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Myanmar Cancer Victims Reveal Deadly Dangers of Betel Chewing in New National Media Campaign

(Nay Py Taw, Myanmar and New York, USA) – The Ministry of Health and Sports (MoHS), The Republic of the Union of Myanmar, in collaboration with the People’s Health Foundation (PHF), have launched the country’s first national mass media campaign to warn people about the proven health harms of using smokeless tobacco. This also is the first campaign in Myanmar to feature the dramatic testimonial stories of real tobacco victims – four men who contracted oral cancer because of their betel quid chewing habit. The campaign, which marks the beginning of a concerted effort from MoHS and PHF to reduce tobacco use, aims to reduce the death toll of betel chewing. The six-week campaign was developed with technical assistance from Vital Strategies and will be broadcast for six weeks on national television and radio channels in Myanmar.

Jose Luis Castro, President and Chief Executive Officer, Vital Strategies, welcomed today’s launch, saying: “We congratulate the Ministry of Health and Sports and the People’s Health Foundation on the launch of this ground-breaking and important campaign. It marks a positive step toward reducing the harm of tobacco and the burden of non-communicable disease in Myanmar. In our experience, such graphic, hard hitting and culturally sensitive campaigns that feature tobacco victims are highly effective in changing knowledge and behavior. We recognize the bravery of the patients featured in this campaign, whose stories show the deadly truth about betel chewing. Alongside policy action from the government to reduce tobacco use, they will help others to avoid the same fate.”

The number of people suffering and dying from non-communicable diseases (NCDs) is growing at an alarming rate, said the Minister of Health and Sports, Dr. Myint Htwe, at a launch event for the new campaign. “NCDs account for more than 40 percent of all deaths in Myanmar,” said Dr. Htwe. “A large percentage of these deadly conditions is caused by tobacco use and chewing betel quid, in packages called kunyar. This campaign will help to warn Myanmar’s people about the real harms of chewing betel quid. In particular, we want to protect our youths from starting to chew. This is also a major focus of our National Health Plan, 2017-2021.”

Support for the campaign from the highest level of government came in a statement from State Counsellor Daw Aung San Suu Kyi, read out by the Minister of Information, Dr Pe Myint, during the launch event. Daw Aung San Suu Kyi wrote: “Over 7 million Myanmar citizens use tobacco products, including kunyar, on a daily basis. The death toll in our country because of tobacco is over 60,000 yearly, according to research. So we are facing a large health challenge. I would like to urge people to avoid betel chewing, to stay healthy.”

The campaign could not have been launched at a more opportune moment, said People’s Health Foundation President Dr U Than Sein. “The death toll is higher in Myanmar than in other low-income countries. About 30 percent of adults over 15 years use smokeless tobacco or chew betel quid in our country, which is a major cause of oral and laryngeal cancers. This problem needs to be addressed urgently. This campaign and the outlawing of betel chewing in government offices, schools and hospitals in May 2016 are great first steps. But tobacco usage, and more specifically betel quid chewing, is a national health problem that merits a long-term approach, combining education, regulation and enforcement. Only then will we be able to structurally decrease the number of unnecessary deaths. We hope to help the Ministry of Health and Sports follow-up on the campaign in the future.”

About the campaign

The campaign is centred on two 30-second Public Service Announcements (PSAs) for television, a radio message, and posters featuring real oral cancer patients. These patients had chewed betel quid for many years, and now have seen their lives destroyed by tobacco-related cancer. All the patients consented to being part of the campaign. The PSAs end with a call to action, saying: “Avoid betel chewing, so you don’t regret your life choices.”

The TV messages, posters and the radio message were tested rigorously in focus groups to ensure they deliver hard-hitting and culturally-appropriate messaging, in order to achieve a real impact in changing habits and attitudes towards betel chewing. Over 90 percent of the focus group found the campaign to be ‘effective’, ‘relevant to me’, ‘taught me something new’, ‘believable’, and ‘makes me more likely to try to quit.‘  This is the first national health campaign in Myanmar to clearly show real-world victims of oral cancer, following in the footsteps of similar successful campaigns in India, Thailand, and Taiwan.

Tobacco use in Myanmar – a growing health and economic problem

According to The Tobacco Atlas, nearly a third (30.6 percent) of adult males, 6.5 percent of adult females, 13 percent of boys and 0.5 percent of girls smoke tobacco in Myanmar. In addition, 29.6 percent of adults use smokeless tobacco. More men, women and boys smoke or use smokeless tobacco than is the average in other low-income countries. This means that more than 152,000 children and more than 7,218,000 adults continue to use tobacco each day. As the use of all forms of tobacco has increased, so has tobacco-related disease and premature death. Tobacco is the cause of 13.2 percent of male deaths and 12 percent of female deaths in Myanmar, killing over 56,400 of Myanmar’s citizens every year. Again, this is higher than the average across other low-income countries.

Betel nut chewing

Almost a tenth of the world’s population chew betel nut, which traditionally has been promoted as being harmless and even beneficial. In reality, betel chewing leads to high rates of oral and laryngeal cancer, which could be prevented. Chewing betel leaf with areca nut and tobacco is a major cause of oral and laryngeal cancers in Myanmar. Oral and laryngeal cancers can make basic functions like eating, talking and expressing facial emotions difficult if not impossible. Sufferers can hide away because of shame, but this means the public do not tend to see the actual harm of betel chewing. Myanmar now joins countries like Taiwan, India and Thailand, where betel nut chewing is also popular, in launching campaigns to discourage people from betel chewing.

FAQs, fact sheets, and stills and a transcript of the PSA are available upon request.

Without urgent action by governments around the world to implement proven tobacco control measures, global tobacco-related deaths will number seven million each year and a billion this century. Vital Strategies calls on all governments to fully implement the WHO Framework Convention on Tobacco Control and strongly enforce tobacco control policies to protect current and future generations from tobacco-related disease and premature death. Research has shown that mass media campaigns and graphic health warnings are one of the most effective means to prompt people to stop using tobacco. They are one of the World Health Organization’s M-P-O-W-E-R (W=Warn) strategies to reduce tobacco consumption. The M-P-O-W-E-R strategies are endorsed and promoted by the Bloomberg Initiative to Reduce Tobacco Use, of which Vital Strategies is a principal partner.

About Vital Strategies

Vital Strategies is a global health organization that seeks to accelerate progress on the world’s most pressing health problems. Our team combines evidence-based strategies with innovation to help develop and implement sound public health policies, manage programs efficiently, strengthen data systems, conduct research, and design strategic communication campaigns for policy and behavior change. To find out more, please visit or Twitter @VitalStrat.

For further information or to arrange an interview with a Vital Strategies public health and tobacco control expert, please contact Tracey Johnston, Vital Strategies, at +44.7889.081.170 or