Baguio draws lessons from anti-smoking law

CRUSHING VICE Baguio Mayor Benjamin Magalong (fourth from left) and other city officials crush a pile of cigarettes to symbolize the fight against smoking in this photo taken on Feb. 28. The World Health Organization cited the local government for its smoke-free initiatives —NEIL CLARK ONGCHANGCO

(First of two parts)

BAGUIO CITY, Benguet, Philippines — Before the pandemic struck, Baguio City was on a mission to be “the place where you will quit smoking,” said city health officer Dr. Donnabel Tubera Panes.

Back then, city officials had to balance Baguio’s status as an education and tourism center and its public health goals, she said.

As it reopens its doors to more tourists this summer, Baguio becomes even more focused to achieve this goal, especially after winning the 2021 “Healthy Cities” award from the World Health Organization (WHO) and the Alliance for Healthy Cities, an international network that advocates for city dwellers’ health.

According to the WHO, tobacco smokers globally face around a 40 percent to 50 percent higher risk of developing severe disease and death from COVID-19 compared to nonsmokers. The Department of Health (DOH) also estimated that 87,600 Filipinos die every year due to tobacco-related illnesses.

WHO Philippines national officer Florante Trinidad said that Baguio won the award under the “sharing clean air” category in the Western Pacific region for its commitment to promoting public compliance with smoke-free laws.

On Feb. 28, Mayor Benjamin Magalong and other city officials received the award with a ceremonial showcase of heaps of confiscated cigarette sticks at the City Hall.

Magalong, also the country’s COVID-19 contact tracing czar, said the city was able to effectively implement smoke-free policies because barangay officials, and even ordinary citizens, are reporting violations, “particularly by visitors.”

“People are really aware of the very strict anti-smoking ordinance in the city of Baguio, and we never had any serious problems in its implementation,” Magalong told the Inquirer.

He stressed: “At the end of the day, it’s all about enforcement of the law without fear or favor. Walang entitlement, dapat pantay-pantay lang (No one is above the law).”

No shortcuts

There was, however, no shortcuts to this victory. It took Panes and other antismoking champions almost 10 years to lobby for a strong policy that can address the increasing smoking prevalence among the youth and adults.

This, even when Baguio became one of the first cities to have a smoke-free ordinance in the country, two years after US Surgeon General Luther Terry issued a definitive report that linked smoking cigarettes with lung cancer in 1966.

The smoke-free ordinance evolved over the years, expanding its scope from garages and taxis to cinemas, government offices, assembly halls and churches; prohibiting smoking in all indoor places, except in designated areas in 2009; and in 2017, prohibiting vape and selling cigarettes by the stick.

In prohibiting the sale of cigarettes per stick, the assumption was that minors would be discouraged to buy a pack of cigarettes or would not be able to afford it.

A pack of cigarettes now costs around P150, or P7 per stick. Ordinance No. 34-2017, or the Smoke-Free Ordinance of Baguio City, passed by the city council in April 2017, also prohibits the use, sale, distribution and advertisement of cigarettes and other tobacco products in all public places, and the sale of tobacco products within 100 meters from schools.

Due to the ordinance, Panes said they were able to decrease smoking prevalence in Baguio by 50 percent or from 34 percent to 17 percent.

But getting here was “a long fight,” said Panes, who had “knocked on the door of every city councilor to ask them to approve the ordinance” since 2000.Panes said it became even more challenging when tobacco companies tried to water down the ordinance in favor of their commercial interests.

“Tobacco industry interference is very real even in LGUs (local government units). Before the ordinance was passed, tobacco industry representatives came to my office because they wanted to amend it. They were there before and after it was approved,” Panes said.

Tobacco interference refers to the tactics used by the tobacco industry to interfere with the setting and implementation of public health policies with respect to tobacco control.

Panes cited an instance when a so-called “sari-sari store association of the Philippines,” which was composed of nonresidents, questioned their rule to ban the sale of cigarettes per stick.

City officials sought help from the elderly, who protested in the streets with gongs and a strong call to protect the ordinance.

“We are not afraid of tobacco interference. As long as you have a strong policy, the tobacco industry’s work can’t prosper, especially if your purpose is to protect the health rights of the people,” Panes said.

Safeguarding public health

According to a 2015 report by public health and law group Health Justice, tobacco addiction stems from poor implementation and inconsistent enforcement of tobacco control policies.

But there are national and international frameworks that serve as guides to LGUs.

Baguio’s ordinance was introduced 12 years after the Philippines and 167 other countries signed the WHO’s Framework Convention on Tobacco Control (FCTC).

The FCTC recognizes “a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests.”

It also discourages incentives to establish or run tobacco businesses “because their products are lethal.”

But tobacco companies try to influence LGUs by funding front groups who could work for their interests on the ground, said ImagineLaw executive director Sophia San Luis.

While the tobacco industry has resisted regulation since the 1950s, San Luis noted that it used the pandemic as an opportunity to “cleanse itself” through publicized donations of health equipment to governments globally.

In the Philippines, the Joint Memorandum Circular between the Civil Service Commission and the DOH in 2010 “restricts interaction between government officials and the tobacco industry to only when strictly necessary.”

But the Southeast Asia Tobacco Control Alliance noted that tobacco industry donations “were accepted and endorsed by the health sector and enforcement agencies,” such as the medical supplies and personal protective equipment (PPE), donated to government agencies.

“[We have to recognize] that tobacco use is contributory to this crisis that we’re experiencing. We have more people who have comorbidities and suffer from respiratory illnesses and are therefore exposed to higher risk of severe COVID and death,” San Luis said.

But for now, Panes and her team are committed to creating a generation of healthy individuals who don’t know what smoking is.“When we were making a Christmas ID for smoke-free Baguio, my 5-year-old daughter asked me what a cigarette is. So, I realized that it’s possible to create a culture where people don’t know cigarettes and will not be exposed to something that harms their health,” she said.

(Editor’s Note: This report is produced under the “Nagbabagang Kuwento Special Reports: Tobacco Industry Interference Story Grants Program” by Probe Media Foundation Inc. and Campaign for Tobacco Free Kids.)

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