Focus on tobacco control in Thailand
By Stephen Hamann, MPH, EdD, and Naowarut Charoenca, MS, DrPH, Bangkok, Thailand
Stephen Hamann is an international affairs consultant at the Tobacco Control Research and Knowledge Management Center and Naowarut Charoenca is an Associate Professor at the Faculty of Public Health, Mahidol University. They are a married couple who have been working on tobacco control in Thailand for more than 25 years.
What is the status of tobacco control in Thailand?
If one looks at comparisons of tobacco control activities and progress through the Southeast Asia Tobacco Control Alliance website, for example, Thailand is quite advanced in tobacco control programs and activities. Though the smoking prevalence among males is still high, about 40 percent, it is very low among females and has been dropping slowly in the entire population over the last 25 years.
Tell us about your commitment and work:
As with many working for tobacco control, our involvement with tobacco research and cessation is a personal story. It has come from our commitment to our education in public health, but also from the realization that the most devastating substance abuse in society comes from the most common drugs, tobacco and alcohol. We have mostly played a supportive role in work that has included community-based tobacco control projects and research to support legislative changes and innovative programs to sustain tobacco control.
Please share some of your success stories:
Research and advocacy for smoke-free places and support for sustainable resources for health promotion, with tobacco control as a central element, are two areas of recent focus.
Thailand passed the Non-smokers’ Health Protection Act (NSHPA) in 1992, but the provisions of the Act were not implemented regarding smoke-free areas until about 2002. From 2000 to present, we have worked with other colleagues to produce more than 10 research studies on secondhand smoke exposure in restaurants, public buildings, transportation stations, pubs and bars, homes, and most recently, international airports1.
These studies highlighted exposure to vulnerable populations including women, children and workers in smoke-filled workplaces2. Though only some of this research was published, our constant involvement provided valuable evidence for activists to push forward strengthening the NSHPA to make Thailand 100 percent smoke-free.
Another area of concern to us has been resources for tobacco control work, including cessation. When one is faced with limited resources, population-based efforts become nearly impossible. Raising taxes on tobacco can reduce tobacco use, as done through the tax for health policy in Thailand, but it does not ensure resources will be allocated for tobacco control.
Thailand has been fortunate to have innovative advocates who proposed a health promotion foundation patterned after Australia’s Victorian Health Promotion Foundation. We played a role in supporting this effort and the development of the Thai Health Promotion Foundation[MH9] , recognized worldwide as an innovative approach to sustainable funding for health, especially important as NCDs become more and more important to good health in low and middle income countries (LMICs). Thailand’s free national quit line was established and is supported by Thai Health.3
What about the future?
Charoenca and colleagues are presently completing youth smoking cessation research and she is the member representative for Africa, Asia, Oceania, and Latin America (AAOLA) on the Board of the Society for Research on Nicotine and Tobacco. This summer, she is a visiting professor at the College of Public Health, University of Iowa. She and Hamann continue to collaborate with others on projects like the International Tobacco Control Policy Evaluation Project, a worldwide policy evaluation study, and the Asian Alliance on Global Health, among others.
Recent efforts have concentrated on countering tobacco industry interference in policy for tobacco control, including efforts against trade agreements like the Trans-Pacific Partnership designed to give the industry mechanisms to destroy national tobacco control policy efforts.
- Kungskulniti N., Charoenca N., Peesing J., et al. Tob Control Published online First: March 17, 2014, doi: 10.1136/tobaccocontrol 2013-051313
- Charoenca N., Kungskulniti N., Tipayamongkholgul M., et al. Tobacco Induced Diseases 2013 11:7
- Meeyai, A. Yunibhand, J., Punkrajang, P., Pitayarangsarit, S. Tob Control Published online First: June 11, 2014, doi: 10.1136/tobaccocontrol-2013-051520