Tobacco control: The Philippines experience

With his tough anti-vice record in his constituency Davao, the Philippines President Rodrigo Duterte is now set to roll out a strict tobacco control law across the country.

Secretary for Health Paulyn Jean Rosell-Ubial told bdnews24.com on Friday at Liverpool, on the sidelines of the Union’s world conference on lung health, that they were expecting the President sign the regulation “within November”.

Once signed, it would be one of the toughest anti-tobacco laws in the Southeast Asia region which will ban smoking in all public places including open spaces such as parks and bus stands. The law will also ban setting up designated smoking zones inside the buildings.

Tobacco costs the Philippines’ economy more than $3.95 billion in health care and productivity losses. About 23 percent adults are daily tobacco smokers.

Anti-tobacco campaigners have already hailed the Philippines for going ahead with the law, despite resistance from the international tobacco industry lobby. The theme of the Liverpool conference is confronting resistance which includes confronting resistance from the tobacco industry lobby.

But with 7,100 islands and 42,000 villages across those islands, implementation of the law would be a challenge for the Philippines authorities.

“We have strong political commitment,” the Secretary of Health told bdnews24.com, in an interview.

“It’ll be the responsibility of the local government authorities to enforce that. And they must enforce it. If you don’t implement, you are listed among the non-complying areas,” she said, giving examples of how the Philippines would implement the law.

Her department has identified tobacco as the primary risk factor in the Philippines for a range of non-communicable diseases.

Bangladesh, where WHO estimated 400,000 people die of tobacco related diseases every year, passed a strong tobacco control law banning smoking in designated public places in 2013. But it took nearly two years to adopt the implementation rules. Even there is no sign of enforcement of the law as yet.

The Philippines’ Secretary of Health said there law does not mandate any specific ways or punishments for implementations.

“The order is just it is banned now. Then it will depend on the local government authorities how they will carry out the order. The punishment can also vary from one area to another,” she said.

For example, she said, in Davao, where the President was a mayor, a “designated taskforce” works to enforce the law.

“It’s not police or the health officials. There are completely different set of people solely responsible for the implementation of the law,” she said.

Davao has the biggest reduction in smoking rates to 25 percent in 2015 from 35 percent in 2008. The secretary for health said this was “faster than the national level”.

“In some cases, traffic control department can be empowered to implement the law since they work on the street,” she said.

She, however, said only law would not be enough for tobacco control.

“It depends on many issues mostly taxation and law. After we imposed syntax in 2013, we witnessed a drastic reduction of tobacco use. It came down to 23 percent in 2015 from 28 percent in 2013,” she said, pictorial health warning also played a role.

“Now we are thinking to start plain packaging. It may take time. But we’ll do that,” she vowed.

"Philippines’ is one of the first countries that adopted tobacco control law in 2003 even before the WHO’s framework convention on tobacco control, FCTC, came into force in 2005".