Executive Summary
Tobacco consumption is a major catastrophe that has continuously claimed lives worldwide. Data from the World Health Organization (WHO) as of July 31, 2023, revealed that more than 8 million people die annually from tobacco consumption globally. Concurrently, approximately 1.3 million non-smokers die due to exposure to secondhand smoke (SHS). Over 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries.
According to data from the United Nations in collaboration with the WHO and the Ministry of Public Health of Thailand in 2021, over 80,000 people in Thailand die annually from smoking (18% of all deaths), with more than 6,000 of these deaths attributed to secondhand smoke exposure. This translates to an average economic loss of 352 billion baht per year, or 2.1% of the Gross Domestic Product (GDP).
Furthermore, smoking was the number one risk factor causing the loss of healthy life years (Disability-Adjusted Life Years or DALYs) out of 74 risk factors studied in 2019, accounting for a loss of 2,817,347 DALYs, which is 14.6% of the total loss. The loss among males was 29 times higher than among females.
However, the United Nations advises that effective investment in tobacco control would require an average annual investment of 2.5 billion baht over 15 years. This investment aims to reduce the number of deaths from smoking and the number of people suffering from non-communicable diseases (NCDs) by 35,790 and 169,117 people, respectively.
The latest survey on the smoking situation among the Thai population by the National Statistical Office in 2021 found that out of 57 million people aged 15 years and older in Thailand, 9.9 million (17.4%) were smokers, showing an overall downward trend. Tracking the situation over a 30-year period from 1991-2021 revealed that males had a smoking rate 26 times higher than females. The smoking rate among males decreased by 1.40% annually, and among females by 2.50% annually. In contrast, the survey found an emerging issue of e-cigarette use, with 78,742 users recorded (0.14%).
Within this group, adolescents aged 15-24 years old account for the largest proportion of e-cigarette use, at 30.5%. This aligns with the results of the Global School-based Student Health Survey (GSHS) in Thailand (2021), conducted by the Department of Health, Ministry of Public Health, which found that students in grades 7-12 (aged 13-17 years old) had increased tobacco product use from 14.1% (2015) to 14.7%, with e-cigarette use specifically at 13.6% (18.7% for male students and 8.9% for female students, respectively).
Even though e-cigarettes are prohibited goods under import and sales bans in Thai law, the current situation shows an increasing quantity available on online platforms, rapidly spreading across all channels. The marketing strategies for e-cigarettes are also becoming more sophisticated. Products are evolving rapidly, becoming more visually appealing, and cheaper. They have changed from ‘ciga-like’ products to ‘Toy Pod’ e-cigarettes resembling toys, snack boxes, or drinks, which are small, fragrant, produce less smoke, have 3-5% Salt Nic levels, are inexpensive, and easy to acquire. This type of marketing is defined as ‘predatory marketing’ (targeting children).
The aforementioned data reflects a change in the tobacco industry’s marketing strategies aimed at children and youth, based on the belief that the earlier young people start smoking, the quicker the opportunity to think of and develop into new smokers.
Additionally, the tobacco industry leverages principles of behavioral science, psychology, and technology as tools for producing advertisements, public relations materials, and distributing e-cigarettes that cater to the modern lifestyle of youth. Examples include designing products that are distinctive, beautiful, compact, and easy to carry; conducting online marketing; sales promotions; and providing trial products to attract the interest of young people.
stimulating curiosity and a desire to experiment, making the products easily accessible, as well as providing distorted information about the health impacts. Therefore, e-cigarettes have become a trendy product with increasing demand, primarily distributed through online platforms. It is thus necessary to establish guidelines for regulating and preventing online e-cigarette sales to reduce access for both new and existing smokers. Continuous study, surveillance, and monitoring of the e-cigarette situation across all platforms are required to keep pace with sellers’ marketing mechanisms, as well as developing effective law enforcement guidelines.
Therefore, to ensure continuity in tobacco control, development of the research system, and capacity building and knowledge management for tobacco control researchers/academics so they can generate knowledge that leads to policy utilization at both central and local levels, the Tobacco Control Research and Knowledge Management Center (TRC) has a mission to drive this forward in collaboration with other network partners in research, academia, and knowledge management to achieve the aforementioned goals in the future. The 7th Tobacco Control Research and Knowledge Management Plan (2024–2026) consists of the vision, mission, and objectives continuing from TRC Phase 6, as follows:
Project 1: Support research funding and research management and create new researchers.
To develop the capacity of research personnel and uphold research ethics in generating knowledge and evaluating key tobacco control policies, with emphasis on current situations and future trends that are significant to the nation and the community. This is done to promote the knowledge management system and research support system, integrate work plans, and coordinate with other research agencies.
(This covers and slightly expands on the content of Objective 1).Project 2: Develop a research information system and knowledge.
To collect tobacco control related information as Big Data and enhance the utilization of information systems for accessing data and promoting knowledge communication channels via media advocacy continuously. This includes developing a system for surveillance, control, regulation, and monitoring the evaluation of the strategic implementation in a concrete manner, ensuring alignment with local situations and contexts. We aim to develop a database system for research, knowledge, and information related to tobacco control (Big Data), and develop a system for surveillance, control, regulation, and monitoring the evaluation of tobacco control at all levels.
(This addresses Objectives 2 and 3).Project 3: Monitor and analyze the situation to synthesize knowledge on tobacco control.
To maximize the benefits of utilization for public policy advocacy in developing systematic and comprehensive tobacco control directions across all dimensions.
(This addresses Objective 4).Project 4: Support the development of academic strength and cooperation of research networks.
In the area of tobacco control at both regional and international levels, as well as with international agencies in accordance with the synthesis of academic work and linkage of knowledge on tobacco control to drive policy proposals (Policy Advocacy) within the framework of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC).
(This addresses Objective 5).Project 5: Support the communication of knowledge and research results on tobacco control.
To the public and relevant individuals in all sectors to raise awareness and possess the knowledge to collaboratively and effectively control tobacco consumption, by building and developing a network of academics in tobacco control (knowledge generators) connecting with knowledge users.
(This addresses the rest of Objective 5).Analysis of strengths and weaknesses of the operations of the 7th phase of the TRC
Analysis of Strengths
- The operation is under an educational institution that is recognized at both national and international levels.
- It is an independent academic organization that focuses on policy-level research referenced by academic evidence, as well as knowledge management, by translating research into public communication and concretely driving policies.
- There is an increasing number and strength of tobacco control researcher networks both domestically and internationally.
- There is improved cooperation with public and private sector agencies in tobacco control, along with joint support for the structural mechanisms of national and provincial tobacco control.
Opportunities
- There are the United Nations Sustainable Development Indicators and Goals (SDGs).
- There is the World Health Organization Framework Convention on Tobacco Control (WHO FCTC).
- The Tobacco Product Control Act B.E. 2560 (2017) is in effect, along with the Third National Tobacco Control Action Plan.
- Integrated measures are in place that prohibit the import, sale, and servicing of e-cigarettes.
Analysis of Weaknesses
- Insufficient Channels/Areas for Disseminating Knowledge for Tobacco Control: This includes inadequate communication that reaches target groups, especially children and youth, via online communication platforms to increase their access to information and news.
- Access to and Linkage with Youth Target Group Networks: These networks include teacher and parent networks, youth networks, and family networks, all necessary for joint action and raising awareness of the dangers of e-cigarettes among young people.
- Incorrect Knowledge and Understanding of the Dangers of E-cigarettes Among the Public, Children, and Youth: This points to the widespread misinformation and lack of understanding regarding the harms of e-cigarettes.
- Insufficient Strength of Smoking Cessation Mechanisms/Service Systems in both Proactive and Reactive Approaches: This highlights the weakness in both offering cessation support (reactive) and actively reaching out to help people quit (proactive).
Threats
- Severe Threat from the Tobacco Industry: This refers to the aggressive actions and influence of the tobacco industry.
- Marketing Strategies for New Tobacco Products, Especially on Online Platforms: This highlights the new, targeted approaches, particularly online, used to promote products like e-cigarettes and heated tobacco products.
- Price Mechanism Gap between Taxed vs. Smuggled Cigarettes and New Tobacco Products: This points to the issue of price differences that make illicit and new products more accessible, undermining tax policies.
- Lack of Awareness and Involvement in Non-Public Health Sectors Related to Tobacco Control: This identifies the problem of insufficient understanding and participation from sectors outside of public health, which is crucial for comprehensive control efforts.
- Free Cannabis Policy Leading to a Cannabis Epidemic Among Children and Youth, Spreading to E-Cigarettes: This explains the unintended consequence of liberalizing cannabis, leading to wider use among minors and an overlap with e-cigarette use.
- Too Short Budget Support Duration Preventing Large-Scale and Long-Term Research: This outlines a limitation in funding that hinders the ability to conduct extensive, long-term research projects.