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Which public health policy in ASEAN is most susceptible to tobacco industry influence?

SEATCA Senior Policy Adviser Dr. Mary Assunta discusses the Tobacco Industry Interference Index at a press launch Monday in Pasig City. Beside her are (L-R) Emer Rojas, Global Cancer Ambassador and President of New Vois Association of the Philippines and Carmen Audera Lopez, team leader of the tobacco-free initiative of the WHO Western Pacific Region. Photo by: Lester Lopez/
The online news portal of TV5

MANILA, Philippines - A day before the celebration of World Cancer Day, a Southeast Asian network of tobacco control advocates launched an index that measures how much the tobacco industry interferes in health laws that govern seven countries.

The Tobacco Industry Interference Index prepared by the Southeast Asia Tobacco Control Alliance (SEATCA) says that the Philippines has the highest level of tobacco industry participation in policy development, followed by Indonesia; Cambodia and Malaysia; Thailand; and Laos and Brunei.

The index assessed the implementation of Article 5.3 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), which 177 countries have signed.

According to this provision, these countries must protect public health policies on tobacco control from the interests of the tobacco industry.

In general, the tobacco industry interferes in tobacco control through six ways, according to WHO:

*It tries to influence political and legislative decisions by, among others, lobbying, looking for legal loopholes, and drafting tobacco control measures. For example, SEATCA found that except for Brunei and Thailand, the other five countries accommodate requests from the tobacco industry for a longer implementation time or a postponement of tobacco control law. The organization also found that all governments except Brunei receive some form of contribution, whether monetary or otherwise, from the tobacco industry.

*It exaggerates the economic benefits of the tobacco industry.

*It manipulates public opinion by making itself appear respectable, through Corporate Social Responsibility (CSR) activities such as building schools and health centers, and providing relief goods and scholarships. Philip Morris International, for example, has increased its CSR spending in six ASEAN countries from $8.2 million in 2009 to $10.2 million in 2012. In the same year, it more than doubled its CSR spending in the Philippines.

*It fabricates support through front groups such as farmers’ groups, smokers’ rights groups, and business groups.

*It discredits proven science and comes up with false data.

*It intimidates governments with litigation or the threat of litigation.

“If it wasn’t for tobacco industry interference, we would have already been finished with the tobacco epidemic and saved many, many, many millions of lives,” said Dr. Carmen Audera-Lopez, team leader of the tobacco-free initiative of the WHO Western Pacific Region, at Monday’s press launch of the index at Café 1771 in Pasig City.

Only product that kills half of customers

According to Dr. Mary Assunta, SEATCA senior policy advisor, tobacco is the only product that kills half of its customers prematurely.

Ten people die every hour because of smoking-related diseases, added Emer Rojas, laryngeal cancer survivor and “victim of tobacco”. He cited scientific research which says no less than 12 different types of cancer may be attributed to smoking, with lung cancer being the second most common cancer in the Philippines, second only to breast cancer.

Rojas, the president of New Vois Association of the Philippines, Inc., underwent a laryngectomy due to tobacco use, and is only able to speak through the aid of a device he holds to his throat.

He lamented that many factors cause the high prevalence of smoking in the country, with almost one-third of the population addicted to the vice.

Cigarette prices remain lower than those in other countries. The tingi (retail) system of selling per stick and the laxity of retailers in selling to minors also contribute to this, said Rojas. The absence of graphic health warnings on cigarette packs is also problematic.

Make no mistake about it, Audera-Lopez said: the tobacco industry will continue to work hard to get more smokers, targeting the developing countries and its young children and teens.

Fortunately, the FCTC makes four recommendations so countries can “defend” themselves against this.

Raise awareness about the addictive and harmful nature of tobacco products, and about tobacco industry interference with the countries’ tobacco control policies.

Establish measures to limit interactions with the tobacco industry and ensure the transparency of those interactions that occur.

Reject partnerships and non-binding or non-enforceable agreements with the tobacco industry.

Avoid conflicts of interest for government officials and employees.

PH curbs govt interaction with tobacco sector

While the Philippines has a high level of tobacco industry interference, it is nevertheless a pioneer in its efforts to curb government interaction with the tobacco industry. In 2010, the Civil Service Commission (CSC) and the Department of Health (DOH) issued the Joint Memorandum Circular 2010-01 to prevent the interaction of the government and the tobacco industry, or when the interaction is necessary, to guide the way it is done. It is the first circular of its kind in Asia.

According to CSC Assistant Commissioner Ariel Ronquillo, the circular, which has the same force and effect as a law, states that public officials and employees may only interact with the tobacco industry for latter’s effective regulation, supervision, or control.

The government cannot accept any “gift, gratuity, favor, entertainment, or loan” from the tobacco industry, either, said Ronquillo. Public officials and employees must also avoid any conflict of interest with the tobacco industry at all times, or else they must resign from their post.

The circular also has strict guidelines for the meetings between government officials and the tobacco industry, and never will a “partnership, dialogue, or collaboration” be allowed between the two.

While the implementation of Republic Act 9211 or the Tobacco Regulation Act allows the tobacco industry a seat in the Inter-Agency Committee on Tobacco, Ronquillo said they have already sent letters to the people involved to say that this is contrary to the circular and must stop.

The tobacco industry, he said, had no business in interfering in any business of the government.

Long, uphill fight

The fight against tobacco industry interference has a long way to go, however. According to Ronquillo, they have yet to record a single complaint. He appealed to Filipinos to report any violations of the circular to the CSC, as well as to report government officials and employees who smoke in their offices, which is not allowed.

As President Benigno Aquino III, arguably the country’s most famous smoker, has yet to kick the habit, this somehow tells Filipinos that smoking is okay. Public opinion can sway him into stopping, said Ronquillo.

The right to health is everybody’s responsibility, he added.

Assunta recommended that governments be stricter in implementing the FCTC, especially as the bulk of smokers are poor. Cigarettes must not be available to or affordable for the most vulnerable in society, she said.

The tobacco industry must also be required to disclose information on production, manufacture, market share, revenues, and expenditures on marketing, lobbying, philanthropy, and political contributions.

She added that CSR activities by the tobacco industry must be banned, as it is also a form of promotion.

“Countries really need to ban so-called CSR activities by the tobacco industry which are really fake CSR activities, because you can’t have an industry killing off its customers and then saying it is doing public good,” she said.

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