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More Asian Governments Declare War On Smoking


Asia has one of the highest rates of cigarette smoking in the world - but smokers are starting to feel the heat as more and more governments in the region declare war on smoking.

For anti-smoking activists, the remote Himalayan kingdom of Bhutan is the ultimate Shangri-la. It outlawed the sale and use of all tobacco products throughout the country last year, making it the world's first non-smoking nation.

Much of the rest of Asia, however, is still clouded in tobacco smoke. Almost half of the world's 1.3 billion smokers live here and there is no sign of a decline. The World Health Organization says an average of 90,000 children and teenagers start smoking everyday - again roughly half in Asia.

The impact of smoking on public health is enormous. The WHO says thousands of people in the region die each day of smoking-related diseases such as cancer, lung diseases and strokes.

But Judith Mackay, founder of the Asian Consultancy on Tobacco Control in Hong Kong, says that despite the size of the problem, the ill effects of smoking do not get enough attention.

"In Hong Kong, for example, we had 350 deaths from SARS (Severe Acute Respiratory Syndrome). We have 6,000 (deaths) a year from tobacco," she noted. " I mean the order of the magnitude is just extraordinarily different, but it is SARS that gets the headlines, the funding, the government's attention, that gets the WHO attention."

In some parts of Asia - mainly in its more developed countries - smokers have already started to kick the habit.

The WHO says in South Korea, for example, male smokers dropped from 70 percent to 50 percent after the government raised tobacco taxes. In Singapore, which has been tough on smoking for years, only about 12 percent of the population smokes - one of the lowest rates in the world.

But the head of tobacco control at WHO's office in Manila, Burke Fishburn, says the less wealthy nations of Asia remain a challenge.

"What is happening in developing countries is that the tobacco industry is having a lot of success, they are getting more and more people to smoke and that's where the fight is right now," he explained.

In China alone about 350 million people are smokers. They light up one out of every three cigarettes in the world.

As smoking rates went down in the United States and Europe, multinational tobacco companies have turned to the developing countries of Asia.

Fishburn says these companies try to dissuade governments from setting up strong tobacco control measures. And they try to make smoking appear fashionable to Asian women who traditionally rarely smoked.

Mackay says, however, that Asia did not turn out to be the easy market that these companies expected.

"The makers of the Marlboro Cowboy cigarettes very much hoped they could ride this Marlboro cowboy into Asia and thought it would be a Wild West frontier and it would be very easily conquered," she said. " I think, however, what they have found in Asia is something quite different - that there is already a growing and quite stiff resistance on the part of governments."

More and more Asian governments realize that tobacco is costing them more than they are gaining from it - including those countries that produce cigarettes such as India, China and the Philippines.

All 27 member-states of the WHO's Western Pacific Region have signed the (WHO) Framework Convention on Tobacco Control, which came into force in February of last year. And Fishburn says all but two governments have ratified it.

"Our region is doing far better than other WHO regions as far as signing on or ratifying the treaty, which I think is very good news for public health," he said.

The convention asks countries to toughen their health warnings on cigarette packages and to introduce bans on tobacco advertisement and promotion within five years. It also encourages signatories to increase the price of cigarettes and expand smoke-free zones.

The WHO says that a price increase of 10 percent leads to a reduction of smokers of about five or six percent.

China produces one third of the world's cigarettes and in some provinces tobacco is the main source of revenue. But Beijing has come to realize the negative impact of tobacco on the health and wealth of the country.

In the mid-90s, the WHO says China spent $6.5 billion a year on health care related to tobacco use. The organization says tobacco kills more than 1.2 million people in China every year.

Beijing ratified the Convention on Tobacco Control In 2004. The WHO representative in Beijing, Henk Bekedam, says this was a great step forward.

"The Chinese government says it is serious about tobacco control, because it signs onto a few steps that it needs to undertake. These are areas of at least considering the issue of increasing the price of tobacco - one of the best instruments in reducing the number of people smoking."

China is expected to put health warnings on cigarette packages this year. Malaysia, Burma and Thailand have all tightened restrictions on smoking in public places.

The Hong Kong government is expected to pass a bill this year banning smoking in all work places.

Even Japan, which has few restrictions on smoking, has put more aggressive health warnings on cigarette packages.

Although no country in the region is likely to go as far as Bhutan by banning smoking entirely, the tobacco industry may begin to feel the heat.