320 likes | 557 Views
CHILD HEALTH AND TOBACCO IN THE PHILIPPINES. BENJAMIN P. SABLAN, JR., MD, FPPS PROFESSOR UNIVERSITY OF THE PHILIPPINES MANILA. DISCLOSURE. Commissioned work given to the PHILIPPINE AMBULATORY PEDIATRIC ASSOCIATION Funded by the World Health Organization
E N D
CHILD HEALTH AND TOBACCO IN THE PHILIPPINES BENJAMIN P. SABLAN, JR., MD, FPPS PROFESSOR UNIVERSITY OF THE PHILIPPINES MANILA
DISCLOSURE • Commissioned work given to the PHILIPPINE AMBULATORY PEDIATRIC ASSOCIATION • Funded by the World Health Organization • Endorsed by the Department of Health Manila
TOBACCO FREE INITIATIVEWHO • Children are a vulnerable group (GYTS) • Need for concerted efforts • Push for critical reforms and interventions that would impact on significant tobacco control • In consonance with the Regional Action Plan for the Tobacco Free Initiative in the Western Pacific (2010-2014)
Share of total mortality of the ten leading causes of death, Philippines, 2004 Tobacco use was responsible for over 58,000 deaths, or nearly 12% of all deaths in the Philippines.
Global Youth Tobacco Survey (GYTS) • Current usage: ~3/10 of students (27.3%; M>F) • Current smokers: ~1/5 of students (21.7%; M>F) • Other tobacco users: 1/10 (9.7%; M~F) • Ever smoked: ~½ of students (46.2%; M>F) • Likely to smoke: ~1/10 of students (13.6%; M>F)
GYTS • ETS exposure at home: ~50% • ETS exposure in public places: ~60% • Desire to quit smoking: ~80% of current cigarette smokers • Taught in school about smoking and its dangers: ~65% • BUT • Buy cigarettes in a store: 56% • Not refused purchase due to age: 64%
GYTS Conclusions • Cigarette smoking among young people in the Philippines is high Compared to 1995 data • 33% increase of prevalence of smoking in Filipino youth • 12% increase in current smoking prevalence
GYTS Conclusions • Filipino boys are more likely than girls to use tobacco • Almost one-fifth of young people begin smoking before the age of 10 years • Over ¼ of never smokers are likely to start smoking this year
GYTS Conclusions • Environmental Tobacco Smoke exposure is very high • Over half of parents smoke • About 3 in 4 are around others who smoke in places outside their homes • Filipino youth smokers usually smoke at home but majority of them prefer to smoke in a friend’s home • Only 4 in 10 think smoking is harmful to their health
GYTS Conclusions • The majority of young people currently smoking want to stop smoking • Over two-thirds or 8 in 10 smokers want to stop • There is lack of access to smoking cessation program
ISSUES Positive indicators for anti-smoking campaign in the Philippines • 72% think cigarette smoking is harmful • 72% think cigarette smoking makes one less attractive • 85% of current smokers want to stop smoking Challenges • 27% of never smokers are likely to initiate smoking in the next year • 39% agree that smoking should be banned from public places • Only 6% of those who wish to quit smoking had access to professional help
Global Heath Issues Affecting the Filipino Child PAPA CONVENTION 2010 • First International Visiting Lecture of Richmond Center, Dr. Jonathan Klein, Executive Director AAP • Paediatric health care providers need to be aware of the continuing pharmacological and health effects of tobacco smoke either through use or second hand exposure • Doctors and other health care professionals can become more effective public advocates for tobacco control in their respective communities
Global Heath Issues Affecting the Filipino Child PAPA CONVENTION 2010 • Physicians may know Tobacco effects • Lack the skills needed to advocate for tobacco control • Physicians are a major force needed in the community for tobacco control advocacy • Coalition on Tobacco control (FCAP – NGOs, media, DOH) • Physicians may be the silent link!!!!
BRIEF TOBACCO INTERVENTION SKILLS TRAININGOBJECTIVES • To provide paediatric health care providers with current information regarding • Physiologic and health effects of Tobacco Exposure • Intervention initiatives for Tobacco Control • To promote practice changes to enhance • Medical provider skills for clinical interventions • Medical provider skills for public advocacy
FRAMEWORK TARGET HEALTH PROVIDERS • Physicians (Child and Adolescent Health Care providers) • All health care providers (nurses, midwives, etc.) TARGET POPULATION • Under 5 infants/toddlers (IMCI counseling) • Children over 5 years old • Adolescents
BTIS TRAINING • Training Modules • Trainors • Training Manual • Health Provider Encounter form • Health Education Materials
BTIS TRAINING • 4 hour training • Training on technical aspects of running course • Didactics • Role Playing • Evaluation • Training on technical issues on Tobacco and Tobacco control
ALGORITHM • Young Child Less than 5 years old • Parent/Caregiver • IMCI approach (Pneumonia, ear infection, nutrition, fever) • Older Child (6-9 years old) • Parent/Caregiver • Child • Adolescent
VIDEO • Generic Version • Concepts 5As • Algorithm used • Easily adaptable (translated in local dialect) • BTIS in real time
BTIS Learnings • Knowledge and Skills • Improved Knowledge • Acquired Skills for BTIS for every health care encounter • Need for community resources development
COMMITMENT • Continue BTIS Training all over the country • 16th Annual Convention (March 8-9, 2011) BTIS Training as a pre-convention a. Academe b. Key Government Physicians/Program Managers
COMMITMENTTo Develop Resource Centers for Motivational Counseling
COMMITMENT • COALITION BUILDING • Physicians as the MISSING LINK • Involve Medical Organizations • Department of Health • Philippine Medical Association • Philippine College of Physicians • Philippine College of Chest Physicians • Philippine Academy of Pediatric Pulmnologists • Philippine Society of Oncology • Society of Adolescent Medicine (SAMPI) • Philippine Ambulatory Pediatric Association