“AN ACT TO EFFECTIVELY INSTILL HEALTH CONSCIOUSNESS THROUGH PICTURE-BASED HEALTH WARNINGS ON TOBACCO PRODUCTS”
By SENATOR PIA S. CAYETANO
March 3, 2014
Mr. President, distinguished colleagues:
According to DOH, for every cigarette stick, a smoker loses at least 5 minutes of his/her life, not to mention the devastating ill-effects on the health of innocent people around him, whose only fault is that they did not forget to breathe.
It has been said that smoking kills, and it kills on a very large scale – nearly six million people each year, in fact. More than five million people die each year from direct tobacco use, while more than 600,000 die from exposure to second-hand smoke. With current smoking patterns, about 500 million people alive today will eventually die due to tobacco use.
Even more alarming is the fact that despite these clear dangers, 80,000 to 100,000 young people around the world become addicted to tobacco every day.
Currently, there are more than one billion smokers in the world, and more than 80% of them live in low and middle-income countries.
It is a fact that smoking comes hand in hand with a web of health problems and complications. According to the Philippine College of Physicians, among these diseases are chronic lung disease, cardiovascular disease, peptic ulcer, and cancers of several organs. For women, it can cause infertility, early menopausal, and pregnancy problems such as fetal abnormalities and even death of the fetus.
Death and diseases – these are the consequences that a smoker faces.
In the report of the Surgeon General 2010, cigarette smoke contains 7,000 chemicals, more than 70 of which are known carcinogens. The most notable ones are:
- Nicotine, a poisonous alkaloid used as an insecticide;
- Ammonia, a chemical which increases the impact of nicotine, thus inducing addiction
- Carbon monoxide, a toxic gas also found in car smoke which can disrupt the amount of oxygen transported in the body; and
- Lead, a poisonous chemical which can stunt growth and cause brain damage.
What’s worse is that these chemicals and hazardous substances pose health risks not only to smokers themselves, but even more to non-smokers who are exposed to it. This is more so because the detrimental effects of smoking extend to the environment, basically through air pollution. As per the Center for Disease Control, tobacco smoke produces six times the pollution of a busy highway when in a crowded restaurant.
Given these facts, it is without doubt that tobacco smoke is an active contributing factor to a hazardous environment as well as a threat to our public health.
Tobacco use in the Philippines
Mr. President, the alarming prevalence of smoking generates deadly results. In fact, five of the top ten death-causing diseases in our country can be attributed to tobacco smoking. The top preventable risk factor is smoking. In a National Nutrition and Health Survey, smoking is found to be the number one cause of stroke and heart attack, even more than diabetes, hypertension, obesity, and high cholesterol.
The adult prevalence of tobacco use in the Philippines is at a high 28.3% – the second highest in the ASEAN region, only next to Indonesia. Yes, Juan de la Cruz is indeed addicted to smoking. In fact, as presented during our hearing in the last Congress, 80% of Filipino households in the poorest quintile have at least one member who smokes. The lowest segment of the income bracket spends 1.1% of their total expenditure on tobacco. This is more than what they spend on education and medical care combined.
And what do Filipinos get in return for this deadly habit? First, the economic impact results to around 315 billion pesos in losses for the Philippines, specifically 44.6 billion pesos in health care cost, and 270 billion pesos in lost productivity. Worse, smoking kills 10 Filipinos every hour. This translates to 87,600 Filipinos losing their lives to tobacco every year.
The Tobacco Regulation Act of 2003
The 12th Congress passed Republic Act 9211, which provided for the requirement of textual health warnings on all tobacco products, prohibition of tobacco advertisements in all mass media, prohibition on outdoor and cinema tobacco advertisements, and ban on tobacco sponsorship in sports, concerts, and cultural and art events, with various time frames, all of which are already in place.
Senate Bill No. 27
Having said that, Mr. President, I now rise to sponsor Senate Bill No. 27, or An Act to Effectively Instill Health Consciousness Through Picture-Based Warnings on Tobacco Products. This bill requires all tobacco products to bear pictures illustrating the ill-effects of smoking.
While many tobacco users know that tobacco is harmful, studies show that most are unaware of its true risks. As the old adage goes, “a picture paints a thousand words.” Studies have shown that picture-based health warnings are more effective than text warnings alone. In fact, a study revealed that such health warnings are “60 times more effective in terms of encouraging cessation and prevention than text-only labels.”
According to the Canadian Cancer Society, as of May 2012, at least 56 countries already require picture warnings as of May 2012 and there are other countries that are still in the process of coming up with similar policies on graphic health warnings. The Gulf Cooperation Council Standardization Organization has likewise adopted a standard on picture warnings to be followed by its member countries such as Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, UAE and Yemen.
Sadly, Mr. President, cigarette packages manufactured in the Philippines and sold in our neighbouring countries such as Singapore and Thailand already include picture-based health warnings because it is required in these two countries. On the other hand, cigarette packages manufactured in Singapore and sold in the Philippines carry only textual health warnings because we do not require pictorial health warnings.
Mr. President, this bill requires all cigarette packages and other tobacco product packages found in the market, including cartons or master cases, to bear highly visible full-colour picture-based health warnings. This will have two components: a photographic picture warning, and an accompanying textual warning that explains in simple terms what the picture is all about.
This bill will also prohibit the use of descriptors, including terms, trademarks, or any sign or feature that creates or is likely to create the false impression that a product or brand is less harmful.
Mr. President, in our Committee Hearing held last January 22, it was encouraging to hear four tobacco companies, namely Philip Morris Fortune Tobacco Corporation, British American Tobacco Philippines, Japan Tobacco International, and Mighty Corporation, express their support for the measure.
Naysayers will say graphic warnings will not stop smoking. But this is negated by the studies I mentioned above.
With the imposition of graphic health warnings at the front packs of tobacco products, this bill thus seeks to deter new smokers from starting the vice and being addicted to it, as well as encourage existing smokers to drop the habit. Thus, this is one of those measures that will definitely contribute to bringing down the number of smokers, especially among the youth.
Mr. President, my dear colleagues, this is the third Congress that I rise to sponsor this measure. I look forward to its end this 16th Congress because with your support for Senate Bill No. 27, we will finally be able to approve the passage of this landmark measure. Together, we can work towards a cleaner and healthier Philippines.
Thank you, Mr. President. Thank you dear colleagues.
Health Justice PowerPoint Presentation (22 January 2014).
 World Bank (1999). “Curbing the epidemic: Governments and the Economics of Tobacco Control”
 Campaign for Tobacco Free Kids, The Global Tobacco Epidemic (April 2013) as cited in the Health Justice PowerPoint presentation “Picture-Based Health Warnings” (22 Janaury 2014).
 Dr. Encarnita B. Limpin’s PowerPoint presentation “Discussions on Sin Tax: Health and Revenues”
 US Department of Health and Human Services: A Report of the Surgeon General, 2010 as cited in Dr. Encarnita B. Limpin’s PowerPoint Presentation
 US Department of Health and Human Services: A Report of the Surgeon General, 2010.
 World Bank (1999). “Curbing the epidemic”
 Center for Disease Control (CDC). (2003). It’s Time to Stop Being a Passive Victim.
 Leading causes of mortality: 1. diseases of the heart; 2. malignant neoplasms; 3. pneumonia; 4. cerebrovascular diseases (is a group of brain dysfunctions related to disease of blood vessels supplying the brain); 5. tuberculosis; 6. chronic lower respiratory diseases; 7. diabetes melletius; 8. certain conditions originating in the perinatal period; 9. assault; 10. nephritis syndrome nephrosis (Nephrotic syndrome is a nonspecific disorder in which the kidneys are damaged, to leak large amounts of protein (at least 3.5 grams per day per 1.73m2 body surface area) from the blood into the urine). (source: Philippines in Figures, NSO)
 National Nutrition and Health Survey, 2008; DOH and DOF PowerPoint Presentation (2012)
 SEATCA, The ASEAN Tobacco Control Atlas (August 2013) as cited in the Health Justice PowerPoint Presentation “Picture-Based Health Warnings” (22 January 2014).
 Family Income and Expenditure Survey, 2003 as cited in the PowerPoint Presentation of Dr. Jessica de Leon of the Department of Health
 Family Income and Expenditure Survey (2009).
 Quimbo, S., et al. (2012). “The Economics of Tobacco and Tobacco Taxation in the Philippines” as cited in the Health Justice PowerPoint Presentation “Picture-Based Health Warnings” (22 January 2014).
 Health Justice PowerPoint Presentation “Picture-Based Health Warnings” (22 January 2014).
 Applied Economics. Cost-benefit analysis of proposed new health warnings on tobacco products. Report prepared for Commonwealth Department of Health and Ageing. [online] 2004. Available from: http://www.treasury.gov.au/documents/794/DOC/Cost_Benefit_Analysis.doc.