My grandfather died of lung cancer, horribly and painfully, too soon before his time. I was 10 years old then and was aghast at how skeletal he had become in his last days.
“He smoked cigarettes for decades,” my father said. “Even after he was diagnosed with cancer, he still could not quit.”
A kind and gentle man, my grandfather did not smoke in front of us but in his room or in the garden. Although the ill effects of passive smoking were unknown then, he knew we would cough when we inhaled cigarette smoke.
My father, who became a doctor, and most of his siblings never smoked, since they witnessed firsthand its lethal effects on Grandpa.
Highest smoking rate
According to the primer “Sin Tax is Anti-Cancer Tax” from the World Health Organization (WHO) and other health groups, the Philippines has the highest smoking rate in Southeast Asia. Some 17.3-million adults smoke (47.6 percent of men and 9 percent of women). The smoking rate for women is the third highest in Asia, second only to Japan and the Republic of Korea.
The young, even tweens, also smoke. Among young smokers, 17.5 percent are girls and 28.3 percent are boys aged 13-15 years.
In 2005, the Senate, which included my father’s classmate, Dr. Juan Flavier, ratified the WHO Framework Convention on Tobacco Control, which says in part that “scientific evidence has unequivocally established that tobacco consumption and exposure to tobacco smoke cause death, disease and disability” and “there is clear scientific evidence that prenatal exposure to tobacco smoke causes adverse health and developmental conditions for children.”
If the Senate accepted the WHO Convention seven years ago, why the delay in passing the sin tax bill?
That smoking kills has been drummed into us in school, with apparently little effect, as some of my students still smoke.
So here are the facts, again.
Every hour, a person dies of lung cancer in the country. One-fourth, 25 percent, of all kinds of cancer can be linked to smoking. While many cancers have genetic causes or are hereditary, smoking is not.
Smoking is not just a risk factor for lung cancer, but also for cancer of the larynx, esophagus, pancreas, stomach, colon, anus, among others. Smoking is also strongly linked to heart attack, stroke and chronic pulmonary disease—the other major causes of death in the country.
Every cigarette has 70 known carcinogens, including ammonia (also found in household cleaners), arsenic (in rat poison), benzene (in rubber cement), butane (in lighter fluid), carbon monoxide (in car exhaust), formaldehyde (in embalming fluid), lead (in batteries), naphthalene (in moth balls), nicotine (in insecticides) and tar (in road paving).
Secondhand smoke kills
Smoking does not just harm smokers but also people close to them—literally. Just as drunks do not just harm themselves but also others when they drive, smokers do not put just themselves at risk but also other people, including loved ones.
It has long been known that passive smoking is as dangerous as actual smoking. Nonsmokers, who are constantly exposed to tobacco smoke, are also at risk. WHO says half of Filipino women and children are passive smokers.
Many women eventually develop cancer because they have the misfortune to live with smokers. As for children, the 2011 Global Youth Tobacco Survey says more than two in five students live in houses with smokers.
In the past month, 55.3 percent of Filipino adults were exposed to tobacco smoke in public transport, 36.9 percent at work, 33.6 percent in restaurants, 25.5 percent in government buildings and, ironically, 7.6 percent in health facilities.
And the poorest of the poor are the hardest hit. Dr. Tony Dans of the University of the Philippines, in an article in 2011 for the prestigious journal The Lancet, said the poorest fifth of the Philippine population smoked more than the wealthiest fifth.
“The current price of tobacco products, especially cigarettes, is the lowest in the region,” says Metrobank Outstanding Teacher Awardee and nurse Josefina Tuazon. “Even with the proposed increase in sin tax, the price will still be low.”
This makes the issue of smuggling, which tobacco companies use as an argument against the sin tax, moot. “Because of the cheap price of our tobacco, even with the sin tax, smuggling will be outward—from the Philippines to other countries,” Tuazon says.
The cost per year of cancer, heart attack, stroke and chronic lung disease is estimated at P177 billion (Dans, in an article for a forthcoming issue of the Philippine Journal of Internal Medicine, puts the figure at P188.8 billion).
The sin tax bill, if passed, will only generate P33 billion on its first year of implementation. But if the bill is passed, the ones who will benefit the most are the children.
The Department of Health says a mere 10-percent increase in tobacco tax will reduce the number of smokers by two million in 2016.
“A unitary specific tax of P30 would prevent nearly 4.6-million youths from taking up smoking and avert almost 2.3-million deaths,” says the WHO primer, which adds that revenue from sin taxes will go to health programs.
“Is the sin tax a revenue measure masquerading as a health care bill?” says Dans. On the contrary, it is “an environmental measure aimed at controlling a societal disease that is masquerading as health problems in individuals.”
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