(People's Health Foundation) -၅၂

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1 (People's Health Foundation) -၅၂ ၂-၂ သ လ ရန က န ၿမ Report on Advocacy workshop on ban of tobacco advertising, held at the University of Public Health, Yangon on 26 June July, 2013 Yangon i

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3 Report on Advocacy workshop on ban of tobacco advertising, 26 June 2013 University of Public Health, Yangon Background Among the tobacco control measures, a comprehensive ban on tobacco advertising, (TAPS), through legislative measures, is effective only if it is broad in scope. When certain forms of direct tobacco advertising are prohibited, the tobacco industry inevitably shifts its expenditure to other advertising, strategies, using creative, indirect ways to promote tobacco products and tobacco use, especially among young people. The effect of a partial advertising ban on tobacco consumption is also limited. This is recognized in Article 13 of the WHO Framework Convention on Tobacco Control (WHO FCTC), which lays down the basic obligation to ban tobacco advertising, promotion and sponsorship. According to Article 13.1 of the Convention, Parties recognize that a comprehensive ban on advertising, would reduce the consumption of tobacco products. The comprehensive ban on advertising, is well defined in the Article 1(c) and (g) of the Convention. Article 1(c) defines tobacco advertising and promotion as any form of commercial communication, recommendation or action with the aim, effect or likely effect of promoting a tobacco product or tobacco use either directly or indirectly. Article 1(g) defines tobacco sponsorship as any form of contribution to any event, activity or individual with the aim, effect or likely effect of promoting a tobacco product or tobacco use either directly or indirectly. Promotional effects, both direct and indirect, may be brought about by the use of words, designs, images, sounds and colours, including brand names, trademarks, logos, names of tobacco manufacturers or importers, and colours or schemes of colours associated with tobacco products, manufacturers or importers, or by the use of a part or parts of words, designs, images and colours. Promotion of tobacco companies themselves (sometimes referred to as corporate promotion) is a form of promotion of tobacco products or tobacco use, even without presentation of brand names or trademarks. Advertising, including display and sponsorship of smoking accessories such as cigarette papers, filters and equipment for rolling cigarettes, as well as imitations of tobacco products, may also have the effect of promoting tobacco products or tobacco use. To ensure that points of sale of tobacco products do not have any promotional elements, the Parties (Member Countries) should introduce a total ban on any display, and on the visibility of tobacco products at points of sale, including fixed retail outlets and street vendors. Some tobacco industries adopted the Brand stretching strategy, where a tobacco brand name, emblem, trademark, logo or trade insignia or any other distinctive feature (including distinctive colour combinations) is connected with a non-tobacco product or service in such a way that the tobacco product and the non-tobacco product or service are likely to be associated. Similarly, some used Brand sharing strategy to promote a brand name, emblem, trademark, logo or trade insignia or any other distinctive feature (including distinctive colour combinations) on a non-tobacco product or service is connected with a tobacco product or tobacco company in such a way that the tobacco product or company and the non-tobacco product or service are likely to be associated. Some tobacco companies make financial or in-kind contributions to organizations, such as community, health, welfare or environmental organizations, either directly or through other 1

4 Advocacy workshop on ban of tobacco advertising, entities. Studies in many countries on their efforts to comprehensively ban the TAPS have shown effectively decreasing the consumption of tobacco products. Research showed that some countries have experienced a decline in consumption of up to 16%, after the introduction of advertising bans. A study of the 22 high-income countries concluded that more comprehensive bans on TAPS reduced tobacco consumption by up to 7.4%. The study showed that the downward trend in tobacco consumption is much steeper in countries with bans than in those without bans, and that partial advertising bans or voluntary agreements had little effect. Before 2003, the advertisements on different brands of cigarettes and cheroots in the mass media (printed papers, newspapers, journals and TV) or on large billboards have been widely seen everywhere. As per the guideline given by the National Health Committee in 1998, the Ministry of Information had issued the ministerial order to the mass media, to have a total ban of cigarette advertising on television, radio and other electronic media. As per guidance of the National Health Committee, the Ministry of Health issued a ministerial order in 2002, to ban on tobacco billboards; no cigarette advertising near the schools, hospitals, sport stadiums, and other publicly visible places. Through the ministerial order by the Ministry of Home Affairs, and also by the instructions of the Mayors of the Yangon and Mandalay Cities, there was a ban on tobacco advertising billboards at all townships by end of March The Ministry of Sports in 2002 issued a ministerial order to gradually reduce sponsorship of sports by tobacco industries, and a total ban at later dates. Through the order of the General Administration Department in 2002, there was a ban on cigarette advertising from all print media, newspapers, journals, magazines. In same year, the National Health Committee had directed to delete scenes promoting tobacco scenes from films, videos, and any other commercial programs. However, surrogate advertisements, promotion of sales, brand stretching and brand sharing are seen for certain brands. The national law - the Control of Smoking and Consumption of Tobacco Product Law (the State Peace and Development Council Law No 5/2006) - adopted in May 2006, in its Chapter 8, had stipulated punishable offences for violating comprehensive ban on tobacco advertising,. However, keeping in view of inefficient law enforcement on tobacco control, industries and sale promotion people dodged the comprehensive stipulated legislation and have used various ways and mechanisms for expanding their brand advertisement, promotion of sales, and sponsorships. Keeping in view of above, People's Health Foundation, in collaboration with the Department of Health, the Society of Preventive and Social Medicine, and the University of Public Health, and with support from WHO SEARO, had organized Advocacy workshop on ban of tobacco advertising,, on 26 June 2013, at the University of Public Health, Yangon. With the agreement of wider participation and full involvement, and at advise of the media people, the workshop's original duration of 2-days has been reduced to one day. (See Annex 1 for detailed programme.) The advocacy workshop was attended by over 70 participants who are dealing with mass media (such as newspaper, journals, magazines, films, video/dvd, Radio and TV channels, FM Radio and any other printed, broadcasting and electronic media), and the public health officials and consumer affairs advocates who are interested in legislative measures for tobacco advertising,. Representatives from national NGOs also attended the workshop. (See Annex 2) General Objectives The general objective of the workshop is to advocate the media people on effective implementation of the Myanmar national policy and legislative measures for comprehensive ban on tobacco advertising, (TAPS), in consistent with the WHO FCTC Article 13 guidelines. 2

5 People's Health Foundation, Myanmar Specific objectives: 1. To provide the media people a basic understanding of the evidence to support requirements for banning tobacco advertising, and the elimination of misleading terminology, and the technical and legislative considerations in implementing the ban for tobacco advertising, promotion and sponsorship, including common loopholes and best practices throughout the World; 2. To provide tailored technical consultations in understanding the role of media in monitoring the industry compliance and enforcement activities on the national policy and legislative measures for tobacco advertising, ; and, make recommendations on effective implementation of national legislation on tobacco control. Summary of Workshop Proceedings The workshop is inaugurated by Professor Dr Nay Soe Maung, Rector of the University of Public Health, at 0900 am, on 25th April 2013 (Thursday), who also welcome all participants and invited guests. Dr Thein Swe, Retd Director-General, Department of Traditional Medicine, and the Vice President of People s Health Foundation, gave the audience a brief explanation of the background, objectives and expected outcome of the workshop. He also thanked for WHO SEARO, for its support, and the Department of Health for agreeing to organize the workshop and also the University of Public Health to host and make all administrative support. He had welcome the media people and appreciated them for taking the interest and full involvement in the workshop. The participants then introduced themselves. Dr Than Sein, President, People s Health Foundation, and retired Director from WHO SEARO, provided the brief background of WHO Framework Convention on Tobacco Control (WHO FCTC), and the details of the Article 13 of the WHO FCTC, which lays down the basic obligation to ban tobacco advertising, (TAPS). He had highlighted the overall evidence concerning the importance of banning tobacco advertising, promotion and sponsorship (TAPS); the experience of other countries on comprehensive banning tobacco advertising, ; including common legal loopholes, pitfalls, lessons learned and new tactics; evidence on the impact of banning tobacco TAPS, and what makes them most effective, and evidence to support basic elements of comprehensive banning TAPS as an effective tobacco control measure. He said that many countries including Myanmar had adopted comprehensive ban on TAPS. However, many countries have deficient in implementing control measures. Tobacco industries also dodged the legislation and used various strategies keeping in view of loopholes in the legislation or implementing more of brand sharing and brand stretching. Dr Nan Naing Naing Shein, Tobacco Control Unit of the Department of Health, gave a brief account on the development of Myanmar Tobacco Control Law, which was enacted in She had elaborated the actions undertaken by various ministries for banning tobacco advertising, (TAPS), even before the national law was enacted. She also described about the various articles of the law for banning TAPS, and also banning sale to minors. She highlighted those articles especially in Chapter 8, which had stipulated punishable offences for violating comprehensive ban on tobacco advertising,. She made short statements on the assessment of current legislative measures, with a view to monitor and evaluate the compliance by the industries as well as to monitor effective enforcement measures. She had requested the media people to collaborate in this endeavour and to make recommendations for improving enforcement, monitoring and evaluation. Professor Myo Oo, retired Head of Department and Professor of Preventive and Social Medicine, and President of the Society of Preventive and Social Medicine, highlighted the 3

6 Advocacy workshop on ban of tobacco advertising, rising trend on the tobacco use, and that tobacco use among male both young and old usage is above 50%, and women one in five are using tobacco, especially at younger ages. He also pointed out that many people who used tobacco as their habits for many years are willing to quit, but they do not have much ideas on how to quit. Daw Ei Ei Swe, health education officer, Department of Health, presented the results of a quick road-side survey, conducted by health education officers, on how tobacco industries had expanded their sale promotion, sponsorship and advertisement, especially in sub-urban areas and rural districts. Short reviews on different styles of advertisement, sale promotion and sponsorship were made in 12 townships of the six Regions (Yangon, Mandalay, Sagaing, Bago and Magwe). She gave examples of many vinyl poster sheets of different sizes, showing young models and brands, sale promotion messages, stickers of various sizes showing brands, advertisement with brands at point of sale, workers at tea bars using T-shirts, cigarette labels on many utensils, etc. She mentioned that since 2002 the ban on cigarette advertising from all print media, newspapers, journals, magazines, has been quite controlled, as there were no advertisement seen on newspapers and journals. Although the ban on advertisement on the electronic media, like TV, movies, videos, and films, etc., has been implemented for some years, with the change of censorship board, there were many scenes showing use of tobacco smoking in a few movie films and videos. She had highlighted that many people both in urban and rural areas did not know about the legislation which had been adopted seven years ago. Many sellers of tobacco products even insisted that if such legislation existed, they would have followed it, especially on advertisement and sale promotion activities. The participants then debated various issues on tobacco control, advertising, sale s, including the evidence on other tobacco control measures. The outcomes of the discussions are as follow: It is prime time for Myanmar to develop effective media strategies for both smoking as well as smokeless tobacco, since the smokeless tobacco is in higher usage among rural and young populations. Myanmar had adopted measures against tobacco advertisement, sale promotion and sponsorship even years before the comprehensive ban on TAPS was stipulated under the 2006-national tobacco control law. However, evidences showed that there were deficiency in implementing the control measures. Tobacco industries also dodged the legislation and used various strategies keeping in view of loopholes in the legislation or implementing more of brand sharing and brand stretching. Media people have been urged to take more education measures for general public and tobacco sellers, and also to make reports on violating banning measures. Media people have been advised to include the original text, in full articles or subarticles of the Myanmar national law on tobacco control, periodically to make reminder to the general public, and also to include stories, messages, plays, etc. on why and how the law has come out for specific measure. Media people (especially those of printed media like newspapers, journals and magazines) can create "anti-tobacco corners" and provide information on tobacco control, both from sources nationally and internationally. Ministry of Health and Ministry of Information could develop a "media plan/strategy" in collaboration with press councils and media groups, that would ensure regular appearances in news, television, radio and printed media, on effective tobacco control measures. Media people could make arrangements for interviewing the cancer, heart and lungs patients, especially who had the experiences of using tobacco (smoke and nonsmoke), and informing the general public how to avoid such diseases by preventing the use of tobacco from young ages. 4

7 People's Health Foundation, Myanmar Ministry of Health needs to expand the services for quitting tobacco, not just at big hospitals, but to make them available at rural health centres and sub-health centres. Representative from Myanmar Maternal and Child Welfare Association agreed to include tobacco control measures as one of the health education activities that they are implementing at their monthly visits to villages. Since the need for effective implementation of the 2006-national tobacco control law has now be the topic of debates at the national assembly, the media people could provide more evidences for effective control measures, with the aim of educating the general public. Use various articles, stories and papers on dangers of tobacco use, how to quit, etc. should be available in each of rural libraries, and paper reading circles should be promoted at these libraries. Future Actions/Recommendations The workshop ended with the following recommendations for the Ministry of Health and Media people to consider them as the requisites for effective implementation of tobacco control measures including banning TAPS. 1) Extensive training and education to all health professionals and media people (health focal persons) are in need to spread the measures enacted in the national Law. The training and education should target them, especially those people who are still using tobacco products, either smoking or smokeless tobacco. 2) In order to educate the people about the importance of Myanmar Tobacco Law which has been promulgated since 2006, similar advocacy workshops should be organized to be participated by at least 2 groups: (a) health professionals, organized through professional associations like Myanmar Medical Association, Myanmar Dental Association, Myanmar Health Assistant Association and Myanmar Nurses and Midwifery Association; and (b) legislative people including local government officials and school head-masters and school teachers. 3) All media should include short education messages or stories on anti-tobacco measures, in their production regularly, at least once in every 2 weeks, either in the journals, magazines. newspapers, TV commercials, etc. 4) Efforts should be made to expand smoke-free places to tobacco-free places, at least to come out with actions for tobacco-free national events. 5) Community-based quitting centres should be promoted and the Ministry of Health needs to provide specific guides on how these centres could be established. Closing Session Dr Than Sein concluded the workshop by thanking all participants for having the understanding and knowledge on how to argue more effectively in implementing legislative measures for tobacco advertising, (TAPS), and for the elimination of misleading practices for TAPS, and making counter arguments and tactics used by tobacco companies to weaken regulatory efforts. He also thanked the host for involving effectively in the deliberations. He expressed his satisfaction as the workshop came out with a series of recommendations that could be useful for the Ministry of Health in adopting measures for banning TAPS. 5

8 Advocacy workshop on ban of tobacco advertising, Advocacy workshop on the ban of tobacco advertising, promotion and sponsorship, UoPH, Yangon, Myanmar, 26 June 2013 Programme ( ) Time Programme Responsible persons Opening Session 8:30 9:00 Welcome & workshop overview Prof. Nay Soe Maung (Rector), and Dr Thein Swe (VP, PHF) Participant introductions Session 1: Evidence overview: Chairman: Prof. Nay Soe Maung, Rector, UoPH 9:00 11:00 Article 13 (plenary) WHO FCTC Article 13 Basic elements (30 minutes) Tobacco Use in Myanmar (20 minutes) Myanmar Tobacco Law: Implementation overview, including Chapter 8 (30 minutes) Tobacco industry tactics and arguments (30 minutes) Session 2: Application of evidence to country action: Chairman: Dr Thein Swe Assessment of current legislative measures for banning TAPS, with a view to monitor and evaluate the compliance by the industries as well as to monitor effective enforcement measures Question & Answer (90 minutes) Lunch Break Role of Mass Media to improve the implementation of comprehensive ban on TAPS Question & Answer (60 minutes) Dr Than Sein Prof Myo Oo (PSMS) Dr Nang Naing Naing Shein (DoH) Daw Ei Ei Swe (HEB) Facilitators and participants Facilitators and participants Tea/Coffee Break Panel discussions: Policy recommendation on comprehensive ban on TAPS: Chairman: Prof Nay Soe Maung Facilitators and participants 1600 Closing Session Dr Than Sein 6

9 People's Health Foundation, Myanmar Advocacy workshop on the ban of tobacco advertising, promotion and sponsorship, Yangon, Myanmar, 26 June 2013 List of Participants No Type of Participants Number A B C D E Print Media 1 Journals/Magazine (Health Digest, Health Care, Good Health, Health Infor, 7-days, Voice, Weekly Eleven, Voice, Pyithu Khit.) 2 Newspapers (Mirror, Myanma Ahlin, Myawady, Shwe Naing-gan, 7- days, Yangon Times, Yangon Times) TV/Radio 1 TV Channels: (MRTV, MRTV4, MRTV International, SkyNet, Myawaddy) 2 FM Radio (City FM, Mandalay FM, Shwe FM, Padamya FM) 4 Film/Video Media National Film Association (EC member-u Aung Khine) 1 Public Health Specialists 1 PSM Society (UMI, UMII, DMS, DMU, NU) 8 2 University of Public Health 8 National NGO 1 People's Health Foundation 5 2 Myanmar Anti-narcotic Association 2 3 Myanmar Health Assistant Association 1 4 Myanmar Medical Association 1 5 Myanmar Maternal and Child Welfare Association 2 6 Consumer Protection Association (Myanmar) Sub-Total 60 F Resource Persons (Than Sein/Thein Swe/DocHtwe/Nay Soe Maung) 5 G Facilitator (NR) DOH-TOB Cell 1 H Participants (NR) 1 Health Education Division, DOH 4 2 DOH 2 Sub-Total 12 Total 72 7