Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries
2.1. Brief History of Counteracting TTCs in Thailand
|Dates||Factors Driving Policymaking||Policies||Accomplishments|
|1985–1989||Government recognition that tobacco control is a high priority public health issue.||Exclusion of all tobacco industry representatives from policymaking.||FCTC Article 5.3; broader understanding and advocacy in tobacco policymaking.|
|1990||Public health community’s recognition that TTCs’ interests compete and conflict with the public health mission.||National Committee for the Control of Tobacco use maps of interests.||FCTC Article 5; national coordinating mechanism.|
|1992||Recognition that TTCs cannot be trusted to voluntarily limit their interactions with government agencies.||Legislation regulating TTC interactions with government agencies.||Laws and regulations on tobacco products and protection of non-smokers. National framework for tobacco control.|
|1993||Recognition that fiscal resources are necessary to implement comprehensive tobacco control and reduce tobacco use.||Tobacco tax for health.||FCTC Article 6; demand reduction through taxes.|
|1996||Recognition that TTCs should disclose cigarette ingredients.||Failed attempt to implement ingredient disclosure law, delayed by 5 years of negotiations with TTCs.||-|
|2000||Recognition that systems management is important.||Thailand Health Promotion Foundation.||Improve effectiveness in implementation.|
|2001||Recognition that substantial human and financial resources are needed to build comprehensive tobacco control.||Legislation establishing the Thailand Health Promotion Fund through a 2% tobacco and alcohol surcharge.||FCTC Article 26-sustainable funds and advocacy.|
|2002||Recognition of the need to strengthen regulations.||Improved smokefree policy. New pack warnings proposed.||Extend existing laws.|
|2003||Recognition of the importance of international commitment.||Thai government ratifies FCTC.||Government and NGO commitment to FCTC.|
|2004||Recognition that TTCs continue to interfere in government policymaking.||Cabinet directive barring TTCs from making financial or material contributions to government officials, or engaging in political activities.||FCTC Article 5.3; regulation of TTC political interference.|
|2005||Recognition of a need to close advertising loopholes.||Point-of-sale ban fully implemented.||FCTC Article 13; stronger enforcement.|
|2008||Recognition of the need to strengthen cessation efforts.||Policy to allocate substantial funding for a national telephone quitline.||FCTC Article 14; smoking cessation support.|
|2009||Recognition that cigarettes are still not sufficiently expensive to dissuade some smokers from smoking.||Legislation increasing tax on cigarettes.||FCTC Article 6; demand reduction through taxes.|
|2010||Recognition of the need to coordinate organizations, experts and researchers.||National Strategic Plan on Tobacco Control.||FCTC Articles 21 and 22, Articles 5.3 and 6.|
2.2. Pioneering Tobacco Control NGOs
2.3. The Thai Health Promotion Foundation (ThaiHealth)
4.1. TTC Strategies
4.1.1. Doing Business with ‘Two Faces’
4.1.2. Seeking to Influence People in High Places
4.1.3. ‘Buying’ Advocates in Grassroots Organizations
4.1.4. Putting up a Deceptive Front
4.1.6. Undermining Controls on Tobacco Advertising, Promotion and Sponsorship (TAPS)
If one takes the pessimistic view of present trends, the tobacco industry could lose all its political clout within two years. Overstated? Not really. If you take away all advertising and sponsorship, you lose most, if not all, of your media and political allies. If you take away those freedoms, there is hardly any barrier to a punitive tax regime, part of it going to fund our complete anathematization through the funding of ever more extreme anti-campaigns courtesy of ‘social levy’ foundations, of which there is a growing fashion .
4.2. Case Examples
4.2.1. A Donation to the Ministry of Education
4.2.2. TabInfo Asia 2009
4.2.3. Bribing Thai Officials
5. Policy Implications
5.1. Policy Innovations to Counteract and Prevent TTC Interference
- Increasing public awareness of regulations prohibiting TTC interference.
- Monitoring public relations, government and TTM contacts with the TTCs, and TTC CSR activities.
- Monitoring vested interest groups that work with TTCs.
- Issuing notifications of regulations prohibiting importation, manufacturing, or sale of new types of tobacco products.
- Informing the public of marketing and other threats from TTCs.
- Establishing surveillance networks of TTC activities down to the community level.
- Taking legal action on new or “below the line” marketing techniques.
- Researching, regulating, and campaigning against tobacco industry CSR activities.
- Monitoring TTC glamorization of tobacco.
- Educating the public to understand that tobacco use is a non-normative behavior.
- Monitoring TTC legal violations, taking legal action, and publicizing prosecutions and penalties.
5.2. Guidance for LMICs
5.3. Recommendations and Options for Low- and Middle-Income Countries
- Establish legal mechanisms to regulate and monitor TTC all interactions with all government agencies. Since tobacco control is a public health issue, legal mechanisms often focus on public health law. Codify in law restrictions on interactions with TTCs that apply to all government agencies and officials. Develop a proactive legal framework that anticipates TTC interference strategies seeking to influence people in high places.
- Ensure transparency and accountability in government. Working transparently with partners inside and outside of government is essential to maintaining a united front for prohibiting TTC efforts to influence people in high places. It is important to establish specific policies limiting TTC interactions with government agencies through publically disseminated rules of engagement for all government and public-supported agencies, including the rejection of TTC-sponsored CSR projects.
- Seek robust, transparent policymaking to avoid TTC stalling tactics and efforts to dilute legislation. Opportunities to take action against TTCs are often time-sensitive, so it is important to act quickly when favorable political conditions for strong action are present. Establish an advocacy plan and timetable that does not give TTCs opportunities to use intimidation to derail strong legislation and regulation.
- Establish sustainable funding for research and surveillance. It is important to identify, study and expose TTC interference. Sustained research and surveillance are cost effective for society. Earmarked taxes on all types of tobacco products equivalent to at least 75% of the retail price are an effective way to support tobacco control research, guarantee resources for tobacco control projects, and build tools to minimize TTC political interference.
- Squelch influence buying in academia and civil society. Work to gain cooperation from partners to follow rules limiting interactions with TTCs to reduce their influence on important people, reduce their ability to buy advocates in grassroots organizations, and put up a deceptive front. Establish consequences for groups and individuals who accept money or other support from TTCs, or who work as surrogates for TTCs.
- Build public support for tobacco control. When official enforcement is weak, an effective alternative can be to engage the general public in monitoring of TTC non-compliance with laws and policies. Build a cadre of watchdogs in the public and constantly highlight the benefits of tobacco control in the media while exposing TCCs’ subversive practices in public.
- Promote innovation and broad implementation through strategic partnering. Tobacco control measures often result in important societal benefits in addition to the improvement of the public’s health. Tobacco control advocates should seek to identify a wide range of stakeholders beyond the field of tobacco control who will be willing to integrate tobacco control into their projects from the national level to the community level. It is important to enlist experts and authorities who support innovative tobacco control measures and who will champion the benefits of confronting TTC interference.
- Denormalize tobacco use to counteract TTC image-making. Counteract TTCs by working on actions that reduce the overall acceptance of tobacco and diminish the credibility of TTCs. Work through these actions to counteract TTC attempts to undermine controls on TAPS. Such actions should include establishing 100% smokefree places, requiring large picture pack warnings, and prohibiting store displays of cigarettes. Use research and advocacy to educate policymakers so that denormalization measures are adopted.
- Upgrade laws to meet all WHO FCTC requirements and guidelines. Understand the political process and map out a political strategy to establish laws for implementing FCTC measures. Building legal support for FCTC provisions may require informing and lobbying policymakers over a long period of time. Work on multiple fronts to show policymakers your determination to move tobacco control through the legislative process. Seek out political supporters regardless of their political affiliation.
- Monitor TTC activities. Build a coalition of marketing, economic, legal and public health experts to monitor TCCs and take preemptive action against TCC interference. Identify front groups and individuals who are likely to be complicit in TTC practices of doing business with two faces by misrepresenting the consequences of tobacco control measures or acting subversively to allow TTCs to put up a deceptive front.
- Foster cooperative efforts among interested parties while excluding TTCs. TTCs often try to pit tobacco control advocates and organizations against each other on important policy issues. Building cooperation therefore comes from being aware of how TTCs seek to manipulate tobacco control partners and interested parties in policymaking. Constantly educate partners and interested parties by providing current examples of TTC interference, and highlight successful strategies for counteracting interference.
- Centers for Disease Control and Prevention, Best Practices for Comprehensive Tobacco Control Programs-2007; US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health: Atlanta, GA, USA, 2007.
- Beaglehole, R.; Bonita, R.; Horton, R.; Adams, C.; Alleyne, G.; Asaria, P.; Baugh, V.; Bekedam, H.; Billo, N.; Casswell, S.; et al. Priority actions for the non-communicable disease crisis. Lancet 2011, 377, 1438–1447. [Google Scholar]
- World Health Organization. Guidelines for Implementation of Article 5.3 of the WHO Framework Convention on Tobacco Control, 2009. Available online: http://www.who.int/fctc/guidelines/artile_5-_3.pdf (accessed on 15 November 2011).
- Wipfli, H.L.; Fujimoto, K.; Valente, T.W. Global tobacco control diffusion: The case of the Framework Convention on Tobacco Control. Am. J. Public Health 2010, 7, 1260–1266. [Google Scholar]
- World Health Organization, WHO Framework Convention on Tobacco Control; WHO: Geneva, Switzerland, 2003.
- Mamudu, H.M.; Gonzalez, M.E.; Glantz, S.A. The nature, scope and development of the global tobacco control epistemic community. Am. J. Public Health 2011, 11, 2044–2054. [Google Scholar]
- Global Tobacco Research Network, Global Tobacco Control Assessment; Global Tobacco Research Network: Baltimore, MD, USA, 2009.
- World Health Organization. WHA 54.18 Transparency in Tobacco Control; WHO: Geneva, Switzerland, 2005. Available online: http://www.who.int/tobacco/framework/wha_eb/wha54_18/en/index.html (accessed on 15 November 2011).
- Brownell, K.D.; Warner, K.E. The perils of ignoring history: Big tobacco played dirty and millions died. How similar is big food? Milbank Q. 2009, 1, 259–294. [Google Scholar] [CrossRef]
- Cheng, M.H. WHO’s Western Pacific region agrees tobacco-control plan. Lancet 2009, 374, 1227–1228. [Google Scholar]
- Action on Smoking and Health Australia. Countering Tobacco Tactics: A Guide to Identifying, Monitoring and Preventing Tobacco Industry Interference in Public Health; ASH Australia: Melbourne, Australia, 2010. Available online: http://www.ashaust.org.au/pdfs/TItacticsGuide.pdf (accessed on 12 October 2011).
- Chitanondh, H. The Passage of Tobacco Control Laws: Thai Davids versus Transnational Tobacco Goliaths; Thailand Health Promotion Institute: Bangkok, Thailand, 2000. [Google Scholar]
- Corporate Accountability International, Protecting Against Tobacco Industry Interference: 2010 Global Tobacco Treaty Action Guide; Corporate Accountability International: Boston, MA, USA, 2010.
- Southeast Asia Tobacco Control Alliance, Status of Tobacco Use and Its Control: Thailand Report Card; SEATCA: Bangkok, Thailand, 2008.
- Shepard, P.L. Profits, Progress and Poverty: Case Studies of international Industries in Latin America; Newfarmer, R.S., Ed.; University of Notre Dame Press: Notre Dame, IN, USA, 1985. [Google Scholar]
- Stebbins, K.R. Transnational tobacco companies and health in underdeveloped countries: Recommendations for avoiding a smoking epidemic. Soc. Sci. Med. 1990, 2, 227–235. [Google Scholar]
- Philip Morris Incorporated. Worldwide Regulatory Affairs 1999 Original Budget. Available online: http://legacy.library.ucsf.edu/tid/vfb06c00 (accessed on 23 September 2011).
- Harris, D. Untitled Interoffice Correspondence from Donald Harris to Matt Winokur; Philip Morris Asia Incorporated: Hong Kong, China, 1992. Available online: http://legacy.library.ucsf.edu/tid/zrq19e00 (accessed on 15 January 2011).
- Tobacco Master Settlement Agreement (1998): Overview, Implementation by States, and Congressional Issues, Report Updated November 5. 1999. Available online: http://www.law.umaryland.edu/marshall/crsreports/crsdocuments/RL30058.pdf (accessed on 15 October 2011).
- Trochim, W.; Stillman, F.; Clark, P.; Schmitt, C.L. Development of a model of the tobacco industry’s interference with tobacco control programmes. Tob. Control 2003, 2, 140–147. [Google Scholar]
- Hamann, S.L. Overview of Tobacco Industry Philanthropy and Public Relations Strategies in Thailand. Presented at Rangsit University, Bangkok, Thailand, 15 December 2003.
- MacKenzie, R.; Collin, J.; Sriwongcharoen, K.; Muggli, M.E. “If we can just ‘stall’ new unfriendly legislations, the scoreboard is already in our favour”: Transnational tobacco companies and ingredients disclosure in Thailand. Tob. Control 2004, 13, ii79–ii87. [Google Scholar] [CrossRef]
- World Health Organization. Global Adult Tobacco Survey (GATS): Fact Sheet Thailand: 2009. Available online: http://www.who.int/tobacco/surveillance/thailand_gats_fact_Sheet_2009.pdf (accessed on 20 March 2012).
- Supawongse, C. Two Decades of Tobacco-Consumption Control in Thailand: Success and Challenges; Tobacco Control Research and Knowledge Management Center: Bangkok, Thailand, 2007. [Google Scholar]
- Vathesatogkit, P. Thai tobacco control: Development through strategic alliances. Dev. Bull. 2001, 54, 63–66. [Google Scholar]
- Chitanondh, H. Thwarting BAT’s Nicophilanthropy in Thailand; Research Report; Health Promotion Institute, The National Health Foundation: Bangkok, Thailand, 2007. [Google Scholar]
- World Health Organization and Thai Health Promotion Foundation, Many Things to Many People: A Review of ThaiHealth; Thai Health Promotion Foundation: Bangkok, Thailand, 2007.
- Charoenca, N.; Kungskulniti, N.; Hamann, S.L. Implications of tobacco industry documents for FCTC advocacy in developing countries. Unpublished work, 2007.
- World Health Organization, Joint National Assessment of the Implementation of the Effective Tobacco Control Policies in Thailand; Tobacco Control Research and Knowledge Management Center: Bangkok, Thailand, 2008.
- Bible, G.C.; Goldberg, H. Philip Morris Website: Corporate Responsibility, Environment. 1999. Available online: http://legacy.library.ucsf.edu/tid/gxd60c00 (accessed on 12 October 2011).
- Harris, D. Memorandum from Philip Morris Asia International on 3 December 1991. Available online: http://legacy.library.ucsf.edu/tid/bsq19e00 (accessed on 12 October 2011).
- Phillip Morris Incorported. Draft Letter to Meechai Rachuphan Regarding Tobacco Control Bill. Available online: http://legacy.library.ucsf.edu/tid/xct87a99 (accessed on 20 September 2011).
- Hirschhorn, N. Evolution of the Tobacco Industry Positions on Addiction to Nicotine: A Report to the Tobacco Free Initiative; World Health Organization: Geneva, Switzerland, 2008. [Google Scholar]
- Yang, S.S.; Malone, R.E. Working to shape what society’s expectations of us should be. Phillip Morris’s societal alignment strategy. Tob. Control 2008, 17, 391–398. [Google Scholar] [CrossRef]
- Philip Morris Asia. PM website 1999. Available online: http://legacy.library.ucsf.edu/tid/gxd60c00 (accessed on 10 November 2011).
- Chaiton, M.; Ferrence, R.; LeGresley, E. Perceptions of industry responsibility and tobacco control policy by US tobacco company executives in trial testimony. Tob. Control 2006, 15, iv98–iv106. [Google Scholar]
- White, J.; Bandura, A.; Bero, L.A. Moral disengagement in the corporate world. Acc. Res. 2009, 16, 41–74. [Google Scholar]
- Australian Health News Research Collaboration, Media Release: Global Survey Shows Tobacco is World’s Least Reputable Industry; University of Sydney: Sydney, Australia, 2010.
- Philip Morris. List of Tobacco Control Advocates by Country. 1999. Available online: http://legacy.library.ucsf.edu/tid/alw65c00 (accessed on 15 October 2011).
- Rekart, P. Ministry of Health Meeting, June 4, 1992; Philip Morris Report of the Meeting. Available online: http://legacy.library.ucsf.edu/tid/jlc81f00 (accessed on 12 October 2011).
- Philip Morris. Memorandum to the Thailand File. Trip Report of Drs. Perry and Leslie Lectures on Indoor Air Quality and ETS in October 1993. Available online: http://legacy.library.ucsf.edu/tid/jcx59b00 (accessed on 12 October 2011).
- Barnoya, J.; Glantz, S.A. The tobacco industry’s worldwide ETS consultants project: European and Asian components. Eur. J. Public Health 2005, 16, 69–77. [Google Scholar]
- Vathesatogkit, P. Guidelines for the Implementation of Article 5.3 of the WHO FCTC. In Proceedings of theWorkshops on Implementation of the Convention, Bucharest, Romania, 8 June 2010.
- Philip Morris. CIAR Far East Meeting 951010 Hong Kong: Asia Situation, 1995. Available online: http://legacy.library.ucsf.edu/tid/sjl44a00 (accessed on 12 October 2011).
- Philip Morris. Search Results: Report on Meeting the Deputy Minister of Agriculture Dated 3 August, 1992. Available online: http://legacy.library.ucsf.edu/tid/guw65c00 (accessed on 12 October 2011).
- Philip Morris International. PMI Charitable Contributions 2010. Available online: http://www.pmi.com/eng/about_us/corporate_contributions/documents/2010_charitable_contributions_total.pdf (accessed on 10 December 2011).
- Yoon, Y.C.; Kin, F.; Lian, T.Y. Profiting from Death: Exposing Tobacco Industry Tactics in ASEAN Countries; Southeast Asia Tobacco Control Alliance (SEATCA): Bangkok, Thailand, 2008. [Google Scholar]
- McCandless, P.M.; Yerger, V.B.; Malone, R.E. Quid pro quo: Tobacco companies and the black press. Am. J. Public Health 2011. [Google Scholar]
- Tsoukalas, T.H.; Glantz, S.A. Development and destruction of the first state funded anti-smoking campaign in the US. Tob. Control 2003, 12, 214–220. [Google Scholar]
- Landman, A.; Glantz, S.A. Tobacco industry efforts to undermine policy-relevant research. Am. J. Public Health 2009, 99, 45–58. [Google Scholar]
- Philip Morris. Some Reflections on Our Present Discontent- or Why We Are Losing the Public Affairs War on Tobacco?; Confidential Report. 1990. Available online: http://legacy.library.ucsf.edu/tid/qcf42e00 (accessed on 12 October 2011).
- Harper, T. Why the tobacco industry fears point of sale display bans. Tob. Control 2006, 15, 270–271. [Google Scholar]
- Nimpitakpong, P.; Pittayakulmongkon, C. Thailand: Young, female ‘ambassadors’ promote cigarettes in Worldwide News and Comment. Tob. Control 2011, 20, 393–396. [Google Scholar] [CrossRef]
- Goddard, C. Corporate Affairs Review: Philip Morris Asian Region. 1997. Available online: http://legacy.library.ucsf.edu/tid/ojk45c00/pdf (accessed on 15 November 2011).
- Vathesatogkit, P. FCTC Article 5.3: Protecting Policies from Commercial and Other Vested Interests of the Tobacco Industry. In Presented at the National Conference on Tobacco or Health, Bangkok, Thailand, 15 August 2007.
- Thai Protesters Smoke out Tobacco Execs. Time Magazine 2009.
- Riggins, T.; Palos, R.S. Tobacco Company Penalties May Signal U.S. Crackdown on Industry Practices Overseas; The Center for Public Integrity: Washington, DC, USA, 2010. [Google Scholar]
- Bureau of Tobacco Control, Department of Disease Control, Ministry of Public Health. National Strategic Plan for Tobacco Control 2010–2014; Ministry of Public Health: Bangkok, Thailand, 2010. [Google Scholar]
- Benjakul, S. Implementation of the National Tobacco Surveillance System, Bureau of Tobacco Control. In Presented at the 10th National Conference on Tobacco or Health, Bangkok, Thailand, 25-26 August 2011.
- Ministry of Public Health, Order Number 116/2554 Appointing Steering Committee and Committee on National Strategic Plan for Tobacco Control and WHO FCTC; Ministry of Public Health: Bangkok, Thailand, 2011 January 25.
- Kin, F.; Lian, T.Y. Surveillance of Tobacco Industry Activities Toolkit, Southeast Asia Tobacco Control Alliance; U-SA Press: Bangkok, Thailand, 2009. [Google Scholar]
- Kin, F.; Assunta, M. Tobacco Industry Interference in Health Policy in ASEAN Countries, Southeast Asia Tobacco Control Alliance; U-SA Press: Bangkok, Thailand, 2009. [Google Scholar]
- Nimpitakpong, P. Tobacco Industry Surveillance and Study Group. In Presented at the 10th National Conference on Tobacco or Health, Bangkok, Thailand, 25–26 August 2011.
- Vathesatogkit, P. Implementation of the FCTC: Challenges and Obstacles—Thailand’s Experience. In Presented at the First Regional Society for Research on Nicotine and Tobacco Latin American Conference, Rio de Janeiro, Brazil, 7 September 2007.
- Levy, D.; Benjakul, S.; Ross, H.; Ritthiphakdee, B. The role of tobacco control policies in reducing smoking and deaths in a middle income nation: Results from the Thailand SimSmoke simulation model. Tob. Control 2008, 1, 53–59. [Google Scholar]
- Stillman, F.; Hoang, M.; Linton, R.; Ritthiphakdee, B.; Trochim, W. Mapping tobacco industry strategies in South East Asia for action planning and surveillance. Tob. Control 2008, 1. [Google Scholar]
- Crosbie, E.; Sebrie, E.M.; Glantz, S.A. Tobacco industry success in Costa Rica: The importance of FCTC Article 5.3. Salud. Publica Mex. 2012, 54, 28–38. [Google Scholar]
- Lee, W.B.; Fong, G.T.; Zanna, M.P.; Omar, M.; Sirrirassamee, B.; Borland, R. Regret and rationalization among smokers in Thailand and Malaysia: Findings from the international tobacco control Southeast Asia survey. Health Psychol. 2009, 28, 457–464. [Google Scholar]
- Beaglehole, R. UN high-level meeting on noncommunicable diseases: Addressing four questions. Lancet 2011, 378, 449–455. [Google Scholar]
- World Health Organization Committee of Experts on Tobacco Industry Documents. Tobacco Company Strategies to Undermine Tobacco Control Activities at the World Health Organization; WHO: Geneva, Switzerland, 2000. Available online: http://www.who.int/tobacco/media/en/who_enquiry.pdf (accessed on 15 January 2011).
- World Health Organization, WHO Report of the Global Tobacco Epidemic. In Warning about the Dangers of Tobacco; WHO: Geneva, Switzerland, 2011.
- Roemer, R.; Taylor, A.; Lariviere, J. Origins of the WHO framework convention on tobacco control. Am. J. Public Health 2005, 6, 936–938. [Google Scholar]
© 2012 by the authors; licensee MDPI, Basel, Switzerland. This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
Charoenca, N.; Mock, J.; Kungskulniti, N.; Preechawong, S.; Kojetin, N.; Hamann, S.L. Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries. Int. J. Environ. Res. Public Health 2012, 9, 1111-1134. https://doi.org/10.3390/ijerph9041111
Charoenca N, Mock J, Kungskulniti N, Preechawong S, Kojetin N, Hamann SL. Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries. International Journal of Environmental Research and Public Health. 2012; 9(4):1111-1134. https://doi.org/10.3390/ijerph9041111Chicago/Turabian Style
Charoenca, Naowarut, Jeremiah Mock, Nipapun Kungskulniti, Sunida Preechawong, Nicholas Kojetin, and Stephen L. Hamann. 2012. "Success Counteracting Tobacco Company Interference in Thailand: An Example of FCTC Implementation for Low- and Middle-income Countries" International Journal of Environmental Research and Public Health 9, no. 4: 1111-1134. https://doi.org/10.3390/ijerph9041111