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Healthy Lifestyle Summit
Balanga City 26 Nov 2010 1
| 1
TOBACCO CONTROL IN THE PHILIPPINES
TOBACCO CONTROL IN THE PHILIPPINES
DR FLORANTE E TRINIDAD Technical Officer ndash Tobacco Free Initiative
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 2
|
4000 chemicals 60 known carcinogens
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 3
|
AFR EMR EURSEAR WPR AMR
25
50
75
Communicable diseases maternal and perinatal conditions and nutritional deficiencies
Noncommunicableconditions
Injuries
Deaths by broad cause group and WHO Region 2000
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 4
|
10 Filipinosdie by the hour from tobacco-related disease
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 5
|
Risk Factors Common to Major
Noncommunicable Conditions Condition Risk factor
Cardio-vascular disease
Diabetes Cancer Respiratory conditions
Smoking
Alcohol
Nutrition Physical inactivity
Obesity
Raised blood pressure
Blood glucose
Blood lipids
Including heart disease stroke hypertension
Including chronic-obstructive pulmonary disease and asthma
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 6
|
WHO Report on Global Tobacco Epidemic 2008
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 7
|
SMOKING CAUSED DISEASES
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 8
|
Second hand smoke is a carcinogenSecond hand smoke is a carcinogen
The following countries have classified SHS as a carcinogen
Germany
Finland
USA ndash SHS is a group A carcinogen with arsenic asbestos benzene radon and vinyl chloride
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 2
|
4000 chemicals 60 known carcinogens
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 3
|
AFR EMR EURSEAR WPR AMR
25
50
75
Communicable diseases maternal and perinatal conditions and nutritional deficiencies
Noncommunicableconditions
Injuries
Deaths by broad cause group and WHO Region 2000
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 4
|
10 Filipinosdie by the hour from tobacco-related disease
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 5
|
Risk Factors Common to Major
Noncommunicable Conditions Condition Risk factor
Cardio-vascular disease
Diabetes Cancer Respiratory conditions
Smoking
Alcohol
Nutrition Physical inactivity
Obesity
Raised blood pressure
Blood glucose
Blood lipids
Including heart disease stroke hypertension
Including chronic-obstructive pulmonary disease and asthma
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 6
|
WHO Report on Global Tobacco Epidemic 2008
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 7
|
SMOKING CAUSED DISEASES
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 8
|
Second hand smoke is a carcinogenSecond hand smoke is a carcinogen
The following countries have classified SHS as a carcinogen
Germany
Finland
USA ndash SHS is a group A carcinogen with arsenic asbestos benzene radon and vinyl chloride
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 3
|
AFR EMR EURSEAR WPR AMR
25
50
75
Communicable diseases maternal and perinatal conditions and nutritional deficiencies
Noncommunicableconditions
Injuries
Deaths by broad cause group and WHO Region 2000
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 4
|
10 Filipinosdie by the hour from tobacco-related disease
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 5
|
Risk Factors Common to Major
Noncommunicable Conditions Condition Risk factor
Cardio-vascular disease
Diabetes Cancer Respiratory conditions
Smoking
Alcohol
Nutrition Physical inactivity
Obesity
Raised blood pressure
Blood glucose
Blood lipids
Including heart disease stroke hypertension
Including chronic-obstructive pulmonary disease and asthma
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 6
|
WHO Report on Global Tobacco Epidemic 2008
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 7
|
SMOKING CAUSED DISEASES
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 8
|
Second hand smoke is a carcinogenSecond hand smoke is a carcinogen
The following countries have classified SHS as a carcinogen
Germany
Finland
USA ndash SHS is a group A carcinogen with arsenic asbestos benzene radon and vinyl chloride
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 4
|
10 Filipinosdie by the hour from tobacco-related disease
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 5
|
Risk Factors Common to Major
Noncommunicable Conditions Condition Risk factor
Cardio-vascular disease
Diabetes Cancer Respiratory conditions
Smoking
Alcohol
Nutrition Physical inactivity
Obesity
Raised blood pressure
Blood glucose
Blood lipids
Including heart disease stroke hypertension
Including chronic-obstructive pulmonary disease and asthma
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 6
|
WHO Report on Global Tobacco Epidemic 2008
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 7
|
SMOKING CAUSED DISEASES
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 8
|
Second hand smoke is a carcinogenSecond hand smoke is a carcinogen
The following countries have classified SHS as a carcinogen
Germany
Finland
USA ndash SHS is a group A carcinogen with arsenic asbestos benzene radon and vinyl chloride
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 5
|
Risk Factors Common to Major
Noncommunicable Conditions Condition Risk factor
Cardio-vascular disease
Diabetes Cancer Respiratory conditions
Smoking
Alcohol
Nutrition Physical inactivity
Obesity
Raised blood pressure
Blood glucose
Blood lipids
Including heart disease stroke hypertension
Including chronic-obstructive pulmonary disease and asthma
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 6
|
WHO Report on Global Tobacco Epidemic 2008
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 7
|
SMOKING CAUSED DISEASES
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 8
|
Second hand smoke is a carcinogenSecond hand smoke is a carcinogen
The following countries have classified SHS as a carcinogen
Germany
Finland
USA ndash SHS is a group A carcinogen with arsenic asbestos benzene radon and vinyl chloride
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 6
|
WHO Report on Global Tobacco Epidemic 2008
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 7
|
SMOKING CAUSED DISEASES
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 8
|
Second hand smoke is a carcinogenSecond hand smoke is a carcinogen
The following countries have classified SHS as a carcinogen
Germany
Finland
USA ndash SHS is a group A carcinogen with arsenic asbestos benzene radon and vinyl chloride
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 7
|
SMOKING CAUSED DISEASES
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 8
|
Second hand smoke is a carcinogenSecond hand smoke is a carcinogen
The following countries have classified SHS as a carcinogen
Germany
Finland
USA ndash SHS is a group A carcinogen with arsenic asbestos benzene radon and vinyl chloride
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 8
|
Second hand smoke is a carcinogenSecond hand smoke is a carcinogen
The following countries have classified SHS as a carcinogen
Germany
Finland
USA ndash SHS is a group A carcinogen with arsenic asbestos benzene radon and vinyl chloride
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 9
|
There is no safe
level of exposure
to second hand
smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 10
|
DISEASES AND ADVERSE HEALTH
EFFECTS CAUSED BY SECOND HAND SMOKE
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 11
|
TUBERCULOSIS AND SMOKING
A STRONG ASSOCIATION bullSmoking substantially increases the risk of tuberculosis and death
from TB
bullMore than 20 of global TB incidence may be attributable to
smoking
bullSmoking is a risk factor for TB independent of alcohol use and
other socioeconomic risk factors
bullSmoking increases the risk of TB disease by more than 2 frac12 times
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 12
|
One out of five heavy smokers will die of lung cancer
RISK
Mouth larynx
throat - 455
Esophagus - 401
Stomach - 141
Cervix - 175
Bladder - 272
Pancreas - 186
Anus - 318
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 13
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 14
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 15
|
THE TOBACCO ATLAS 2009
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 16
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 17
|
Womens uptake and cessation of smoking Womens uptake and cessation of smoking
ndash Women are more susceptible to nicotine addiction than men
ndash Biopsychosocial factors make it harder for women to quit smoking such as
bull hormonal cycles and pregnancy bull the fear of weight gain bull the need for social support in quitting
smoking
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 18
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Irreversible and serious health consequences for pregnant women and fetus such as low-birth-weight infants and possible long-term effects on child behaviour
(Source WHO 2008)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 19
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 20
|
Different health risks associated with womenrsquos smoking
Different health risks associated with womenrsquos smoking
ndash Smoking women have shown to have enhanced mortality from breast cancer than non-smoking women
ndash Smoking women develop certain diseases like lung cancer faster than men
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 21
|
Tobacco industry targeting womenTobacco industry targeting women
The tobacco industry has developed deceitful marketing strategies to target female smokers
ndash Tobacco advertisements have associated womenrsquos smoking with independence glamour and sexual attractiveness
ndash Marketing efforts calling cigarettes low tar light or mild thereby sending out misleading messages that smoking is less harmful
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 22
|Deadly product packaged in candy colors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 23
|
Deadly product packaged in fruity flavors
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 24
|
Tobacco Advertising and YouthTobacco Advertising and Youth
bullMuch tobacco advertising targets the needs of young people
bullExposure to tobacco marketing is causally related to youth smoking initiation dagger
bullYouth who own tobacco company promotional items are morelikely to become smokers Dagger
bullYouth smoking is much more responsive to advertising than adult smoking
Sources National Cancer Institute Tobacco Control Monograph No 19 2008 daggerIbid DaggerPierce et al (1998) Biener and Siegel (2000) Sargent et al (2000) Pollay et al (1996)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 25
|
Tobacco use is a
pediatric disease
80-90 of smokers initiate
use before the age of 18
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 26
|
Is the health sector convinced that
this is about addiction
Is the health sector convinced that
this is about addiction
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
It is estimated that it
takes a child 3-4 years
of regular use
for dependence to
set in
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 27
|
If it is so bad why do people smoke
If it is so bad why do people smoke
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 28
|
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Paradigm shift SMOKING is now considered a DISEASE not just a habit
Smoking Cessation A form of medical treatment
not just a preventive measure
NICOTINE DEPENDENCE SYNDROME
Mental amp behavioral disorder due to use of
tobaccoICD 10 F172
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 29
|Source J Henningfield
ldquoldquoAmong All Who Have Ever Tried Among All Who Have Ever Tried
a Single Cigarette Almost 13 a Single Cigarette Almost 13
Would Develop Nicotine Would Develop Nicotine
DependencerdquoDependencerdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 30
|
- US Judge Gladys Kessler 2006
ldquoThe TOBACCO INDUSTRY is an industryhellip that survives and profits from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year an immeasurable amount of human suffering and economic losshelliprdquo
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 31
|
The Role of the Industry in Causing Disease
Industry actions
Public actions
Healthconsequences
DeceptionNicotine manipulationAdvertisingConspiracy
Youth smokingAddictionContinued smoking
Tobacco-related diseases
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 32
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullBe vigilant about industry tactics that seek to obstruct delay or circumvent the development andor implementation of public health legislation
bullLimit interactions with the tobacco industry
bullEnsure transparency of interactions that do occur
bullNot enter into any partnerships or non-enforceable agreements with the tobacco industry
bullProtect against conflicts of interest for those involved in setting and implementing tobacco control policies
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 33
|
To strengthen national tobacco control measures and implementation of national legislation governments should
bullEnsure transparency of tobacco industry operations and activities
bullSet their own targets and determine implementation dates based on best practices rather than be subject to the industryrsquos direction and
timetable
bullNot compromise on tobacco control measures when threatened with legal action by the tobacco industry
bullNot hesitate to apply FCTC Article 19 (Liability) and take the tobacco industry to court when it violates legislation
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 34
|
Building Blocks of Tobacco Control
bullDo not partner with the tobacco companies on activities that are not tobacco-relatedbullDo not participate in industry-initiated dialoguesbullDo not accept compromises in smoke-free spaces initiatives that include the use of ventilation technology andor separate smoking and non-smoking areas bullDo not endorse the tobacco companiesrsquo ldquoaccommodationrdquo and ldquocourtesy of choicerdquo programmesbullDo not endorse participate or partner with the tobacco companiesrsquo youth smoking prevention programmesbullDo not focus all tobacco control activities on school-based programmes often paid for by the tobacco companiesbullDo not accept compromises on tax increases because of the tobacco companiesrsquoarguments that it will lead to an increase in smugglingbullDo not compromise on a comprehensive advertising ban
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 35
|35
Lies of the Tobacco IndustryLies of the Tobacco Industry1 Causation cannot be established for SHS and disease
2 Epidemiological studies are ldquojunk sciencerdquo and subject to serious bias
3 Controversy exists among scientists
4 Ventilationaccommodation are effective SHS control strategies
5 Bans hurt the hospitality industry and restaurants lose money when complete indoor bans are implemented
6 Local government units cannot enact an anti-tobacco ordinance much stricter than the national law
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 36
|
Framework Convention on Tobacco Control (FCTC)
Aim protect present and future generations from the consequences of tobacco
Powerful global public health tool ndash first Public Health Treaty under WHO
Unique introduced urgency into tobacco control negotiated binding international law comprehensive approach
36
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 37
|
MPOWER
Monitor tobacco use and prevention policies
Protect people from tobacco smoke
Offer help to quit tobacco use
Warn about dangers of tobacco
Enforce bans on tobacco advertising promotion amp sponsorship
Raise taxes on tobacco
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 38
|
Paradigm for Tobacco Control
INDIVIDUAL
SOCIETY
TOBACCOADDICTION
PriceeconomicSmoke-free AirCounter
marketingCessation
treatmentPrevention
activitiesProduct
regulationLiability
Pro-tobacco MarketingAccess
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 39
|
Global Tobacco Surveillance System (GTSS) - Components
Global Tobacco Surveillance System (GTSS) - Components
Youthndash Global Youth Tobacco Survey (GYTS)
Adultsndash Global School Personnel Survey (GSPS)ndash Global Health Professions Students Survey (GHPSS)ndash Global Adult Tobacco Survey (GATS)+
School based survey+ Household survey
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 40
|
GLOBAL YOUTH TOBACCO SURVEYPrevalence
GLOBAL YOUTH TOBACCO SURVEYPrevalence
Prevalence of Students who are ldquoCurrent Cigarette Smokersrdquo
115
175166
234
12
182
262
124
78
0
10
20
30
40
50
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 41
|
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
GLOBAL YOUTH TOBACCO SURVEYExposure to Second Hand Smoke
Percentage of Students with One or More Parents who Smoke
554 551 541547 529 525
561 563 553
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Percentage of Students Exposed to Smoke in Public Places
582 586 648588 594 672
578 582 628
0
20
40
60
80
100
1999 2003 2007
TotalBoyGirl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 42
|
GLOBAL YOUTH TOBACCO SURVEYCessation
GLOBAL YOUTH TOBACCO SURVEYCessation
Percentage of ldquoCurrent Smokers who Always Feel Like Having a Cigarette
First Thing in the Morningrdquo
3
54
08
47
08
32
5
07 030
2
4
6
8
10
1999 2003 2007
Total
Boy
Girl
Percentage of ldquoCurrent Smokers who Want to Stop Smoking Nowrdquo
852 88881
846
896
88
857
882
893
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 43
|
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
GLOBAL YOUTH TOBACCO SURVEYTobacco Control Initiatives
Percentage of Students NOT Refused Sale When Buying Cigarettes in a Store
596
477
636
48 567
637487
725
511
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Percentage of Students Offered a ldquoFreerdquo Cigarette by a Representative
14 101 55
176 156 7
114
66
41
0
20
40
60
80
100
1999 2003 2007
Total
Boy
Girl
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 44
|
Global Adult Tobacco Survey (GATS)Global Adult Tobacco Survey (GATS)
Purpose
To systematically monitor adult tobacco use amp track key tobacco control measures
ndash Within country comparisons over timendash Between country comparisons
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 45
|
Number of current
smokers in the
Philippines
173 million
(283)
Male smokers 146 million (477)Female smokers 27 million (89)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 46
|
GATS (2009) GATS (2009)
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 47
|
GATS (2009) GATS (2009)
Figure 2 Average Number of Cigarette Smoked by Daily Cigarette Smokers by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
106113
70
0
2
4
6
8
10
12
OVERALL Men Women
Sex
Number of Cigarettes
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 48
|
GATS (2009) GATS (2009)
Figure 3 Average Age of Initiation of Daily Smoking Among Ever Daily Smokers 18-34 years old by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
191
176 174
15
16
17
18
19
20
OVERALL Men Women
Sex
Age in years
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 49
|
GATS (2009) GATS (2009)
Figure 4 Second Hand Smoke Exposure at Home Philippines Global Adult Tobacco Survey (GATS) 2009
488396
544
0
20
40
60
80
100
Smoking Allowed insidethe Home
Exposure Daily inside theHome
Exposure Monthly insidethe Home
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 50
|
GATS (2009) GATS (2009)
Figure 6 Second Hand Smoke Exposure in Public Places Philippines Global Adult Tobacco Survey (GATS) 2009
255
553
336
76
0
20
40
60
80
100
PublicTransport
RestaurantsGovernmentOffices
Health CareFacilities
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 51
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 52
|
GATS (2009) GATS (2009)
Figure 7 Smoking Cessation Status of Adults 15 years and older by Sex Philippines Global Adult Tobacco Survey (GATS) 2009
215
478
606
467
605
209250
539611
0
20
40
60
80
100
Quit Rate (EverDaily)
Quit Attempt(Past Year)
Interested inQuitting (Current
C igaretteSmokers)
Percent
Total Men Women
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 53
|
GATS (2009) GATS (2009)
Figure 8 Percent of Respondents Who Believe That Smoking Causes Certain Illness Philippines Global Adult Tobacco Survey (GATS) 2009
940956
813755
0
20
40
60
80
100
Smokingcauses
lungcancer
Smokingcausesseriousillness
Smokingcausesheartattack
Smokingcausesstroke
Illness
Percent
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 54
|
GATS (2009) GATS (2009)
Figure 10 Average Cigarette Expenditure per Month Among Manufactured Cigarette Smokers by Sex Philippine Global Adult
Php3264 Php3392
Php 2328
050
100150200250300350
OVERALL Men Women
Sex
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 55
|
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Percent Distribution of Current Manufactured Cigarette Smokers by Last
Brand of Manufactured Cigarettes Purchased (Philippine GATS 2009)
Fortune334
Marlboro194
Champion111
Hope72
Philip Morris52
Winston26
More29
Might52
Other130
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 56
|
Distribution of monthly expenditures of poor household
Distribution of monthly expenditures of poor household
13
16
131
26
63
82
33
26
611
Food
Clothing
Housing
Health
Education
Utilities
Transport ampCommunicationTobacco
Other expenses
Source Tobacco and Poverty Study in the Philippines May 2006 Basic Data FIES 2003
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 57
|
Impact of Tobacco Use on Individuals and Families
Impact of Tobacco Use on Individuals and Families
bullPoor families spend a larger proportion of their income on tobacco than do people of higher socioeconomic groups
bullMoney spent on tobacco cannot be spent on food sheltereducation and health care
bullTobacco users are more likely to fall ill and die prematurely of tobacco-related diseases resulting in loss of income and high health care costs
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 58
|
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Summary of Economic Costs in US$) for Four Smoking-related Diseases
(2003 using SAMMEC methodology figures)
Smoking-related Diseases
Health Care Costs
Productivity Losses from
Death
Productivity Losses from
DiseaseTotal Costs
Lung Cancer 9188871 189709987 3407151 202306009
CVD 507315052 2930533343 38910556 3476758951
CAD 236888476 1312836695 88922515 1638647686
COPD 104561119 569530925 54043648 728135692
All 4 Diseases 857953518 5002610950 185283871 6045848339
Source Tobacco and Poverty Study in the Philippines 2006
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 59
|
How Tobacco Contributes to Poverty National-Level
bullTobacco not only impoverishes those who use it it puts an enormous financial burden on countries from
1048590 Increased health-care costs1048590 Lost productivity due to illness and early death1048590 Foreign exchange losses1048590 Environmental damage
Environmental degradationbull1048590 About 200000 hectares of forests consumed each year by
tobacco farmingbull1048590 Estimated 5 of all deforestation in developing countries
where tobacco is grown is due to tobacco productionbull1048590 Pollution from pesticides and fertilizersbull1048590 Solid and chemical waste from manufacturing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 60
|
Key Population-Level InterventionsKey Population-Level Interventions
bullTobacco tax increases are the best way to cut consumption especially among the young and the poor
Support national law that would increase excise taxes of cigarettes
bullEnact and enforce ordinances establishing 100 smoke-free public places
bullChange image of smokingSupport national law on graphic health warning
bullHelp with cessationSimple medical advice pharmacotherapy
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 61
|
Tobacco Free Plan-It Mini Survey
Core Adult Tobacco Survey (9 CATShellipand 3 kittens)
Q1 Current tobacco smoking statusDo you currently smoke tobacco on a daily basisless than daily or not at all
Q2 Past tobacco smoking statusIn the past have you smoked tobacco on a daily basis less
than daily or not at all
Q3 Currently chewing tobaccoDo you currently chew tobacco on a daily basis less than daily or not at all
Q4 Frequency of smoking in the homeHow often does anyone smoke your home Daily weekly
monthly less than monthly or never
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 62
|
Core Adult Tobacco Survey
Q5 Smoking at the workplaceDuring the past 30 days did anyone smoke in indoor (enclosed)
areas where you work
Q6 Receiving brief cessation advice from a health care workerDuring any visit to a health care worker in the past 12 months wereyou advised to quit using tobacco
Q7 Thinking about quitting because of health warnings on cigarette packs
In the last 30 days have warning labels on cigarette packages led you to think about quitting
Q8 Tobacco advertisingIn the last 30 days have you noticed any pro-tobacco advertisements
Q9 Cigarette promotionsIn the last 30 days have you noticed promotion of cigarette brands in
clothing gift items or free samples
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 63
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
Penalties
Citation Ticket System
Smoking Cessation Program
Smoke Free Task Force Duties and Responsibilities
Information Campaign
Financing
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 64
|
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
ELEMENTS OF AN IDEAL ANTI-TOBACCO ORDINANCE
Prohibited Acts
ndash Smoking in enclosed or partially enclosed public places workplaces public conveyances or other public places
ndash Selling or distributing tobacco products in a school public playground or other facility frequented by minors or within 100 meters from any point in the perimeter of these places
ndash Selling or distributing tobacco products to minorsndash Purchasing tobacco products from minorsndash Placing cinema and outdoor advertisements of tobacco products ndash Placing posting or distributing advertising materials of tobacco
products such as leaflets posters and similar materials outside the premises of point-of-sale establishments
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 65
|
Five Arsquos for the Health Care Practitioner
ASK Systematically identify all smokers at every visit
ADVISE Strongly urge all smokers to quit
ASSESS Determine willingness to make a quit attempt
ASSIST Aid the patient in quitting
ARRANGE Schedule follow-up contact
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 66
|
Need to pass a National Law on Graphic Health Information
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 67
|
What you can do to Protect Kids from Second Hand Smoke
What you can do to Protect Kids from Second Hand Smoke
Make your home and vehicle smoke-free at all times If there are smokers in your family they should always go outside to smoke Opening the window is not enough
Make sure your childrenrsquos day care centers and schools are 100 smoke- and tobacco-free
Insist that no one smokes around your children
Choose smoke-free restaurants and malls
The single best step If you smoke QUIT Quitting smoking will also reduce the chance that your children will grow up to become smokers themselves
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 68
|
ldquoThe cure for this devastating epidemic is dependent not on medicines or vaccines but on the concerted actions of government and civil societyrdquo
mdashMargaret Chan 2008Director General World Health Organization
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|
Healthy Lifestyle Summit
Balanga City 26 Nov 2010 69
|