• 95% of the population is Buddhist
• Total number of Pagodas = 3,907
• Total number of Monks (students not included) = 55,755

About 1 in every 60 adult men is a monk. Most men become a monk sometime in their life, usually when young.

Pagoda: Buddhist temple with surrounding premises and buildings

Monks started to get active in tobacco control in 1999

According to most Buddhist monks in Cambodia, Buddhist precepts do not specifically mention tobacco use. But they do teach “Sura meraya majja pamadatthana veramani” - abstinence from the use of addictive substances Majja = all addictive substances.

Buddhist monks cluster survey in four
provinces and Phnom Penh, 2001

• The total smoking prevalence of Buddhist monks: 27% – 49% depending on province
• 72% are exposed to others’ smoke every day, 83% don’t like being around smokers
• 72% received offerings from the community.
  Low consumption levels: 8.7 cigarettes/day, 17% of smokers smoke more than 20 cigs/day.
• 94.7% want to quit, 98% would attend a quit program.
• 62% of monks are willing to teach about TOH.
• 83% believe cigarette advertising should not be allowed.
• Source of information about TOH: 52.5% from the mass media.

Buddhist monks cluster survey in four
provinces and Phnom Penh, 2004

• The total smoking prevalence of Buddhist monks: 14.6% – 37.5% depending on province
• 81% are exposed to others’ smoke every day, 91.8% don’t like being around smokers
• 92.3% believe smoking can cause harm to other, 95.8% believe smoking is addictive
• 97.8 believe smoking is bad for health
• 45% received offerings from the community.
  Low consumption levels: 8.8 cigarettes/day, 30% of smokers smoke more than 20 cigs/day.
• 94.3% want to quit, 99.3% would attend a quit program.
• 59.64% state that there is a cigarette-smoking ban, which keeps people from smoking in the pagoda.
• 77.6% of monks are willing to teach about TOH.
• 89.5% believe cigarette advertising should not be allowed.
• 93.5% believe that there should be a Health warning on tobacco products.
• 79.7% believe that government should increase tax on cigarette and tobacco product
• Source of information about TOH: 50.94% from the mass media.

Community in 2001:

• 69% believe monks should not smoke.
• 72% believe tobacco advertising should not be allowed.
• 80% want to quit.
• 85% would attempt to quit if recommended by a monk.
• 95% believe smoking is addictive.

Community in 2004:

• 90.94% believe monks should not smoke.
• 85.53% believe tobacco advertising should not be allowed.
• 80% want to quit.
• 88.93% would attempt to quit if recommended by a monk.
• 93.69% believe smoking is addictive.
• 94.37% believe smoking is bad for health

Focus groups and key informant interviews:

• Monks are respected role models and teachers and are closely associated with schools.
• Buddhism teaches against harming self and others.
• Buddhism teaches against the use of addictive substances.
• Some monks encourage the community not to offer tobacco.
• Disposing of offerings of tobacco is OK. Some monks bury the tobacco offerings so that they do not harm others.
• Some community members are confused by the conflicting messages from the media, monks and health professionals.
• Tobacco advertising is considered misleading and against Buddhist teachings.
• Monks want more information and resources to use for teaching.

Khmer Quit Now!

The “Khmer Quit Now!” smoking cessation program has been an important part of the establishment of smoke-free Wats. Among monks, self-reported quit rates have been an extraordinary 87% at one year follow up. The self-reported quit rates among monks has been biochemically validated to be 98% accurate. Various reasons have been postulated to support this high quit rate, including:

• Strong peer support within the communal environment of the Wat.
• Strong self-discipline as suggested by other sacrifices that monks must make.
• Supportive spiritual reasons for quitting.
• Avoidance of the shame of failure when their position as a role model must be upheld.
• Relatively low consumption and levels of addiction due limited access to tobacco.

Success of Monks who have quit smoking: