I have always believed that protecting our children cannot be the responsibility of parents and schools alone. Sometimes, protection must also come in the form of policies that draw a clear line between what we tolerate and what we refuse to normalize. In this regard, the City Government of San Fernando, Pampanga deserves recognition for Ordinance No. 2014-007, which restricts smoking and vaping in public places and limits the sale and advertising of tobacco and e-cigarette products around schools and other areas frequented by minors. Having a healthy and safe environment not only for us but for the future generation must be a commitment that the whole community must support and take to heart.
For years, smokers have heard the same reminders about what cigarettes can do to their health. Perhaps this constant repetition has made some of these warnings easier to ignore. But the consequences have not gone away. The World Health Organization (WHO) reports that tobacco still kills more than seven million people every year, including more than 1.6 million nonsmokers who die from exposure to secondhand smoke. Around 1.2 billion people worldwide continue to use tobacco, and about 80 percent of them live in low- and middle-income countries. These numbers remind us why smoking cannot be viewed solely as a matter of personal choice. When its consequences reach the people around us, health truly becomes a public good that all of us have a stake in protecting.
Here in the Philippines, the challenge remains very real. The 2021 Global Adult Tobacco Survey reported that 18.5 percent of Filipino adults, representing about 14.4 million people, currently smoked tobacco. The prevalence was considerably higher among men at 33.3 percent, compared with 3.2 percent among women. Conducted by the Philippine Statistics Authority and Department of Health, with technical support from the WHO and other partners, the survey also looked at Filipinos' exposure to secondhand smoke, smoking cessation, and tobacco advertising and promotion. Behind these percentages are families and communities where the effects of tobacco use are not confined to the person holding the cigarette.
And this, perhaps, is what we sometimes forget. A person may choose to smoke, but the people around that person do not choose to breathe the smoke. Secondhand smoke consists of smoke from burning tobacco products and smoke breathed out by people who smoke. There is no safe level of exposure to it. Even brief exposure can cause harm, while prolonged exposure is associated with serious diseases, including heart disease, stroke and lung cancer. Children are particularly vulnerable because their bodies are still developing.
This makes smoke-free public spaces much more than an inconvenience imposed upon smokers. They are a form of protection for everyone else. A child riding a jeepney should not have to breathe cigarette smoke on the way to school. A family spending an afternoon at a public park should not have to move elsewhere because somebody is smoking beside them. A government employee, a commuter, a restaurant worker or a pregnant woman should not have to accept secondhand smoke simply because they happen to share a public space with someone who smokes. Our freedom to make personal choices must always be balanced with our responsibility not to endanger the health of others. This is precisely why local policies that create smoke- and vape-free spaces deserve not only our compliance but our support.
But there is another side to this conversation that deserves compassion. Nicotine is highly addictive, and telling smokers to "just stop" greatly underestimates how difficult quitting can be. Many smokers already know the risks. Many may even sincerely want to quit. The encouraging finding from the Philippine survey is that 63.7 percent of current smokers were planning or thinking about quitting, while more than half of smokers who had visited a health-care provider during the previous 12 months had been advised to quit. Perhaps this is where our reminders should change from simply saying, Smoking is bad for you, to asking, How can we help you stop?
Quitting should therefore be approached with support rather than judgment. Evidence-based assistance can include behavioral support and appropriate medicines or nicotine-replacement therapies that help manage nicotine withdrawal and cravings. The WHO likewise places offering help to quit tobacco use among the key measures governments should undertake to reduce tobacco consumption. Determination certainly matters, but smokers should not have to depend on willpower alone. Families can encourage them, health professionals can guide them, workplaces can support them, and communities can create environments that make quitting easier rather than smoking more convenient.
And while we help those who have already developed the habit, we have an even greater responsibility to prevent the next generation from starting. Nicotine is particularly harmful to children and adolescents because their brains are still developing, and early nicotine exposure can affect attention and learning while increasing the likelihood of long-term dependence. This gives added meaning to efforts to keep cigarettes, e-cigarettes and their advertising away from schools and other places frequented by young people. The best way to help a child quit smoking or vaping is to help ensure that he or she never starts in the first place.
In the end, protecting public health cannot rest on an ordinance alone. Government can establish smoke-free spaces, schools can educate, health workers can help people quit, parents can model healthy behavior, and businesses can comply with restrictions. But laws become truly meaningful only when citizens understand why they exist and willingly do their part. If health is indeed a public good, then protecting it is not just government's business. It is everyone's business.
