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Asia: Up in Smoke?

May 26, 2010

By John J. Brandon

For the past 23 years, May 31 has held significance that few are even aware of – World No Tobacco Day. Started in 1987 by the World Health Organization (WHO), World No Tobacco Day has for almost a quarter century encouraged 24 hours of abstinence from all forms of tobacco around the globe, in an attempt to shine a light on the negative health effects of tobacco use.  But smoking is on the rise in Asia – sharply – so clearly not everyone is heeding the message.

Of the world’s 1.3 billion tobacco smokers, 700 million live in Asia. China, India, and Indonesia are the world’s largest consumers of tobacco. China’s 350 million smokers puff on 2 trillion cigarettes a year. Cigarette smoking in Indonesia has increased by 26 percent over the past 15 years. Increased smoking is having considerable public health consequences across the region. As life spans increase across Asia, diseases caused by smoking – cardiovascular disease, lung disease, and various forms of cancer – are overtaking infections as a leading cause of premature death. Of the 5.5 million people who die from smoking-related illnesses each year, half are in Asia. China and Indonesia alone account for 1.7 million smoking deaths. By 2050, researchers estimate that smoking deaths in Asia will be four times what they are today.

Smoking has declined in the U.S. and elsewhere in the West and some studies, such as a 2008 Gallup poll, suggest that this is due to bans on tobacco advertising, increased taxes, and greater public awareness of the risks involved with smoking. Meanwhile, Asia has become the fastest growing market for international tobacco companies as they heavily promote their products in order to off-set slowing sales in their home markets. In October 2010, the American trade association, World Tobacco, will hold what it calls Asia’s biggest tobacco expo in Indonesia. The expo’s official messaging encourages industry leaders to: “Place your support in a country where the government is positive toward the tobacco industry.”  In response, Asian state-owned tobacco monopolies are building themselves up in order to compete.

Although a number of Asian nations, including China, are signatories to the WHO’s 2005 Framework Convention on Tobacco Control (FCTC), which provides an internationally coordinated response to combating the tobacco epidemic, their tobacco enterprises still serve as major sources of employment and revenue. The China National Tobacco Corporation employs 500,000 workers, and profits and taxes from tobacco sales represent 8 percent of the country’s national budget. In 2005, revenue from tobacco in China amounted to $31 billion, which was more money than was budgeted for the nation’s five-year plan to promote free education to school children ($27 billion). Indonesia’s tobacco industry employs 200,000 people to roll the country’s famous kretek cigarettes (cloves mixed with tobacco). Indonesia is not a FCTC signatory, declaring it simply cannot afford to do so.

The 2010 theme for World No Tobacco Day is “Gender and Tobacco.” While 60 percent of Asian men smoke, only 3 percent of women do; an untapped market in the eyes of international tobacco companies. Indeed, the tobacco industry is increasingly targeting Asian women with messages equating smoking with equality and personal freedom, such as a recent advertisement seen in Indonesia that featured former American Idol winner Kelly Clarkson with the name of a popular local cigarette brand across the top. Cigarette advertisements in Asia also promote the notion that smoking “ultra lights” or “super slims” help women to control their weight and are somehow healthier.

Despite these challenges, some Asian governments and civil society groups are now working to discourage smoking and to educate their citizens on the public health risks. Thailand has one of the most progressive records of trying to buck the Asian trend – in 2006, it banned smoking in air-conditioned restaurants, bars, and other public places, and now requires health warnings on all cigarette packs. Thailand’s percentage of adult males who smoke is 37 percent, far below the 70 percent average of men who smoke in Indonesia, Vietnam, and Cambodia.

In January, seven large Chinese cities introduced bans on smoking in workplaces and many public venues. Indonesia’s second largest Muslim organization, Muhammadiyah, issued a fatwa against smoking, declaring it “sinful” for Muslims. While not legally binding, the fatwa appears to have begun to impose a social stigma on cigarette smoking in a country where an estimated 25 percent of youth (age 13-16) are now regular smokers.

How to discourage people from smoking while relying on the revenue tobacco generates for national coffers will clearly continue to be a challenge for Asian nations. But the WHO estimates that the eventual toll for tobacco usage worldwide could be as high as one billion deaths in the 21st century, 10 times the 100 million deaths related to smoking in the 20th century. And, this is bound to put a hefty strain on Asia’s health care systems. Given such ominous projections, perhaps Asian governments and their citizens need to ask themselves whether they can afford to continue smoking.

John J. Brandon is The Asia Foundation’s Director of International Relations Programs in Washington, D.C. He can be reached at [email protected].

Related locations: Cambodia, China, India, Indonesia, Thailand, Vietnam



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