Regional perspective: Youth and smoking
The Department of Health (DOH) in Northern Mindanao has based its regional statistics on health and smoking cases from the survey by the World Health Organization (WHO) that is conducted every three years, said Dr. Andresa Beñas, head of the Lifestyle-Related Disease sub-program of the Local Health Division.
While adults remain dominant in the figures of those who smoke, Beñas also emphasized the youth's involvement in smoking, a major factor for her office's effort in advocating for health literacy campaigns on anti-smoking.
"In 2010-2011, it was seen (around) 27.7 percent of our youth, from high school, (who) are smoking," she said, adding that this was based on the 11 densely populated private and public high schools in the region. The number of respondents, however, was not revealed during the interview.
"In 2014-2015, came another survey -- the report was still similar, but (it was) a little bit lower, but still at 27.5 percent. It's significance was that men and women almost have the same (smoking habit), but many women smoke," she said.
The involvement of high school students, who are still considered minors or below 18 years old under Philippine laws, posed as a challenge for the Philippine National Police (PNP) when it comes to enforcing anti-smoking laws and ordinances (as partners in task forces organized by local government units).
Prior to his re-assignment, then PNP-Northern Mindanao spokesperson, Police Superintendent Lemuel Gonda said in May that they would not call it "apprehension" or "arrest" but rather "rescue," and conducting such also needs the assistance and presence not only of the parents of the minors involved but also of social workers from local or regional social welfare and development offices.
"There are many laws involved in dealing with minors, it's not only anti-smoking laws but also laws pertaining to children, as we might violate their rights," he said, adding that they are avoiding any commission of children's rights violation.
Regional health perspective
In the 2012 regional health profile written by Dr. Chona Echavez and Jennefer Lynn Bagaporo, researchers from the Research Institute for Mindanao Culture of Xavier University-Ateneo de Cagayan, they collected information from various regional health data revealing that the highest leading cause of sickness in Northern Mindanao is Acute Respiratory Infection (ARI) with a rate of 2,500 cases for every 100,000 population.
This is distantly followed by bronchitis with a rough estimate of 1,400 cases for every 100,000 population. The third cause of morbidity in the region is pneumonia with 1,000 cases per 100,000 populations. Bronchitis and pneumonia can be possible causes of severe ARI. The figures did not mention on the distribution of age, gender, and the actual numbers of health cases.
Smoking was attributed as one of the health risk factors that resulted in the deaths related to these illnesses or diseases. Other factors include unhealthy lifestyle such as unhealthy habits of eating, lack of exercise, and too much intake of alcohol.
"Nonetheless, it is also important to note that although these are not in the picture of the 10 leading disease in the region, dengue hemorrhagic fever and malaria cases are also prevalent and are major health problems in some areas in the region," the research stated.
The research was part of the "Health Research Priorities in Region 10" as a regional basis for the National Unified Health Research Agenda.
Beñas added that for two decades, heart disease was the top leading lifestyle-related diseases, but she clarified that it has to be validated whether the major cause of it was due to smoking, because of many factors to consider.
"Number three is cancer, number five is diabetes or chronic respiratory diseases... diabetes was included because once you have diabetes, you should no longer smoke. Why? Because smoking will increase the damage in the blood vessels," she said, adding that the four diseases she mentioned are part of the top 10 causes of death in Northern Mindanao.
Meanwhile, Dr. Ulysses Dorotheo, Philippines program director Philippines, Southeast Asia Tobacco Control Alliance, said smoking is the single biggest preventable cause of non-communicable diseases (NCD).
He said that in "the context of the word's (and our country's) growing NCD crisis," the four major NCDs are heart disease, chronic lung disease, cancer, and diabetes, the same diseases as mentioned by Beñas earlier.
"The other main causes of these major NCDs are alcohol abuse, unhealthy diet, and physical inactivity, but tobacco use is the only one that contributes to all four NCDs (the other three risk factors do not contribute to lung disease)," Dorotheo said.
He added that statistics on tobacco smoking in relation to cases of lung cancer, based on recent studies, showed that seven out of 10 cases were due to smoking, two out of 10 were due to other air pollutants, and one out of 10 was due to genetic risk.
"This is because a smoker's risk is as high as 1,400 percent or 14x the risk of developing lung cancer as compared to the risk of a non-smoker (this is known as 'relative risk'). For laryngeal cancer, the evidence shows that 9/10 of cases are due to smoking," he said.
"Note that there is a move to shift away from the term 'lifestyle-related disease' because 'lifestyle' connotes personal choice and putting the blame on the sick person, when in reality, these NCDs could be prevented by regulating harmful products (tobacco, alcohol, unhealthy food) and creating/promoting health-conducive environments," he added.
(This story was produced under the "Mga Nagbababang Kuwento: Reporting on Tobacco and Six Tax Media Training and Fellowship Program" by Probe Media Foundation with the support of the Campaign for Tobacco-Free Kids.)