During the Covid-19 pandemic, strengthening tobacco control laws makes even more sense for Thailand.
While Thailand tackles its third wave of the epidemic, the country has been facing another, even more deadly epidemic of many years' standing: tobacco use.
The Covid-19 virus has claimed around 700 lives in Thailand as of mid-May 2021. During the same period, tobacco has killed nearly 80,000, or over 100 times more people.
Every year, May 31st marks World No Tobacco Day. This year's theme is "Commit to Quit," aimed at empowering tobacco users to succeed in stopping tobacco use through policy and support.
Over 10 million people smoke tobacco in Thailand.
Now is a good time to quit and support those quitting. Quitting can save your life and that of loved ones: smoking and exposure to second-hand smoke can cause chronic health conditions such as heart disease, stroke, cancer, diabetes, and lung disease, which increase the risk of severe Covid-19 outcomes.
It is never too late to quit. Lungs begin to work better within just two weeks of quitting tobacco.
However, given the highly addictive nature of tobacco and its enormous socioeconomic aspects and impacts, quitting is often beyond individual action.
It requires an integrated policy where a "whole-of-government" and "whole-of-society" approach creates an enabling policy and social environment to support tobacco users to quit.
Quitting can keep households from facing poverty, by preventing financial hardship in low-income households through the extra expenditure and lost income opportunities associated with disease, disability or premature death of breadwinners.
In Thailand, people in the bottom 25% of the population in economic terms spend 17% of their income on tobacco: it diverts significant household resources from productive investments that can help lift and keep people out of poverty, such as food, education, and agricultural inputs. The impacts are even more severe today when many are losing income due to the pandemic.
Tobacco also inflicts a massive economic cost: a 2020 study by the Chulalongkorn University estimated Thailand lost 93 billion baht from tobacco use in 2017, equivalent to 0.65% of its GDP or 17% of health expenditure.
Thailand's contracting economy coupled with swelling Covid-related expenditure cannot afford unnecessary losses, particularly when the loss is preventable such as tobacco use.
In short, quitting tobacco makes health, economic and development sense.
In recent decades, Thailand has made remarkable achievements in tobacco control, notably since the country joined the WHO Framework Convention on Tobacco Control, the first international public health treaty adopted in 2003.
Thailand, for example, was the first country in Asia to roll out plain cigarette packaging, which puts the logo-free brand name in a standardised format alongside a graphic warning to make smoking less attractive.
Thailand also bans electronic cigarettes as well as smoking and cigarette-butt littering on its most popular beaches, which protects not only the health of tourists and locals, but also vital economic resources: beautiful beaches, pristine oceans, and diverse marine life.
Gaps exist, however, particularly in tobacco taxation. Thailand received a score of merely 1.75 out of 5 in the most recent Tobacco Tax Scorecard, which assesses the performance of tobacco tax policies across 174 countries.
As the extent and frequency of tobacco tax increases fall behind inflation and income growth, tobacco products in Thailand are more affordable today than in 2008.
Different tax rates for different tobacco products (for example, manufactured cigarettes versus shredded tobacco for roll-your-own cigarettes) allow switching to lower-taxed products instead of helping people quit when taxes are increased.
Tobacco tax increases present the single most effective, pro-poor measure to help stop youth from starting smoking and motivate tobacco users to quit.
It also brings many other benefits: it boosts labour productivity and economic growth; cuts avoidable public expenditure and increases government revenue; reduces poverty and inequality; and mitigates environmental damage. These development gains can accelerate Thailand's progress toward achieving the Sustainable Development Goals (SDGs).
The government recognises these gaps and intends to act. Unfortunately, the implementation has been delayed. Strengthening tobacco taxation is a win-win: it can empower Thailand to better cope with the Covid-19 crisis, by helping smokers quit, thereby decreasing the risk of worse Covid-19 outcomes; and by generating additional revenue for Covid-19 response, some of which could be allocated to supporting tobacco quitting and helping tobacco farmers shift to alternative crops or livelihoods as in the Philippines.
To examine the cost of non-communicable diseases (NCDs), for which tobacco is the leading risk factor, the UN Interagency Task Force on the Prevention and Control of NCDs, WHO and UNDP in partnership with national stakeholders are developing an investment case at the request of the government.
NCDs account for 74% of all deaths in Thailand and are strongly associated with Covid-19 related deaths. Tobacco control must be an integral part of the Covid-19 response.
World No Tobacco Day reminds us that the whole-of-government and whole society must work together to stop the tragic loss of lives due to tobacco. Now is the time to act.
Renaud Meyer is Resident Representative, UNDP in Thailand. Dr Daniel Kertesz is WHO Representative to Thailand.