Cigarettes, Not Bird Flu, Is Vietnam's Big Killer

by Andrew Lam

(PNS) -- While on assignment in Vietnam last Christmas, I turned into a smoker, at least temporarily. I resisted at first, but my new acquaintances thought I was standoffish. My interviews didn't work very well. So I gave in.

I took cigarette offers and, in fact, bought some to give to others. Voila, the conversation began to flow. Soon, I'd come home reeking of tobacco smoke.

"So. (Puff. Puff.) Tell me, brother, how capitalism is working out in a communist country?" Puff. Puff. "Yes, uncle, I'm curious about whether a multiparty system will ever arrive in Vietnam? (Puff. Puff.)"

Taking and offering cigarettes is how friends and associates greet each other. It's like a handshake. If you don't shake hands, don't expect the natives to be friendly. According to the World Health Organization (WHO), more than 70 percent of Vietnamese men and 5 percent of women light up regularly.

"If you don't smoke people will think you're a sissy," says a young man. Another, an upwardly mobile 30-year-old account executive for a fashion magazine says, "My job demands the ability to drink and smoke. My business is done in bars and restaurants. You got to smoke."

Don't get me wrong. With a degree in biochemistry and two uncles who died from cigarette smoking, I'm very aware of the habit's deleterious effects. I puff but, like President Clinton, I don't ever inhale. Back in San Francisco, I wouldn't ever think of lighting up. If someone wants to smoke in my apartment I suggest he stand by the window or go outside. A typical Californian, I tolerate many antics, but not smoking, in my home.

As it is, Vietnam is now paying dearly for its bad habit. Fear of the avian flu is rising in the country, but it has only killed 35 people so far. Smoking, on the other hand, kills more than 40,000 people each year, and the number is increasing, fast. The WHO warns that possibly 10 percent of Vietnam's 84 million population, or more than 8 million people, will die early of smoking.

Statistics show that nicotine addiction is more prevalent in Asia than anywhere else. Asian males consume virtually half of the world's cigarettes. Vietnamese men, of course, contribute to the trend, with highest smoking prevalence rate for men in the world.

Indeed, brands like Phillip Morris and Marlboro are making a killing here, pun intended. Many foreign tobacco companies employ youths to hawk cigarettes. On holidays, beautiful young women dressed in red velor ao dai dresses with the Marlboro logo give away Marlboro baseball caps, if you buy a carton.

A carton of Marlboro could be a third of someone's monthly salary, however. The Marlboro man has become the symbol of luxury in Vietnam. Offer any American cigarette and people will talk to you. An average Vietnamese makes about $300 dollars a year. He spends about $40 dollars yearly on cigarettes. If it doesn't kill him, smoking puts him in the poorhouse.

Lately the government has stepped up anti-smoking campaigns. The State Movie Bureau, for instance, declared that it will edit any smoking scenes in locally made films, with an exception for "indispensable smoking scenes" like war scenes where soldiers share a smoke. Heroic figures still get to smoke on screen. Ho Chi Minh, for example, was a smoker.

But the regime's anti-smoking campaign so far is largely cosmetic. Among Vietnam's few profitable state-owned companies are beer and cigarette firms. Tobacco taxes, besides, make up more than 3 percent of the national budget.

Ironically, it's in California where many Vietnamese immigrants quit smoking. One of the most effective anti-smoking campaign ever waged among Southeast Asian refugees here was done by Suc Khoe La Vang, the Vietnamese Community Health Promotion Project out of University of California in San Francisco. It was directed by the late Chris Jenkins who, for 16 years, worked tirelessly to improve the health of Vietnamese and other Asians in the United States.

"Up to 50 percent of the participants quit in the first year," one doctor in San Jose boasted about the program. He showed films, charts and documents on how smoking affects one's health and, more important, the health of one's family. One man cried and said he didn't know secondary smoke was killing his kids, or at least making them less smart, the doctor reported. "He found the strength to quit," the doctor said.

If Vietnam wants to really change its bad habit, it should do more than edit local films. The key is to educate the population on the effects of secondhand smoke. A Vietnamese won't give up for himself, but for his family it's another matter.

Meanwhile, I too have a new resolve. I'm prepared to say "No" next time someone offers me a cigarette when I'm back in Vietnam, even at the risk of being seen as standoffish or even, god forbid, a sissy.