Smokers, experts divided over smoking ban plan

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A smoker in September 23 Park in downtown Ho Chi Minh City. The government is assessing public opinion on a draft law that would significantly limit smoking in public places.

Public health officials say a ban on smoking in public places would be a "˜historic' step; smokers doubt it will be enforced.

Tuan Anh, 43, plans to avoid restaurants with designated smoking sections.

It's not the smoke that drives him away. Anh, a chain smoker, just does not like the idea of being discriminated against.

"I am well aware that smoking is harmful to my health and the health of others but I can't kick the habit"”I've tried a few times," said the Ho Chi Minh City real estate dealer who estimates he's smoked about 20 cigarettes a day for the past four years. "Smoking is everywhere here. A smoking ban will probably just increase the number of violators rather than reduce the number of smokers."

In 2009, the central government issued a decision banning smoking in healthcare facilities, libraries, theaters, cultural centers, public vehicles and indoor workplaces. A decision signed by the prime minister, is considered a legal document, but its legal value is weaker than a law that is passed by the parliament.

The decision supposedly went into effect in January 2010"”though attitudes, like Anh's, continue to prevail. Most of Vietnam's smokers appear unaware (or unconcerned) that the 2009 decision ever took effect.

At the moment, the government is collecting opinions on a draft law proposing further restrictions on tobacco use.

The law would extend the existing ban to cinemas, children's amusement parks, circuses, buses and airplanes.

The law would also call for the creation of designated smoking areas at colleges and vocational schools, offices, cultural centers, sports centers, roofed stadiums, exhibition centers, restaurants bars, karaoke lounges, trains and boats.

If approved, the new law will take effect in 2013.

Fatal habit

SIX STRATEGIES
FOR SLASHING SMOKING

* Monitor tobacco use and assess the impact of tobacco prevention policies.

* Protect people from secondhand smoke.

* Offer help to tobacco users looking to quit.

* Warn and educate people about the dangers of tobacco use through strong, graphic pictorial health warnings and hard-hitting, sustained mass media public education campaigns

* Enact and enforce comprehensive bans on tobacco advertising, promotion and sponsorship; and the use of misleading terms, such as "light" or "low-tar".

* Raise prices of all tobacco products by increasing tobacco taxes.

(Source: the World Health Organization)

Anh, a die-hard smoker, doubts the law will ever be enforced.

"No restaurant is going to force smokers to abide by any kind of ban, unless they want to chase away their customers," he said.

Many smokers share his skepticism.

One doctor, who declined to be named, told Thanh Nien Weekly that he often sneaks cigarettes in "secret places" while making his rounds at a public hospital in HCMC - far from the disparaging eyes of his patients and their relatives.

"I can't quit smoking," he admitted. "It's really a shame."

Cuong, an assistant bus driver on the Long An Ho Chi Minh City route, said that smoking is banned on his bus but smokers often ignore the rule.

"On some buses, the drivers and their assistants also smoke," he said. "There isn't a "˜no smoking' sign anywhere on the bus."

The World Health Organization (WHO) estimated that tobacco kills 40,000 Vietnamese every year, and by 2030 this number will increase to 70,000 annually. The victims don't just include smokers, but also millions of non-smokers"”including mothers and children"”who are exposed to second hand smoke.

Smoking-related illnesses are rapidly increasing and have overtaken communicable diseases as the number one cause of hospitalization, according to statistics maintained by the Ministry of Health.

Jorge Alday, associate director of Policy and Communications at the New York-based World Lung Foundation, said that smoking among adults has decreased slightly in Vietnam, during the past 10 years.

Still, he said, the figure hovers at around half of adult men and about 15 million adults in the country overall.

Smoking also has a large economic impact on poor households.

"A smoker in Vietnam currently spends about VND1.1 million a year on cigarettes, using valuable resources that could be contributed to the cost of food or education for the family," he said. "The loss or illness of an adult male in the household also has a detrimental impact, both economically and emotionally."

Positive move

Despite skepticism about its potential effectiveness, Vietnamese experts say that the draft law represents a positive step in the right direction.

"It is a starting point," said Do Thi Phi, program coordinator at the Hanoi-based Center for Research and Community Development Services (CDS). "Few people now smoke indoors, at the workplace. In public places, a lot of people have raised their voice against smokers."

Alday said that the passage of this law would signify a "historic step for Vietnam," as it demonstrates a commitment by the government to protect the health of Vietnamese citizens.

However, he said that the experience of the 2010 smoking ban in public indoor places proves that passing strong legislation is only one part of the process.

"Recent research shows that the majority of the Vietnamese public understands the dangers of smoking and of second hand smoke, and that they support smoke-free public places," he said. "Effective communication can shift this knowledge and attitude to self-enforced behavior."

Pham Hoang Anh, Vietnam's Country Director of HealthBridge a Canada-based NGO working to improve the health of vulnerable populations, also said that by passing the Law on Prevention and Control of Tobacco Hazards, Vietnam will have the most powerful legal tool to protect people from the harms of smoking.

"This is especially important, given that, at this stage, there exist many legislative documents ["¦] regulating tobacco control but the content of some of these documents is inconsistent and some of those are not really "˜pro public health,'" she told Thanh Nien Weekly.

"To make the law strong, Vietnam should follow the guidelines of the Framework Convention on Tobacco Control, an international treaty of whom, Vietnam is a member," she said.

To reduce the number of smokers in Vietnam, Anh advised the government to effectively implement policies that would keep the cigarette prices high by consistently increasing taxes.

She also urged the government to push for a comprehensive ban on tobacco advertisement and to effectively enforce a smoke-free policy in indoor public and work places.

Anh reminded that it takes ten or twenty years of tobacco use before the effects of smoking emerge in the form of cancer or heart disease.

"Even if we [implement] strong tobacco controls today, we may still see a rise in deaths due to smoking as a reflection of the situation in the past," she said.

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