Stakeholder’s Assessment of the Awareness and Effectiveness of Smoke-free Law in Thailand

Background This study reports stakeholders’ ratings, and perceived gaps in World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) Article 8 implementation in Thailand viewed against WHO’s Guidelines for Article 8 and to inform action in preparing the 2017 Tobacco Product Control Act. Methods Stakeholder ratings of Guideline provisions of Article 8 on a three-tiered scale of implementation from understanding to effectiveness and efficiency were used to identify gaps in enforcement and compliance important to success in meeting Article 8 goals. This stakeholder assessment occurred through a stakeholder meeting of 55 stakeholders in Bangkok, Thailand in June 2016. Results The average of all assessment ratings by stakeholders on an ascending 0-3 scale had a mean score of 1.67, which means the level of implementation for Article 8 in Thailand was rated less than effective for enforcement. The assessment shows that the public understanding of smoke-free principles is also poor at a mean of 1.28, that there is incomplete effectiveness of smoke-free measures with a mean of 1.75, and only a general effectiveness that smoke-free protections are adequately covering most places with a mean of 1.98. More needs to be done to make all places compliant through enforcement efforts rated with a mean of only 1, and that more is necessary for protection from tobacco-smoke exposure in other public places and in private vehicles with mean ratings of 1.71 and 1.14. Conclusion This stakeholder approach using a three-tiered rating scale found that the implementation of Article 8 in Thailand is still lacking. With this approach, stakeholders identified critical issues needing improvement and informed changes in the then-proposed Tobacco Product Control Act which later was adopted in 2017

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

Stakeholder’s Assessment of the Awareness and Effectiveness of Smoke-free Law in Thailand

Abstract Background: This study reports stakeholders’ ratings, and perceived gaps in World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) Article 8 implementation in Thailand viewed against WHO’s Guidelines for Article 8 and to inform action in preparing the 2017 Tobacco Product Control Act. Methods: Stakeholder ratings of Guideline provisions of Article 8 on a three-tiered scale of implementation from understanding to effectiveness and efficiency were used to identify gaps in enforcement and compliance important to success in meeting Article 8 goals. This stakeholder assessment occurred through a stakeholder meeting of 55 stakeholders in Bangkok, Thailand in June 2016. Results: The average of all assessment ratings by stakeholders on an ascending 0-3 scale had a mean score of 1.67, which means the level of implementation for Article 8 in Thailand was rated less than effective for enforcement. The assessment shows that the public understanding of smoke-free principles is also poor at a mean of 1.28, that there is incomplete effectiveness of smoke-free measures with a mean of 1.75, and only a general effectiveness that smoke-free protections are adequately covering most places with a mean of 1.98. More needs to be done to make all places compliant through enforcement efforts rated with a mean of only 1, and that more is necessary for protection from tobacco-smoke exposure in other public places and in private vehicles with mean ratings of 1.71 and 1.14. Conclusion: This stakeholder approach using a three-tiered rating scale found that the implementation of Article 8 in Thailand is still lacking. With this approach, stakeholders identified critical issues needing improvement and informed changes in the then-proposed Tobacco Product Control Act which later was adopted in 201

Case study of a solid waste scavenger community with respect to health and environment

Thesis (D.P.H.)--University of Hawaii at Manoa, 1991.Includes bibliographical references (leaves 168-178).Microfiche.xiv, 178 leaves, bound ill. 29 c

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