Since the return of Big Tobacco to Myanmar en masse in 2013, smoking rates have increased markedly. Tobacco control experts warn that the firms’ sophisticated strategies are likely to push more people into the clutches of addiction
From the backseat of a traffic-stranded cab attempting to travel from Yangon’s airport to a city hotel, Myanmar’s burgeoning love affair with cigarettes quickly starts coming into focus.
Vendors peer into car windows, peddling cigarettes. Calling one over, the cab driver buys two individual filter tips and lights up, eagerly espousing the low cost of his favourite brand, Red Ruby.
In the city’s central downtown area, kiosks selling everything from a single brand to a staggering array of tobacco products are situated on nearly every street corner. And the smokers aren’t far behind. Cigarette vendor Sein Win, 46, is adamant that more people have taken up the habit in recent years, although this has not translated into an increase in customers – he blames the sheer number of salespeople trying to ride the boom. “My sales rate is lower than before because there are new vendors opening,” he said.
While many in the country have traditionally preferred chewing betelnut or smoking cheroots – local cigars that turn popular teashops into a haze of smoke as customers puff away with aplomb – Myanmar is currently seeing a rapid increase in the popularity of manufactured cigarettes as political change swings open the country’s doors to investment.
Tobacco firms were among the first global brands to descend upon Myanmar in 2013 after its quasi-civilian government began implementing reforms. Japan Tobacco International (JTI), British American Tobacco (BAT) and the state-owned China Tobacco now all have a presence there.
It’s little wonder. According to the WHO, 45% of adult males and 8% of women used some form of tobacco each day in Myanmar in 2012, although just a tiny fraction – an estimated 4% – smoked cigarettes, meaning that a large potential market was ripe for the taking. Meanwhile, in 2013, market research firm Euromonitor identified Myanmar as one of the top 20 potential markets for consumer goods companies globally, on account of increased investment along with population growth – and named tobacco as one of the seven key industries in the nation of about 55 million people.
According to Than Sein, the president of People’s Health Foundation in Myanmar, there are now 62 brands of cigarettes clamouring for a share of the country’s tobacco market, compared to the 10 or 15 brands that were available in the 1990s.
Judith Mackay, a senior advisor at Vital Strategies who has been a leading advocate for tobacco control for 30 years, said that as smoking rates have fallen in developed countries, Big Tobacco has turned its attentions to new horizons. “They really tend to go all out to get any smokers they can,” she said. “The low- and middle-income countries are particular targets.”
“Typically, these markets have high smoking rates and, in many cases, are trying to attract investment,” added Ross Mackenzie, a public health expert at Macquarie University in Sydney. “Transnational tobacco corporations take advantage of globalised production and distribution networks and economies of scale to promote their brands.”
BAT, which had a joint venture with a military-owned company until leaving Myanmar in 2003 following a concerted campaign by overseas human rights activists, has invested $50m to build its factory on the outskirts of Yangon to begin producing its London brand of cigarettes – the top-selling brand before Red Ruby took its mantle in the intervening years.
“The foreign tobacco companies bring in very sophisticated advertising, promotion and sponsorship that the [local] monopolies don’t have”
The return of BAT, and establishment of others, is “highly significant” in terms of changing cigarette consumption habits, according to Mackay, who said these transnational tobacco companies were on a different level to government-affiliated firms and monopolies. “The foreign tobacco companies bring in a new scenario of very sophisticated advertising, promotion and sponsorship, which in general the monopolies don’t have; they bring with them much more sophisticated obstruction to legislation.”
According to May Myat Cho, the Myanmar country coordinator for the Southeast Asia Tobacco Control Alliance (SEATCA), official sentinel surveys clearly show that male smoking rates dipped from a peak of 48.6% in 2003, the year BAT left Myanmar, before climbing to 46.8% when the firm returned in 2013 and increasing sharply to 60.3% last year.
Similarly, the surveys showed female smoking rates were at 13.7% in 2003, but this had increased to 18% in 2015.
Women and young people, in particular, are in the crosshairs for tobacco firms. Vendor Sein Win said most of his customers are aged between 15 and 20, but his youngest is just ten years old. “There is no age limitation for selling cigarettes here. If an underage person comes and asks to buy cigarettes, we have to sell to them. We don’t want any problems.”
He is mistaken: Myanmar banned the sale of tobacco to minors aged under 18 in 2006, when the government introduced a tobacco control law that also prohibits all forms of tobacco advertising, the sale of individual cigarettes and requires health warnings be printed on tobacco products.
However, according to experts, Big Tobacco is using myriad tactics to circumvent this legislation, which, despite government efforts, is not being implemented by authorities on the ground. “They take advantage of limited and/or poorly [enforced] tobacco control regulations in aggressive marketing campaigns that include some combination of traditional advertising and sponsorship of sports, music and cultural events, which can also lead to access to policymakers,” MacKenzie said of the firms’ strategies globally.
In a recent interview with Frontier Myanmar magazine, BAT Myanmar managing director Rehan Baig denied that his company was using advertising in the country. SEATCA’s Myat Cho disputed this, saying that as well as selling and distributing cigarettes at teashops and restaurants, “they are also distributing complimentary napkins, ashtrays and lighters at teashops, and actually with the brands [visible]”. She added that cigarette kiosks often display promotion posters and some companies, she cited JTI in particular, were known to distribute free cigarettes at major religious festivals – both practices that are outlawed.
One of the more insidious, less-well-known avenues used by Big Tobacco to influence government policy is via the International Tax and Investment Centre (ITIC), which Mackay described as a “front organisation” for the alcohol, tobacco, oil and food industries that sets up secretive meetings with government officials worldwide to pressure them into keeping taxes low. She added that there is plenty of evidence the organisation is active in Myanmar.
“They have their meetings in the House of Lords in London; they’re a very, very powerful group of retired finance ministers and customs officials, and they’re using other front organisations and challenging governments. And when they get into a country, particularly, it seems to get even worse,” she said. “What they do is, they work with the ministry of finance, so the health people often… have no knowledge of them,” she added.
Despite this, Myat Cho is optimistic that the country’s new health minister, Myint Htwe, a former director of the non-communicable diseases department at the WHO’s regional office, will draw upon his experience to tackle tobacco use in Myanmar. Last year, the government increased taxes on tobacco products from 50% to 60%, and pictorial health warnings – shown to be effective in deterring smokers in other countries – are due to be introduced in September.
“The tobacco industry already wrote letters to the Ministry of Health to delay the implementation, so we’re expecting those challenges, but we’re working closely with the ministry and providing our assistance [with] whatever they need, so I think it will be effective,” she said. “And also the taxes on tobacco changed from ex-factory price to retail price, so the revenue will be increased, but whether it will be immediately effective on the reduction of smoking – they need to increase the tax higher.”
Regardless, in-country production, which makes cigarettes much cheaper and more accessible than foreign imports, is ramping up. At the height of military rule in the 1990s, approximately 500m sticks were produced in the country annually, according to official government statistics provided by SEATCA. This jumped to 3 billion by 2005, and it is estimated that 5 billion were manufactured last year. An increasing tide of production is difficult to stem, especially while the novice government has serious political, economic and social challenges it must now manage.
“The difficulty is that tobacco tends to be a rather low priority” in comparison to other issues, said Mackay. “The other difficulty is that, up to now, countries like Myanmar have been fighting infectious diseases such as TB, malaria and maternal mortality and infant mortality. They have no or very little experience dealing with the sophisticated tobacco companies; it’s a different paradigm, dealing with a vector that is not a mosquito, that is not a bacteria.”
The upshot, she added, is that a growing number of people in Myanmar are likely to take up cigarettes or swap their traditional tobacco for manufactured filter tips. “We’re certainly not talking within a year or two, but I would suspect if you were to review this in ten years’ time, you certainly might find a shift in the cigarettes people are smoking, particularly the young, and particularly the better educated; that would be the pattern.”
University student Kaung Htet Lin, 16, started smoking about a year ago amid peer pressure. Now, he struggles to kick the habit. “I want to quit, but I can’t because if someone smokes in front of me, I want to smoke and inhale too,” he said.
And in his changing preferences – from a local brand to one owned by tobacco giant BAT – could lie an early glimpse of the future: “Mostly I smoked Red Ruby; now I’m smoking Lucky Strike.”
Smoke gets in your eyes
The long, strange history of global tobacco use
Some smoke it, some chew it, others curse it. Regardless of its toxic health effects, tobacco has been a global pastime for centuries. Its origins are in the Americas, where the World Health Organisation (WHO) claims cultivation of the plant began as early as 6,000 BCE. Within 150 years of European settlers arriving to the ‘New World’, the tobacco plant was being used around the globe.
While in past centuries snuff and cigars were among the more popular methods of enjoying tobacco, the early 1900s ushered in mass cigarette production, and the modern cigarette was born in 1913 with R.J. Reynolds’ Camel brand. Smoking subsequently grew in popularity throughout the 20th century.
In 1951, however, the first large-scale study of the relationship between smoking and lung cancer was produced, followed by mounting evidence of the associated health risks. Smoking rates in industrial countries have dropped off significantly over the past 60 years, but tobacco use in the developing world remains a major health concern. The WHO predicts that tobacco use will cause 8.4 million deaths annually by 2020, 70% of which will occur in developing countries.