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Teenage Smoking in the Philippines

I lit my first cigarette when I was 10 years old. Why? Out of curiosity. I always wondered why so many grown-ups smoke. It was as if smoking a cigarette was the ticket one needed to be called an adult. "It must be cool," I thought then as I puffed my first puff. I coughed. And coughed and coughed. Still, I tried to smoke some more. The cough ceased and I was blowing smoke. As I finished, I noticed a horrible sour taste left in my mouth. It smelled terrible. "So, this was smoking? What's so cool about it?" I wondered. That was the first and last time I smoked.

While quitting smoking remains one of the best prevention methods to avoid dying prematurely and anti-smoking advocates have not been remiss in their campaigns, and yet, smoking continues. For this post, I'd like to focus on teenage smokers and explore why they try to smoke and continue to smoke. Here are some facts:

4 out 10 students aged 13-15 years old smoke cigarettes. [CDC-MMWR, 2005]

Almost one fifth of young Filipinos begin smoking before age 10. [Miguel-Baquilod, M., NEC, 2001]

70 percent of boys begin smoking by age 20. Among Filipino girls, residence in cosmopolitan Metro Manila is associated with high probability of smoking, and those who were raised with both parents present were less likely to smoke than those who grew up with a single parent. Also, for both genders, those who have close relationships with parents were less likely to smoke [Teen Tobacco Epidemic in Asia, 2004]

Among factors influencing smoking, the following are significant: (1) media advertising, (2) exposure to smoke in public places, and (3) one or more parents who smoke. [CDC-MMWR, 2005]

This is the most ironic and puzzling part: nearly 90 percent (88.7% in 2003) of Filipino adolescents supports the ban on smoking in public places, and want to quit (88.2% in 2003). [CDC-MMWR, 2005]

A very small percentage (7.2% in 2000 and 3.8% in 2003) admitted that they wanted their first cigarette thirty minutes after waking up in the morning. [CDC-MMWR, 2005]

In 1983, the popularity of Marlboro among youth exceeded that in the adult population. Marlboro then held a 35–40 percent share in Metro Manila but "more than 50%" in high schools. [Mason, W., 1983]

62.8 percent of Filipino adolescents are not refused purchase when buying tobacco products in a store. [CDC-MMWR, 2005]

More males had tried quitting than females. One woman wondered why she should ‘divorce’ her ‘favorite Hope’ (a brand of cigarette), her ‘constant companion’, while another refused to quit for fear of weight gain. [Health Promotion Int., 2003]

In one investigation, it was found out that among female Filipino smokers, smoking is seen ‘as a substitute for expressing feelings’, particularly anger and unhappiness. [Kaufman, N. J. and Nichter, M., 2001]

The Philippines is the 15th biggest consumer of cigarettes in the world, and the largest cigarette consumer among the Association of Southeast Asian Nations (ASEAN). [PDI, 2002 and WHO, 2001]

Loss in productivity and health care costs amount to billions of pesos, which can be put into better use, should smoking be prevented or eliminated among Filipinos.

My proposed solutions:

Enforce Republic Act 9211 and publicize how offenders are penalized.

Make anti-smoking warnings bigger, more colorful, and more visible. If possible, place it in billboards and suggest that government sponsor advertisements of similar nature in television, radio, and print media. On the other hand, ban cigarette advertisements! Also, ask advertising agencies to modify marketing strategies and refrain from focusing on the youth sector.

Make anti-smoking warnings appear on ALL sides of the cigarette pack: front, back, top, bottom, and all side panels. This must be done indefinitely and not on a limited time basis only.

Refuse cigarette purchase among adolescents and penalize those stores who commit this offense.

Make cigarettes very expensive. Consider this irony: the price of Marlboro in the Philippines is the second lowest among all ASEAN nations, while the prices of basic medicines are among the highest in Asia. What do you call that? It is cheaper to get sick and more expensive to get healed?

How can you make cigarettes very expensive? By increasing tobacco or cigarette taxes. Legislators and the government should have a direct hand in this. The most price-responsive are the lower-income groups and the youth. By making cigarettes expensive, we can discourage them from smoking.

Emphasize and make anti-smoking a part of the school curriculum from elementary to collegiate level.

Sponsor student field trips to hospital wards where patients with smoking-related illnesses are confined to highlight the results of long-term smoking.

Ban children and young people from openly selling cigarettes in the streets.

Give incentives like discount coupons to smoke-free households. Smoking drains nearly 20 percent of the household income of smokers' families.

There is nothing cool or glamorous about getting sick or dying young or making others sick because of second-hand smoke. Getting bad breath or yellow teeth from smoking won't make anyone popular. The ultimate goal is to make the youth sector realize this, and not make them develop such a harmful habit.

Written by Dr. Emer, http://emeritus.blogspot.com