Each 31 May is celebrated by the World Health Organisation (WHO) as World No Tobacco Day.
All students in the Faculty of Allied Health Sciences, Thammasat University know, the Thammasat University Library collection includes many books of interest on the subject of tobacco control and the damage caused to society and individuals of tobacco smoking.
As the WHO website explains,
This yearly celebration informs the public on the dangers of using tobacco, the business practices of tobacco companies, what WHO is doing to fight the tobacco epidemic, and what people around the world can do to claim their right to health and healthy living and to protect future generations. The Member States of the World Health Organization created World No Tobacco Day in 1987 to draw global attention to the tobacco epidemic and the preventable death and disease it causes.
World No Tobacco Day demonstrates the threats that the tobacco industry poses to the sustainable development of all countries, including the health and economic well-being of their citizens.
There have been many noteworthy academic research articles and theses written about tobacco control in the Kingdom, including one published in the July 2019 issue of BMC Public Health.
As its website indicates,
BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community… All articles published by BMC Public Health are made freely and permanently accessible online immediately upon publication, without subscription charges or registration barriers.
The article, Smoking prevalence and attributable deaths in Thailand: predicting outcomes of different tobacco control interventions, was coauthored by Dr. Suchunya Aungkulanon, a public health specialist, and colleagues from the International Health Policy Program, Ministry of Public Health in Nonthaburi
As its website informs us,
The International Health Policy Program, Thailand (IHPP) is a semi-autonomous program conducting research on the national health priorities related to health systems and policy in Thailand. The program, which is now part of the Bureau of Policy and Strategy-MOPH, aims to improve the national health care systems through generating knowledge and reliable evidence on improving health systems and policy to the public and Thai policy makers. Furthermore, the original aim of the program which was to strengthen the capacity of Thai researchers is still carried out through conducting policy relevant research in the areas of health care finance, economic evaluation, public health insurance, and health policy analysis. The researchers of the program are promoted to pursue postgraduate studies either in the country or abroad. During the last nine years, IHPP has shown an outstanding record in health policy and systems research. It has identified and addressed key emerging issues in health systems with the application of tools such as health economics, health financing, and health policy analysis. IHPP has focused not only on research, but on policy processes and policy utility of research findings; this demanded researchers to work closely with related stakeholders in each particular field. Most importantly, IHPP has physical proximity to, but an arm-length relationship with, policy makers in and outside the Ministry of Public Health in order to maintain policy relevance and scientific integrity and independence.
The article’s abstract includes the following observations:
Despite substantial positive impacts of Thailand’s tobacco control policies on reducing the prevalence of smoking, current trends suggest that further reductions are needed to ensure that WHO’s 2025 voluntary global target of a 30% relative reduction in tobacco use is met. In order to confirm this hypothesis, we aim to estimate the effect of tobacco control policies in Thailand on the prevalence of smoking and attributed deaths and assess the possibilities of achieving WHO’s 2025 global target. This paper addresses this knowledge gap which will contribute to policy control measures on tobacco control. Results of this study can help guide policy makers in implementing further interventions to reduce the prevalence of smoking in Thailand…
Results
Given that the baseline prevalence of smoking in 2010 was 41.7% in males, the target of a 30% relative reduction requires that the prevalence be reduced to 29.2% by 2025. Under a baseline scenario where smoking initiation and cessation rates among males are attained by 2015, smoking prevalence rates will reduce to 37.8% in 2025. The combined tobacco control policies would further reduce the prevalence to 33.7% in 2025 and 89,600 deaths would be averted.
Conclusion
Current tobacco control policies will substantially reduce the smoking prevalence and smoking-attributable deaths. The combined interventions can reduce the smoking prevalence by 19% relative to the 2010 level. These projected reductions are insufficient to achieve the committed target of a 30% relative reduction in smoking by 2025. Increased efforts to control tobacco use will be essential for reducing the burden of non-communicable diseases in Thailand.
The article offers these findings:
While an annual tax increase had the largest impact on smoking prevalence, brief advice showed potent and immediate effects on reduction in smoking attributable deaths with almost 55,000 fewer deaths. Combined interventions resulted in a 4% reduction. As shown in Table 4, the cumulative number of deaths over the 10 year period between 2016 and 2025 was 2,235,851 among males aged > 15 years. By 2025, a total of 99,784 tobacco related deaths, or 4.5% of the total deaths from all causes, were projected to be averted by implementing the combined tobacco policies. This follows the brief advice to quit smoking in clinical settings which contributes to 2.46% of all-cause mortality.
Of particular interest is the finding that efforts to persuade people to stop smoking cigarettes saves tens of thousands of lives and spares many Thai families the pain of seeing their relatives suffer from smoking-related illnesses.
While enforcement of smoking regulations remains an ongoing issue, there is agreement that raising the taxes on cigarettes will decrease consumption, which is a good thing for Thai public health overall.
Also of interest is the finding:
Scenario 4: increased coverage of a health facility-based brief advice intervention on smoking cessation
Brief advice is one of the most cost-effective disease prevention interventions [33], and is feasible to integrate into primary health care centers due to its relatively low cost. Cochrane Systematic Reviews estimated that a brief advice intervention can increase the rate of smoking cessation by up to 66% . Despite these guidelines and its cost-effectiveness, this intervention is largely neglected by health professionals in low- to middle-income countries. Smokers are not offered cessation advice in clinical encounters. The ITC Survey reported large variations in coverage of brief advice by health professionals, ranging from less than 10% in New Zealand to over 50% in the USA . Thailand’s Health Welfare Survey reported that 29% of the population had visited a health facility during the past 30 days prior to the survey. We assumed that 30% of smokers visit a healthcare provider of which all received advice to quit smoking, and the smoking cessation rate from this intervention was 66%.
