Access to cigarettes among the youths in seven South-East Asian countries

Abstract

1 Published by European Publishing on behalf of the European Network for Smoking and Tobacco Prevention (ENSP). © 2021 Satpathy N. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial 4.0 International License. (http://creativecommons.org/licenses/by-nc/4.0) Dear Editor, The global tobacco epidemic kills about eight million people annually. In many countries, cigarettes are the most commonly used tobacco product and most smokers start cigarette smoking when they are still minors. Nearly 9 in 10 cigarette smokers try their first cigarette before the age of 18 years. Evidence shows that adult smokers with less intentions to quit have a history of initiating smoking in their adolescence. The key component of a comprehensive tobacco control program involves restricting the supply of and demand for tobacco products to discourage youths and young adults from initiating smoking. This is an obligation of Parties signatory to the WHO Framework Convention on Tobacco Control (FCTC). Every nation from South-East Asia (SEA), except Indonesia, has signed and ratified the WHO FCTC. However, the enforcement of compliant FCTC comprehensive tobacco legislation differs from country to country. Indonesia is a country that is neither a signatory nor a party to the FCTC. Global Youth Tobacco Survey (GYTS) data have indicated that the methods for physical access to cigarettes vary across the SEA region. Buying them from a store, shop or on the street, followed by other sources, were the preferred methods of obtaining cigarettes among boys in all countries, except for East Timor where buying from vending machines was the most way to purchase cigarettes. Similarly, the preferred methods of getting cigarettes among girls were the other sources followed by shops, kiosks or on the street sales, except for East Timor where vending machines followed by shops or kiosks were the preferred way to obtain cigarettes. In all countries except Indonesia, the weekly pocket money was insufficient to buy a cigarette packet having 20 cigarettes, for the majority of students. In Bhutan, East Timor, and Indonesia where girls’ cigarette smoking was >2%, financial access among girls was higher than for boys. Among the seven SEA countries, except Indonesia, all had ratified the WHO FCTC during 2003 and 2004. The countries brought in to force their tobacco control legislation along with school tobacco control policy during the period 2005–2017, while GYTS was implemented during 2013–16. At the time of GYTS, East Timor and Thailand had no tobacco control legislation including the ban on tobacco sales to or by minors and by vending machines (Table 1). Despite restrictions on tobacco sales to minors in other countries, in the majority of instances vendors supplied cigarettes to the students, which was highest for Bangladeshi boys and Indonesian girls. Restricting access and age restrictions on tobacco product sales have been enforced in many countries with varying success, due to resource constraints that inhibit implementing these laws. A less obvious reason may be the subtle impression created by the law that consumption of tobacco is an adult AFFILIATION 1 Department of Community Medicine, Institute of Medical Sciences, Sum Hospital, Sikhsha O Anusandhan University, Bhubaneswar, India 2 KIIT School of Public Health, Kalinga Institute of Industrial Technology, Bhubaneswar, India 3 Department Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi University, New Delhi, India