South Asia’s evolving tobacco hydra: moving from quandary to hope

Abstract

The South Asian region occupies a unique place in global tobacco control because of a broad spectrum of widely used tobacco products and the consequent mix of local and transnational tobacco industries. Cigarette use is especially high among males in many countries, while bidis are widely used in India, Bangladesh and Sri Lanka, and are very inexpensive. Smokeless tobacco use is a global problem, but the bulk of use is in South Asia and there is emerging promotion of newly developed tobacco and nicotine products across the region. With the transnational cigarette industry contributing a significant amount in taxes, the bidi industry employing millions of workers and many farmers engaged in tobacco farming, the industry is powerful and exploits this when countering proposed advancements in tobacco control policy. Despite industry interference and major challenges, this region has achieved remarkable successes in tobacco control, including large pictorial warnings that cover up to 80%–90% of the pack in some countries, stringent rules on depiction of tobacco in movies, bans on advertising and promotion, and smoke-free public places. Key challenges include increasing the tax component of retail prices and reducing tax concessions, regulating newly developed products and countering the aggressive tactics of the tobacco industry. Strategies to advance tobacco control in the region may also include standardised packaging of tobacco products, sustained mass media campaigns to warn the population of the harms of tobacco use and promote use of available cost-covered cessation services, and supply-side measures such as vendor licensing.

Common assumptions in tobacco control that may not hold true for South-East Asia

“…21 SEAR nations like India, Maldives, Nepal and Sri Lanka have made substantial strides with the introduction of 80-90% of pictorial health warnings on ST products. 61 India ratified the WHO FCTC and enacted Cigarettes and Other Tobacco Products Act (COTPA) 2003, which prohibits tobacco product advertising both directly and indirectly. However, the ST industry has continued to flout advertising bans through brand stretching, using same brand names for tobacco and non-tobacco products.…”

Tobacco Industry and Surrogate Advertising in South East Asia Region: Moves and Countermoves

“…19 Diversification of surrogate advertisements on the Internet and online gaming event sponsorship by tobacco companies is another emerging phenomenon that runs unregulated globally, with no federal or state laws existing for prevention or control. 1,20 Over time, surrogate advertising evolved into smarter and more subtle brand placements, just toeing the line of the law and easily falling through the cracks and loopholes (Table 1). And even after years of the cat and mouse game between tobacco companies and the laws catching on, the consumer response essentially remained in the favor of tobacco companies, as reported by recent studies and substantiated by continued high sales of tobacco products despite extensive demand reduction measures.…”

“…19 Diversification of surrogate advertisements on the Internet and online gaming event sponsorship by tobacco companies is another emerging phenomenon that runs unregulated globally, with no federal or state laws existing for prevention or control. 1, 20…”

“…Tobacco Industry and Surrogate Advertising in South East Asia Region: Moves and Countermoves F or decades, tobacco consumption has been a public health concern in the world, especially South East Asia Region, which currently accounts for 81% of global smokeless tobacco users and is home to >22% of global adult smokers aged ≥15 years. 1,2 Asia is not only the world's largest tobacco producer but also the largest tobacco consumer. 3 The tobacco industry in this region has been facilitated by complex cross-border factors, including trade liberalization, direct foreign investment, global marketing, transnational tobacco advertising, promotion, and sponsorship.…”

Analysis of Socio-Economic of Tobacco Farmers in Probolinggo Regency East Java Indonesia

“…The Probolinggo Regency Government will assemble a Tobacco Products Industrial Area situated in one of the tobacco-creating focuses of the Probolinggo Regency (Hiscock & Bloomfield, 2021); (Gupta et al, 2022). The advancement of this Tobacco Products Industrial Area intends to foster the tobacco business in the Probolinggo Regency, which will build the success of tobacco ranchers in the Probolinggo Regency.…”