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Tobacco plain packaging catching on worldwide: Canadian Cancer Society report

http://www.marketwatch.com/story/tobacco-plain-packaging-catching-on-worldwide-canadian-cancer-society-report-2016-11-09

The trend to reduce smoking and cancer rates by forcing tobacco companies to use plain packaging is gaining momentum across the globe, concludes an international report released today by the Canadian Cancer Society. The report shows that 4 countries have plain packaging laws in place and 14 others are working on it.

Plain packaging requirements prevent tobacco companies from using colours, logos and design elements to market their cancer-causing products. The shape of the package must be in a standardized format, outlawing sales tactics such as slim packs appealing to girls and young women. Health warnings still appear on plain packages.

“Plain packaging is a global trend and it is coming to Canada, too,” says Rob Cunningham, senior policy analyst, Canadian Cancer Society. “We must continue to show leadership in the fight against the marketing of tobacco.”

In 2001 Canada was the first country in the world to implement graphic picture warnings on cigarette packages. Since then, more than 100 countries and territories (105 in total) have followed Canada’s lead – accounting for 58% of the world’s population – as illustrated in this graph. Canada’s leadership in graphic picture warnings has resulted in enormous health benefits globally.

Smoking is the leading cause of preventable disease and death in Canada, including about 30% of all cancer deaths and 85% of lung cancer cases. Tobacco kills 37,000 Canadians every year.

Tobacco packaging is one of the last and most effective ways for companies to promote their products, with eye-catching logos and colours designed to appeal to consumers. Plain packaging reduces tobacco use by eliminating promotion on packaging, reducing product appeal, curbing package deception, and increasing the impact of health warnings. Research shows that plain packaging works.

“Plain packaging is a crucial next step for Canada to reduce smoking and save lives,” says Cunningham. “We strongly support the federal government’s commitment to follow the lead of Australia and other countries to implement plain packaging to curtail the marketing of these cancer-causing products.”

Plain packaging is required in Australia, the United Kingdom and France, and will be by 2018 in Hungary. The 14 countries working on plain packaging are Canada, New Zealand, Ireland, Norway, Slovenia, Uruguay, Thailand, Singapore, Belgium, Romania, Turkey, Finland, Chile and South Africa.

Canada’s federal government included a commitment to plain packaging as part of its 2015 election platform. After forming a government, Prime Minister Justin Trudeau identified it as a “top priority” in a mandate letter to Health Minister Jane Philpott. On May 31, 2016 – World No Tobacco Day – Minister Philpott launched a 3-month public consultation on plain packaging. The federal government is now reviewing the responses and developing regulations.

The Canadian Cancer Society report released today – Cigarette Package Health Warnings: International Status Report – ranks 205 countries and territories based on the size of their health warnings on cigarette packages and lists countries that have finalized requirements for picture warnings. Canada ties for 8th in the world with package warnings that cover 75% of the package’s front and back. Nepal and Vanuatu are tied for top spot with a warning size of 90%, while India and Thailand are 3rd at 85%. The United States is in last place with minimal requirements for health warnings on either the front or back of the package.

The Canadian Cancer Society is calling for plain packaging to be implemented in Canada as part of a strengthened Federal Tobacco Control Strategy, which should also include increased funding to support additional programming and policy measures. Health Canada’s current strategy expires on March 31, 2018. The existing Tobacco Act is 2 decades old and must be modernized.

The Society’s report, published every 2 years, reviews and ranks cigarette health warnings internationally and tracks developments in this important area of tobacco control.

Other report highlights include:

94 countries and territories require warnings to cover at least 50% of the package front and back (on average), up from 60 countries in 2014 and 24 in 2008. — The top countries ranked in terms of warning size (as an average of the front and back of the package) are: 1. 90% Nepal 1. 90% Vanuatu (effective in 2017)

3. 85% Thailand 3. 85% India 5. 82.5% Australia (75% of front, 90% of back) 6. 80% Sri Lanka 6. 80% Uruguay 8. 75% Brunei 8. 75% Canada 8. 75% Laos 8. 75% Myanmar
The Canadian Cancer Society’s report was released today in Delhi, India, at the 7th session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control being held Nov. 7-12. The report was released to support implementation of the WHO Framework Convention on Tobacco Control, ratified by 180 countries. The goal of this international treaty is to control the global tobacco epidemic. Its guidelines recommend that parties consider implementing plain packaging.

Cigarette Package Health Warnings report in English Cigarette Package Health Warnings report in French

About the Canadian Cancer SocietyThe Society is a national, community-based organization of volunteers whose mission is to eradicate cancer and enhance the quality of life of people living with cancer. Thanks to our donors and volunteers, the Society has the most impact, against the most cancers, in the most communities in Canada. For more information, visit cancer.ca or call our toll-free bilingual Cancer Information Service at 1-888-939-3333 (TTY 1-866-786-3934).

SOURCE Canadian Cancer Society (National Office)

European fund firms largely resist tobacco divestment campaign

http://www.reuters.com/article/us-europe-funds-tobacco-divestment-idUSKCN11C1PW

Eighteen months after the launch of a global campaign to persuade money managers to black-list tobacco stocks, just one major European investor has answered the rallying cry.

Others are largely sticking with an industry that remains lucrative despite tightening restrictions on smoking and a series of lawsuits in the United States, saying they are duty-bound to seek the best returns for their clients.

Even a United Nations-backed treaty which aims to cut tobacco consumption by almost a third within 10 years is failing to deter many investors in the likes of Philip Morris International (PM.N), British American Tobacco (BATS.L), Japan Tobacco (2914.T) and Imperial Brands (IMB.L).

“We are firmly of the view that profits, cash and dividends from tobacco stocks have many years of strong growth ahead,” said Stephen Lamacraft, fund manager at Woodford Investment Management.

Still, the Global Taskforce for Tobacco Free Portfolios, backed by the Union for International Cancer Control, has scored one big victory since it began campaigning in March 2015 for financial institutions and pension funds to divest an estimated $60 billion from the industry.

In May this year, French insurer and fund manager Axa agreed to ditch its tobacco holdings, becoming the first major European investor to sign up to the campaign, although others had already opted out of tobacco before it was launched.

Axa said its role as a health insurer meant it could no longer justify investing in something that had such a “tragic” impact on public health. At the time it held 200 million euros in tobacco stocks and about 1.6 billion euros ($1.8 billion) in bonds issued by the cigarette makers.

Even then, the process is lengthy. Axa has almost completed selling the shares but will keep the bonds until they mature. Only in 2027 will the bulk – 97 percent – be off its books.

Many other investors appear reluctant to discuss the issue. Reuters contacted 24 large fund managers which hold tobacco stocks, and all but seven declined comment or did not respond.

INVESTMENT APPEAL

According to the World Health Organization (WHO), tobacco kills around 6 million people each year, including 600,000 non-smokers exposed to second-hand smoke.

Many of the passive victims are children.

The Taskforce’s global Project Manager, Melbourne-based Bronwyn King, has persuaded more than 30 Australian superannuation funds to ditch tobacco but the campaign faces a tougher challenge in Europe.

The same goes for the United States, where one influential investor, the California Public Employees’ Retirement System is reviewing a 16-year investment ban on tobacco after a study estimated the policy had cost it $2 billion to $3 billion in returns.

Campaigners reject the fiduciary duty argument – that funds must seek the best returns for their clients. They note that about 180 countries have signed up to the WHO’s Framework Convention on Tobacco Control, which aims to cut consumption by 30 percent by 2025 through new regulations and tax increases that will make tobacco less affordable.

Currently just a handful of countries fully comply with the treaty, implying a significant future hit to the value of tobacco stocks when others follow suit.

“Over the longer term, (the treaty) has to decrease the validity of the product – you will have fewer people wanting or being able to buy tobacco and that has to impact the investment appeal of the producers,” said Rachel Melsom, UK director of campaign group Tobacco Free Portfolios.

Philip Morris International, Imperial Brands and BAT declined to comment. Japan Tobacco did not immediately respond to a request for comment.

ONE BILLION SMOKERS

The tobacco industry sells about 5.6 trillion cigarettes a year to the world’s 1 billion smokers, many of whom live in low and middle-income countries. Here consumption is expected to keep rising due to growing populations and income.

More people are quitting smoking or cutting down in developed countries, but overall revenue and profit margins are consistently buoyed by companies’ ability to raise prices.

International players have also largely shielded themselves from direct exposure to the U.S. market, which has a history of litigation against big tobacco companies. For instance, Philip Morris has been separated from Altria (MO.N), which sells its Marlboro cigarettes in the United States.

In the 10 years to 2015 – a period that included the crisis of 2008-09 – the MSCI World Tobacco Index rose 10.4 percent compared with just 2.64 percent on the MSCI World Index.

All this appeals to many fund managers. For instance, the 9.2 billion pound ($12.3 billion) CF Woodford Equity Income Fund managed by veteran fund manager Neil Woodford holds BAT and Imperial Brands – makers of the Lucky Strike and Gauloises brands respectively – among its top 10 positions.

“(Tobacco’s) dependable dividends are increasingly highly-prized and still represent attractive yields,” said Lamacraft.

The dividend argument doesn’t always hold water. London-listed British American and Imperial reported dividend yields of 3.2 percent and 3.78 percent respectively, compared with an average 4.06 percent across the FTSE 100 index. New-York listed Philip Morris International has a 4.01 percent dividend yield.

Louise Dudley, portfolio manager at Hermes Investment, said she has barred tobacco stocks because she believes returns are unsustainable in the long-term.

“The industry has faced and continues to face increased regulation and consumers are becoming more aware of the health impacts of tobacco. The general trend is towards more healthy lifestyles. Tobacco products don’t tend to fit within that.”

CLIENT ATTITUDES

A spokeswoman for Standard Life Investments (SLI) said its decision not to black-list tobacco reflected the needs and views of its clients. But Melsom said ordinary savers didn’t always know where their money was being invested.

“If every individual who has a pension fund could see their level of investment in tobacco and the costs associated with that, I think that would make a difference,” she said.
Client attitudes towards tobacco varied widely, according to Iain Richards, Head of Responsible Investment, EMEA, at Columbia Threadneedle Investments. “We are satisfied that, for our mainstream funds, our approach is measured, works well and serves our clients’ best interests. We therefore don’t intend to adopt a blanket divestment policy on tobacco,” he said.

Amra Balic, Head of BlackRock’s EMEA Investment Stewardship team (BLK.N), said her firm did not make social, ethical or environmental values judgments on behalf of clients, and company engagement was critical in addressing the health and social risks of tobacco.

“I don’t think that we will end up, by divestment, in a world where tobacco won’t exist, therefore engagement by responsible investors is key to holding companies to account on ESG (environmental, social and governance) issues”.

A spokeswoman for M&G, another investor in the sector, said it regularly discussed environmental, social and ethical risks with tobacco company management, and encouraged improvements where it considered performance to be poor.

SLI, BlackRock, M&G, Columbia Threadneedle, Handelsbanken and Aberdeen Asset Management all said clients could bypass tobacco with their socially responsible investment (SRI) funds. Handelsbanken said about 40 percent of the assets that it manages are in funds that exclude tobacco investments.

The performance of SRI funds, which often also avoid industries such as armaments and alcohol, is typically benchmarked against indexes that exclude tobacco firms.

But mainstream funds are benchmarked against indexes that usually include them. Any that chooses to drop tobacco stocks is likely to underperform its benchmark index, putting pressure on managers to stick with the status quo.

“You need to benchmark against other funds that don’t include tobacco and see how you how perform in other investments you have put in its place,” Melsom said.

The following firms declined to comment or didn’t respond to a Reuters request for comment:

JPMorgan Asset Management, Nordea Asset Management, Invesco Perpetual, Morgan Stanley Investment Management, Vanguard, Franklin Mutual, Capital Group, RBC, Legal & General Investment Management, Credit Suisse Private Banking, SEB Investment Management, Andra AP Fonden, Forsta AP Fonden, Oppenheimer Funds, Gabelli Funds, Capital Research and Reinet Investments.

($1 = 0.7482 pounds)
($1 = 0.8965 euros)
(additional reporting by Martinne Geller; editing by David Stamp)

Some racial, ethnic groups continue smoking cigarettes at higher rates

Substantial disparities found among American Indians/Alaska Natives, Korean and Puerto Rican Americans

Despite a significant decline in overall adult cigarette smoking since 1964, disparities in cigarette smoking remain among racial and ethnic population groups, according to a new study from the Centers for Disease Control and Prevention (CDC) published in today’s Morbidity and Mortality Weekly Report (MMWR).

For example, current (past 30-day) cigarette smoking during 2010-2013 was lower among Asians overall (10.9 percent) compared with Whites (24.9 percent). But among Asian sub-groups, the prevalence of current cigarette smoking ranged from 7.6 percent among Chinese and Asian Indians to 20.0 percent among Korean Americans. The American Indian/Alaska Native population had the highest prevalence of cigarette smoking at 38.9 percent. The findings in this study show the importance of identifying higher rates of tobacco use across and within racial/ethnic population groups to better understand and address differences in tobacco use among U.S. adults.

Larger sample size for racial/ethnic subgroups

Estimates of cigarette smoking prevalence are usually presented in aggregate for racial or ethnic populations, such as Asian or Hispanic, because sample sizes are too small to provide estimates among racial/ethnic subgroups within these populations. To get a large enough sample size for this study, researchers aggregated data from the National Survey on Drug Use and Health collected between 2002-2005 and 2010-2013 to assess cigarette-smoking prevalence among 6 racial and ethnic population groups and 10 select subgroups in the United States.

“Even though the overall cigarette-smoking rate is declining, disparities remain among racial and ethnic groups and within subgroups,” said Bridgette Garrett, Ph.D., associate director for health equity in the CDC’s Office on Smoking and Health. “Looking beyond broad racial and ethnic population categories can help better focus the strategies that we know work to reduce tobacco use among sub-groups with higher rates of use.”

Hong Kong women and men enjoy world’s longest life expectancy due to low smoking rates, health experts claim

Second place held by Japanese women and Icelandic and Swiss men

Hong Kong’s women and men enjoy the longest life expectancy in the world, according to data released by Japan’s health and welfare ministry on Wednesday.

The average lifespan for women in Hong Kong is 87.32 years, and local men on average can expect to live to 81.24.

Japanese women took second place at 87.05, while Icelandic and Swiss men shared the second position in the men’s category at 81 years.

The overall life expectancy gap between women and men fell by 0.07 year last year, compared with the previous year’s figures.

Since 1985, Japanese womenhad the world’s longest average life expectancy. But this changed in 2011 when Hong Kong women overtook them after the catastrophic earthquake and tsunami in north-eastern Japan [2] in March that same year.

Japanese women then regained the top spot in 2012 and managed to retain it for three consecutive years until last year.

A Japanese health ministry spokesman said longer lifespans resulted from improved medical treatment and technology in beating diseases like cancer.

Meanwhile, local health experts expressed little surprise over the findings for Hong Kong.

University of Hong Kong public health professor Lam Tai-Hing said the city’s low smoking rates were the main reason for its life expectancy results. “Smoking in Hong Kong compared with 30 years ago has been reduced by half,” he said, adding that recent data showed 19 per cent of local men smoked and only 3 per cent of local women smoked.

Lam noted that, when compared with Japan’s number of smokers – 30 per cent of men and 10 per cent of women – Hong Kong would continue to eclipse Japan in life expectancy rates in future. Michael Ni Yuxuan, a clinical assistant professor of public health at HKU, agreed with Lam. “Hong Kong has extremely low tobacco rates compared with the UK, US and Japan,” he said.

Ni highlighted low infant and maternal mortality rates as another major factor. Department of Health figures showed infant mortality rates in the city dropped from 9.7 per 1,000 live births in 1981 to 1.3 per 1,000 last year.

But Lam cautioned that differences between Hong Kong and Japan had to be taken into consideration. “Hong Kong is a city. Japan is a whole country,” he said, explaining that Japanese living in rural areas may have worse nutrition than Hongkongers as well as less accessibility to health care and education – factors in life expectancy. “In general, people in the city have longer lives, and people in Hong Kong have good access to education, clean water and electricity,” he added.

Source URL: http://www.scmp.com/news/hong-kong/health-environment/article/1995947/hong-kong-women-andmen-enjoy-worlds-longest-life?edition=hong-kong

SMOKING AND KIDS

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Tobacco Consumption in China Falls

http://sino.co.uk/2016/06/23/tobacco-consumption-in-china-falls/

In a victory for Government health policies, tobacco consumption in China has fallen for the first time in over 20 years.

The Financial Times reports that there’s been a fall of 2.4%, although the Chinese market remains enormous, accounting for 45 percent of all cigarette sales in the World.

China’s Government has recently been proactive in enforcing smoking bans in municipal spaces, and has increased tobacco duty from 5% to 11%.

Meanwhile, City A.M. has contrasted the decline of tobacco sales in China with a growing market in Europe.

The paper also reported that the worldwide growth of vaping products has slowed.

TOLL OF TOBACCO IN THE UNITED STATES OF AMERICA

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Cigarette market sees 2.4 per cent volume decline

http://www.tobaccojournal.com/Cigarette_market_sees_2_4_per_cent_volume_decline.53649.0.html

Cigarette sales fell in the world’s largest tobacco market in 2015 for the first time in two decades, according to research by Euromonitor International.

The country’s cigarette market lost some 60 billion sticks last year, Shane MacGuill, head of tobacco research at Euromonitor, said. He attributed the decline to wholesale tax hikes, increased government control on production and greater health awareness in some regions.

“We do not see 2015 as a one off with the Chinese market now projected to lose about 5% of its volumes between 2015 and 2020,” MacGuill said.

E-cigarettes – where are we now? Update

http://www.lexology.com/library/detail.aspx?g=2fd418f1-e1d9-4d19-ac31-e9228c3c2b91

E-cigarettes have become ever more popular since they first appeared on the market in 2007, and regulators have struggled to keep up. There has been much debate about the advantages and risks of using them. Community pharmacy is playing a significant role in the way the debate plays out, because many sell e-cigarettes, yet others regard such sales as unethical.

Increasingly, e-cigarettes are being seen as a positive tool in the ongoing battle to reduce smoking and last year research published by NHS England concluded that e-cigarettes were 95% safer than conventional cigarettes. The Royal College of Physicians published its own report at the end of April 2016 entitled “Nicotine without Smoke – Tobacco Harm Reduction”. The report explains that due to the negative impact on health of smoking tobacco, combined with other undesirable effects such as a reduction in economic productivity, smoking is responsible “for more loss of quality and quantity of life in the UK than any other avoidable cause” and concludes that the use of non-tobacco nicotine products, particularly e-cigarettes, has “huge potential to prevent death and disability from tobacco use.”

The number of people who smoke tobacco has already reduced considerably over recent decades. In 1972 51% of men and 41% of women smoked. By 2014, those figures had reduced to 21% of men and 16% of women. However, even these reduced percentages mean that there are still 8.7 million current smokers in the UK. According to the Royal College, the resulting direct cost to the NHS from smoking related illness is currently exceeds £2 billion each year. Taking into account other associated costs, such as social care and a decrease in economic productivity, the overall annual cost to the tax-payer is estimated to be approximately £14 billion. The Royal College has been involved in reviewing the effect of smoking for many years although, at first there was little enthusiasm at Government level for any real control over tobacco. The College published a report in 1962 identifying tobacco smoking as the main cause in the significant increase of cases of lung cancer, but, it was not until 1998 that a comprehensive tobacco control policy in the UK was published.

Because approaches to reducing the number of smokers have not been wholly successful, together with the fact that nicotine, in itself, is not a highly dangerous drug (although the smoke which is inhaled when smoking tobacco is), has led the Royal College to conclude that the use of e-cigarettes is, on balance, beneficial. This approach is consistent with Public Health England’s research that “While vaping may not be 100% safe, most of the chemicals causing smoking-related disease are absent and the chemicals present pose limited danger.

The views of Public Health England and the Royal College of Physicians will not mean that sales of e-cigarettes will be unregulated. Ministers in Wales attempted, unsuccessfully, to ban e-cigarettes from public spaces this year, and in the UK, the MHRA recently licensed e-Voke as the first e-cigarette to have a licence as a medicinal product, opening up the possibility of vaping on prescription. However, given the costs of obtaining the necessary licence – which the Royal College of Physicians puts at between £252,000 and £390,000 plus annual costs of up to £249,000, this is unlikely to be a particularly popular option, despite the credibility having a licence gives the product.

For those e-cigarettes that do not have a licence, the EU Tobacco Directive will came into force on 20 May. This regulates the content of e-cigarettes and imposes labelling and leaflet requirements. E-cigarettes must not contain more than 20 mg nicotine per ml; there are restrictions on additives; child resistant packaging is mandatory; and information leaflets must include possible adverse effects, addictiveness and toxicity. E-cigarettes must also continue to comply with advertising codes enforced by the Advertising Standards Authority.

Tobacco companies tried to prevent the Tobacco Directive coming into force. In May, the European Court of Justice rejected this challenge, holding that human health requires a high level of protection that descriptions such as ‘low-tar’, ‘light’, ‘ultra-light’, ‘natural’, ‘organic’, ‘without additives’, ‘without flavours’ or ‘slim’, could mislead consumers, by suggesting that the products concerned are less harmful or that they have beneficial effects. An argument by the tobacco companies that their descriptions were helpful to consumers was dismissed by the court, which said the descriptions were “intended more to exploit the vulnerability of consumers of tobacco products who, because of their nicotine dependence, are particularly receptive to any element suggesting there may be some kind of benefit linked to tobacco consumption, in order to vindicate or reduce the risks associated with their habits.”

Despite any residual disquiet about the long term effects of e-cigarettes, it looks as though they are here to stay, and this is reflected in the increasing number of pharmacies which are now selling them.

Charles Russell Speechlys LLP – Rachel Warren

Indonesia on track to having world’s highest smoking rates

http://asiapacificreport.nz/2016/06/05/indonesia-on-track-to-having-worlds-highest-smoking-rates/

With few commitments to curb cigarette consumption, Indonesia is poised to have the largest population of smokers in the world in the next decade.

Currently, the country ranks fourth on the list of countries with the most smokers, behind China, Russia and the US. But while other heavy-smoking countries are enforcing tough tobacco controls, Indonesia is planning to double tobacco production.

Indonesia already has the world’s highest smoking prevalence among males, as 67.4 percent of males over 15 years old smoke. The cost of treating tobacco-related diseases in the country is currently estimated to reach Rp 11 trillion (NZ$1.21 billion) a year, 0.29 percent of the country’s gross domestic product (GDP).

“If we don’t prevent and control the impacts of smoking, then there’s a chance we will become the world’s largest tobacco consumer in the next 10 years,” the Health Ministry’s disease control director general, Muhammad Subuh, said during an event to mark World No Tobacco Day.

The governments of China, Russia and the US have realised that health costs and other hidden expenses resulting from smoking are far higher than the money generated from the tobacco industry.

A study published last year in The Lancet medical journal said that a third of all men currently under the age of 20 in China, the world’s largest tobacco producer and consumer, would die prematurely if they did not give up smoking.

Therefore, China signed the World Health Organisation’s (WHO) Framework Convention on Tobacco Control (FCTC) in 2006. Since then, the Chinese government has worked earnestly to implement the FCTC by adopting a series of measures to control the tobacco epidemic.

Loose controls

Even though tobacco-related diseases claim 200,000 lives in Indonesia every year, the government has refused to sign the FCTC, resulting in loose cigarette controls and the country being dubbed the tobacco industry’s playground.

Like China, Russia and the US have also taken steps to ensure that the tobacco industry does not endanger the future of their young generations.

“We’ve seen changes taking place in countries with very difficult, complex environments. For example, Russia. It now has one of the strongest tobacco control laws in the world. If you had asked us 10 years ago whether Russia would be where they are, we would’ve said it’s very difficult as the industry is very active,” World Lung Foundation senior vice-president of communications Sandra Mullin told The Jakarta Post.

Russia signed the FCTC in 2008 and introduced a comprehensive tobacco control law in 2013, effectively banning advertising of tobacco products as well as sponsorship of events by tobacco companies.

The law aimed to reduce the number of annual tobacco-related deaths from 400,000 to 150,000-200,000.

The US, meanwhile, saw its smoking rates hit an all-time low in 2014, with only 16.8 percent of adults smoking, after it passed the Tobacco Control Act into law in 2009.

The law also bans sales of cigarettes to minors and tobacco-brand sponsorship of sports and entertainment events or other social and cultural occasions.

Conversely, the Indonesian government has only made minor efforts to tone down tobacco campaigns. Since 2015, it has banned tobacco advertising in mass media, on public transportation and in all public places. It also bans any form of tobacco advertising aimed at minors.

The government has also been adamant about supporting the tobacco industry by planning to double cigarette production to 524.2 billion cigarettes a year by 2020, the Industry Ministry’s 2015 tobacco industry roadmap states.

“If we see the roadmap, we can just imagine our little children being told to smoke,” the Health Ministry’s director of non- communicable diseases, Lily Sulistyowati, said.

Hans Nicholas Jong is a Jakarta Post reporter.