Jigmi Wangdi
In response to the surge in tobacco imports and growing consumption, the Ministry of Health (MoH) has outlined its strategy to balance economic and public health concerns, particularly in light of tobacco’s link to non-communicable diseases (NCDs).
Officials from the ministry emphasised that, while tobacco imports have risen, especially from countries outside of India in 2024, health remains the primary concern.
The MoH has emphasised the need to strike a delicate balance between permitting legal tobacco imports to curb illicit trade and strengthening public health policies to address the risks associated with tobacco consumption. Health officials pointed out that while economic benefits may arise from tobacco imports, they will be carefully managed to ensure they do not compromise the public’s health.
Between 2020 and June 2024, Bhutan imported a total of 531 million cigarettes, with 511 million sourced from India and 19 million from other countries. The value of these imports reached Nu 1.524 billion, with 2022 marking the highest year at Nu 1.4 billion in tobacco imports. In the first half of 2024 alone, imports amounted to Nu 337 million.
The second quarter of 2024 saw a sharp increase in cigarette imports from countries other than India, totaling Nu 14 million—a 237.75 percent rise compared to the cumulative imports from non-Indian sources over the previous three years.
This significant uptick highlights the growing diversification in Bhutan’s tobacco supply chain and underlines the need for continued vigilance in managing public health impacts.
Tobacco use remains a major risk factor for NCDs, which account for 69 percent of deaths in Bhutan, according to the National Health Survey (NHS) 2023. In light of this concerning figure, the MoH has announced plans to reintroduce stricter controls on tobacco sales.
Health officials emphasised that they will enhance tobacco control measures, expand tobacco cessation programmes, intensify public awareness campaigns on the dangers of tobacco use, and review tobacco taxation policies. These efforts aim to reduce tobacco consumption and promote cessation, with a special focus on the general population and vulnerable groups.
The NHS report underscored limited progress in addressing NCDs, reinforcing the need for the ministry’s actions, especially in the context of increased tobacco availability following the 2021 amendment of the Tobacco Act. The reintroduction of stricter controls is expected to counter the growing accessibility and use of tobacco products.
Officials from MoH are actively considering various measures to combat tobacco use, including revisiting and potentially strengthening existing tobacco regulations. Plans include enhancing tobacco cessation programmes and launching aggressive public health campaigns to raise awareness about the dangers of tobacco consumption.
Additionally, officials indicated that increasing tobacco taxes and more strictly enforcing smoke-free environments may be integral components of a broader strategy. Drawing on recommendations from regional health experts at a recent two-day workshop focused on interventions for NCDs, the ministry aims to adopt a multi-pronged approach. This strategy will emphasise reinforcing smoke-free laws, raising tobacco taxes, and implementing comprehensive anti-tobacco campaigns.
“We will ensure robust monitoring and collaboration with local authorities to effectively enforce these policies, prioritising public health while addressing the challenges posed by tobacco use,” officials stated. This coordinated effort reflects a commitment to mitigating the public health impact of tobacco and improving overall community health outcomes.
The 2021 amendment to the Tobacco Act was partly introduced to address tobacco smuggling during the pandemic. In light of potential stricter controls, the Ministry of Health is prepared to implement measures to prevent a resurgence of illicit trade.
“Although Bhutan is not a signatory to the Protocol to Eliminate Illicit Trade in Tobacco and Tobacco Products, the ministry, in collaboration with relevant stakeholders, is ready to enhance enforcement strategies,” officials stated.
These strategies will focus on preventing illegal activities while safeguarding public health through targeted initiatives designed to reduce smoking rates, especially among vulnerable populations.
The ministry’s proactive stance reflects a commitment to balancing regulatory measures with the need to combat illegal tobacco trade, ensuring that public health priorities are maintained in the face of evolving challenges.