Tobacco Research Study 25 November, 2009 - “Functionaries and servants of whatever rank, high or low, once they have entered the Dharma door of the Choje Drukpa, may not perform deeds that violate Dharma, such as sleeping with women, using intoxicating substances, such as tobacco…”

This was the world oldest tobacco control law contained in the Zhabdrung Ngawang Namgyal’s legal code, “Golden Yoke of Legal Edicts” before his death in 1651. 358 years later, Bhutan’s highest legislative body, the parliament is still debating the Tobacco Bill.

Bhutan officially banned the sale of tobacco and tobacco products on December 17, 2004. Subsequently smoking in public places was also banned. Yet, even as members of parliament debate the provisions of the bill, tobacco products are easily available, there is a thriving black market and not many public places, including offices, are free of smokers.

Before the Tobacco Bill was discussed in the National Assembly, a research study on “Tobacco use policy making and administration in Bhutan” was presented to the parliamentarians. The study carried out by Michael Givel, a professor with the department of political science, university of Oklahoma, USA, talks of tobacco laws from Zhabdrung’s time to the present law. The policies related to tobacco use, administrative implementation and outcomes of the policy.

According to professor Givel’s study, there was no clear delineation in coordinating and implementing the 2004 anti-tobacco law with no authorising legislation delineating agency roles and no plans delineating the implementation of goals, objectives, and outcomes. There was also no periodic, ongoing, consistent, and internally conducted scientific studies on tobacco consumption in Bhutan before or after 2004, says the study. “No public internal assessment was conducted on the administrative effectiveness of the anti-smuggling efforts.”

In terms of budget, no new budget was allocated to enforce and implement the law since the ban in 2004, nor was personnel hired to enforce and implement the law.

Professor Givel recommends Bhutan to institute a public governmental tobacco control plan, including general and strategic operating plans. “It’ll create a rationalistic approach to coordinate and mobilise public and private resources to counter tobacco use and exposure to secondhand tobacco smoke.” The plans should also contain requirements for agency information sharing and agency cooperation in law enforcement efforts.

A key non-criminal approach in reducing tobacco consumption is recommended as a comprehensive and ongoing tobacco counter-marketing effort. The study also recommends raising taxes on tobacco products, based on over 100 peer reviewed publications, which showed that increase in cigarette tax lead to decrease in overall consumption, with effect of 10 percent tax on cigarette reducing cigarette use by 2.5 to 5 percent. However, it states that tobacco tax should not be substantially higher than in India, if tobacco sales ban were to be repealed. This is because the incentive to smuggle cigarette would be substantially greater if higher taxes are imposed on sale.

Periodic analyses of anti-smuggling and black market efforts and program effectiveness and efficiency are also recommended.

As secondhand smoke is highly carcinogenic and impacts both smokers and non-smokers, the study recommends maintaining the current law on prohibiting smoking in public places. The study also recommends engaging non-government organisations from the religious, business and community sectors in efforts and programmes of civic progress and responsibility and actively involve in community and government anti-tobacco educational awareness efforts.

Fiscal allocations for criminal and non-criminal anti-tobacco approaches should be tied directly to the programme goals and objectives of government planning document to counter tobacco use and smuggling, recommends the study. It also recommends that Bhutan should stand ready on an ongoing basis to later in part or whole amend its policy and administrative implementation efforts to effectively counter tobacco use and smuggling. “This can only occur with scientific surveillance and evaluation occurring on an ongoing basis,” it states.