Children are exposed to high-powered cigarette advertising in this Phnom Penh playground.
D riving past Phnom Penh's 30 meter billboards you could be forgiven for thinking
the only thing the city sells is tobacco. Images of affluent Westerners with their
cigarette of choice bombard the travelling public.
A dozen leathery Marlboro men from the American West saddle up on the skyline, while
Mild Seven's sporty types are portrayed as happy and healthy, riding mountain bikes
over snowy peaks. Meanwhile, children playing in Hun Sen Park are watched over by
the sophisticated, cigarette wielding Davidoff man with the enigmatic slogan, "The
more you know..."
Ironically, what people know about tobacco in Cambodia is largely dictated by what
cigarette companies choose to tell them. "Promotion girls" give away free
cigarettes, umbrellas adorned with company logos shade popcorn sellers, TV and radio
stations push the merits of smoking, and live concerts are sponsored by local brands.
However, it seems that most of the city's residents would like the Marlboro man and
his fellow smokers to ride off into the sunset: WHO figures show three-quarters of
Phnom Penhois want an end to tobacco advertising in the capital. That, say experts,
would be a good start.
"[Cigarette companies] know that developing countries like the Western style,"
says Po Samnang of the National Center for Health Promotion (NCHP). "The billboards
have to come down, especially those in Phnom Penh. They convey a bad image."
As tobacco controls take hold in the West, cigarette companies have focused more
on developing nations. An August, 2001 report from the Adventist Development and
Relief Agency (ADRA) that examined the prevalence of smoking in Cambodia stated multinationals
have targeted Cambodia as "a prime market".
There are next to no regulations governing the marketing and sale of cigarettes in
Cambodia. Although government media are banned from advertising tobacco and companies
are responsible for affixing a small health warning to cigarette packets, there is
no age limit on sales and no regulation on public advertising. In such an environment,
tobacco companies increasingly restricted by regulations elsewhere have carte blanche
to fire at will from their highly funded arsenal of campaigns.
The aggressive marketing techniques used by cigarette companies in Cambodia coincide
with some of the worst smoking statistics in the world. Figures from Indochina Research,
a private research firm, show 69 percent of men and 10 percent of women in Cambodia
smoke. The numbers are even higher in rural areas: previous ADRA and Ministry of
Health (MoH) calculations put the figure for men near 85 percent.
ADRA's report explained that tobacco consumption has "penetrated deep in the
Cambodian culture". Cigarettes are given as gifts to Buddhist monks and wedding
guests. They are used as bribes, as a substitute for money, even to keep mosquitoes
and insects at bay.
Yel Daravuth is head of ADRA's Tobacco or Health Program and a long term campaigner
for tobacco controls. He says most people in Cambodia know smoking is bad for the
health, but simply don't realize how bad. Many doctors, he says, still haven't grasped
the serious health impacts of smoking.
Inadequate health records in Cambodia mean it is impossible to find precise figures
on smoking-related diseases, but a 1997 report from the MoH and WHO, based on international
figures, estimated 5,800 smoking-related deaths in Cambodia annually.
Curbing the Epidemic, a World Bank publication on the relationship between advertising
and the consumption of cigarettes, says while smoking related illnesses were once
an affliction of developed countries, they are now rapidly shifting to the developing
world. It predicts that by 2020, seven out of every ten people killed by smoking
will be in low and middle-income nations.
NCHP's Samnang says people have yet to realize the enormous impact smoking is having
and will have on the country.
"People here always focus on HIV, AIDS and TB and not on the hidden dangers
of smoking," he says.
The MoH has been unsuccess-ful in its attempts since 1993 to ban tobacco advertising,
even though other countries in the region, notably Thailand and Vietnam, have managed
to do so.
Tobacco is big business in Cambodia and it is proving hard to break the habit.
Kun Lim from British American Tobacco (BAT), which has 43 percent of the local market,
says revenues generated "from the tobacco farm onwards," contribute $34.4
million annually to the economy, or 2 percent of GDP.
Figures from Indochina Research show that 13 percent of advertising revenue for TV
and print media comes from cigarette companies. With an annual advertising budget
of $4 million, tobacco companies easily outspend the country's small anti-smoking
lobby, whose visible advertising budget is under $10,000. That is less than Davidoff
spent placing its billboard in a children's park.
Peou Yada, under-secretary of state at the Ministry of Information, agrees that cigarette
companies have free rein to do whatever they want in Cambodia. While "people
are more important than the revenue from cigarette advertisements," Yada says
he is also concerned about the impact an advertising ban would have on broadcast
media.
That said, it appears the unlimited firepower of cigarette companies in Cambodia
may be coming to an end. The government recently formed an inter-ministerial committee
that within two years should have drafted a law regulating tobacco.
WHO's tobacco control officer, Greg Hallen, says that the committee will help prepare
local efforts to comply with WHO's Framework Convention on Tobacco Control (FCTC),
a global treaty on tobacco regulation due to be signed May 2003. The convention,
which involves 191 member nations, is likely to include regulations on tobacco marketing,
taxation, labeling, smuggling, and controlling smoking in public places.
In October 2001, Samnang, Yada and Daravuth attended the third FCTC negotiation meeting
in Geneva. They are upbeat about what it will mean for tobacco control in Cambodia,
but Daravuth warns that the country should not rely on the FCTC to ban advertising.
"I think [the FCTC] is a good idea but it is not good enough," he says.
"Cambodia has to be willing to ban advertising itself. We cannot wait for the
FCTC."
The three main tobacco companies, meanwhile, are running a worldwide self-regulation
program in a bid to improve their poor reputation. By the end of this year Philip
Morris, BAT and Japan Tobacco will apply so-called International Marketing Standards
that aim at responsible promotion of their products.
Manmindar Singh, BAT's regional trade manager, says the standards will ensure companies
do not market cigarettes at children or non-smokers. Promotion has been and will
be aimed solely at current adult smokers, he says. For instance, advertising at events
in enclosed spaces will be permitted only where three-quarters of the audience is
18 or older. TV adverts will be limited to adult programs and age-restricted movies.
With billboards, though, he admits the policy is more difficult.
"I cannot envision a situation where you have a billboard that is not accessible
to anyone aged under 18," says Singh.
Nonetheless, BAT spokesman Kun Lim says that his company has already started removing
billboards from Phnom Penh. They will be replaced, he says, with fewer, smaller and
more responsible adverts that do not use young models or well-known figures.
The voluntary standards have drawn a cynical response from tobacco control groups
which claim the companies are simply jumping before they are pushed in an attempt
to undermine externally imposed regulation. WHO decried the standards as "neither
new nor effective".
"We know from research that voluntary standards haven't worked, and that only
a total ban does," says WHO's Hallen.
One school, one hospital, eight pagodas, all smoke free. By global standards these
figures are tiny, but with soaring smoking statistics and a vacuum of tobacco regulations
in Cambodia, the steady increase of smoke free zones is a big step forward.
On February 4 last year, Samrong Andet pagoda in Phnom Penh declared itself smoke
free. One year on, chief monk and tobacco educator Seun Than says monks from other
provinces who visit Samrong Andet are filtering the message through to other pagodas.
ADRA worked with Samrong Andet in its quest to become Cambodia's first smoke free
pagoda and has since helped seven other pagodas. A large proportion of Cambodia's
Buddhist monks smoke, with gifts of cigarettes common. On average, states an ADRA
report, they are given seven packs a month.
ADRA's Yel Daravuth says combating smoking among monks, who have a great deal of
influence in Cambodian society, involves warning them about the health hazards and
asking communities not to give them cigarettes.
"Working in this area offers a lot of challenges day by day," says Daravuth.
"It is frustrating, but we are keeping strong."
In pursuit of smoke-free zones
