The political economy of tobacco and poverty alleviation in Southeast Asia: contradictions in the role of the state.

Of the members of the Association of Southeast Asian Nations (ASEAN), all but Indonesia have embraced the Framework Convention on Tobacco Control and all endorse some form of tobacco control policy. Nevertheless, except for Brunei, all these states are, to varying degrees, complicit in investing in or promoting the tobacco industry, often using the justification of poverty alleviation. Tobacco use is the major preventable cause of illness and death among the populations of these countries. Claims that tobacco alleviates poverty in developing countries have increasingly been discredited: thus continuing state support for the industry represents a fundamental paradox. Using primary documents from governments and the tobacco industry, and published studies investigating tobacco and poverty, this article explores the contradictions inherent in the state seeking to prevent tobacco use in the interests of health, while actively promoting tobacco for the economic benefit of its citizens. These contradictions result in both symbolic and substantial harm to tobacco control efforts: tobacco production is legitimized, rational policy principles are violated, direct cooperation between the state and multinational tobacco corporations is made possible with associated opportunities for mollifying control policies, and different state agencies work at cross purposes. Although tobacco exports within the Association of Southeast Asian Nations (ASEAN) also threaten the group's health solidarity, it is argued that divestiture of state ownership of capital in tobacco corporations and a commitment by states not to promote tobacco are urgently required if the Convention is to have full effect both in the countries of the region and in other states that have ratified it.