Tobacco Control In Taiwan

Kun-Yu Chao, MD, MSDeputy Director-GeneralBureau of Health Promotion , DOH

2

6764.9

48.546.940.5

24.22221.82224.125.730

37.3

2827.22718.6

23.7

4.12 1.9 4.4 2.9

14.5

7.63.5 3.5

1417 19.2 19.3 21.2

28 26 24.8 25

16.322.2

39.51

0

10

20

30

40

50

60

70

80%

Male

Female

Adult Smoking Rate 2006

Reference：” The Tobacco Atlas” WHO, 2006.

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Adult Smoking Rate in Taiwan

Male

Female

1987 Import cigarettes

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Adult Smoking Rate in Taiwan (cont.)

Male

Female

1987 Import cigarettes

1997 Tobacco Hazards Prevention Act

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Adult Smoking Rate in Taiwan (cont.)

Male

Female

1987 Import cigarettes

1997 Tobacco Hazards Prevention Act

2002 Health and Welfare Surcharge

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Adult Smoking Rate in Taiwan (cont.)

Male

Female

1987 Import cigarettes

1997 Tobacco Hazards Prevention Act

2002 Health and Welfare Surcharge

2006 Surcharge Doubled

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Global Youth Tobacco Survey ( GYTS ) in Taiwan

• Ages 13-15, in 2004 → 2006– Total : 6.5% → 7.5% (↑14.9%)– Male : 8.5% → 9.6% (↑14.1%)– Female : 4.2% → 4.7% (↑11.7%)

• Ages 16-18, in 2005– Total : 14.0%– Male : 20.7%– Female : 7.8%

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Smoking Rates of Men by Age

9.64

20.73

39.51

0

5

10

15

20

25

30

35

40

age 13-15 age 16-18 age >18

%

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President of Taiwan Signed FCTC

Instrument of Accession

March 30, 2005

+ Taiwan

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Core Provisions of the FCTCto Reduce the Demand for Tobacco

• Price and tax measures • Non-price measures • Protection from exposure to tobacco smoke • Regulation of the contents, disclosures , packaging/ labeling of tobacco products • Education, communication, training and public awareness • Advertising, promotion and sponsorship • Demand reduction measures concerning tobacco dependence and cessation

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Cigarette Price & Tax

Reference： .”The Tobacco Atlas” WHO, 2006.

1.69 1.67 1.43

2.87

7.26

4.41

9.37

6.68

76.3%

27.0%

39.6%38.0%

60.6%

61.1%

78.0%

67.9%

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

Taiwan China Thailand Japan Canada U.S.A. Australia U.K.0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%Price Tax Tax as a proportion of cigarette price

USD

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Price and Tax Measures (Ar.6)Legislation • 1997 : Tobacco Hazards Prevention Act• 2000 : Tobacco and Alcohol Tax Law • 2006 : Surcharge doubled• 2007 : Amendment of Tobacco Hazards Prevention Act (effective 2009)

Advocacy in congress

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Before amendment After amendment 2006,2007

Tobacco tax NT$5 ($0.15) / pack NT$10 ($0.3) / pack

Annual revenues

NT$10 billion ($300 million)

NT$20 billion ($600 million)

Allocation

1.National Health Insurance (70%)

2.Tobacco control (10%)3.Public health (10%)4.Social welfare (10%)

1.National Health Insurance (89%)

2.Tobacco control (3%)3.Public health (3%)4.Social welfare (3%) 5.Taxation / smuggling (1%)6.Alternation crops and related

(1%)

• Health and Welfare Surcharge

Price and Tax Measures (Ar.6)

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Packaging and Labeling (Ar.11 )

• Health warnings with pictures covering at least

35% of the package surface (effective in 2009)

• Any false, misleading brand names to create an

erroneous impression banned (effective in 2009)

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Ad., Promotion and Sponsorship (Ar.13)

• Current : allow limited advertising In magazines• Amendment (effective 2009) :

– Totally prohibition of advertising, promotion and sponsorship of tobacco products

– More penalty for violations

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Reduce Tobacco Dependence (Ar.14)

• Smoking Cessation Clinics– Began in 2002 (247,731 people serviced)– 2294 cessation clinics (age >18)– 19.7% point abstinence rate at 6 months

• Smokers’ Helpline – Began in 2003 (152,450 people serviced)– 6 days a week, 12 hours each day– 22.1% point abstinence rate at 6 months

• Community Smoking-cessation Programs 2003-2006, 1,306 programs for 21,372 cases

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Education, Communication, Training & Public Awareness (Ar.12)

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Education, Communication, Training & Public Awareness (Ar.12)

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Education, Communication, Training & Public Awareness (Ar.12)

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Avoidance of Second-hand Smoking (Ar. 8)

Smoke-free armed forces

Smoke-free campuses

Smoke-free restaurants

Smoke-free workplaces

Smoke-free historic spot

Smoke-free parks

Smoke-free tribes

• National programs • Local projects

Smoke-free streets

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Sales to and by Minors (Ar.16)

Ban to sell tobacco products to minors under 18

（ Coordinate major convenience chain-stores not to sell tobacco products to minor under 18）

Ban the sale of cigarette individually or in small packets

• More penalties ( effective in 2009)

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Violating Rate for ＜ 18 Sale Ban

60%

67.70% 70% 70%

90%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

A B C D E

violating rate ofconvenient stores

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“No-smoking Paradise”

• A Tobacco Control Exhibition for aged 10-18• Fantastic exhibition to strengthen adolescents’

awareness of tobacco hazards, and skills for refusing smoking

• More than 250,000 visitors within one year• Please visit the show room and enjoy it !

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Challenge

Taiwan has tried her best, but

• Adult's male smoking rate is still high

• Smoking rate of adolescent is increasing

• No marked change of consumption of tobacco products

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Global thinking, Local action

Taiwan has participated global tobacco control

movement

Still, we need your supports !

Thanks for your attention