Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries

Transnational tobacco companies (TTCs) interfere regularly in policymaking in low- and middle-income countries (LMICs). The WHO Framework Convention for Tobacco Control provides mechanisms and guidance for dealing with TTC interference, but many countries still face ‘how to’ challenges of implementation. For more than two decades, Thailand’s public health community has been developing a system for identifying and counteracting strategies TTCs use to derail, delay and undermine tobacco control policymaking. Consequently, Thailand has already implemented most of the FCTC guidelines for counteracting TTC interference. In this study, our aims are to describe strategies TTCs have used in Thailand to interfere in policymaking, and to examine how the public health community in Thailand has counteracted TTC interference. We analyzed information reported by three groups with a stake in tobacco control policies: Thai tobacco control advocates, TTCs, and international tobacco control experts. To identify TTC viewpoints and strategies, we also extracted information from internal tobacco industry documents. We synthesized these data and identified six core strategies TTCs use to interfere in tobacco control policymaking: (1) doing business with ‘two faces’, (2) seeking to influence people in high places, (3) ‘buying’ advocates in grassroots organizations, (4) putting up a deceptive front, (5) intimidation, and (6) undermining controls on tobacco advertising, promotion and sponsorship. We present three case examples showing where TTCs have employed multiple interference strategies simultaneously, and showing how Thai tobacco control advocates have successfully counteracted those strategies by: (1) conducting vigilant surveillance, (2) excluding tobacco companies from policymaking, (3) restricting tobacco company sales, (4) sustaining pressure, and (5) dedicating resources to the effective enforcement of regulations. Policy implications from this study are that tobacco control advocates in LMICs may be able to develop countermeasures similar to those we identified in Thailand based on FCTC guidelines to limit TTC interference

Tobacco industry globalization and global health governance: : towards an interdisciplinary research agenda

Shifting patterns of tobacco production and consumption, and the resultant disease burden worldwide since the late twentieth century prompted efforts to strengthen global health governance through adoption of the Framework Convention on Tobacco Control. While the treaty is rightfully considered an important achievement, to address a neglected public health issue through collective action, evidence suggests that tobacco industry globalization continues apace. In this article we provide a systematic review of the public health literature and reveal definitional and measurement imprecision, ahistorical timeframes, transnational tobacco companies and the state as the primary units and levels of analysis, and a strong emphasis on agency as opposed to structural power. Drawing on the study of globalization in international political economy and business studies, we identify opportunities to expand analysis along each of these dimensions. We conclude that this expanded and interdisciplinary research agenda provides the potential for fuller understanding of the dual and dynamic relationship between the tobacco industry and globalization. Deeper analysis of how the industry has adapted to globalization over time, as well as how the industry has influenced the nature and trajectory of globalization, is essential for building effective global governance responses

Skin infections among beach users and staphylococci in Hawaii marine waters

Thesis (D.P.H.)--University of Hawaii at Manoa, 1991.Includes bibliographical references (leaves 157-168).Microfiche.xiii, 168 leaves, bound ill. 29 c

Tobacco control: Lessons learnt in Thailand

This review of legislation, obstacles faced, and challenges to be met, outlines present tobacco control lessons learnt in Thailand. A review of over twenty years of tobacco control experience in Thailand is provided in seven areas including policy formulation and the role of civil society, as well as in essential WHO Framework Convention on Tobacco Control areas. A descriptive, historical review shows how stakeholders, policies and resources were mobilized in Thailand, and what lessons resource-challenged countries might use from the Thai experience

Environmental damage from tobacco pollution of air and water on Thailand beaches

Background Cigarette butts are known to be dangerous since they are mostly non-biodegradable plastic and contain dangerous chemicals embedded in filter material. Pollution from secondhand smoke on congested beaches and from cigarette waste on beaches in low- and middle-income countries (LMIC) has received relatively little attention, and its assessment is important for environmental protection and human health. Methods We conducted an observational investigation to assess availability of cigarettes, population of smokers, warnings not to smoke, and number of cigarette butts on and adjacent to two popular public beaches in Thailand. We also took 88 measures of PM 2.5 levels in beach lounge areas on these beaches using equipment and protocols previously used for the assessment of secondhand smoke in outdoor locations. Results Total, smoker and child populations varied with up to 100 total population, 4 smokers and 15 children in a 400 square meter area. This translates to 50 or more smokers along a 250 meter beach front area. In less than eight hours of cigarette butt collection, 2,810 cigarette butts were collected at one beach and 3,666 butts collected at the second beach with 56% collected in the beach lounge area. Peak PM 2.5 air pollution from smokers lounging on these beaches reached as high as 716 and 1,335 µg/m3 taken within 2 meters from active smokers. Cigarette retail sales were widely available close to the beaches, and only one beach had any “No smoking” signs posted. Conclusions Pollution of beaches is evident by the number of cigarette butts and the level of secondhand smoke exposure in Thai beach areas. In Thailand and similar LMIC where beaches are heavily used, we recommend a consumer education approach which highlights pollution dangers to children and the natural environment, followed by a ban of smoking on beaches

Smoking among migrant factory workers in Thailand

Background In Thailand, Samut Sakhon province is the location of thousands of factories that employ Myanmar migrants to process seafood and in the production of other goods. Our aim was to characterize migrants' smoking status and the factors that are important to smoking-related behaviors of this worker population. Methods A questionnaire was used to evaluate socio-demographic, personal and psychosocial factors related to smoking status. Variables assessed included smoking status, knowledge and behavior. Sample size was calculated using experience from a previous study of migrant workers in this province. A convenience sample of 300 migrant workers at one factory was collected. Results Most migrant workers were males, with 90% current smokers. Most workers were married, but many did not have their families with them since they came as low-wage day workers. Mean age of smoking initiation was 18.59 years. Male gender, limited education, poor knowledge of smoking harms, smoking by friends, and having 6 or more of their 10 closest friends smoking were significant predictors of smoking (p-value < 0.05). While these variables were significant, the psychosocial variables of workplace and community circumstances (separation from family and isolation from the larger Thai community) resulted in a very high smoking rate among the male workers interviewed (94%). There was limited encouragement to quit smoking in the migrant work setting or community. Conclusions Our results and analysis shows high conformity to peer and workplace conditions which enabled and reinforced smoking behavior. Policies and actions to inform migrants of the dangers of tobacco use and the establishment of smoke-free environments in the workplace and community when working in Thailand should be developed within the migrant community. Since interventions have been developed for Thai factory workers, similar projects in the migrant community should be developed and implemented to promote better health for migrant workers

Radiological risk assessment in the Asian green mussel (Perna viridis) and the Thai seafood consumers

There are several sources of radionuclides to be accidentally and routinely released into the marine ecosystem leading to bioaccumulation of such radionuclides in marine biota in Thailand. Radioactive contamination in local seafood can result in significant health effects via the human food chain. This study aims to estimate radiation doses received by the Asian green mussel (Perna viridis), and the Annual Committed Effective Doses (ACEDs) and Lifetime Cancer Risk (LCR) from 137Cs, 226Ra, 232Th, and 40K in the mussels via ingestion. The mussels were collected from the offshored shellfish farms in the Gulf of Thailand and the Andaman Sea during wet and dry seasons between 2020 and 2021 for radioactivity measurement using HPGe gamma spectrometry. The results showed that 137Cs, 226Ra, 232Th, and 40K concentrations in the green mussels ranged from 0.0049 to 0.0623 Bq/kg, 1.86 to 3.67 Bq/kg, 0.34 to 0.62 Bq/kg, and 3.80 to 30.74 Bq/kg, respectively. Radiation dose rates in the shellfish estimated using the ERICA Tool were found to be in a range of 0.50–0.76 µGy/h which were well below the screening value of 10 µGy/h. In addition, the ACEDs ranged between 6.41 and 72.78 µSv/yr which were lower than 300 µSv/yr. While the LCR values estimated in the present study ranging from 3.55 × 10−6 to 2.82 × 10−5 did not exceed the recommended value of 10−4. It could be concluded here that eating the green mussels from the studied areas did not cause any radiological health risk in the Thai seafood consumers. However, future investigations are recommended to be conducted in the green mussels from other locations and in young consumers where higher ACEDs and LCR values were recorded