Dr Osornprasop said after the tax increase on tobacco they found there was a marked shift from smoking manufactured cigarettes to tapaka Tonga because is not taxed.

"It’s very cheap and widely available in shops throughout the country, which is the result from our latest end-line survey," he said.

“We asked the smokers, what is the main reason for them to change consumption behaviors. And it is very clear, price is the main reason for shifting consumption, and health was a much less important reason among the smokers.”

"In the end-line survey, we added more questions about tapaka Tonga. We found that the majority of smokers in Tonga nowadays actually smoke tapaka Tonga and not manufactured cigarettes," he said.

Unhealthy substitute

“Tapaka Tonga remains the key unhealthy substitute, which is widely available and accessible and commercial tapaka Tonga should be taxed,” he said.

Meanwhile, the Acting Minister of Finance and Minister of Revenue and Customs, Hon Mateni Tapueluelu in his opening address said the objective of this workshop was not only to share findings and recommendations of the NCD taxation policy assessment with key stakeholders but to solicit their feedback, before finalizing and making recommendations while considering implications to improve future policy implementation.

He said Tonga had implemented various programs to curb the rising tide of NCD burden in the Pacific.

Among the interventions, Tonga used taxation policy on sin taxes such as taxes on tobacco, unhealthy food and beverages, and alcohol to influence consumer choice and behaviour. In 2013 policies were implemented on food products, tobacco and alcohol. Since then the Government of Tonga had added further taxation policies through amendments to the current national tariff schedule, he said.

"It is important to monitor the implementation, outcome and impact these interventions have, which in turn will help policymakers make well informed decisions on the way forward to improve the health of all Tongans."

He said the Ministry of Finance and National Planning in November 2016 requested the World Bank to conduct the assessment on these specific taxation policies.

The workshop attended by health officials, NGO, government officials is funded by the World Bank and other donors including the Governments of Australia, New Zealand, Japan and Tonga Health.