobacco use. Especially among those reduces the appeal of tobacco products. In 2012, Australia
with low literacy levels, pictorial health warnings (PHWs) are was the first country to implement standardized/plain
an effective health promotion tool to increase awareness of tobacco packaging. More than 30 countries and territories
tobacco’s harmful effects with no costs to government. moving forward with standardized packaging, with 21
countries having adopted the measure, 3 countries having it
As part of a growing global trend, at least 134 in practice and at least 14 other countries are in varying stages
countries/jurisdictions have legislated PHWs to date in of introducing standardized packaging laws. With the recent
accordance with WHO FCTC Article 11 and its World Trade Organization dispute panel decision upholding
implementation guidelines, adopted at the third session of Australia’s right to require standardized packaging, it is
the FCTC Conference of Parties (COP 3) in 2008. In 2016, expected that even more countries will follow suit.
ASEAN became the first region in the world where all ten
member states require PHWs on tobacco packages. In ASEAN, Thailand, Singapore and Myanmar have adopted
standardized packaging, which eliminated all promotional
The Article 11 Guidelines recommend that health warnings aspects of packaging including brand colours, logos and
be as large as possible and include pictures to effectively graphics on tobacco packages, effective on 10 September
communicate health harms of tobacco use. Thailand 2019, 1 July 2020 and 10 April 2022 respectively. Other
currently requires the world’s fourth largest PHWs (85% ASEAN countries (Malaysia and Philippines) are underway to
front and back of the pack) after East Timor and Turkey adopt a similar measure.
(92.5%), Maldives, Nepal, Vanuatu and Benin (90%) and
New Zealand (87.5%). Four other ASEAN countries (Brunei,
Lao PDR, Myanmar and Singapore) require PHW sizes that
are considered international best practice (at least 75%).
_
Increasing number of countries requiring PHWs on cigarette packages (2001 2022)
Philippines Cambodia Myanmar Lao PDR

(2016, 2018, 2020, 2022) (2016, 2018, 2021) (2016_2017, 2017_2018, (2016) 134
2018_2019, 2019_2020, 130
_ 125
2020 2021, 2022) 122
117
109
100
Singapore Thailand Brunei Malaysia Vietnam Indonesia
(2004, 2006, (2005, 2007, (2008, 2012) (2009, 2014) (2013) (2014, 2018)
2013, 2020) 2010, 2014,
2019, 2022) 77
72
65
56
41
35
26
11 12 18
2 2 3 5
1
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
( ) Year of PHWs rotation
114
Leader of pack warnings size
Five ASEAN countries among top 24 countries worldwide with the largest pictorial health warnings size.
Country % Average PHW size % PHW size (front) % PHW size (back)
1 Timor-Leste 92.5 85 100
1 Turkey 92.5 85 100
2 Maldives 90 90 90
2 Nepal 90 90 90
2 Vanuatu 90 90 90
2 Benin 90 90 90
3 New Zealand 87.5 75 100
4 Hong Kong (S.A.R., China) 85 85 85
4 India 85 85 85
4 Thailand 85 85 85 Globally, 134 countries/
5 Australia 82.5 75 90 jurisdictions have now
5 Cook Islands 82.5 75 90 required pictorial health
5 Niue 82.5 75 90 warnings on tobacco
packages.
6 Gambia 81.5 81.5 81.5
7 Chad 80 80 80
7 Sri Lanka 80 80 80
7 Uruguay 80 80 80
8 Ethiopia 78 78 78
9 Brunei 75 75 75
9 Canada 75 75 75
9 Lao PDR 75 75 75
9 Myanmar 75 75 75
9 Singapore 75 75 75
9 Tajikistan 75 75 75
Thailand: Asia first standardized packaging (85%)

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 Pictogram
British American Tobacco (BAT), that led to an injunction being issued by the 85%
Central 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. Brand variant 15%
Thailand is the first Asian country to enforce standardized packaging for tobacco products. On 14 December 2018, Thailand’s
Standardized Packaging Regulation was enacted with effect after nine (9) months (on 10 September 2019) with a 3-month full
phase-out of old cigarette stocks by 8 December 2019. All cigarettes packaging must be sold in drab brown-colored packs with cigarette
brand names printed in a standardized font type, size, color, and location, without brand colors or logos. The new standardized
packaging complements Thailand’s pictorial health warnings, which occupy the upper 85% of the front and back panels of packs,
currently the largest in ASEAN.
Quick Thailand continues to be a regional leader in the area of tobacco product packaging and labelling.
Fact Its Tobacco Product Control Act enacted in 2017 authorises the Minister of Public Health to
prescribe the standards for package size, colour, marks, labels, and display of trademarks,
pictures, and messages on tobacco packages.
115
Among the world’s largest: Thailand, Brunei, Lao PDR, Myanmar and Singapore
Large PHWs on cigarette packages in five ASEAN countries
Thailand (85% front and back)*
*These are 4 out of 10 new Thailand PHW images for the 6th rotation, effective by 11 January 2022.
Brunei (75% front and back) Lao PDR (75% front and back)
Myanmar (75% front and back)* Singapore (75% front and back)
* These are 2 out of 10 new Myanmar PHW images for the 6th rotation,
effective by 10 April 2022.
116
Chapter 9: A Picture Is Worth A Thousand Words
Pictorial health warnings on cigarette packages in other ASEAN countries

Malaysia (50% front and 60% back) Cambodia (55% front and back)
Vietnam (50% front and back) Indonesia (40% front and back)
Philippines (50% front and back)*
*These are 4 out of 10 new Philippines PHW images for the 4th rotation, effective by March 2022.
ASEAN image bank of copyright-free pictorial health warnings

In collaboration with ASEAN Focal Points on Tobacco
Control (AFPTC), SEATCA has established a sharing
mechanism of copyright-free pictorial health warning
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/
117
Evolution of pictorial health warnings and standardized packaging in ASEAN
Country Years of implementation Position, size and Language Number of rotating Cessation
and rounds of rotation location health warnings messages
Brunei 2008, 2012 Top 75% front and back Malay (front), 7
English (back)
Cambodia 2016, 2018, 2021* Top 55% front and back Khmer 2
Indonesia 2014, 2018 Top 40% front and back Bahasa Indonesia 5 Layanan Berhenti Merokok
(0800-177-6565)
Lao PDR 2016 ** 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)
_ _ _
Myanmar 2016_2017, 2017_2018, 2018_2019, Top 75% front and back Burmese 10
2019 2020, 2020 2021, 2020 2021,
2022***
Philippines 2016, 2018, 2020, 2022**** Bottom 50% front and back Filipino (front) 12 Quit Smoking:
English (back) Call DOH Quitline 1558
(formerly 165-364)
Singapore 2004, 2006, 2013, 2020***** Top 75% 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
2014, 2019, 2022******
Vietnam 2013 Top 50% front and back Vietnamese 6
*The implementation of 3rd rotation of Cambodia PHWs effective on 1 August 2021 was delayed to 1 December 2021 due to strong tobacco industry interference.
** 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.
***Myanmar was the third ASEAN country to implement standardized packaging requiring 10 PHWs for smoked and smokeless tobacco products (5 PHWs each), effective by 10 April 2022.
****The 4th rotation of the Philippines PHWs effective by March 2022.
*****Singapore has implemented standardized packaging and increase the pictorial warning size from 50% to 75% effective by 1 July 2020.
******Thailand standardized packaging with a new set of 10 rotating pictorial health warnings effective by 11 January 2022.
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.
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.
118
Implementation timeline of the latest pictorial health warnings and standardized packaging in ASEAN
Country Pictorial health warnings Standardized packaging Size: Front/Back Date of approval Date of implementation Duration of compliance
for tobacco industry
Brunei 75%/75% 13 Mar 2012 1 Sept 2012 Less than 6 months
Cambodia* 55%/55% 20 Nov 2020 1 Aug 2021 9 months
Indonesia** 40%/40% 13 Dec 2017 31 May 2018 12 months
Lao PDR*** 75%/75% 23 May 2016 1 Jan 2018 19 months
Malaysia 50%/60% 11 June 2013 1 Jan 2014 Less than 7 months
Myanmar**** 75%/75% 12 Oct 2021 10 Apr 2022 6 months
Philippines***** 50%/50% 15 Apr 2021 Mar 2022 12 months
Singapore ****** 75%/75% 1 July 2019 1 July 2020 12 months
Thailand******* 85%/85% 14 July 2021 11 Jan 2022 6 months
_
Vietnam 50%/50% 8 Feb 2013 8 Aug 2013 (soft pack) 6 10 months
8 Dec 2013 (hard pack)
*The implementation of 3rd rotation of Cambodia PHWs effective on 1 August 2021 was delayed to 1 December 2021 due to strong tobacco industry interference.
**The second rotation of PHWs in Indonesia was implemented earlier before the end of one-year grace period given to tobacco industry coincided with the WNTD 2018 as there was no change
in the warning size.
***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).
****Myanmar was the third ASEAN country to implement standardized packaging requiring 10 PHWs for smoked and smokeless tobacco products (5 PHWs each), effective by 10 April 2022.
*****The implementation of 4th rotation of Philippines PHWs effective by March 2022.
******Singapore ranked second country in ASEAN to implement standardized packaging, effective by 1 July 2020.
*******Thailand was the first country in ASEAN to implement standardized packaging, effective by 10 September 2019. The 6th rotation of pictorial health warnings, effective by 11 January 2022.
Best practice: Australia’s plain packaging – A world first

Australia was the first country to implement plain packaging of cigarettes,
effective on the 1st December 2012. The plain packaging law restricts or Front Back
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. 75% 90%
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 25%
settlement. The legal claim for alleged breaches in the ‘fair and equitable 10%
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 Quick All the legal challenges brought by the
packaging law sets a precedent for the world and encourages other
countries especially in the ASEAN region (Thailand and Singapore)
Fact tobacco industry against plain packaging
laws have been dismissed by the courts
are considering to implement plain packaging. There are increasing and tribunals across the globe.
number of countries in various stages of development and adoption
of similar laws.
119
Standardized/plain packaging around the world
As of November 2021, at least 38 countries and territories moving forward with
standardized packaging, with 21 countries having adopted the measure following
Australia’s lead (in 2012), 3 countries (Monaco (from France), Cook Islands (from
United Kingdom New Zealand), and Niue (from Australia) having it in practice and at least 14 other
20 May 2016 countries are in varying stages of introducing standardized packaging laws.
20 May 2017
Norway Denmark Netherlands
1 July 2017 1 July 2021 1 Oct 2020
Canada 1 July 2018 1 Apr 2022 1 Octo 2020
Ireland
9 Nov 2019 30 Sept 2017
7 Feb 2020 30 Sept 2018 Belgium
1 Jan 2020
1 Jan 2021
Guernsey
31 July 2021
31 July 2022 Myanmar
10 April 2022
10 April 2022
Jersey
1 Jan 2022
31 July 2022 ASEAN
France Turkey
20 May 2016 5 July 2019
1 Jan 2017 5 Jan 2020
Saudi Arabia
23 Aug 2019 Singapore
1 Jan 2020 1 July 2020
1 July 2020
Israel
8 Jan 2020
8 Jan 2020 Australia (2012) New Zealand
Slovenia 1 Oct 2012 14 Mar 2018
1 Jan 2020 1 Dec 2012 6 June 2018
1 Jan 2020
Manufacturer Level
Retail Level Hungary* Thailand
1 Jan 2022 10 Sept 2019
1 Jan 2022 8 Dec 2019
Uruguay
21 Dec 2019
21 Dec 2019
Standardized packaging in ASEAN (Thailand, Singapore and Myanmar)

Thailand, Singapore, and Myanmar are the first in Asia and among the 24 countries and territories that implement standardized
packaging for tobacco products, eliminating all promotional aspects of packaging including brand colours, logos and graphics on
tobacco packages. Singapore’s PHWs size on the package surface, increased to 75% from 50% (introduced since 2004) along with
the standardized packaging regulation.
In ASEAN, Thailand leads with the largest pictorial warnings (85%), followed by Brunei, Lao PDR, Myanmar and Singapore
requiring a warning size of 75%.
Quick In February 2016, the Malaysia Health Ministry announced its plan on standardized packaging,
Fact though no firm dates were included.
There were numerous protests from industry lobby groups in the media and a month later (on 21
March) the Health Minister said no implementation date will be announced until his Ministry talks
with the tobacco companies on intellectual property rights. Since then, there has been no update on
this policy.
120
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 In the English language on one side
(2012) to Health. panel of the pack and in the Malay
language on the other side panel
Produk Ini Mengandungi Nikotina dan Tar yang Menyebabkan Ketagihan dan
Membahayakan Kesihatan.
Indonesia Tidak ada batas aman! Mengandungi lebih dari 4,000 zat kimia berbahaya, On one side panel and in
(2012) 43 zat penyebab kanker Bahasa 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 On two side panels using different
(2016) the same toxic in vehicle exhaust qualitative statement and in
Lao language
Cigarette smoke contains Hydrogen Cyanide
that destroys lung vessels and tissues
Nicotine in cigarette is addictive and use in pesticides
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 On one side panel and in
(2009) karbon monoksida yang membahayakan kesihatan Malay 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 “Cigarettes contain Nitrosamine,
(2021) compounds that can cause cancer. Quit Smoking. Benzopyrene and others which are
the compounds that can cause cancer.
Nicotine, Tar and Carbon Monoxide contained in Cigarettes can cause Quit Smoking” must be printed on
heart and lung failure. Quit Smoking. the left side panel and the other texts
on the right side panel. Both texts
in Myanmar language
(continued)
121
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 BUTANE On one side panel and in
(2019) (SANGKAP SA LIGHTER FLUID) Filipino language
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 AMMONIA
(PANLINIS NG KUBETA)
Cigarette Smoke Contains Ammonia (Toilet Cleaner)
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 On one side panel and in
(2012) chemicals, of which at least 60 can cause cancer. The chemicals include English language
tar, nicotine, carbon monoxide, formaldehyde, ammonia and benzene
Thailand Template A Template B On two side panels using different

(2021) 1. Smoking increases the risk of tuberculosis. 1. With tuberculosis, the chance of dying qualitative statement
(1 group = A,B template)
from smoking increases 3 times. and in Thai language
2. Smoking at home is hard to quit 2. Smoking at home is linked to children’s
risk of addiction to cigarette. 1A
3. Smoking causes cancer and painful death. 3. Cigarette causes 20 types of cancer.
1B
4. Nicotine in cigarettes is a toxic substance. 4. Nicotine toxicity harms brain.
5. Smoking causes LDL cholesterol. 5. Smoking causes atherosclerosis. 2A
6. Selling cigarettes to kids harms 6. 7 in 10 kids addicted to cigarette
young generation. can’t quit. 2B
7. Every smoked cigarette harms lung. 7. Smoking causes chronic pneumonitis.
8. Smoking causes stroke. 8. Smoking causes heart attack. 3A
9. Smoking causes liver cancer. 9. Smoking causes colon cancer. 3B
10. With hypertension, smoking can lead 10. With diabetes, smoking can lead
to stroke soon. to complications soon. 4A
4B
Note: Lao PDR, Malaysia, Myanmar, Philippines, Singapore, and Thailand prohibit the display of emission yields (tar, nicotine, and carbon monoxide) on packages.
Ban on false or misleading descriptors in ASEAN

2007 2009 2010 2012 2013 2015 2016
Thailand Malaysia Lao PDR Indonesia Singapore and Vietnam Cambodia Myanmar and Philippines
For more detailed information, please visit http://tobaccolabels.seatca.org and refer SEATCA Tobacco Packaging and Labelling
Index: Implementation of WHO Framework Convention on Tobacco Control Article 11 in ASEAN Countries, 2019.
122
Myanmar Tobacco advertising at point-of-sale in ASEAN
No ban
POS Advertising POS Pack Display
Lao PDR
Ban Ban
No ban No ban No ban
Philippines
No ban
Vietnam
Thailand No ban
(Allowed display of only 1 pack
Ban, effective 2005 or carton per brand, 2012)
Brunei Darussalam
Ban, effective 2010
Cambodia
No ban
(Allowed display of only
1 pack per brand, 2015)
Malaysia
No ban
Singapore
Ban, effective 2017
Indonesia
No ban
(Only 5 cities/districts - Bogor, Bekasi, Depok,
Sukabumi and Tasikmalaya that have banned cigarette
display at point-of-sale (POS) by local ordinances)
123
Chapter 10
Pulling the Plug on Tobacco Marketing
and Tobacco Philanthropy
To maximize profits, the tobacco industry invests billions of countries (57) 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 All ASEAN countries are implementing a TAPS ban, but
use. A wide range of TAPS strategies are employed to directly most are partial bans, with Indonesia having the weakest
and indirectly make tobacco products attractive and TAPS restrictions in the region.
pervasive, targeting not only potential tobacco users (i.e.
youth, who are highly receptive to tobacco marketing) and In addition to a ban on direct tobacco advertising in most
current and former tobacco users, but also policy makers and ASEAN countries, Brunei, Singapore, and Thailand also ban
the public, so as to artificially create the impression that the display of tobacco packs at POS to reduce the visibility of
tobacco use is normal and non-harmful or that the tobacco tobacco products. These three countries also require licenses
industry is a socially responsible corporate sector. for tobacco retailers to facilitate regulatory compliance.
Therefore, Parties to the WHO FCTC “recognize that a Only three ASEAN countries (Lao PDR, Myanmar and
comprehensive ban on advertising, promotion and Thailand) currently ban CSR activities by the tobacco
sponsorship would reduce the consumption of tobacco industry, while only the publicity of tobacco industry CSR is
products” (Article 13) because an effective TAPS ban can prohibited in Cambodia, Singapore and Vietnam.
reduce the appeal of tobacco use (out of sight, out of mind),
thereby helping prevent youth uptake, discouraging tobacco As this chapter illustrates, more still needs to be done to
use, and preventing ex-users from relapsing. To be effective, achieve a comprehensive TAPS ban across the ASEAN
a TAPS ban must be comprehensive and cover all forms of region, noting that the industry will continue to find
TAPS. Partial bans are ineffective because the tobacco innovative ways and constantly evolve its marketing tactics to
industry will maximize TAPS forms that are not banned (e.g. promote and market its products, such as through creative
banning mass media TAPS but allowing TAPS at points of package designs, new product flavors, new media, and
sale (POS) or on the Internet, or allowing CSR activities by cross-border advertising.
the tobacco industry). Globally, an increasing number of
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 POS - Point-of-Sale
CSR - Corporate Social Responsibility
Singapore Ban publicity
Ban
Thailand
Partial Ban
Vietnam Ban publicity
Allow 1 pack/
carton per brand
No Ban
124
Chapter 10: Pulling the Plug on Tobacco Marketing and Tobacco Philanthropy
Tobacco marketing channels

• On billboards • Person-to-person sale
Outdoor tobacco advertising billboards can be Tobacco industry recruits pretty young girls
found in the Philippines and Indonesia*. as promoters to sell cigarettes.
Ban No ban
Brunei Indonesia
Cambodia Philippines
Lao PDR
Malaysia
Myanmar
Singapore
Thailand
Vietnam
*As of May 2020, there are 16 cities/districts including Jakarta province
that have banned outdoor advertisement and billboards. This include
Jakarta Province; 5 cities (Bukit Tinggi, Padang Panjang, Payakumbuh,
Bogor, Depok); 10 districts (Bekasi, Padang, Sawahlunto, Banggai,
Karangasem, Klungkung, Pasaman Barat, Jembrana, Dianyar, Badung).
Ban TAPS via internet in ASEAN

Country Year Country Year Country Year
Cambodia 2015 Philippines 2008 Brunei No ban
Lao PDR 2010 Singapore 1993 Indonesia* No ban
Malaysia 2004 Thailand 2017
Myanmar 2006 Vietnam 2013
*No ban on TAP via internet, however, advertising in information technology media shall comply with the provisions of the
tobacco products trademark website which applies age verification to restrict access only to persons aged 18 or older.
Bans on retail display of tobacco products: Brunei, Singapore and Thailand

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, Thailand
to the advertising effect of tobacco product displays as
well as encourages current smokers attempting to quit Singapore
by minimising impulse purchases of tobacco products.
125
Curbing tobacco industry CSR activities in ASEAN
Progress in curbing tobacco industry CSR activities
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.
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.”
For more detailed information, please visit http://tobaccowatch.seatca.org and https://timonitor.seatca.org/, also refer to SEATCA Tobacco Advertising, Promotion and
Sponsorship (TAPS) Index: Implementation of WHO Framework Convention on Tobacco Control Article 13 in ASEAN Countries, 2019, Whitewashing a harmful business:
Review of tobacco industry’s CSR activities in ASEAN, 2021 and Hijacking ‘Sustainability’ from the SDGs: Review of Tobacco Related CSR activities in the ASEAN
Region (2017).
126
Myanmar
(since 2006) Ban sale of single sticks of cigarettes in ASEAN
Lao PDR Regulation sale of single stick
(since 2009)
Ban
No ban
Price per stick of popular brand (USD)
Philippines
Marlboro
0.16 (PHP 7.75)
Fortune
0.11 (PHP 5.55)
Thailand
(since 2017) Vietnam
Thang Long
0.02 (VND 500)
State Express 555 Gold
0.07 (VND 1,575)
Cambodia
(since 2015) Brunei Darussalam
(since 2005)
Malaysia
(since 2004)
Singapore
(since 2002)
Indonesia
Marlboro
0.1 (IDR 1,495)
A Mild
0.11 (IDR 1,593)
127
Chapter 11
Protecting Future Generations
from Nicotine Addiction
Youth smokers, particularly in low- and middle-income cigarettes, and some countries have already seen a significant
countries, are a huge potential market for industry’s future rise in teen use.
growth. Tobacco companies target children and youths,
whom they refer to as “replacement smokers” to replace older Globally, there are 111 countries have either banned or
smokers who either quit or die from tobacco-related diseases. restricted the sale of ENDS. Thirty two of these countries
Youth smoking therefore remains the front line of the (covering 2.4 billion people) ban the sale of ENDS, and the
tobacco epidemic, as youths are more susceptible to tobacco other 79 countries have adopted one or more legislative
marketing, and nicotine addiction is more entrenched in the measures to regulate ENDS, covering 3.2 billion people. In
developing adolescent brain. On average, most smokers start ASEAN, five countries (Brunei, Cambodia, Lao PDR,
smoking before the age of 20. Singapore, and Thailand) already ban ENDS and HTPs.
The tobacco industry keeps inventing new ways to sell harm Transnational tobacco companies also produce ENDS and
through novel marketing schemes, attractive and colourful HTPs and promote these as being less harmful than
packaging, new flavors, and new products to appeal to the conventional cigarettes and as smoking cessation devices.
young and first-time smokers. In ASEAN, menthol and Noting that there are no long-term studies on the safety of
flavoured cigarettes are unregulated and widely available. these devices and insufficient evidence on their benefit as
Single stick cigarette sales, which increase accessibility to tools for smoking cessation, the WHO and some national
cigarettes, are banned in all but available in three ASEAN health authorities, such as the Australian National Health
countries (Indonesia, Philippines and Vietnam), while the and Medical Research Council (NHMRC) and the US
sale of kiddie packs (containing less than 20-sticks) is still National Academies of Sciences, Engineering, and Medicine
allowed in Indonesia and Philippines. (NAS), have recommended a precautionary approach and
action to minimize harm to users and bystanders and to
The emergence and rapid market growth of a new and wider protect vulnerable groups such as young people, until clear
range of alternative nicotine products such as electronic evidence of safety, quality and efficacy are produced. For
nicotine delivery systems (ENDS, which include e-cigarettes HTPs, the WHO recommends that these be regulated
and are available in myriads of flavours) and heated tobacco similarly to other tobacco products.
products (HTPs) are a new challenge for preventing nicotine
addiction and other health harms. Such gadgets, with their This chapter also highlights initiatives to protect present and
sleek designs and flashy marketing easily appeal to youths future generations from nicotine addiction and tobacco
and increase the risk for transitioning to conventional harms.
Source of cigarettes for youth

Percentage of youth who purchased cigarettes from a store/shop/street vendor/kiosk,
they were not refused purchase because of their age and bought individual sticks*
% Youth purchased cigarettes from % Youth purchased cigarettes were not % Youth bought cigarettes
a store/shop/street vendor/kiosk refused purchase because of their age as individual sticks
**Brunei (2019) 8.1 62.8 7.5
Indonesia (2019) 76.6 60.6 71.3
Lao PDR (2016) 55.6 59.8 42.3
Malaysia (2016) 42.5 50.6 41.7
Myanmar (2016) 54.5 62.9 61.9
Philippines (2019) 77.1 37.1 76.1
Thailand (2015) 67.4 44 19.6
84.7
Vietnam (2014) 73.6 55.7
* No data available in Cambodia and Singapore. **Store in this context means illegal tobacco vendor because there is no licensed tobacco
128
Source of ENDS for youth
Percentage of youth who purchased ENDS from a shop/kiosk/shopping mall,
they were not refused purchase because of their age and obtained from friends/someone else
4.9
Brunei (2019) % Youth purchased ENDS % Youth obtained ENDS from
11.5
from a shop/kiosk/shopping mall friends
were not refused purchase someone else
1.7 because of their age
Indonesia (2019) 2.0 online
7.8 someone
17.5
53.2
Malaysia (2016) 4.6
43.3
15
* No data available in Cambodia, Lao PDR, Myanmar, Philippines, Singapore, Thailand and Vietnam.
Percentage of total youth smokers* and ENDS users in ASEAN
(%) (%)
ENDS
Smoking
Brunei (2019) Brunei (2019)

6.1 13.3
**Cambodia (2016)
2.4 **Cambodia (2016)
2.3
***Indonesia (2018)
19.2 ***Indonesia (2018)
Lao PDR (2016) 10.9
6.4
Lao PDR (2016)
****Malaysia (2017) 4.3
13.2
Myanmar (2016) ****Malaysia (2017)
8.3 9.8
Philippines (2019)
10 Philippines (2019)
14.1
*****Singapore (2014-2016)
4
Thailand (2015)
Thailand (2015) 3.3
11.3
****Vietnam (2019) ****Vietnam (2019)
2.6 2.6
* 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.
*** Indonesian youth aged 10-18 years old ****The data is based on youth aged between 13 and 17.
***** Youth smoking prevalence (4%) is a consolidated figure from three different surveys among youth aged 13-20 between 2014 and 2016.
129
Targeting youths, young adults and women

Menthol and fruit-flavored cigarettes sold in ASEAN
No ban
Cambodia
Brunei
Indonesia
Quick In 1981, a Philip
Lao PDR
Fact Morris researcher
stated:
Malaysia "Today's teenager is
tomorrow's potential
Myanmar regular customer. . .”
Philippines Myron E. Johnston,
Philip Morris researcher,
Singapore Vietnam Indonesia Philippines Myanmar 1981 sent report to
Robert B. Seligman,
Thailand* then vice president of
research and development
Vietnam* at Philip Morris in Richmond
* Menthol flavor only.
Countries that have banned kiddie packs (less than 20 sticks per pack) in ASEAN
Ban
Brunei 2005 Lao PDR 2009 Myanmar 2006 Thailand 2017

Cambodia 2015 Malaysia 2010 Singapore 2002 Vietnam 2016
No ban
Indonesia
Philippines
Indonesia Philippines
A Mild, the most popular local brand Marlboro, the most popular foreign
sold in 12 and 16 sticks per pack. brand sold in 10 sticks per pack.
130
Chapter 11: Protecting Future Generations from Nicotine Addiction
_
Minimum age for tobacco use 21 years old Kazakhstan Mongolia
Canada
United States of America Kuwait

India
Honduras
Sri Lanka Palau
Singapore*
Uganda
Samoa
More than 20 countries worldwide have raised the minimum legal age for
tobacco use to at least 21 years old. Such measure would reduce tobacco
initiation and overall prevalence of tobacco use, prevent tobacco-related
diseases and save lives.
*In Singapore, the minimum age for smoking will be raised to 19 effective on 1 January 2019. It will also raise
and do it progressively every January until 2021 requiring citizens to be at least 21 to smoke.
Minimum legal age for the purchase, possession and use of tobacco in ASEAN – 18 years and above
Clear indicator inside POS about the prohibition of tobacco sales to minors
Required No
Brunei Malaysia Philippines Vietnam Cambodia Thailand

Indonesia Myanmar Singapore Lao PDR
Sellers request for evidence (reached full legal age) before sale
Quick 5.6 million children
Required No
Fact alive today will
ultimately die early
Brunei Singapore Cambodia Lao PDR Myanmar from smoking if
we do not do more
Philippines Thailand Indonesia Malaysia Vietnam to reduce current
smoking rate.
131
Global status of ENDS ban

Globally, about 38 countries have banned the sale of electronic nicotine delivery system (ENDS, also known as
e-cigarette), 73 countries restricting the sale and 36 countries regulating nicotine (and/or other) contents of
e-cigarettes.
Turkmenistan Nepal Bhutan North Korea
Turkey
Syria Japan
Iran
Antigua and Thailand
Egypt
ASEAN
Mexico Barbuda India
Oman Lao PDR
Nicaragua Venezuela Gambia Cambodia
Suriname Qatar Brunei
Panama Kuwait Singapore
Colombia Ethiopia Seychelles Sri Lanka
Brazil Uganda Timor-Leste
Mauritius
Australia
Uruguay
Argentina
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 (ENDS) or a vaporizer (e-cigarettes); nasal snuff, oral snu gutkha, khaini and zarda.
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.
132
Chapter 11: Protecting Future Generations from Nicotine Addiction
Status ban of Electronic Smoking Device (ESD) in ASEAN

Country Ban on ESD* (ENDS, HTPs Regulated nicotine (and/or other)
and Shisha/hookah) content/s of e-cigarettes No ban
Brunei (2005)
Cambodia (2014)**
Lao PDR (2018)
Singapore (2014)
Thailand (2014)
Indonesia***
Malaysia****
Myanmar
Philippines*****
Vietnam
*Electronic smoking device (ESD) means Electronic Nicotine Delivery Systems / Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS), Heated Tobacco Products (HTPs), and other new and emerging
smoking devices, including consumables, e.g. e-liquids and heat sticks. If ESDs are banned by law, full points are awarded for questions relating to ESDs.
**Cambodia National Authority for Combating Drugs has passed a circular banning the importation, trafficking, sale, and use of tobacco heated products (HTPs) in Cambodia on 18 March 2021.
***Appears to be ‘legitimized’ only by being subject to tax laws. According to the 2017 Ministry of Finance regulation on tobacco products, nicotine-containing e-cigarettes are regarded as other processed
tobacco or products that contain extract and essence of tobacco. E-liquids are taxed (ad valorem) at 57% of retail price.
****Beginning 1 January 2021, e-liquid without nicotine was subjected to an ad valorem excise tax of 10% and an excise duty of MYR 0.40 (USD 0.10) per millilitre of e-liquid. E-liquid with nicotine is
regulated under the Poison Act 1952 and enforced by Ministry of Health Malaysia. This is a federal law and applied to all state in Malaysia. Under this regulation, e-liquid containing nicotine cannot be sold
as a consumer product in Malaysia. The Malaysian National Fatwa Council has declared all vapour and shisha products as "haram" (forbidden in Islam). Five out of 13 states (Johor, Kelantan, Kedah,
Penang, and Terengganu) have banned the sale of e-cigarette under the state jurisdiction.
***** Philippine Republic Act 11467 stipulates tax increments for heated tobacco sticks and e-liquids. Executive Order 106/2020 prohibited the importation of unregistered e-cigarettes (with and without
nicotine) and heated tobacco products including restrictions on use, sale, distribution, or advertising of e- cigarettes and heated tobacco products. A health warning label will be required for all e-cigarettes
and heated tobacco products.
Tobacco-free generations: Philippines, Singapore, and Thailand
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.
On 21 July 2017, the PTI filed a Petition for Prohibition against Balanga City on the grounds of pre-emption,
alleging prohibitions delineated in the CNSO supersede and therefore violate national regulations established
by the Tobacco Regulation Act of 2003. Currently, the lower courts have ruled in favour of the PTI. Balanga
City is contemplating exploring legal remedies to defend its local autonomy to develop public health policies
promoting general welfare.”
Balanga City also passed new legislation – New Comprehensive Tobacco and Nicotine Regulation for the
Protection of Health And Welfare Ordinance.
133
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 (2017 2021)
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. Social media and digital media are utilitised convince the target youths
not to start smoking and to actively participate in advocacy campaigns.
The project has expanded to engage more youth leaders and organizations. In
2017, about 100 youth leaders (from seven youth groups) and 9 leading
organizations were engaged to support, promote and share the Gen Z project with
their network through a series of workshops and trainings for 4,000 youths across
the country. The youth groups continued to support the pilot projects in selected
ten provinces, including Phuket, Krabi, Khonkhen, Srisaket, Ubonratchathani,
Nakhonratchasima, Pitsanulok, Chiangmai, Petchaboon, and Maehongson.
In 2019, a new initiative ‘MPOWER GEN Z’ was designed to build and strengthen
the capacity of youth groups in different areas including media (writing news,
creative video clip) and tobacco industry monitoring and surveillance through a
‘Gen Z Academy Programs’. Four Gen Z Academy workshops were held with a
participation of 356 young leaders across ten provinces between 2019 and 2021.
At present, the Gen Z project has reached out to more than 10,000 Thai youths. Key activities implemented to
support the Gen Z project includes:
• Seed grants for youth-related organizations including school and media (10 projects in 12 provinces across
the country)
• Development of website for Gen Z Academy (from Zero to Hero)
• Engagement in social media platforms (Facebook/ Twitter/ Instagram/ YouTube/ Tik Tok/ LINE)
- To establish a communication and dissemination channel reaching out and connecting with Gen Z
network at all times.
- To disseminate information on tobacco control besides encouraging Gen Z youth in the network to
participate in the creative activities.
- To connect and link information to other social media channels in a quick and effective manner.
• Connecting with net idol and influencer as motivation and inspiration for youths to engage in the Gen Z
activities.
• Developing and supporting the production of new materials (T-shirt/pen/face mask)
134
Tobacco farmers in ASEAN
Myanmar **
Total number of tobacco farmers
Labour force
Lao PDR** % of total employment
Less than 0.1
0.1 – 0.3
0.31 – 0.5
Philippines
(2019-2020)
41,516
43,719,197
0.095
Thailand
(2020) Vietnam
(2011)
12,752
38,483,132 223,180
0.033 52,143,760
0.43
Cambodia
(2016)
19,174 Brunei Darussalam*
8,909,179
Malaysia*** 0.22
(2020)
140
15,904,357
0.00088
Singapore*
Indonesia
(2019)
597,966
135,802,884
0.44
*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. However, there are small-scale farmers for sliced tobacco for the local market only.
135
Chapter 12
Alternative Livelihood for
In recent decades, transnational tobacco companies have
Tobacco Growers as determined by tobacco companies. Other challenges in
shifted tobacco leaf cultivation from high-income to the cultivation of tobacco leaf include Green Tobacco
low-income countries, where 90% of tobacco farming now Sickness and other health hazards for farmers,
takes place. Eight of the ten ASEAN countries, excluding environmental degradation, unpaid labor, and child labor.
Singapore and Brunei, are engaged in tobacco cultivation on
different scales. About 324,575 hectares of land was used for Article 17 of the WHO FCTC requires Parties to promote
tobacco farming, producing a total of 517,323 million economically viable alternative livelihoods for tobacco
tonnes of tobacco leaves across the region in 2019. farmers and workers. In ASEAN, the Malaysian government
has actively implemented crop substitution since 2004, with
Generally, the number of farmers employed in tobacco kenaf being promoted as an alternative crop for tobacco. A
cultivation in ASEAN countries is small compared to overall total of 1,364 hectares and 928 growers involved in kenaf
national employment, contributing less than 1% of total cultivation in 2019. Under the 11th Malaysia Plan (2016 -
employment in all the producing countries. Tobacco 2020) the government has allocated MYR 5 million (USD
cultivation is highly labor-intensive and employs entire 1.206 million) in strengthening the kenaf R&D and MYR
households (including unpaid women and children) in many 58,989,000 (USD 14.23 million) for kenaf new planting
stages of planting, harvesting, curing and marketing. Most program. The total number of tobacco farmers in Malaysia
tobacco farmers are smallholders, cultivating only part of a declined significantly and there are small-scale farmers (140)
hectare, and do not turn a profit due to major input costs for sliced tobacco for the local market only. Tobacco farmers
(rental fees to landowners, costs of seedlings, feritlizers, in Cambodia, Indonesia, and Philippines are progressively
insecticides, and wood fuel for curing) and low leaf prices switching to more profitable alternative crops and
livelihoods.
Tobacco farming in ASEAN
269,803
236,489 Total area harvested (ha) Total production (mt)
66,780
56,706
51,016
28,018 28,008 30,033
19,514
14,756 14,502 12,806
7,741 5,515
188.07 211.4
Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Thailand Vietnam
(2019) (2019) (2019) (2019)* (2019) (2019) (2019) (2019)
* Since 2013, the Malaysia government disengaged from supporting and promoting tobacco and now solely implements policies to regulate the tobacco industry.
However, there is small-scale farming for sliced tobacco for the local market only.
136
Malaysia: Sustainable way out _ Kenaf alternative crop
2004 0.4 (1)
2005 42 (25)
2006 112 (13)
2007 285 (92)
2008 464 (167)
2009 343 (50)
2010 1,693 (409)
2011 1,140 (687)
2012 1,331 (653)
2013 1,824 (1,129)
2014 2,000 (914)
2015 2,274 (880)
2016 2,502 (1,086)
2017 1,432 (500)
2018 1,408 (679)
2019 1,364 (928) Kenaf cultivation total area (ha) Number of 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 commodities sector. It has high potential for cultivation in a tropical climate and was promoted by the government
as an alternative crop for tobacco in 2004. About MYR 5.8 million (USD 1.53 million) was allocated for kenaf research and
development (R&D) to attract industrial players to invest in kenaf between 1996 and 2005. Under the 11 th Malaysia Plan (2016 -
2020) implementation of programs and projects made by rolling plan, the government has allocated MYR 5 million (USD 1.206
million) in strengthening the kenaf R&D and MYR 58,989,000 (USD 14.23 million) for kenaf new planting program.
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
mechanization will be given to kenaf's growers.
At present, the kenaf cultivation area involved 1,364 hectares with a total of 928 kenaf growers in 2020.
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 Others Vegetable (cabbage,

(coffee, chili, tomato, potato,
• Ex-tobacco farmers’ yearly income significantly increased by 69% after ginger, etc.) baby-beans) 21.5%
they shifted to other crops. Fruits 2.1%
• Three in four (71%) ex-tobacco farmers shifted to grains followed by (banana, etc.)
vegetables (21.5%), fruits and others crops, which are much profitable 5.2%
than tobacco. Grains (rice, soya beans, corns)
15.2 71.2%
9
Tomato Chili
Coffee
From tobacco From other crops

before shifting after shifting
137
Philippines: Profitability of farming other crops vs tobacco
5,639.6 Farmers in Ilocos Norte, Ilocos Sur, La Union, and Pangasinan (Region
1) preferred to plant non-tobacco crops since they require less input and
Net income per hectare (in USD)
Sweet Pepper
labor compared to tobacco.

Vegetable crops such as tomato, garlic, eggplant, pepper (sweet/hot) and
bitter gourd provided much higher income than tobacco.
Cultivation of mungbean and peanuts also resulted in higher income
compared to tobacco.
4,089.1
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
Cambodia: Tobacco farmers switched to other crops Rice field
Some tobacco farmers realized that tobacco farming is less profit-

able 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 Region (2018).
138
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Chapter 8: Clearing the Air for a Healthier Environment Myanmar

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Your quick access to the latest information on

Tobacco Control in ASEAN Countries
SEATCA Online Resource Center

www.seatca.org
Up-to-date Resources on
. Tobacco Control Laws in ASEAN .
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. Smoke-free ASEAN .
. Packaging and Labelling .
. Tobacco Industry Watch .
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Apartment 4D, Thakolsuk Place,
115 Thoddamri Road,
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Southeast Asia Tobacco Control Alliance

Fifth Edition December 2021

© Southeast Asia Tobacco Control Alliance 2021

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

Tan Yen Lian

Fifth Edition December 2021

Chapter 1: Profiting from Deadly Products 4

Chapter 2: Nicotine and Tobacco Addiction 26

Chapter 3: Basic Needs Sacrificed 46

THE SOLUTION: WHO FCTC 55

Chapter 5: Human and Financial Resources for Tobacco Control 70

Chapter 6: Insulating Public Health Policies from Industry Interference 78

Chapter 7: Reducing Tobacco Affordability and Consumption 86

Chapter 8: Clearing the Air for a Healthier Environment 100

Chapter 11: Protecting Future Generations from Nicotine Addiction 128

Chapter 12: Alternative Livelihood for Tobacco Growers 136

The silver lining of COVID is that it has given the

Dr Poonam Khetrapal Singh

“SEATCA remains committed to stand with

Still, the ASEAN community continues to be a target

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

Southeast Asia Tobacco Control Alliance (SEATCA): Team Members

Cambodia: Dr Yel Daravuth, National Professional Officer, WHO TFI Cambodia

Indonesia: Dr Widyastuti Soerojo, SEATCA Country Coordinator, Indonesia

Lao PDR: Dr Maniphanh Vongphosy, SEATCA Project Coordinator, Lao PDR

Philippines: Health Promotion Bureau, Department of Health

The old ways and new

ways to sell harm.

Tobacco company shares of global cigarette market, 2019

Tobacco Industry profit in global market (2017 – 2020)

7.91 8.06 8.04 8.21

Excessive number of cigarette retailers in selected ASEAN countries

Tobacco manufacturing facilities in ASEAN

Indonesia Bantul Malang Jakarta Selatan* Jakarta Selatan* Jakarta**

Lao PDR Vientiane

Malaysia Seremban*** Kuala Lumpur Kuala Lumpur

Myanmar Yangon Yangon

Philippines Tanauan City, Batangas Malolos City, Bulacan

Less than 1% of tobacco company shareholders domiciled in ASEAN

Big transnational tobacco companies consolidating their power in ASEAN

“This transaction is a tremendous strategic fit for our business

Top 20 global cigarette exporters (2019)

Quick The global tobacco market size was valued at USD

Top 20 global cigarette importers (2019)

Lao PDR 56,706

63,040 66,800 57,384 66,651 66,969

Cigarette production, import and export in ASEAN Countries Countries

127,620 Production (million sticks)

4.7 Imperial Brands (IB)

ENDS market size in ASEAN (2015 – 2023)

Corporate cover up: PMI, BAT and JTI CSR in ASEAN

British American Nicandro Durante 11.05 M 7.28 B No data available

Imperial Brands Alison Cooper 2.84 M 1.29 B No data available

Top 4 ASEAN countries receiving PMI CSR funding (2011 – 2020)

Indonesia Malaysia Philippines Thailand

2,252,938 2,457,126 4,792,016

Distribution of PMI CSR activities (2020)

PMI in-kind contribution (2020)

Tobacco industry’s CSR during COVID-19 pandemic in ASEAN

Local Tobacco Companies

Myanmar Traditional Cheroot

Thailand Tobacco Authority of Thailand 4

Vietnam Vietnam National Tobacco 2