No Smoke Zone

Asian Geographic - - On Assignment -

they started smok­ing, it was dif­fi­cult to stop. From the first puff of cig­a­rette smoke, Joey, 58, and Clark (who asked to be quoted un­der a pseu­do­nym), 29, con­tin­ued smok­ing, un­til their health de­te­ri­o­rated.

A heavy smoker for nearly four decades, Joey nearly lost his life to cig­a­rettes. In 2014, he felt his legs prickle, go numb, and turn pur­ple in a mat­ter of hours. In the emer­gency room, Joey was in­formed that both his legs had to be am­pu­tated. He had pe­riph­eral vas­cu­lar dis­ease – or Buerger’s dis­ease – which causes the blood ves­sels to clot. The con­di­tion is strongly as­so­ci­ated with tobacco use.

“At that point I al­ready ac­cepted what was go­ing on, but I was hop­ing that one leg would be saved,” ex­plains Joey. “I was sur­prised when I woke up at the ICU after hours and saw the other leg was in­tact. I cried be­cause I was over­joyed.” Joey quit smok­ing after his am­pu­ta­tion. He has been smoke-free for three years.

Clark has been an on-and-off smoker for eight years. He stopped smok­ing when he be­gan ex­pe­ri­enc­ing dif­fi­culty in breath­ing. A year later, he still had short­ness of breath. He was di­ag­nosed with HIV.

“Ap­par­ently, my breath­ing prob­lem was a symp­tom of my HIV,” he shares. “I said to my­self, as I thought the cig­a­rette was not the rea­son, that maybe I’ll just go back to smok­ing.” Clark started smok­ing again, but re­cently quit again. At the time of the in­ter­view for this ar­ti­cle, he was smoke-free for three weeks and count­ing.

Tobacco use has se­ri­ous health con­se­quences – even more so for peo­ple liv­ing with HIV. It in­creases the risk of can­cer, heart dis­ease, tu­ber­cu­lo­sis, and stroke, and can lead to dis­abil­ity or death.

Ac­cord­ing to the 2015 Global Adult Tobacco Sur­vey, there are an es­ti­mated 15.9 mil­lion smok­ers in the Philip­pines – a rel­a­tive re­duc­tion of 20 per­cent in five years. The Philip­pine Depart­ment of Health, Depart­ment of Fi­nance, and World Health Or­ga­ni­za­tion (WHO) es­ti­mate that over one mil­lion Filipinos have quit smok­ing, at­tribut­ing this de­cline to a num­ber of tobacco con­trol in­ter­ven­tions in place.

The Philip­pines is do­ing well in re­duc­ing its tobacco us­age rates compared to other coun­tries in the western Pa­cific re­gion. The Philip­pine govern­ment, sup­ported by the WHO, has im­ple­mented a num­ber of tobacco con­trol mea­sures – in­clud­ing a re­cent ex­ec­u­tive or­der signed by Pres­i­dent Ro­drigo Duterte in May 2017 that es­tab­lished smoke-free en­vi­ron­ments in pub­lic places; a tobacco quit line has also re­cently been launched by the Health Depart­ment and the Lung Cen­ter of the Philip­pines to of­fer sup­port to peo­ple look­ing to quit. The coun­try has also worked to­wards im­ple­ment­ing laws re­lat­ing to graphic health warn­ings and tax­a­tion on tobacco prod­ucts.

After his am­pu­ta­tion – be­fore he quit smok­ing – the tax­a­tion on tobacco helped Joey re­duce the num­ber of cig­a­rettes he smokes per day. He sees the Sin Tax Law – which was im­ple­mented in 2008 – as a good thing. “It be­came more ex­pen­sive, so I also less­ened the num­ber of pack­ets I bought. From three packs a day, I was buy­ing one and a half,” he says.

Clark is still strug­gling to quit smok­ing once and for all; he has con­stant crav­ings. “I don’t like see­ing the im­age with the tube in the throat… That makes me re­ally afraid,” he says. “I’ve been feel­ing some­thing in my throat which I haven’t had time to have checked. But I in­tend to one of these days.” Clark is open to try­ing out other means of stay­ing cigratte-free, in­clud­ing tex­ting the mo­bile ces­sa­tion hot­line op­er­ated by the Lung Cen­ter of the Philip­pines. “I shouldn’t have started smok­ing. If I did not start puff­ing, my life would have been eas­ier,” says Clark.

Joey, on the other hand, has no re­grets about where smok­ing has led him. Today, he speaks out as an anti-tobacco ad­vo­cate.

“Anti-tobacco ad­vo­cacy is very im­por­tant be­cause as long as [peo­ple] can avoid smok­ing, they should do so,” he shares. “Since it isn’t too late for oth­ers, I want to im­part my ex­pe­ri­ence and hope to per­suade oth­ers to avoid smok­ing.” ag

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