To ask who is to blame that we have smoking in our midst is a tricky question. I practically grew into it, having a Mom who smoked that triggered arguments with my father so consistently that we eventually ended up a broken family. Obviously I understood those frayed nerves from a single parent trying to raise me and my siblings, so well, that I picked up the habit when I was just in college. Sure enough, for every problem or tragedy that struck my life, I became more and more dependent on smoking to cope and stay afloat. It wasn’t until I had too many pack-years, frequent bouts with bronchitis in a year, grown-up children whom I could not play hide-and-seek with my habit anymore – that I started to stare at the mirror, a reflection of someone I did not want to be.
In 2008, it was painful to watch the last stages of emphysema take away my Mom. Every breath she took lashed at the memory of how I started my self-destruction. Before she succumbed to a fatal coma, she whispered a dying wish for me to stop smoking. To this day, I can still feel her frail hands and that piercing look of death. We would have later on learned that she died from both respiratory and multiple organ failure.
We can go through a long list of persons, places and things to blame on why smoking prevails and appears to have inculcated a culture of fatalism (wala na tayong magagawa nandiyan na yan, mamamatay rin lang tayo). I would rather ask the question, WHO CAN DO SOMETHING ABOUT IT? We can.
Global initiatives to curb the demand for tobacco has reached local shores. As expected, the first responders are health authorities and advocate-organizations who are closest to the mandate about trying to save lives. The irony is that we are still missing the Robin Hood of our times, a prominent figure who will unabashedly use the charm, money and wit and maybe, risk it all, to see through the beginning of the end of the smoking culture.
Government can really do better. More recently, RA 10351 (otherwise known as the act restructuring the Sin Tax Bill) is in the news again, more because government is still playing safe despite increases in excise tax. Even the guarantee of 4% increase of specific tax on tobacco products will not redound into a dramatic decrease in prevalence of smoking.
With chronic smokers feeling largely fatalistic and will probably the more resistant to medical intervention and public smoking bans, price and tax measures will control probability of preventing the habit from our youth – to result in significant decrease in smoking prevalence. Obviously and hopefully, smoking and deadly diseases of this addiction will be, ultimately, exclusive to the rich, stupid and stubborn.
At the moment there are 3 lawmakers who may be in a position to use price and tax measures to control tobacco consumption, only if their mandate is genuinely for better health and not creating a squeaky-clean image for the electorate come the May 2019 elections.
Do we still need research-based UAI (usage, attitude and image) to determine at which price, smokers will probably not be able to afford to buy tobacco products?
According to Train Law, as championed by Senator Angara, the price range of P35 to P40per pack of cigarettes over the next years rate of tax inputs, we are actually setting the stage for 1 million new smokers to thrive by 2022.
On the other hand, the option from SB 1605 of Senator Ejercito, principal author of the Universal Health Care Bill, is an estimate price of P60 per pack, reversing the prevalence of smoking by as much as 500,000 smokers in the next 4 years.
However, if we truly desire to SAVE A MILLION LIVES, we should take a more serious look into SB 1599, introduced by Senator Pacquiao, to retail a pack of cigarettes at a price of P90, or a mind-boggling 60% increase from prices today. As they say, choose your poison well but this time. consider making a decision for the greater good.
One argument that ordinary folks may see in higher taxes is government just making blood money from a flourishing industry. The equation would be better balanced if this revenue from sin taxes can be sufficiently re-channeled to the healthcare of people such as an expanded and more comprehensive benefits-system from the recently-enacted Universal Health Care (UHC) Law.
It is disheartening to note, however, that the current budget allocation for UHC is still exclusive of primary healthcare, which is key in addressing conditions like bronchitis or persistent cough. These symptoms of worsening lung health of smokers are often neglected or ignored, especially if it will entail out-of-pocket expenses for the patient.
Our society’s poor,poorer and poorest are among the most prone to contract Non-communicable Diseases (NCDs) due to their unhealthy lifestyle and lack of access to better information and options. Directly proportional to this is a higher prevalence of smoking in this segment and therefore will benefit most from including primary care benefits in the UHC Bill. Of course this will require a large chunk of government funding which we hope can come from raising tobacco tax.
Sometimes only when we directly experience that pain of losing someone to these diseases can we make a turnaround that the change we want to achieve must be bigger than us. Sometimes it needs an entire nation to rise up and rally behind forces that prevent us from achieving the kind of life we truly deserve.
That chapter in my life when Mom died is life-changing, but the new one unfolded, one with almost infinite possibilities, that I dared take its course. Unlike most runners whose journey towards their first marathon was the result of wanting to lose weight, I started running and training, simply put, to STOP SMOKING. Lucky for me, the dopamines from running gave me a longer-lasting high that made me more determined to kick the habit for good. I did not want to die as a statistic, but rather a living testimony that it can be done, with help from family and friends, with support from government.
The Catalysts of Tobacco Control
These are the people who get into the minds of people by seeking truths and justices, so that our children and children’s children, can experience a healthier tomorrow.
Action for Economic Reforms (AER) is a public interest organization that conducts policy analysis and advocacy on key economic issues. It was founded in 1996 by a group of progressive, independent, reform-oriented, scholars and activists in the Philippines.
Vital Strategies is a global public health organization that seeks to accelerate progress on the world’s most pressing health problems. It envisions a world where every person is protected by a strong public health system. It thrives on evidence-based strategies with innovation to help develop sound public health policies, manage programs efficiently, strengthen data systems, conduct research, and design strategic communication campaigns for policy and behavior change.
Probe Media Foundation Inc. (PMFI) is a non-profit organization dedicated to improving the quality of media in the Philippines and the Asia-Pacific region through training of professional and aspiring media practitioners.
Broadcast journalists, who were part of the Probe Productions Inc. (PPI) a pioneering independent television production company, established the Probe Media Foundation. PPI crusaded against corrupt, irresponsible and sensationalist journalism by producing shows of substance and good production values. Local and international award-giving bodies have taken notice; making PPI the most recognized and awarded independent production company in the Philippines.
Dr Tony Dans, prominent IM-Cardio from PGH, is the perfect specialist-advocate for tobacco management and eradication. His influence spans relevant socio-medical issues like dengue/dengvaxia, malnutrition and even autism.