You can breathe the air in Bhutan

THIMPU, Bhutan — The Himalayan kingdom of Bhutan is well on the way to becoming the first nation on earth to completely ban the use of tobacco, hot on the heels of the recently adopted global Framework Convention on Tobacco Control, the world’s first anti-smoking treaty.

Bhutan Health Minister Sangay Ngedup told the World Health Assembly in Geneva last month that his nation of 2 million inhabitants is aiming to be smoke-free by the end of the year.

“We will not spare any efforts to stamp out smoking,” he said. “We will set a great example for all other countries to follow.”

Bhutan has adopted an anti-smoking approach combining tradition, religious persuasion and saturation health education across the country to curb the smoking habits of its citizens.

Today, 19 of the country’s 20 districts have declared themselves tobacco-free, and Bhutan has become the first country to ban the sale of tobacco in its airport duty-free stores.

A devout Buddhist nation, Bhutan draws from its religious history to wage a campaign against smoking. In 1629, the warrior monk and founder of modern Bhutan, Shabdrung Ngawang Namgyal, introduced the world’s first-ever prohibition on smoking and chewing tobacco when he banned it from all government buildings and religious centers.

Since then smoking has never been encouraged in Bhutan, but like all developing countries it witnessed a steady increase in smokers during the latter half of the past century as it became exposed to aggressive marketing and ready supply from global tobacco companies.

“Smoking was becoming a serious issue for our country, and the rapid rise in the cancers and other smoking-related diseases was a major economic burden on our public health system,” said Bhutan’s director of health, Dr. Gado Tshering.

Bhutan’s health authorities began to claw back in the war against tobacco when they hit on a novel approach of teaming health workers with religious leaders to travel the country in an influential “Health and Religion Project,” beginning in 1997.

Dr. Gado said the aim of the project was to go to every village and explain to people that smoking is not only bad from a health point of view, but is also a serious religious sin.

“There is no doubt that having the two elements working together, and with strong and vocal support from the king and other government leaders, has led to a large proportion of people giving up smoking,” he said.

Health workers estimated that there may be as few as 25,000 smokers left in the country, down from almost 300,000 a decade ago.

One of those who has given up cigarettes in recent times is Paro resident Chheda Dukpa, a smoker for 17 years.

“We were being told that smoking was bad for our health, but when the district lama came in 2000 and told me I was smoking too much and that it was a big sin, then I promised I would never smoke again, and I never did,” he said.

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