Dr Marquizo, Head of the WHO Convention Secretariat
Dr Keeratihattayakorn, Director-General, Department of Disease Control, Ministry of Public Health, Thailand
Partners, Associates, Colleagues and Friends
Good morning to you all.
Tobacco use is a significant risk factor for cardiovascular and respiratory diseases, more than 20 different types of cancer, and many other debilitating health conditions. Valuable lives are lost due to tobacco use every year.
Likewise, excessive alcohol consumption has negative health consequences. It is a risk factor for mental disorders, communicable and noncommunicable diseases, premature mortality, injury, and domestic violence. These all have severe economic and societal costs.
As per the fifth edition of the WHO global report on trends in prevalence of tobacco use 2000–2030, our South-East Asia Region is doing exceptionally well in combating the current tobacco epidemic.
From 2000 to 2022, the current tobacco use prevalence among adult men decreased from 68.9% to around 43.7%. Among adult women, it decreased from 33.5% to around 9.4% in the same timeframe.
Despite this,, as of 2022, our Region still has the highest average tobacco use prevalence rates among adults globally. More significantly, over 280 million smokeless tobacco users, nearly 77% of the global total, are in our Region, as are around 11 million adolescent tobacco users, or 30% of the global total.
As we can see, we need to further prioritise effective implementation of all WHO Framework Convention on Tobacco Control (FCTC) measures at the country-level. This must be done to address both supply-side and demand-side issues, in relation to all forms of tobacco use, to ensure reduction in prevalence of tobacco consumption across our Region.
Elimination of the illicit trade in tobacco products is a key supply-side policy to reduce tobacco use and its health and economic consequences. Experience from many countries shows illicit trade can be successfully addressed, even when tobacco taxes and prices are raised. This results in increased tax revenues while simultaneously reducing tobacco use.
However, progress has been rather slow in our Region in combating illicit trade. Appropriate policies and tools are either not in place, or often poorly implemented. In our Region, only India and Sri Lanka are parties to the WHO FCTC Protocol to Eliminate Illicit Trade in Tobacco Products. Effective track and trace mechanisms are also largely missing across our Region.
An estimated 25% of global alcohol consumption is unrecorded. This is usually of a lower price and appeals to consumers from low socioeconomic status and people with underlying alcohol use disorders. It is often irregularly labelled, thus often containing unknown an unknown ethanol percentage and potentially toxic compounds. It is a complex interplay of these factors which make unrecorded alcohol potentially more harmful than regulated alcohol.
Notably, unrecorded alcohol consumption is associated with disproportionate harm that goes beyond toxicity, and is linked to hazardous drinking patterns, alcohol use disorders and social marginalization. The online sale of unrecorded alcohol, which circumvents alcohol availability regulations, is an emerging and not yet well-explored issue.
Thus, the public health implications of this consultation for our Region are immense.
This workshop is an ideal platform to share global best practices and the latest evidence with the policymakers of our Member States, to monitor and combat illicit tobacco trade and unrecorded alcohol consumption.
I note with appreciation that the consultation will also review the best practices in national quitlines and will explore the possibility of having integrated quitlines for tobacco, alcohol and substance use in our Region. Such an initiative would go a long way to effectively and efficiently tackle these public health menaces.
I agree that effective control of illicit tobacco trade and unrecorded alcohol is a challenging and daunting task, but now is the time to patiently and prudently make our decisions and choose the best way forward.
As a first step, all our remaining Member States should become Parties to the WHO FCTC Protocol to Eliminate Illicit Trade in Tobacco Products.
Second, Member States should make sincere efforts and devote optimal resources to develop, implement and sustain effective ‘track and trace’ mechanisms for tobacco products. Also, it is essential to compile existing, and generate new, Regional evidence on illicit tobacco trade and unrecorded alcohol. This will enable policymakers in our Region to make better-informed and more effective policy decisions to monitor and combat these.
I am sure this regional consultation will go a long way in supporting our Member States to chalk out the best way forward to tackle illicit tobacco trade and unrecorded alcohol in the Region.
I wish all of you an informative, engaging and productive consultation, and a pleasant stay in Bangkok.
Thank you.