Asia Pacific Cities Alliance for Tobacco Control and NCDs Prevention - AP-CAT
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Asia Pacific Cities Alliance
for Tobacco Control and
NCDs Prevention
AP-CAT
Asia Pacific Cities Alliance for
Tobacco Control and NCDs Prevention
Together - we bring health solutions
Kathmandu
NEPAL Bharatpur
Rangpur
Nay Pyi Taw AP-CAT is in
40 cities and
BANGLADESH
Mandalay Bac Lieu
12 countries
INDIA Thai Tap
VIETNAM
MYANMAR
Jhenaidah
Thai Binh
Manikganj LAOS
Vientiane
Bengaluru
THAILAND
Balanga
Mandaluyong
Hermosa Dinalupihan
Siem Reap
Mariveles
CAMBODIA Kampong Cham
Phnom Penh Amlan
Dipolog
PHILIPPINES
Samal General Santos
Kuala Lumpur
MALAYSIA
Riau Island
Kuching North
MALAYSIA
SINGAPORE
INDONESIA
Jakarta Yogyakarta
Denpasar
Sleman
Bantul
Depok
Bogor
Kebumen
Kulon Progo Klungkung TE
LES
OR Ermera Municipality
TIM
CAMBODIA INDONESIA LAO PDR NEPAL SINGAPORE
Kampong Cham Bantul Vientiane Bharatpur
Siem Reap Bogor Kathmandu TIMOR LESTE
Phnom Penh Bandung MALAYSIA Ermera Municipality
Denpasar Kuala Lumpur PHILIPPINES
BANGLADESH Depok Kuching North Amlan VIETNAM
Jhenaidah Jakarta Balanga Bac Lieu
Manikganj Klungkung MYANMAR Dipolog Dong Thap
Rangpur Kebumen Mandalay Dinalupihan Thai Binh
Kulon Progo Nay Pyi Taw General Santos
INDIA Riau Islands Hermosa
Bengaluru Sleman Samal
Yogyakarta Mandaluyong
Mariveles
About Us
About Us
The Asia Pacific Cities Alliance for Tobacco Control and NCDs Prevention (AP-CAT) was established in 2016,
united by their shared vision to create tobacco free environments. AP-CAT has two co-chairs, Dr Bima Arya
Sugiarto, Mayor of Bogor City, Indonesia and Francis Anthony S Garcia, Mayor of Balanga City, Philippines.
Under their leadership, AP-CAT has been joined by 40 cities from 12 countries with support from Ministry of
Health Indonesia, Ministry of Health Cambodia, Ministry of Health and Sports Myanmar, Ministry of Health
Lao PDR and Ministry of Health and Population Nepal, Bloomberg Initiative to Reduce Tobacco Use and
the International Union Against Tuberculosis and Lung Disease (The Union). The Union Asia Pacific office in
Singapore hosts the secretariat of the AP-CAT.
Contact us:
AP-CAT Secretariat
The Union Asia Pacific
146 Robinson Road #06-01
Singapore 068909
email: ap-cat@theunion.org
01
of the world’s
Tobacco kills 1.1 billion smokers
live in low and
middle income Use accounts for 10%
countries of all deaths and...
people each year • 71% of Lung Cancer
• 42% of Chronic Respiratory
diseases
Deaths from • 10% of Cardiovascular
Second Hand
Smoke
Source: http://www.who.int/en/news-room/fact-sheets/detail/tobacco
Purpose
Recognizing that subnational leaders’ play a key role in the subnational and national heath
development agenda, the aims of the regional Mayor and subnational leaders’ alliance are to build
stronger political commitments, new partnership opportunities as well as sustainable and effective
utilization of resources and stronger public health system performance & outcomes.
Objectives- ACT
ACT to make and implement a comprehensive tobacco control policy with effective use of resources
at national and subnational level.
CREATE local innovations and solutions to prevent non-communicable diseases.
TACKLE and prevent industry’s interferences in policy development and implementation by
establishing rules and regulations, and mobilizing stakeholders and media.
02
How It Works
1. Country to country: Organize regional meetings to share successes and challenges faced
in implementing tobacco control strategies; identify actions with indicators and targets.
2. City to city: Mayors and leaders visit city to city within the country and beyond the country
to motivate their fellow-mayor by sharing best practices and lessons learnt achieved in NCD
and tobacco control. Cities are encouraged to adopt best practice policies.
3. Policy to practice: Effective implementation is vital. Members of the alliance facilitate to
establish a Mayor’s alliance at country level to widen program coverage and gaining the
political will in translating policies into practices.
4. Subnational to national: the leaders meet the national policy makers with evidences to
improve NCD and tobacco control policies and their implementation such as raising taxes
and prices on tobacco, alcohol and other junk foods and drinks, promoting larger pictorial
health warning, creating tobacco free environments
5. Mayors to media: Mayors disseminate fact and figures and policy outcomes to media and
public on regular basis to enhance the impacts.
03
Current Tobacco Smoking
Prevalence (15+)
Legend Male Female
Percentages
70 66.2
64.9
60
52.1 50.8
50
43.8 45.3
43
40.3 40.5
40
33.6
30 27 25.4
20
11 10.3
10 7.1 8.4 8.6
5.1 4.8
2.7 2.1 1.4 2.2 1.1
0
• Cambodia • China • Indonesia • Lao PDR • Malaysia • Myanmar • Nepal • Philippines • Singapore* • Thailand • Timor Leste • Vietnam
Countries
Source: Figures taken from WHO on the global tobacco epidemic, 2017
* cigarette smoking prevalence data only
04
Myanmar
Myanmar Subnational Government Alliance for Tobacco Control
and Prevention of Non-Communicable Diseases (NCDs)
Myanmar committed to establish the
Myanmar Subnational Government Alliance
for Tobacco Control and Prevention of
Non-Communicable Diseases (NCDs), with
the time bound action plan to implement
tobacco control and NCD prevention
programmes at the subnational level.
Myanmar Mayors, Social Ministers (from state and region), The Union
Minister for Health and Sports and Members of Parliament announce the
establishment of the alliance, June 2018
Vietnam
Vietnam Provincial Alliance for
Tobacco Control
Established to protect the health of
people through stronger enforcement of
existing tobacco control laws, integrate
tobacco control into noncommunicable
disease prevention programs, build
capacity and increase cooperation of
local government, and change social
norms. Bac Lieu, Thai Binh, Dong Thap The provinces signing to create the Vietnam
Provincial Alliance for Tobacco Control, 2017.
05
Cambodia
Cambodia Tobacco control law 2015
mandates;
i) The ban of tobacco advertising
promotion and sponsorship,
ii) Graphic health warnings,
iii) Smokefree environments,
iv) Banning of sales of tobacco
products to minors,
v) Increase tobacco tax.
Cambodia Smokefree Cities and Cambodia smokefree cities and NCD Prevention Alliance (CAT): Phnom Penh,
Kampong Cham, Takmao, Siem Reap, Preah Sihanouk & Battambang joined the
NCD Prevention Alliance (CAT): The CAT. National Centre for Health Promotion, Ministry of Health facilitates and offers
alliance was established in 2017 with technical assistance.
the aim to create local innovations
and local solutions for effective implementation of tobacco control and NCDs interventions at subnational
level by consolidating local political will and sharing resources in partnership with national government.
Siem Reap: Improving Compliance of smokefree
environments
100%
88% 85% 88%
79% 82% 84%
80% 74%
70% 70% 69% 69%
60%
48%
40%
27%
20% 2018
0% 2017
0%
Hotels Education Health Restaurants Goverment Clubs/Bars Public
Facility Facility Offices Transport
Lessons learnt:
• Strong partnerships between national and subnational governments
• Building awareness and partnership with hotel and restaurants
owners
• Regular monitoring (almost monthly)
• Distribution of no smoking signage to all venues
• Training and orientation to enforcement agencies
Educating restaurant owners on smokefree laws
06
Timor-Leste
Ermera
Moving towards a Tobacco Free City
Municipal government bans smoking in all public
places and work places including;
• Education facility
• Health facility
• Hotels and restaurants
• Government offices
• Public transport
Municipal government fosters partnership with youth President of Ermera Mr. Jose Martinho dos Santos
leaders, community based organizations, students, presenting a plan of action in the event. The event
teachers, international partners and media to promote was graced by Minister of Health Dr. Rui Maria de
Araujo and WHO Representative to Timor-Leste.
tobacco control and prevention of NCDs.
Front 85%, back 100%
Youth volunteers for tobacco control
The President of Ermera Municipality took a lead role in
supporting Ministry of Health Timor-Leste in adoption and
implementation of the world largest pictorial health warning on
tobacco packs in 2018.
Average: 92.5% pictorial health
warning, the world largest
07
Indonesia
Bogor
COMPLIANCE OF BAN DISPLAY OF TOBACCO PRODUCTS AT
THE POINT OF SALE IN BOGOR CITY, DEC 2017
100% 94.8%
90.7% 90.3%
88.5%
90%
80%
Bogor City successfully implemented a 70%
ban of display of tobacco products at 60%
the point of sale
50%
40%
20%
10%
9.3% 9.7% 11.5% 5.2%
0%
Found display of Found tobacco Found tobacco Found tobacco
tobacco products advertising promotion sponsorship
Dr Bima Arya Sugiarto, Mayor of Bogor
City, placing anti-smoking signages on Yes, found No, not found
public transport in Bogor City
Klungkung
Klungkung Regulation No.5 year 2016, bans all outdoor tobacco advertising
Mayor I Nyoman Suwirta in enforcement action- removing outdoor Mayor with community and media: Mr I Nyoman Suwirta,
tobacco adversiting encourages and raises awareness of smokefree through media
and community engagement events.
08Indonesian Mayor and Regent Alliance for Tobacco Control and NCDs Prevention
The alliance plays an important role in
the expansion of tobacco control at the
subnational level. More than 100 cities and
districts are implementing smokefree and
ban tobacco advertising and promotion in
Indonesia
Dr Hasto Wardoyo, Mayor of Kulon Progo
conducts one to one meetings with
Mayors and regents in Indonesia to build
commitments on smokefree policies, share
experiences, lessons learnt and provide
technical support for comprehensive
regulation drafting.
Dr Hasto Wardoyo meets with Mayor of Kendal Regency, Central Java
I am a heavy smoker but I really
support Dr.Hasto’s idea. For the sake
of Bajarnegara youngster’s future and
our people’s health from the impact
of smoke, we are going to create
Government’s regulation about Smoke-
Free Area.
– Mayor of Banjarnegara, Indonesia
09Philippines
Balanga City: Moving Towards a Tobacco Free Generation
Pioneering Tobacco
Control Efforts
Mayor Francis Anthony S. The City Government of Balanga renewed its commitment
Garcia (right) to eliminate tobacco use . Clad in bright red shirts, city
government employees led by Mayor Francis Anthony S.
(1) Ordinance No. Garcia paraded along the streets on February 28 2017.
21 series of 2008
Total cigarette ban imposed
on the University Town and
surrounding areas within
Balanga is the first tobacco-free-generation
a 1-km radius city in the world
(2) Ordinance No.
16 series of 2016
Regulates sale of tobacco
products to all born on or
after 1 January 2000
Tobacco Free
Generation
2016: More than 16218 participants joined the mass
Zumba at the launch of Balanga City’s Tobacco Free
Generation., an official Guinness World Record.
10Malaysia
Kuala Lumpur city has amped up its smokefree activities in 2017/2018
Smokefree enforcement team enforcing smokefree zones in Kuala Lumpur City Educating restaurant owners on smokefree
Leading by example:
Kuala Lumpur City Hall
quit smoking workshop.
11AP-CAT commits to...
Reduce
tobacco
Manage use
Reduce
Chronic harmful use
Respiratory of alcohol
Disease
Best buys
for tacking Reduce
Manage NCDs unhealthy
Cancer
diet
Manage
Reduce
cardiovascular
physical
disease and
inactivity
diabetes
Tobacco Control Best Buys
1. Create a smoke free city
Develop and implement a 100% smoke-free policy in all public places and work places – Cleaning air and
preventing exposure to secondhand tobacco smoke
2. Ban tobacco advertising, promotion and sponsorship
Develop and implement a regulation that bans tobacco advertising, promotion and sponsorship
completely - Preventing children and youth from picking up smoking
123. Increase size of Pictorial Health Warning (PHW)
Work with Ministry of Health to enhance policy communication in increasing a size of PHW on tobacco
packs and make a provision of PHW on alcohol products – Preventing people from using harmful products
and building public awareness
4. Raise Taxes
Build policy advocacy to raise taxes and prices on tobacco, alcohol and other harmful products
– Saving lives and saving money
5. Stopping Tobacco Organizations and Products
– Safe guarding people’s health from tobacco industry
6. Establish NCD prevention program
Establish NCD prevention program into primary health care services and integrate tobacco control into
health and development agenda – Reducing NCD related deaths and diseases
7. Create tobacco free generation (TFG): TFG policy initiative is a path toward eliminating
addiction, disease, and premature deaths caused by tobacco products and creates a tobacco-free future
– An endgame for tobacco
8. Establish country level alliances,
Build subnational partnerships at the national level – Expanding AP-CAT
9. Monitor and evaluate
Ensure interventions are implemented and progressing – Do what we commit
Co-Chairs
Mayor of Bogor City, Indonesia
Dr Bima Arya Sugiarto (left)
Mayor of Balanga City, Philippines
Francis Anthony S Garcia (right)
13Singapore
SENIOR MINISTER OF STATE FOR HEALTH,
MR CHEE HONG TAT, AT THE ASIA PACIFIC
CITIES ALLIANCE FOR TOBACCO CONTROL
MEETING, TUESDAY, 5 SEPTEMBER 2017
“Tobacco control requires effective partnerships and the
participation of all stakeholders. I am glad to see many
officials and healthcare experts come together to share
experiences on this important topic. Singapore looks
forward to learn from all of you and to better understand
best practices in your countries and cities for reducing
smoking prevalence. Together, we can improve the health
of our people by working together and taking a united
stand on tobacco control.”
AP-CAT
Asia Pacific Cities Alliance for
Tobacco Control and NCDs Prevention
Together - we bring health solutions
14The Union and AP-CAT congratulate the government of Singapore
for its tobacco control leadership in the region.
Recent advances in tobacco control
2017
• Tobacco Point-of-sale Displa Ban:
Singapore bans on displays of tobacco products at
point-of-sale which came into force on 1 August.
• Increasing the minimum sale age for tobacco
products:
Singapore passed a legislation on 7 November 2017
that will increase the legal minimum age a person
can buy tobacco products, from 18 to 21. On 1
January 2019 the legal age will be raised to 19, and Ban display of tobacco products - A tobacco product cabinet
at a FairPrice supermarket.
will increase by an additional year in 2020 and 2021. (Photo: Gabriel Choo/ Yahoo News Singapore)
• Because many smokers take up the habit before
the age of 21 – and because the tobacco industry
aggressively targets young adults – increasing
the minimum sale age for tobacco products will
complement proven strategies for reducing
tobacco use.
2018
Plain Packaging: Singapore will introduce a plain
packaging by 2020. No cigarette packs sold in
Singapore will be allowed to carry logos, brand images
or any promotional information. (Photo: Straits times News Singapore)
15AP-CAT 12
Cities
8
Countries
16AP-CAT 23
Cities
9
Countries
17ABOUT THE UNION KNOW
We conduct research to provide evidence
The Union is a global scientific organisation
with the mission to improve health among of or public health policy and practice
people living in poverty. We do that by SHARE
conducting scientific research, working with
We disseminate scientific knowledge to
governments and other agencies to translate
research into better health for people around
strengthen public health programmes.
the world, and delivering projects directly in
ACT
the field. The union is made up of a global
membership body of people who help to
We deliver services and conduct advocacy
advance our mission, and a scientific institute to safeguard people’s health.
that implements public health projects within
countries. For close to 100 years, we have The 50th UNION WORLD
CONFERENCE ON LUNG
been leaders in the fight against some of the HEALTH
world’s biggest killers including tuberculosis
30 OCT – 2 NOV |
lung disease and tobacco use. HYDERBAD, INDIA
Acknowledgements AP-CAT is supported by:
AP-CAT is thankful for the support of the MINISTRY OF MINISTRY OF MINISTRY OF
HEALTH HEALTH AND
Ministries of Health of the respective countries. HEALTH
INDONESIA LAO PDR SPORTS MYANMAR
We highly appreciate the support of the
Bloomberg Initiative to reduce Tobacco use
and The Union. MINISTRY OF HEALTH
AND POPULATION,
NATIONAL CENTRE FOR
HEALTH PROMOTION
NEPAL CAMBODIA SWISSCONTACT
INDONESIA FOUNDATION
We would also like to extend our gratitude for
the support of the civil societies and NGOs
that are passionate in their cause to protect
TOBACCO FREE GENERATION VIETNAM PUBLIC HEALTH
people from the harms of tobacco and the INTERNATIONAL ASSOCIATION
prevention of non-communicable diseases.
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