Comparing Tobacco and Alcohol Policies From a Health Systems Perspective: The Cases of the Philippines and Singapore
Summary and overview
In this analysis, researchers developed scorecards measuring the progress of tobacco and alcohol policy in the Philippines and Singapore. The scorecards were developed using a systems approach, based on the following domains:
- leadership and governance,
- human resources,
- service delivery and medical products and technologies, and
- how well these contribute to SDG goal 3 (Health and Well-being), the Framework Convention on Tobacco Control (FCTC) and the Global Alcohol Strategy.
Both the Philippines and Singapore scored high for tobacco control. When it comes to alcohol policy the Philippines received a weak score and Singapore a moderate score.
“Singapore (52.5) scored higher than the Philippines (34) on the alcohol control scorecard. … despite a marked difference in financing capacities, the strengths of Singapore’s alcohol control measures lie in an array of tax measures, licensing regime, restrictions in availability (minimum legal age, zoning, and time of sale), access to essential medicines, and [DUI] prevention measures.”Herrera Amul, G., Etter, J. Comparing Tobacco and Alcohol Policies From a Health Systems Perspective: The Cases of the Philippines and Singapore. Int J Public Health (2022) https://doi.org/10.3389/ijph.2022.1605050
Both Singapore and the Philippines lack legally binding regulations on alcohol advertising, promotion and sponsorship. Voluntary industry measures are in place, but these are known to be ineffective. Both countries also lack specific and written guidelines on interaction with the alcohol industry to protect policies from commercial interests.
The researchers also note that the key agency for alcohol policy in Singapore is the Police Force, not the Ministry of Health. While tobacco is seen as a critical concern for public health, alcohol remains primarily an issue of public order and road safety in the country.
Avenues for Intervention
Under the headline “Avenues for Intervention” the researchers suggest more effective implementation of the FCTC and the Global Alcohol Strategy:
- Concrete, legally binding and enforceable policy measures,
- Capture the commercial determinants of health, adress the political influence of the alcohol industry, and
- While the FCTC requires parties to allot funding for tobacco control, there is nothing simlilar for alcohol. The global funding gap for implementing alcohol policies needs to be adressed.
First, leadership and governance are critical in tobacco and alcohol control, as the effective implementation of the FCTC and the Global Alcohol Strategy relies on concrete, legally binding and enforceable policy measures. This calls for stronger engagement of various actors—intergovernmental organizations, global health networks, non-government organizations, community organizations, and the academe—to work with governments to pursue, promote and support the implementation of stronger alcohol and tobacco control policies.
Second, given the pervasiveness of self-regulation for the alcohol industry in the Philippines and Singapore and the lack of marketing restrictions, the political influence of the alcohol industry merits a better response from policymakers.”Herrera Amul, G., Etter, J. Comparing Tobacco and Alcohol Policies From a Health Systems Perspective: The Cases of the Philippines and Singapore. Int J Public Health (2022) https://doi.org/10.3389/ijph.2022.1605050
To provide a comparative analysis of current tobacco and alcohol control laws and policies in the Philippines and Singapore.
The researchers used a public health law framework that incorporates a systems approach using a scorecard to assess the progress of the Philippines and Singapore in tobacco and alcohol control according to SDG indicators, the WHO Framework Convention on Tobacco Control and the WHO Global Alcohol Strategy. They collected data from the scientific literature and government documents.
Despite health system differences, both the Philippines (73.5) and Singapore (86.5) scored high for tobacco control, but both countries received weak and moderate scores for alcohol control: the Philippines (34) and Singapore (52.5).
Both countries have policy avenues to reinforce restrictions on marketing, improve corporate social responsibility programs, protect policies from the influence of the industry, and reinforce tobacco cessation and preventive measures against alcohol harms.
Using a health system-based scorecard for policy surveillance in alcohol and tobacco control helped set policy benchmarks, showed the gaps and opportunities in these two countries, and identified avenues for strengthening current policies.