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The Schizophrenic State of Tobacco Control in the Philippines. Republic of the Philippines DEPARTMENT OF HEALTH. GEOGRAPHICAL DISTRIBUTION OF MALARIA PHILIPPINES (Based on 10-year Ave, 1991 – 2000). Category A Provinces 25 Provinces more than 1000 cases/year or situation worsened.
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The Schizophrenic State of Tobacco Control in the Philippines Republic of the Philippines DEPARTMENT OF HEALTH
GEOGRAPHICAL DISTRIBUTION OF MALARIA PHILIPPINES (Based on 10-year Ave, 1991 – 2000) • 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) Source: Malaria Control Program, 2000
The Situation High mortality and morbidity rates from tobacco-related disease • Increasing prevalence for tobacco • use among children and women - Limited government resources for tobacco-related diseases
Tobacco is sold by single sticks on the streets by child vendors 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 industry is formidable The Supply of Tobacco
Tobacco advertising is a major source of income for the broadcast and print media Entertainment industry “glamorizes” tobacco Culture of accommodation inhibits non-smokers from demanding a smoke-free environment Many political leaders are smokers The Demand for Tobacco
The Schizophrenic State • Voted for the ratification of the FCTC • Enacted Tobacco Regulation Act of 2003 • & Excise Tax Law of 2005 • Updated local ordinances against • smoking – Makati, Davao, • Mandaluyong, etc.
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 Strategy HEALTH PROTECTION HEALTH PROMOTION Public Empowerment For Policy Change
The Old Strategy - Focus on educational programs for children in schools - Promote healthy lifestyle
The New Strategy • Aggressively mobilize a constituency to support the Tobacco Regulation Act of 2003, the Excise Tax Law of 2005 and local tobacco control legislation - Use the FCTC to buttress national tobacco control policies
FROM SCHIZOPHRENIA TO WHOLENESS EXTRA CHALLENGE
The Six Components of the NTCP - Media, Advocacy & Promotion - Smoking Cessation Program - Epidemiologic Surveillance & Research - Education Program - Economic Alternative Program for Tobacco Farmers - Legislation/ Public Policy Development
Media, Advocacy & Promotion • There is no such thing as industry vv health “balance” • Blacklist agencies, organizations, companies, individuals associated with tobacco industry
Media, Advocacy & Promotion - Case find patients cum victims of exposure to tobacco for litigation
Smoking Cessation Program - Set up smoking cessation clinics in all government retained hospitals & major medical centers
Surveillance & Research Global Youth Tobacco Survey Health Professionals’ Tobacco Survey Burden of Illness Studies Packaging & Labelling Tobacco Industry Activities Monitoring 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
Legislation TheTobacco 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.
Legislation - 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 Policy Development • 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 Policy Development • 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 Policy Development • National Push for an issuance to declare: - Tobacco as a hazardous substance - Nicotine-containing products as prescription drugs
Legislation B. International Treaty - Invoke the Framework Convention on Tobacco Control (FCTC) - a WHO initiative and international legal instrument which will circumscribe global tobacco consumption
In Summary • Tobacco control is in a state of ambuguity & schizophrenia • It is incumbent upon health professionals to bring the true picture clearly into focus