BACKGROUND AND IMPLEMENTATION CHALLENGES: Tobacco use remains a critical public health issue, causing over 60% of tobacco-attributable deaths in the South-East Asia and Western Pacific regions. Myanmar, Timor-Leste, Indonesia, and Nepal face challenges in combatting this epidemic, including limited financial resources, policy implementation gaps, and insufficient integration of tobacco control into broader health strategies. Despite the presence of national tobacco control laws and adherence to the WHO Framework Convention on Tobacco Control (FCTC) in most cases, structural and financial barriers persist. The Index of Tobacco Control Sustainability (ITCS), comprising 31 key indicators, was used to assess and guide efforts for sustainable tobacco control in these countries.
INTERVENTION OR RESPONSE: Structured ITCS assessments involved focus group discussions with stakeholders from governmental and non-governmental sectors to evaluate gaps in policy, structure, and resources. The process reviewed tobacco control programs and developed action plans to address identified shortcomings. Examples of innovative responses include Nepal’s use of its Health Fund and Indonesia’s subnational tax allocations, which provided dedicated resources for tobacco control efforts. These strategies facilitated improvements in structural organization and policy execution.
RESULTS AND IMPACT: From 2016 to 2022, ITCS scores showed substantial progress: Myanmar improved from 43 to 82, and Indonesia from 54 to 74. These advances reflect enhanced policy implementation, structural capacity, and resource mobilization. Nonetheless, challenges persist in areas like capacity building, promoting research, and implementing robust tobacco taxation policies. These insights demonstrate the importance of embedding tobacco control within broader health and development frameworks.
CONCLUSIONS: The ITCS assessments highlight the effectiveness of evidence-based, strategic approaches to tobacco control. Strengthening intergovernmental collaboration, securing sustainable funding, and refining policy frameworks are essential for lasting progress. These findings provide actionable lessons for other low- and middle-income countries striving to achieve sustainable tobacco control.