Republic of the PhilippinesDEPARTMENT OF HEALTH

The Schizophrenic

State of Tobacco Control

in the Philippines

Category A Provinces• 25 Provinces• more than 1000 cases/year• or situation worsened

Category B Provinces• 22 Provinces• 100 to 1000 cases/year

Category C Provinces• 18 Provinces• less than 100 cases/year

Category D Provinces• Provinces that are already malaria-free (no more indigenous cases for at least 3 years)

GEOGRAPHICAL DISTRIBUTION OF MALARIA PHILIPPINES (Based on 10-year Ave, 1991 – 2000)

Source: Malaria Control Program, 2000

The SituationThe Situation

- - Limited government resources for tobacco-related diseases

- Increasing prevalence for tobacco use among children and women

HHigh mortality and morbidity rates from tobacco-related disease

The Supply of Tobacco

Tobacco production and sale is a source of income for poor families

Tobacco tycoons are politically well- connected to members of the legislative and executive branches of government

Tobacco is sold by single sticks on the streets by child vendors

Tobacco industry is formidable

The Demand for The Demand for TobaccoTobacco

Entertainment industry

“glamorizes” tobacco

Culture of accommodation inhibits non-smokers from demanding a smoke-free environment

Many political

leaders are smokers

Tobacco advertising is a major source of income for the broadcast and print media

The Schizophrenic State The Schizophrenic State

- Voted for the ratification of the FCTC Voted for the ratification of the FCTC

- Enacted Tobacco Regulation Act of 2003 & Excise Tax Law of 2005

- UpdatedUpdated local ordinances against smoking – Makati, Davao, Mandaluyong, etc.

The Schizophrenic State The Schizophrenic State

Health professionals smoke in front of their patients – 1 out of 3 MDs

National Tobacco Authority looking for alternative uses of tobacco

Department of Trade & Industry chairing the IAC for Tobacco Control

Department of Education accepts money for schools & lauds Phillip Morris for Youth Smoking Prevention Program

OP inaugurates a Phillip Morris plant

The Shift in StrategyThe Shift in Strategy

HEALTHHEALTH PROMOTIONPROMOTION

HEALTHHEALTH PROMOTIONPROMOTION

HEALTHHEALTH PROTECTIONPROTECTION

HEALTHHEALTH PROTECTIONPROTECTION

Public Empowerment For Policy ChangePublic Empowerment For Policy Change

The Old StrategyThe Old Strategy

- - Focus on educational Focus on educational programs for children programs for children in schoolsin schools

- Promote healthy - Promote healthy lifestylelifestyle

The New StrategyThe New Strategy

-Aggressively mobilize a constituency Aggressively mobilize a constituency to support the Tobacco Regulation Act to support the Tobacco Regulation Act of 2003, the Excise Tax Law of 2005 and of 2003, the Excise Tax Law of 2005 and local tobacco control legislation local tobacco control legislation

- - Use the FCTC to buttress national Use the FCTC to buttress national tobacco control policies tobacco control policies

FROM SCHIZOPHRENIA TO FROM SCHIZOPHRENIA TO WHOLENESS WHOLENESS

EXTRA CHALLENGE

The Six Components of The Six Components of the NTCPthe NTCP

- Media, Advocacy & Promotion- Smoking Cessation Program- Epidemiologic Surveillance &

Research- Education Program- Economic Alternative Program for

Tobacco Farmers- Legislation/ Public Policy

Development

Media, Advocacy Media, Advocacy & Promotion& Promotion

- There is no such thing as industry vv health “balance”

- Blacklist agencies, organizations, companies, individuals associated with tobacco industry

Media, Advocacy & Media, Advocacy & PromotionPromotion

- Case find patients cum victims of exposure to tobacco for litigation

Smoking Smoking Cessation Cessation ProgramProgram

- Set up smoking cessation clinics in all government retained hospitals & major medical centers

Surveillance & Surveillance & Research Research

Global Youth Tobacco SurveyHealth Professionals’ Tobacco

SurveyBurden of Illness StudiesPackaging & LabellingTobacco Industry ActivitiesMonitoring of Implementation of

Tobacco Regulation Act, Excise Tax Law, FCTC, Ordinances

Education Program

- Integrate TC in medical/allied health professionals’ curricula

Economic Alternative Program

- Abolish the National Tobacco Authority

LegislatiLegislationon

The Tobacco Regulation Act provides for:

- prohibiting sale of cigarettes to minors

- banning smoking in public places such as schools, health facilities, public conveyances, food preparation areas, etc.

LegislationLegislation- banning of tobacco ads, sponsorships taxation ban ads on TV & radio – 1 jan 2007 ban ads on cinema & outdoor ads

– 1 july 2007 ban ads on mass media advs – 1 july 2008 - warning labels - economic alternative for tobacco

farmers

Legislation / Public Legislation / Public Policy DevelopmentPolicy Development

A. National Step up implementation of the

Tobacco Regulation Act by the IAC, chaired by the DTI and vice-chaired by the DOH

- Provide incentives to local governments & groups deputized to catch offenders & collect fines

Legislation / Public Legislation / Public Policy DevelopmentPolicy DevelopmentA. National - Push for implementation of

the Excise Tax Law; plan to wisely spend monies earmarked for “disease prevention”

- Increase levies to provide disincentives to ”sensitive”, perilous companies

Legislation / Public Legislation / Public Policy DevelopmentPolicy DevelopmentA. National

Push for an issuance to declare:

- Tobacco as a hazardous substance

- Nicotine-containing products as

prescription drugs

LegislationLegislationB. International Treaty

- Invoke the Framework Convention on Tobacco Control (FCTC)

- a WHO initiative and international legal

instrument which will circumscribe

global tobacco consumption

In SummaryIn Summary

-Tobacco control is in a state of Tobacco control is in a state of ambuguity & schizophreniaambuguity & schizophrenia

-It is incumbent upon health It is incumbent upon health professionals to bring the true professionals to bring the true picture clearly into focuspicture clearly into focus

Thank Thank You You !!