According to MOHW statistics for 2021, heart disease, cerebrovascular disease and hypertensive disease—all related to hypertension—were ranked as the second, fourth and sixth leading causes of death in Taiwan, respectively. Since hypertension has no obvious symptoms, it is known as the silent killer. The Health Promotion Administration began raising awareness of this issue in partnership with the Taiwan Hypertension Society, Taiwan Pharmacist Association and Taiwan Millennium Health Foundation. About 3,300 blood pressure measurement stations were set up nationwide in locations like convenience stores, cosmetics retail outlets and pharmacies. According to the 2017-2020 Nutrition and Health Survey in Taiwan, the hypertension control rate of people over the age of 20 was 46.1 percent. Although there was a slight decrease when compared with the results of the previous period (2016-2019) according to the results of the 2018 Survey on Health Promotion Status and Outcomes, 76 percent of the people over the age of 18 measured their blood pressure at least once a year, which showed that the public understands the importance of blood pressure self-management.
Diabetes was the fifth leading cause of death in Taiwan in 2021. Working in collaboration with clinics, local foundations and public health and welfare organizations, 22 cities and counties in Taiwan have launched community care networks for diabetes patients since 2003. The networks have helped enhance care quality, develop training and accreditation systems for medical professionals and set up interdisciplinary medical teams. Under the networks, 362 health care facilities have been accredited as diabetes health promotion centers by the HPA. The NHI has also established a pay-for-performance scheme targeting the disease, providing financial incentives to medical institutions that achieve diabetes treatment standards and goals. These measures have led to significant improvements in outcomes.
To strengthen public awareness of diabetes prevention and diabetes control, the HPA has published a series of patient education materials, such as posters and brochures, and patient decision aids containing detailed information on diabetes care. Each year on World Diabetes Day, the HPA also collaborates with local government health departments and relevant associations to organize news conferences, lantern ceremonies, hiking events and festivals to boost understanding of diabetes prevention.
In line with WHO recommendations, Taiwan offers subsidized screenings for five types of cancer: breast, cervical, colorectal, oral and lung cancer. Research shows that cervical screenings can lower the incidence and mortality rates for cervical cancer by between 60 and 90 percent. Since 1995, Taiwan health authorities have encouraged women aged 30 and over to receive cervical cancer screening every three years. Women aged 30 and over with an NHI Card and National Identification Card can receive free examinations at NHI-contracted clinics and hospitals. As of the end of 2022, a total of 1.98 million women had undergone screenings, resulting in 1,343 diagnoses of cervical cancer and 2,790 of cervical carcinoma in situ. In addition, precancerous lesions were identified in 10,345 patients. The standardized incidence rate for cervical cancer in Taiwan dropped from 25.2 per 100,000 people in 1995 to 7.8 per 100,000 people in 2020. The standardized mortality rate for cervical cancer dropped from 11.0 per 100,000 people in 1995 to 2.8 per 100,000 in 2021, dropping by about 70 percent.
Since the Tobacco Hazards Prevention Act took effect in 1997, the HPA has launched various programs in line with the WHO’s MPOWER measures. Under the initiative, the WHO urges countries to monitor tobacco use; protect people from tobacco use; offer help to quit tobacco use; warn about the dangers of tobacco; enforce bans on tobacco advertising and promotion; and raise taxes on tobacco products. The measures unveiled in Taiwan include expanding smoke-free areas; launching new packaging warning labels; prohibiting tobacco advertising; increasing taxes on tobacco products; and strengthening cessation services. The smoking rate above the age of 18 in Taiwan decreased from 21.9 percent in 2008 to 13.1 percent in 2020. In addition, the proportion of senior high school students smoking dropped from 14.8 percent in 2007 to 7.2 percent in 2021, while the percentage of junior high students smoking declined from 7.8 percent in 2008 to 2.2 percent in 2021. Taiwan has already achieved the WHO's noncommunicable diseases (Noncommunicable Diseases, NCD) target of a 30 percent relative reduction in the prevalence of tobacco use by 2025.
However, as products more attractive to people (such as electronic cigarettes, heated tobacco products, and flavored tobacco products) gradually emerged around the world, the scope of the current version of the act was unable to address those products, putting people at risk of tobacco and nicotine side effects, especially young people. Taiwan’s Ministry of Health and Welfare referred to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), experiences from other countries, and opinions from all walks of life to develop the Tobacco Hazards Prevention Act Amendment. The amendment passed the third reading in the Legislative Yuan on January 12, 2023. The amendment was promulgated by president on February 15, 2023, and implemented on March 22, 2023. The highlights of the amendment include banning all kinds of imitation tobacco products (e.g. electronic cigarettes), requiring designated tobacco products (e.g. heated tobacco products) to undergo the health risk assessment review, raising the legal smoking age from 18 to 20, increasing the size of health warning graphics and text labels on tobacco packaging from 35 to 50 percent, expanding nonsmoking places and increasing penalties.