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A public smoking ban is needed

A 'no smoking' sign sits in the window of a pho restaurant in Phnom Penh’s Chamkarmon district
A 'no smoking' sign sits in the window of a pho restaurant in Phnom Penh’s Chamkarmon district yesterday. Vireak Mai

A public smoking ban is needed

It may not seem too long ago that people were able to smoke freely wherever they wanted, in airplanes, restaurants, hotel rooms and even hospitals.

Eventually, the overwhelming evidence of the harmful effect of exposure to second-hand smoke made lawmakers realize that it may help to ban smoking in certain areas. In 1990, the first indoor public smoking ban in the world was passed in San Luis Obispo, California.

This ban included smoking in restaurants and bars. Since then, many cities, states and countries across the globe have followed the example of San Luis Obispo and have worked to create smoking bans.
Indeed, living in a smoke-free environment is simply good for health.

As a first step towards a total ban on smoking in public places in Cambodia, the Ministry of Health recently issued a circular that gives the right to managers of public places, including educational and health institutions, public transport, restaurants, hotels, museums, playgrounds, gas stations and historical and cultural sites, to ask smokers to leave the premises if they light up.

Though the circular is only advisory, without any punitive measures for transgressors, it is an important step towards protecting the public from exposure to dangerous tobacco smoke.

But much more needs to be done to reduce the deadly impact of smoking and exposure to tobacco smoke. Strong legislation for a smoke-free environment in the Kingdom is urgently needed.

According to the latest National Adult Tobacco Survey (NATS) Cambodia, 90 per cent of Cambodian citizens are exposed to second-hand smoke at indoor public places.

This is the highest percentage among ASEAN countries reflecting the need for more effective legislative measures in Cambodia to protect the public, particularly children, from exposure to tobacco smoke. The survey also revealed 80 per cent of Cambodians support the government in adopting a policy that bans smoking in all public and work places.

The data related to smoking in the Kingdom is alarming. About 30 people die every day from tobacco related diseases, many of whom are still in their productive years.

That means that in 2013 about 10,000 Cambodians lost their lives prematurely to an epidemic that is entirely preventable. Almost one in every seven deaths among those between 30 to 44 years of age and one in seven among those aged between 45 to 59 years were attributable to tobacco use.

Without urgent and comprehensive tobacco control measures the tobacco death toll will rapidly escalate to an estimated eight million deaths globally by 2030.

With the WHO Framework Convention on Tobacco Control (FCTC) countries have an important and effective tool to put effective tobacco control in place.

The Western Pacific Region is the only region that has 100 per cent ratification of the FCTC, demonstrating how seriously governments view tobacco control.

Cambodia was one of the early countries to ratify the FCTC in 2005. One of the important articles in the FCTC, Article 8, lays out the measures that countries have to take to protect the public from exposure to second-hand smoke.

The Article 8 guidelines provide a step-by-step guidance on measures governments can take such as the scope of legislation (smoking in indoor public and workplaces, public transport, etc), its enforcement, including penalties, and monitoring mechanisms.

The time is now right for the Kingdom to move towards a policy of 100 per cent smoke-free environment for all its citizens.

Countries in the ASEAN region such as Brunei, Malaysia, the Philippines, Singapore, Thailand and Vietnam have put in place effective smoke-free policies and legislations with penalties that have shown to be effective in establishing healthy smoke-free environments.

The experiences of these countries need to be emulated as they demonstrate what works. Let there be no mistake: There is no safe level of exposure to tobacco smoke, contrary to what the tobacco industry is promoting.

As early as 1986 the US Surgeon General’s Report provided evidence that exposure to tobacco smoke causes cancer in non-smokers.

It is a misconception that smokers and non-smokers can co-exist in harmony, for instance, in restaurants that have separate smoking and non-smoking rooms or in buildings or offices with smoking rooms.

This does not work because smoke does not respect physical boundaries, with the result that non-smokers become victims of passive smoking.

While public education is vital in getting the message across, legislative measures underpinned by fines are necessary to deter would-be-violators. The recent circular on the ban of smoking in public and work places in Cambodia is a good start to ensure a smoke-free environment.

The next step is the passing of the Law on Tobacco Control that should include strong punitive measures in the form of fines for violators of the ban on smoking in public and work places.

At the end of the day, a public smoking ban will be a strong contribution to a healthier Cambodia.

Dr Pieter JM Van Maaren is Representative of the World Health Organization in Cambodia.

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