The Denormalization of Smoking

Smoking could be considered as one of the cheapest forms of vices in the Philippines. A pack of Marlboro cigarettes with twenty sticks on an average costs PhP25 (USD 0.50). It can be as cheap as PhP15 per pack, while signature cigarettes are at least at PhP 100. Accessibility to tobacco through cheap prices is one, if not the biggest factor that has lead to the normalization of smoking and tobacco use in countries such as the Philippines.

According to the latest statistics, more than 17 million Filipinos smoke on a regular basis, with 13.8 million Filipinos who smoke everyday. Pegging one cigarette stick a day at one peso each, we can make a conservative estimate of Filipinos collectively spending 13.8 million pesos a day for smoking alone – such a huge amount of money for a country where poverty is prevalent. It is a pity that while poverty is experienced by a huge part of the Filipino population, even one whose earnings are within or below the minimum wage devotes his salary not only for food, transportation, and other basic necessities, but also for smoking as a vice.

It is said that tobacco use drains approximately 20% of the household income of a Filipino smoker’s family, and more than half of Filipino families are said to be not smoke-free. At a country perspective, tobacco and smoking-related problems lead to an estimated cost of 43 billion pesos in terms of having to provide healthcare for those who have smoking-related health problems, as well as for the loss of productivity, as about 200,000 Filipino men develop smoking-related diseases in their productive years of age. It is a vice that leads to four among the ten most common diseases that cause death in the Philippines.

It is also a sad fact that many vendors of cigarettes in the Philippines are children. Aside from addressing child labor, children should be protected from the hazards of smoking. Approximately 80,000 to 100,000 of children start smoking everyday, half of whom live in Asia including the Philippines. Observational learning is a way of which children learn how to smoke, i.e., through adult models, peers, the media, and basically the environment and society wherein the child belongs to, where smoking has been normalized. Environmental smoke exposure is one of, if not the most, critical factors that facilitate smoking among children and the youth.

Initiatives have been implemented with the attempt of raising awareness in terms of the implications of smoking to one’s health. A part of these are fear-arousal awareness campaign materials posted in public areas such as train stations, showing graphic representations of the hazards of smoking similar to those on each pack of cigarettes as imposed by the graphic health warning bills in other countries. At present, the government only requires health warnings in cigarette packs such as one that reads "smoking kills" aside from a total ban of positive smoking media advertisements since year 2008.

Although fear-arousal communications as a persuasion strategy have been proven to be effective, it is not able to deliver considerable improvement in terms of tobacco use and smoking. Some Filipino smokers have also confirmed that health warning campaigns have a low impact in terms of their decision on whether to continue or quit smoking, unless for example they have a family member who has acquired a smoking-induced disease.

However, the Philippines has to take more serious action and develop more strategic policies and programs in regulating tobacco use and smoking in the country. Aside from having effective awareness and persuasion campaigns, and establishing smoke-free areas, increasing taxation to tobacco, therefore increasing prices, will lead to regulated smoking and tobacco use. This could be more effective in the denormalization of smoking, especially for smokers who would feel the impact of this vice at an economic perspective, specifically the youth who are the potential new market of the tobacco industry and even adults at the poverty line which comprise a big chunk of the population. 

The Philippines is one of those countries known to have the cheapest cigarettes while having high-priced medicines. The government has imposed value-added tax to most of products and services that Filipinos purchase, and prices of medicines have been lowered but are still expensive for a huge part of the population. Current cigarette tax is at 2.47 pesos per pack for cheaper brands, up to 27.16 pesos for premium cigarette brands. The chief of the Department of Health has proposed a PhP90 (USD 2.00) tax for each pack of cigarettes with 20 sticks, modelling it with US President Barrack Obama’s proposal of imposing USD 0.10 for every cigarette stick.

However a few days ago Malacaß┐ćang denied and disowned any policy discussion of the Health secretary’s proposal. At present, the country has deficits in terms of the remaining budget that it has especially to address high expectations on the new administration including in terms of social welfare. The government can implement this increase in taxation on tobacco and use it directly in providing better healthcare for Filipinos, just as other countries have imposed high excise taxes on cigarette products to compensate for smoking-related spending that the state has to undertake.

 Imposing higher taxation on tobacco and using it directly to improve the Philippine healthcare system is a win-win solution, as it should either way lead to better health for Filipinos with less tobacco use and therefore less incidences of smoking-related diseases, as well as the generation of revenue which could serve as additional budget for social welfare and healthcare, for instance, in making cheaper medicine more available or improving healthcare provided by government hospitals.

Aside from imposing higher taxation on tobacco, another denormalization strategy is to identify smoke-free areas where smoking is prohibited. Makati, one of the more urbanized cities of Metro Manila or the National Capital Region, prohibits smoking inside commercial premises such as restaurants and bars. Universities have also imposed the same policy within their premises, which helps prevent smoking among the youth.

Having the right policies, programs, and most especially, the right attitude, Filipinos can collectively address societal issues such smoking, which could lead to better healthcare, and wiser and more efficient spending and use of resources. Revenues from tobacco taxation and savings from the minimization and regulation of smoking could bring us a long way. It’s just a matter of having a collective vision, strong leadership, and determination and effort from each individual as an integral member of the society.

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