2010-12-31-世界卫生组织-2011_GATS_Country_Report_Thailand_executive_summary_22页_6mb

2011 GATS, Thailand: Summary

Core Content

The Global Adult Tobacco Survey (GATS) was conducted in Thailand in 2011, following the 2009 survey, using a standardized global protocol. This survey is a nationally representative household survey targeting all noninstitutionalized individuals aged 15 years and above. It aims to provide data for the formulation, tracking, and implementation of effective tobacco control interventions, in line with the WHO FCTC (Framework Convention on Tobacco Control) and its MPOWER strategy, which includes six key demand reduction measures.

The survey employed a three-stage stratified cluster sampling method and collected data from 21,488 households, resulting in 20,606 interviews with individuals aged 15 and above. The overall response rate was 96.3%, with an average interview time of 21.9 minutes per respondent. Fieldwork was conducted from 1 October to 30 December 2011.

Main Findings

Tobacco Use

• 24.0% of adults (13.0 million people) smoked tobacco in 2011.
• Men smoked more frequently than women (46.6% vs. 2.6%).
• Rural areas had higher smoking rates than urban areas (25.9% vs. 20.3%).
• The most common tobacco products were manufactured cigarettes (15.2%) and hand-rolled cigarettes (14.4%).
• 15–24 years age group had the highest prevalence of manufactured cigarette smoking (20.1%).
• Poor and less educated individuals had higher rates of hand-rolled cigarette use.
• Smokeless tobacco use was reported by 3.2% (1.7 million people), with women (5.2%) and people aged 60+ (13.6%) being more likely to use it.
• Betel quid with tobacco was the most common form of smokeless tobacco use (1.8 million people).

Tobacco Cessation

• 36.7% of current smokers and recent quitters made a quit attempt in the past 12 months.
• Urban smokers were more likely to attempt quitting than rural smokers (41.3% vs. 34.7%).
• 90.7% of smokers quit without assistance.
• Healthcare providers asked 65.3% of smokers about their smoking status and advised 55.8% to quit.
• Smokeless tobacco users had a 16.4% quit attempt rate, with 25.1% being asked about their use and 16.3% advised to quit.

Second-Hand Smoke (SHS) Exposure

• 30.5% of workers exposed to SHS at workplaces (4.2 million people).
• Men had higher SHS exposure than women (37.1% vs. 22.8%).
• Rural workers had higher SHS exposure than urban workers (35.2% vs. 25.4%).
• The three most common public places of SHS exposure were markets (68.8%), bars/night clubs (68.4%), and restaurants (46.9%).
• 36.0% of people were exposed to SHS at home at least monthly.
• Rural areas, those with lower education, and lower SES had higher SHS exposure at home.
• SHS exposure at home increased from 33.2% (2009) to 36.0% (2011), while workplace SHS exposure remained stable.

Economics of Tobacco Use

• 47.3% of current smokers bought their last cigarettes as individual sticks.
• The median price for 20 manufactured cigarettes increased from THB 45.0 (2009) to THB 58.0 (2011).
• Manufactured cigarette expenditure accounted for 9.7% of monthly personal income.
• Shredded tobacco was much cheaper than manufactured cigarettes (THB 37.5/month vs. THB 585.5/month).
• 88.3% of cigarette smokers purchased from grocery stores.
• 4.8% of current smokers purchased cigarette packs without pictorial health warnings (PHWs), with the Southern region having the highest rate (18.5%).

Media and Awareness

• 81.2% of people noticed anti-smoking information in the past 30 days, mostly via television (68.1%).
• 25.7% of people noticed tobacco advertisements, promotions, and sponsorships (TAPS).
• 94.6% of current smokers noticed coloured PHWs on cigarette packages, and 62.6% of those thought about quitting due to PHWs.
• 75.2% of shredded tobacco users noticed black and white PHWs, with 49.5% considering quitting.
• The percentage of people exposed to anti-smoking information decreased from 86.9% (2009) to 81.2% (2011).
• The percentage of people exposed to TAPS increased from 17.8% (2009) to 25.7% (2011).
• The percentage of people who thought about quitting due to PHWs decreased from 67.0% (2009) to 62.6% (2011).

Key Recommendations

Monitor Tobacco Use and Policies

• Enhance cooperation with community organizations to limit youth access to tobacco.
• Systematically monitor violations of tobacco control laws and industry interference.
• Launch continuous awareness campaigns through social and community networks.
• Integrate tobacco-related questions into ongoing national surveys.

Protect from SHS

• Amend the Non-Smoker's Health Protection Act, 1992 to strengthen enforcement and penalties.
• Raise awareness about SHS risks, especially in rural and disadvantaged communities.

Offer Help to Quit

• Improve cessation services by training healthcare providers.
• Integrate 2As (ask and advise) into primary health-care services.
• Expand the reach of the Quitline 1600.
• Establish effective referral systems for quitting.

Warn About Tobacco Dangers

• Revise the Tobacco Control Product Act, 1992 to include coloured PHWs on all tobacco products.
• Update PHWs every two years.
• Use clear, simple, and direct warnings with recognizable images.
• Increase the size of PHWs and consider plain packaging to reduce brand influence.

Enforce Bans on TAPs

• Amend legislation to align with WHO FCTC guidelines.
• Monitor tobacco industry interference.
• Ensure strict enforcement of bans on tobacco advertising, promotion, and sponsorship.

Raise Tobacco Taxes

• Advocate for higher taxes on all tobacco products.
• Prohibit the sale of cigarettes in loose form.
• Increase public awareness and community monitoring to prevent access to minors.
• Support political commitment to tobacco control policies.

Conclusion

The 2011 GATS provides comprehensive data on tobacco use, cessation, SHS exposure, and economic factors in Thailand. It highlights the need for continued and intensified tobacco control efforts, especially in reducing youth access, increasing public awareness, and enforcing existing laws. The comparative analysis with the 2009 survey indicates some positive trends in awareness and policy compliance, but also reveals persistent challenges in cessation attempts and SHS exposure. The findings support the implementation of the WHO MPOWER strategy to improve tobacco control outcomes in the country.