Smoking: a modern tragedy

One of the most difficult aspects of living in Asia for an non-smoking American  is experiencing the huge gulf between smoking attitudes in the U.S.A. and here. Whereas smoking rates have been in decline in America  and in some other parts of the developed world, they are increasing in most  of the developing world and remain stubbornly high in Eastern Europe.

The giant tobacco companies have seen their bottom line take a hit over the last couple of decades in the U.S.A. as a result of litigation, increasingly strict laws,  and an educational  campaign run by health advocacy organizations. However, R.J. Reynolds , Philip Morris, British American, and Imperial Tobacco have not been sitting on their hands. Their boardrooms all have large maps of the world on the wall. They are trans-national corporations and for every smoker they lose in the U.S.A., they gain two or three in Nigeria, Egypt, Viet Nam, China ,  Singapore, and Brazil. China now has 320 million smokers.


Here in Viet Nam, I’m situated at their furthest pole from America in terms of tobacco education and public/government attitudes toward smoking. The Vietnamese have the unfortunate distinction of having one of the highest smoking rates in the world, especially among men. The official government statistics claim that over 50% of the male population smokes, though I estimate  the figure is closer to 75% based on my observations around Ho Chi Minh City.

According to statistics from the World Health Organization, Viet Nam has 18 million smokers with tobacco killing  40,000 every year. Over 8 million people are exposed to second-hand smoke in the workplace and 47 million are exposed at home. The future does not look bright and one major reason is that the government has a disincentive to decrease smoking rates as it has a monopoly on cigarette production. Additionally, cigarette production employs 15,000 and taxes  on cigarettes bring in $350 million to the state budget yearly. Given this situation, I think what we will see is more laws will be passed to placate those sounding alarm bells, while simultaneously doing nothing to actually enforce them.


The laws that do exist, such as the 2009 decree which banned smoking in public places, are universally ignored. People light up everywhere and anywhere. The only non-smoking establishments which I have come across are a few European-run, fine- dining restaurants in the middle of District 1. (Which, by the way, are always packed.)

Cigarettes are sold in stores and on the street. According to law, vendors are not supposed to sell to minors under 18, but again this is widely ignored. Vendors sell to anyone who asks for them. It’s a ritual here for groups of men to sit on the street and drink iced coffee and smoke. Young men, especially in the working class, are expected to smoke. You may be considered a sissy if you don’t.

Drive around Ho Chi Minh City on a motorbike, and you will see young men riding with their phone in one hand and a cigarette in the other. Most of the 15 or 20 billion cigarettes consumed yearly here are tossed into the streets.


In the evenings, one can often see groups of Asian men sitting in restaurants, enveloped in a cloud of smoke. This scene occurs not before or after the meal, but during it. The men will hold their fork or chopsticks with the right hand and the cigarette in their left. Take a bite, inhale, take a bite, inhale. The first time I saw cigarettes listed on a menu, I was astonished.  Not only do the restaurants here allow smoking, they encourage it. Might as well make a little money if everyone is already doing it.

doctor smoking

I have had to quit going to a few excellent restaurants, simply because I cannot tolerate the smoke. There’s a restaurant on Le Lai Street near my house which serves excellent food and has a wide selection of hard -to- find European ales. Unfortunately, it is quite popular with Asian men who come sample the ales and they all smoke. Once,  I noticed a young boy of 10 years old, probably the son of one of the servers, who was sitting inside, and I remarked to the women, “Do you know how much smoke this young boy is getting exposed to every night he hangs out here?”

The woman replied to me, “I know you are right, but what can we do? These are our customers. I cannot tell them to stop.” I explained that she could indeed make her restaurant non-smoking and that her customers would still come back for the good food and drink. She was unconvinced. This is the common mind-set here. The fear is that if you enforce a non-smoking rule, the smokers will become irate and abandon your restaurant.  I use the example of the USA as a counter argument to this, but it is an uphill battle to convince business owners.


Finally, it should be noted that Vietnamese are hardly the only ones who have problems with tobacco addiction. I live near one of the prime tourist areas of downtown Ho Chi Minh City, known as the ‘backpacker district.’ Judging from what I see amongst the European crowds sitting on the sidewalks, in the cafes and in the restaurants, their smoking rates nearly match the Asians. I see mothers and daughters placidly sharing a pack of smokes. The majority of young European females I see around the district smoke. It’s a given. The French, of course, smoke like chimneys. Just last week, I sat in one of my favorite diners in the district to have  some lunch. At a small two-top in front of me sat a middle aged  French woman with an older  French woman, possibly her mother or an auntie. When the older woman finished her meal, she casually took one of her expensive European cigarettes out, lit it, and began blowing smoke into the younger woman’s face, while she was still eating. They were sitting not more than a foot apart.


What can be done? Considering the wealth, power, and advertising budget of the tobacco companies, combined with the addictive power of cigarettes, the struggle for a healthier world promises to be a long and arduous one. The native Americans used tobacco ritually, and safely, for thousands of years before the arrival of the Europeans. The  new arrivals discovered  the plant and started smoking  it but, divorced from its ritualistic and cultural context,  its addictive properties soon took a toll. The tobacco companies, not surprisingly, added their own cocktail of chemicals to the natural plant  to increase its addictiveness. It’s been said that tobacco is the red man’s revenge on the white man for alcohol, which has so devastated Native American communities all over the Americas. Looking at the world today, the red man’s revenge has also extended to the yellow man in Asia , the brown man in Latin America and the black man in Africa.

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