If you wondered why Bhutan formulated the Tobacco Control Act then you should think this document to be the child of the parental document, World Health Organization FCTC (Framework Convention on Tobacco Control). Bear with me, there are few documents that we need to go through, not the most interesting to read but it sheds light on the unnecessary penalty of the Tobacco Control Act like never before.
On 12th August, 2004 Bhutan was one of the first forty countries to ratify the WHO FCTC. It is one of the most popular United Nations treaties and has 172 signatories. The WHO FCTC “is an evidence-based treaty that reaffirms the right of all people to the highest standard of health. It represents a paradigm shift in developing a regulatory strategy to address addictive substances; in contrast to previous drug control treaties, the WHO FCTC asserts the importance of demand reduction strategies as well as supply issues.” The document defines tobacco control as “a range of supply, demand and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.” “The core demand reduction provisions in the WHO FCTC are contained in articles 6-14: price and tax measures to reduce the demand for tobacco (which most countries are implementing and South Korea made US$ 17 million from tax), and non-price measures to reduce the demand for tobacco, namely: protection from exposure to tobacco smoke; regulation of the contents of tobacco products; regulation of tobacco product disclosures; packaging and labeling of tobacco products; education, communication, training and public awareness; tobacco advertising, promotion and sponsorship; and, demand reduction measures concerning tobacco dependence and cessation. The core supply reduction provisions in the WHO FCTC are contained in articles 15-17: Illicit trade in tobacco products; sales to and by minors; and, provision of support for economically viable alternative activities.” In some countries like China compensation to people are paid by tobacco factories on health grounds.
While it also encourages countries to take national legislative measures, in Article 13 it also states that parties which have a ban on certain forms of tobacco advertising, promotion and sponsorship have the sovereign right to ban those forms of cross-border tobacco advertising, promotion and sponsorship entering their territory and to impose equal penalties as those applicable to domestic advertising, promotion and sponsorship originating from their territory in accordance with their national law. Very importantly it states that it does not endorse or approve of any particular penalty. Most countries that have ratified the convention, especially the European countries are implementing measures where packaging of tobacco products have pictorial representations or stickers which showcase the ill effects of using tobacco or by introducing high percentages of tax and by banning smoking in public spaces and work places. So if the above were the guidelines to frame the historic Tobacco Control Act of Bhutan, what is the basis for the fourth degree felony penalty? The first of its kind in the world!
Now the next document to go through is the recent International Tobacco Control (ITC) Bhutan Project report. The overall objective of the ITC report is to measure the psycho-social and behavioral impact of key national level policies of the WHO FCTC. The study very clearly lists two main limitations of the study in their report. Firstly “the ITC Bhutan survey was conducted before the 2010 Tobacco Control Act, and thus could not measure the impact of 2010 law, with its specific penalties for violations, affected enforcement, the tobacco black market, and smoking in public places. Secondly, the ITC Bhutan survey was not a fully national sample since it was conducted only in four dzongkhags.“ The report is a recent compilation of a survey conducted two years ago therefore the data is out dated. I say outdated because to justify the existence of such a severe penalty in our legal system, recent and accurate data is needed. But since it is a piece of research some good information has come out of it which can later be used as a baseline data or reference point.
The other big problem is extrapolating the results of four dzongkhags to the whole country which is problematic because of individual differences, scoio-economic differences and cultural reasons which have not been considered in the survey. Researchers generally also face the challenge of collecting accurate information especially when government officials are conducting the survey and the truthfulness of the respondents is questionable. Other limitations would be the kind of questions that were asked (the questionnaire was not released in the report) and also linguistic translations when the questions were being asked. One of the preliminary questions had the word “sophistication” and how would that translate in Dzongkha or Sarchop or Nepali or Bumthap? And the biggest flaw of this survey is the sampling. The survey attempted to understand people’s beliefs, attitudes and behavior of tobacco users and non users towards the 2004 national ban, and the sample consisted of 84% (1555) non tobacco users and 16% (251) tobacco users, so every time any percentage was calculated it was obviously sky rocketing 80s and 90s on whatever was being questioned. Now do the math of the match, majority was five times the minority, and so whose ideas would dominate the survey?
Amidst all this sophisticated study, Lyonpo Zangley Dukpa stated that “the results of this study will reinforce our government’s mandate to continue creating strong barriers to the availability of tobacco in Bhutan.“ The report also highly recommends cessation programs, public education campaigns and scientific research. No where does the report speak of penalty or encourages to continue enforcing the penalty. This leaves room for researchers to conduct a psycho-social research on the current scenario after people have been imprisoned for possession of tobacco without a tax receipt. Also a good scientific research should be replicable and the validity of this survey is questionable.
The third report is a recent report published this month called the FCTC “Needs Assessment for the Implementation of the WHO framework Convention on Tobacco Control in Bhutan” and contains international feedback on the report submitted by Bhutanese officials. One of the statements says “Tobacco Control Act goes beyond the Convention by banning cultivation, selling and buying and supply and distribution of tobacco and tobacco products in the whole country. Bhutan became the first and thus far, the only country to have ever embarked on such a course of action.” The comment on the above by FCTC was, “it is therefore recommended that Bhutan may identify other areas such as introducing strong measures like packaging, etc in which it can implement measures beyond those required by the Convention.” This essentially means that Bhutan should try to put stickers or put pictorial messages on tobacco product covers to discourage advertising of tobacco products. The Bhutanese comment on the report also says that Bhutan cannot control packaging of tobacco products available abroad (but since we want to always stand out), it mentions “Bhutan has the opportunity to implement the best packaging and labeling measures,” there we go again, we want the best looking cigarette covers now! This report identifies the gaps and has recommendations on how we should have proper clinics, hot line numbers for people who need help, commercial products which help de-addict nicotine, and really emphasizes to focus on treatment and raising awareness before the enforcement of the law.
The FCTC, ITC, The Tobacco Control Global Progress Report and even the Tobacco Control Act have good motives as their basis, which is to encourage people to live a healthy life, but what was the reason to enact such a severe penalty, the only kind in the world- to curb the use of tobacco? The tobacco control measures should be strategic and aimed towards changing human behavior, converting tobacco users to non tobacco users, through demand reduction strategic means and measures not through punishment, a fourth degree felony! What is this supposed to achieve? Health of the highest standard? How?
I think the ruling government has to really reconsider the amendment of the penalty at the earliest. There is no basis, what so ever for such a penalty to exist in our legal system, that is actively destroying lives of people (27 so far) by imprisoning them and that too on no grounds of reasonable evidence.