Youth smokers, particularly in low- and middle-income countries, are a huge potential market for industry's future growth. Tobacco companies target children and youths, whom they refer to as “replacement smokers” to replace older smokers who either quit or die from tobacco-related diseases. Youth smoking therefore remains the front line of the tobacco epidemic, as youths are more susceptible to tobacco marketing, and nicotine addiction is more entrenched in the developing adolescent brain. On average, most smokers start smoking before the age of 20.
The tobacco industry keeps inventing new ways to sell harm through novel marketing schemes, attractive and colourful packaging, new flavors, and new products to appeal to the young and first-time smokers. In ASEAN, menthol and flavoured cigarettes are unregulated and widely available. Single stick cigarette sales, which increase accessibility to cigarettes, are banned in all but available in three ASEAN countries (Indonesia, Philippines and Vietnam), while the sale of kiddie packs (containing less than 20-sticks) is still allowed in Indonesia and Philippines.
The emergence and rapid market growth of a new and wider range of alternative nicotine products such as electronic nicotine delivery systems (ENDS, which include e-cigarettes and are available in myriads of flavours) and heated tobacco products (HTPs) are a new challenge for preventing nicotine addiction and other health harms. Such gadgets, with their sleek designs and flashy marketing easily appeal to youths and increase the risk for transitioning to conventional cigarettes, and some countries have already seen a significant rise in teen use.
Globally, there are 111 countries have either banned or restricted the sale of ENDS. Thirty two of these countries (covering 2.4 billion people) ban the sale of ENDS, and the other 79 countries have adopted one or more legislative measures to regulate ENDS, covering 3.2 billion people. In ASEAN, five countries (Brunei, Cambodia, Lao PDR, Singapore, and Thailand) already ban ENDS and HTPs.
Transnational tobacco companies also produce ENDS and HTPs and promote these as being less harmful than conventional cigarettes and as smoking cessation devices. Noting that there are no long-term studies on the safety of these devices and insufficient evidence on their benefit as tools for smoking cessation, the WHO and some national health authorities, such as the Australian National Health and Medical Research Council (NHMRC) and the US National Academies of Sciences, Engineering, and Medicine (NAS), have recommended a precautionary approach and action to minimize harm to users and bystanders and to protect vulnerable groups such as young people, until clear evidence of safety, quality and efficacy are produced. For HTPs, the WHO recommends that these be regulated similarly to other tobacco products.
This chapter also highlights initiatives to protect present and future generations from nicotine addiction and tobacco harms.
*Menthol flavor only.
5.6 million children alive today will ultimately die early from smoking if we do not do more to reduce current smoking rate.
Smokeless cigars, smokeless cigarillos and smokeless cigarettes; dissolvable tobacco or nicotine; any product containing nicotine or tobacco that may be used topically for application, by implant or injection into any parts of the body; and any solution or substance of which tobacco or nicotine is a constituent that is intended to be used with an electronic nicotine delivery system (ENDS) or a vaporizer (e-cigarettes); nasal snuff, oral snu gutkha, khaini and zarda.
The Malaysia Health Ministry call for a ban on vaping and sale of e-cigarettes, however, due to strong lobbying by the vaping industry resulted in the non-nicotine based e-cigarettes being allowed and to be regulated by the Domestic Trade, Cooperatives and Consumerism (DTCC) Ministry and the Ministry of Science, Technology and Innovation.
The tobacco-free generation concept prohibits the sale of any tobacco products including electronic nicotine delivery systems (ENDS) and other similar products to any citizen born on or after 01 January 2000 in the City of Balanga. This was enforced through the enactment of Tobacco Free Generation End-Game Strategy Ordinance of Balanga City, Bataan in 2016.
On 21 July 2017, the PTI filed a Petition for Prohibition against Balanga City on the grounds of pre-emption, alleging prohibitions delineated in the CNSO supersede and therefore violate national regulations established by the Tobacco Regulation Act of 2003. Currently, the lower courts have ruled in favour of the PTI. Balanga City is contemplating exploring legal remedies to defend its local autonomy to develop public health policies promoting general welfare.”
Balanga City also passed new legislation - New Comprehensive Tobacco and Nicotine Regulation for the Protection of Health And Welfare Ordinance.
Singapore is the first country to call for a ban on sale of tobacco products to those born after 2000, initiated by the civil society. It referred to as the millennium generation (TFG2000), to protect the next generation from tobacco.
Thailand launched Gen Z Strong: No Smoking program targeting at those born between 1995 and 2009 or aged between 7 and 20 years in 2016 to be a smoke-free generation. Social media and digital media are utilitised convince the target youths not to start smoking and to actively participate in advocacy campaigns.
The project has expanded to engage more youth leaders and organizations. In 2017, about 100 youth leaders (from seven youth groups) and 9 leading organizations were engaged to support, promote and share the Gen Z project with their network through a series of workshops and trainings for 4,000 youths across the country. The youth groups continued to support the pilot projects in selected ten provinces, including Phuket, Krabi, Khonkhen, Srisaket, Ubonratchathani, Nakhonratchasima, Pitsanulok, Chiangmai, Petchaboon, and Maehongson.
In 2019, a new initiative 'MPOWER GEN Z' was designed to build and strengthen the capacity of youth groups in different areas including media (writing news, creative video clip) and tobacco industry monitoring and surveillance through a 'Gen Z Academy Programs'. Four Gen Z Academy workshops were held with a participation of 356 young leaders across ten provinces between 2019 and 2021.
At present, the Gen Z project has reached out to more than 10,000 Thai youths. Key activities implemented to support the Gen Z project includes: