Table 2. Implementation status of best-buy interventions for the prevention and control of noncommunicable diseases in seven Asian countries in July 2018.
Best-buy intervention | Indicator description | Bhutan | Cambodia | Indonesia | Philippines | Sri Lanka | Thailand | Viet Nam |
---|---|---|---|---|---|---|---|---|
Tobacco demand-reduction measures18 | ||||||||
1. Increase excise taxes and prices on tobacco products | Total taxes as % of the price of the most sold brand of cigarettes was maximum 75% and above, minimum 51%24 | Not applicable, as sale of tobacco banned in Bhutan | Total tax: 25.2% of retail price in 2016. Retail cigarette price affordable. No changes between 2008 and 2016 | Total tax: 57.4% of retail price in 2016. Retail cigarette price affordable. Cigarettes more affordable in 2016 than 2008 | Total tax: 62.6% of retail cigarette price in 2016. Cigarettes less affordable in 2016 than 2008 | Total tax: 62.1% of retail cigarette price in 2016. Tobacco price affordable. No changes between 2008 and 2016 | Total tax: 73.5% of retail price in 2016. Retail cigarette price affordable. No changes between 2008 and 2016 | Total tax: 35.7% of retail cigarette price in 2016. Cigarettes more affordable in 2016 than in 2008 |
2. Eliminate exposure to second-hand tobacco smoke in all indoor workplaces, public places and public transport | Compliance score for smoke-free environments as per WHO report.18 High compliance: 8–10; moderate compliance: 3–7; minimal compliance: 0–2 | Compliance score: 10/10 in 2016. Not yet enforced compliance in cafés, pubs, bars, government facilities and universities | Compliance score: 5/10 in 2016. Not yet enforced compliance in restaurant and government facilities | Compliance score: 1/10 in 2016. Not yet introduced smoke-free regulation in government facilities, indoor offices, restaurant, cafés, pubs and bars | Compliance score: 5/10 in 2016. Not yet introduced smoke-free regulation in indoor offices, restaurants, cafés, pubs and bars | Compliance score: 6/10 in 2016. Not yet introduced smoke-free regulation in restaurants, cafés, pubs and bars | Compliance score: 7/10 (score from 2013 MPOWER report25). Complete compliance with smoke-free regulation in health-care facilities, educational facilities, universities, government facilities, indoor offices, restaurants, cafés, pubs and bars and public transport | Compliance score: 5/10 in 2016. Not yet introduced smoke-free regulation in café, pubs, bars and public transport |
3. Implement plain or standardized packaging and/or large graphic health warnings on all tobacco packages | Mandates plain or standardized packaging or large graphic warnings with all appropriate characteristics | Not applicable | Mandates pictorial and text health warnings on packaging of cigarettes, other smoked tobacco and smokeless tobacco, covering 55% of front and back areas. Two specific health warning approved | Mandates pictorial and text health warnings on packaging of cigarettes, other smoked tobacco and smokeless tobacco, covering 40% of front and back areas. Five specific health warnings approved | Mandates pictorial and text health warnings on packaging of cigarettes, other smoked tobacco and smokeless tobacco, covering 50% of front and back areas. Twelve specific health warnings approved | Mandates text and pictorial health warnings on packaging of cigarettes and other smoked tobacco, covering 80% of front and back areas. (Ban on smokeless tobacco.) Four specific health warnings approved | Mandates text and pictorial health warnings on packaging of cigarettes and other smoke tobacco, covering 85% of front and back areas. Ban on smokeless tobacco. Ten specific health warnings approved | Mandates text and pictorial health warnings on packaging of cigarettes, other smoked tobacco and smokeless tobacco, covering 50% of front and back areas. Six specific health warnings approved |
4. Enact and enforce comprehensive bans on tobacco advertising, promotion and sponsorship | Compliance score as per WHO report.18 High compliance: 8–10; moderate compliance: 3–7; minimal compliance: 0–2 |
Compliance score on direct advertising ban: 10/10; promotions and sponsorship ban: 10/10; indirect promotions ban: 10/10 | Compliance score on direct advertising ban: 8/10. No ban on indirect promotions except on publicizing corporate social responsibility activities of tobacco companies | No ban on direct tobacco advertising in TV or radio, magazines, billboards, point-of-sales or the internet. Compliance score on free distribution ban: 3/10; promotional discounts on television ban: 0/10; non-tobacco products identified with tobacco brand names ban: 1/10 | Compliance score on direct advertising ban: 6/10. No ban on promotions except appearance of tobacco brands on television or films (product placement) score: 9/10; indirect promotions ban: 6/10 | Compliance score on direct advertising ban: 8/10; promotions ban: 5–10/10; indirect promotions ban: 6/10 | Comprehensive regulations on advertising, market promotion and sponsorship, and indirect promotions (no score reported in 2017 WHO MPOWER report25) | Compliance score on direct advertising ban: 10/10; promotions ban: 6–8/10; indirect promotions ban: 6/10 |
5. Implement effective mass-media campaigns that educate the public about the harms of smoking/tobacco use and second-hand smoke | Implemented a national anti-tobacco mass-media campaign designed to support tobacco control, of at least 3 weeks duration with all appropriate characteristics24 | No national media campaign implemented between 2014 and 2016 | National media campaign implemented on television and radio between 2014 and 2016. Content and target audience guided by research, though no post-campaign evaluation was made | Media campaign implemented between 2014 and 2016. Content and target audience guided by research, with post-campaign evaluation | Comprehensive media campaign implemented between 2014 and 2016. Content and target audience guided by research, with post-campaign evaluation | No media campaign implemented between 2014 and 2016 | Comprehensive media campaign implemented between 2014 and 2016. Content and target audience guided by research, with post-campaign evaluation | Comprehensive media campaign implemented between 2014 and 2016. Content and target audience guided by research, with post-campaign evaluation |
Harmful use of alcohol reduction measures19 | ||||||||
1. Enact and enforce restrictions on the physical availability of retailed alcohol (via reduced hours of sale) | National legal minimum age for on- and off-premise sales of alcoholic beverages19 | 18 years | No defined legal age | 21 years | 18 years | 21 years | 20 years | 18 years |
Restrictions for on- and off-premise sales of alcoholic beverages by hours, days, places of sale, density of outlets, for specific events, to intoxicated persons, at petrol stations19 | Restrictions for all categories except density | No restrictions | Restrictions only for hours and places | Restrictions only for hours, places, density and specific events | Restrictions for all categories | Restrictions for all categories except density and specific events | Restrictions only by place, density and for intoxicated persons | |
2. Enact and enforce bans or comprehensive restrictions on exposure to alcohol advertising (across multiple types of media) | Legally binding regulations on alcohol advertising, product placement, sponsorship, sales promotion, health warning labels on advertisements and containers | Yes, except advertising on containers | Regulations only on alcohol sponsorship | Yes, except advertising on containers | Regulations only for health warning labels on alcohol advertisements and containers | Yes, except advertising on containers | Yes, except advertising on containers | Yes, except advertising on containers |
3.Increase excise taxes on alcoholic beverages | Excise tax on beer, wine and spirits | Yes, except for spirits | Yes | Yes | Yes | Yes | Yes | Yes |
Unhealthy diet reduction measures22 | ||||||||
1. Adopt national policies to reduce population salt/sodium consumption | Adopted national salt policies | No | No | No | No | No | Yes | No |
Applies voluntary or mandatory salt cut-offs on selected foods | No | No | No | No | No | Applies voluntary salt reduction in processed food and snacks with healthier choice logo. Mandatory regulation for food labelling in guideline daily amounts | No | |
Physical activity22 | ||||||||
1. Implement communitywide public education and awareness campaign for physical activity, which includes a mass media campaign | Country has implemented, within past 5 years, at least one recent national public awareness programme on physical activity | Yes | No | Yes | Yes | Yes | Yes | No |
Health systems24 | ||||||||
1. Member State has national management guidelines for four major noncommunicable diseases through a primary care approach | Availability of national guidelines for the management of cardiovascular diseases, diabetes, cancer and chronic respiratory diseases | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
2. Drug therapy for diabetes mellitus and hypertension using total risk approach), and counselling to individuals who have had a heart attack or stroke and to persons with high risk (≥ 30%, or ≥ 20%) of a fatal and non-fatal cardiovascular event in the next 10 years | Proportion of primary health-care facilities offering cardiovascular risk stratification for the management of patients at high risk for heart attack and stroke23 | Less than 25% | Less than 25% | Less than 25% | More than 50% | More than 50% | More than 50% | Less than 25% |
Availability of selected noncommunicable diseases medicines at 50% or more of primary-health care facilities22 | 4/12 drugs | 3/12 drugs | 11/12 drugs | 4/12 drugs | 11/12 drugs | 9/12 drugs | 2/12 drugs |
WHO: World Health Organization.
Note: Affordability of cigarettes is defined by the percentage of per capita gross domestic product required to purchase 2000 cigarettes of the most sold brand.18