1. Implementation of FCTC Article 8 in Seychelles
Ms. Bharathi Viswanathan
Focal Point, Tobacco Control
Public Health Department
Ministry of Health
Victoria
Seychelles
Presentation prepared for the Regional Workshop on FCTC preparatory meeting,9-12 October 2012, Dakar, Senegal

2. Development of Tobacco control Act in Seychelles
High profile activities for tobacco control since 1990s
National surveys (1989, 1994, 2004; GYTS 2002); WHDs, media programs, etc
Active participation of Seychelles in all INB FCTC meetings
Seychelles ratified the FCTC in 2003 (first in AFRO region)
National Committee for Tobacco Control appointed by minister in and legislation developed since 2000; previous attempts since 1996
Broad local input with broad consortium of stakeholders; and international assistance from TFK (R Nathan), WHO and World Bank
Tobacco Control Act enacted in August 2009
Act includes, among various provisions: total ban on smoking in all enclosed public/work places, total ban on advertising, promotion and sponsorship, 50% area display of health warnings on packages, etc.
WHO classifies Act amongst the most comprehensive in the world

3. Total ban on smoking in all enclosed work/public places and on public transport and in selected outdoor public places
What is enclosed?
Any place covered by a permanent or transient roof or ceiling (e.g. rooms, verandas, shelters, tent)
Enclosed by one or more walls or sides (e.g. stadium)

4. Workplace, public places & public transport
Enclosed work places include:
rooms, verandas, toilets, eating areas, elevators, foyers stair case and any other common area
Enclosed public places include:
restaurants, bar, discotheques, hotels, theatres, church halls, shopping centers, gymnasiums, stadiums and others
Out door public places including premises of:
schools, hospitals and children day care centers
All vehicles transporting public including:
taxis, buses and all other public transports if hired or for payment
Exceptions are not allowed

5. Enforcement plan
Ban on smoking publicized repeatedly through the media
Spots on ban on smoking aired extensively on national TV
Several media programs (adverts/programs on TV, radio, leaflets)
Several information sessions organized in work and other places
More than 5000 letters sent to all work/public places
Training for enforcement officers (police, PHC, health, etc)
Continuous media and other sensitization programs (schools, work places, media, minister’s message)

6. Enforcement
Employers, managers and their representatives must ensure that no client or worker smokes in any enclosed work place, public place or public transport
Owner of a public place or enclosed work place must display “no smoking” sign notices as prescribed in a visible manner at all times
Public vehicles must also display the no smoking sign

7. No smoking sign

8. Policy for tobacco control in Seychelles: a success story
In 2000, students of all schools handed over pledge signed by 14’385 to VP at State House.
WHO award given to MOH, 2004
Adoption of FCTC at WHA, Geneva, 2003

9. Display of no smoking sign in public places
banners promoting smoke free Jeux des Iles in 2011

10. Information leaflet

11. Penalties
Smokers: SR 1,000 (~100US$) on first conviction and up to SR. 8,000 or imprisonment not exceeding 3 years on subsequent convictions.
Owner/manager of hospitality/transport premise: SR 5,000 on first conviction and up to SR. 20,000 or imprisonment up to 3 years on subsequent convictions
Failing to display “No Smoking” signs where smoking is prohibited SR 5,000 on first conviction and up to SR. 20,000 or imprisonment up to 3 years on subsequent convictions can be prosecuted.

12. Evaluation of the ban smoking in enclosed places
Survey in May 2010 to evaluate enforcement of ban on smoking in restaurants, bars and discos in the country
Two thirds of restaurants, bars and discotheques participated
Questionnaire to 3 patrons, 2 workers, one manager
Results:
Ban on smoking well implemented (90%)
‘No smoking signs’ displayed in 60% of places
Only 50% of the workers reported having received training
40% of workers felt uncomfortable to ask a smoker to stop
Viswanathan B et al. Good compliance with a smoking ban in public places: a rapid assessment in the Seychelles. Tobacco Control 2011;20:

13. Prevalence of main risk factors in the population aged in 1989 and 2004: tobacco use decreased largely  
 
 
Bovet P et al. Divergent 15-year trends in traditional and metabolic risk factors of cardiovascular diseases in the Seychelles. Cardiovascular Diabetology 2009;8:34

14. Marked decrease in age-adjusted stroke and MI mortality between 1989 and 2010: role of decreasing tobacco prevalence
Stringhini S et al. Declining stroke and myocardial infarction mortality between 1989 and 2010 in a country of the African region. Stroke 2012;43:

15. Priority next tasks (regulations )
Regulation of display of health warnings
Health warnings to cover ≥50% of main display areas
Regulation completed, awaiting publication in official gazette (October)
To be enforced by mid 2013
Prepare regulations to empower special enforcement officers
who can inspect
how to conduct inspections
Prepare instruments for business reporting
Formant and content related to amount, selling price, brands of tobacco manufactured/imported/export
country imported, transshipped or exported
statements on display on packets
date of import/export

16. Challenges & lessons learnt
Good surveillance since 20 years: link surveillance data and policy development; generated broad interest, and helped build no smoking norms and consensus on interventions
Tobacco control led by a same single CVD unit: clear focus and long term coherent strategy to advance policy
FCTC brought political support and provided guidelines on how the legislation needed to be developed
Mobilizing leadership and commitment at all levels
Involving local and international experts
Seeking integrated, multidisciplinary and multi-sector approaches

17. Conclusions Seychelles Tobacco Control Act came in to force in 2009
Act is comprehensive and largely complies with FCTC
Ban on smoking well implemented but needs further strengthening
Need to formalize inspections and enforce penalities
Need for ongoing training to workers
Need for continued education on ban and other policy in mass media
Regulations on health warnings is being finalized
Seychelles has advanced policies for TC but further strengthening is needed
Large decrease in age adjusted rates of CVD mortality is likely related to a large part to decreasing smoking prevalence

18. Thank you