Conference theme: Professional Alliance Moving Together for a Tobacco-Free Society

This year, the 13^th Asia Pacific Conference on Tobacco or Health (APACT13) takes place virtually while the world continues to struggle with the devastating effects of the COVID-19 pandemic.

Tobacco use, with its known adverse health risks, is now even more of a hazard, further straining public health systems that have already been stretched, fractured, and decimated during the pandemic. The removal of face masks, repetitive hand-to-mouth actions, and spread of respiratory droplets through tobacco smoke and e-cigarette aerosol while smoking could accelerate coronavirus transmission. And smokers are more likely to become seriously ill and die from COVID-19 than non-smokers. Yet, it is business as usual for the tobacco industry; cigarettes, electronic nicotine delivery systems, and heated tobacco products continue to be aggressively promoted, including to young people.

Tobacco companies even falsely present themselves as part of the pandemic relief solution by engaging in COVID-19 vaccine development and well-publicized corporate social responsibility (CSR) activities. And governments have been pressured by this non-essential industry to allow tobacco product manufacturing to continue unabated during the pandemic.

With every aspect of life affected by COVID-19, we, the delegates of APACT13 declare that effective tobacco control is now more critical than ever. We must stop the tobacco industry in its tracks. The COVID-19 pandemic is an additional and crucial reason for us to expedite the endgame for the tobacco epidemic. Governments must reduce both the supply and the demand of these lethal products, as outlined in the World Health Organization Framework Convention on Tobacco Control (FCTC), which is the comprehensive bare-minimum blueprint for tobacco control implementation.

The Conference makes the following recommendations.

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To stem the COVID-19 pandemic

We urge all governments to achieve the following within 12 months:

1. Implement a nationwide mass media campaign on the heightened risk of COVID-19 faced by cigarette, electronic smoking device, and waterpipe users, and on the risks presented by secondhand exposure. 
2. Explicitly classify all tobacco products as non-essential items. 
3. Prohibit tobacco companies from engaging in and publicizing corporate social responsibility (CSR) giving. The tobacco industry is a threat to, not a part of, the pandemic relief solution, and these activities violate FCTC Article 5.3 on protecting public health policies from commercial and vested interests, as well as FCTC Article 13 on banning advertising, promotion, and sponsorship. 
4. Include a robust tobacco control strategy in their national plans for the UN COVID-19 Response and Recovery Fund. 

To accelerate the tobacco endgame

5. In line with this year’s conference theme, the Medical Association of Thailand (MAT) and the National Alliance for Tobacco Free Thailand (NATFT) will seek the support of the Asia Pacific region’s professional medical and public health networks and alliances to release a joint statement of commitment to tobacco control by January 2022. 
6. By the next APACT conference, at least 30% of countries should introduce a whole-of-government Code of Conduct to prevent tobacco industry interference in policymaking, in line with FCTC Article 5.3 guidelines. 
7. All countries will identify at least three cases of in-country tobacco industry interference, and at the next APACT conference, present these cases and actions taken to address and counter the interference. 
8. We call on all governments and other entities in the region to sever all ties with the Foundation for a Smoke-Free World (FSFW). Fully funded by Philip Morris International, FSFW is co-opting health-focused smoke-free messages to mask its true objectives, promoting electronic smoking devices as allegedly safer alternatives to traditional cigarettes and undermining tobacco control policymaking. 
9. We renew the call for governments to adopt, strengthen, and sustain the implementation of 100% smoke-free policies in all enclosed workplaces, public places, and public transportation, covering all forms of tobacco products including waterpipes and electronic smoking devices. 
10. We call on governments to ensure adequate and sustainable financial and human resources for tobacco control, proportionate to the magnitude of disease and deaths caused by tobacco. 
11. We urge all FCTC Parties to reaffirm their commitment to tobacco control at the Ninth Session of the Conference of Parties (COP9) to the FCTC in November 2021. 

Supply reduction measures:

12. To effectively control the tobacco supply chain, governments should require a license for all commercial activities related to the manufacture, distribution, and sale of tobacco products. In addition, the number and location of retailers should be limited to restrict access to tobacco products. 
13. We urge all Asia Pacific countries to plan and implement a phase-out of all commercial tobacco sales within the next 10 years. At the same time, we commend those nations that have banned the use and sale (including online sales) of all electronic smoking devices, and urge all other countries to do the same. Electronic smoking devices are harmful and addictive, and young people in particular are being targeted by an industry in need of new consumers. 
14. We urge countries to become a Party to the WHO FCTC Protocol to Eliminate Illicit Trade in Tobacco Products and prevent illicit trade from undermining price and tax measures, health goals, and the economy. 

Demand reduction measures:

15. By the next APACT conference, we urge all governments to raise the minimum legal age of purchase for tobacco products to at least 21 years, in line with scientific evidence on nicotine addiction and brain development. 
16. By the next APACT conference, we urge all countries to have implemented a tobacco excise tax increase that effectively reduces tobacco affordability with a view to achieving a tobacco excise burden of at least 70% of the retail price. Tax increases that reduce affordability fulfill the dual purpose of discouraging tobacco use and increasing government revenue, which could be channeled into tobacco control and/or COVID-19 pandemic recovery efforts. 
17. By the next APACT conference, we urge all countries to require standardized (plain) tobacco product packaging and at least 75% pictorial warnings on product packages. 
18. We urge all governments to prohibit the use and sale of flavoured tobacco products, including menthol, as these promote tobacco use and uptake and nicotine addiction.