Docs urge rais­ing smok­ing age to 21

Philippine Daily Inquirer - - FRONT PAGE - —STORY BY JOVIC YEE

The govern­ment should con­sider adopt­ing a rec­om­men­da­tion by a United Na­tions agency to raise to 21 years old the min­i­mum age for smok­ers, the Philip­pine So­ci­ety of Med­i­cal On­col­ogy said on Fri­day. Health au­thor­i­ties, alarmed by the rise in lung can­cer cases and the preva­lence of smok­ing among the youth, also called for the strict en­force­ment of the na­tion­wide ban on smok­ing in pub­lic places.

The govern­ment should con­sider adopt­ing a rec­om­men­da­tion by a United Na­tions body to raise to 21 years old the min­i­mum age for smok­ers, the Philip­pine So­ci­ety of Med­i­cal On­col­ogy (PSMO) said on Fri­day.

Ac­cord­ing to in­com­ing PSMO pres­i­dent Bue­naven­tura Ramos Jr., mov­ing the min­i­mum age for smok­ers will help re­duce the risk of smok­ing-re­lated health prob­lems, such as lung can­cer, which last year saw more than 17,000 new cases to be­come the se­cond lead­ing type of can­cer af­flict­ing Filipinos.

The United Na­tions In­ter­a­gency Task Force (UNIATF) on the Pre­ven­tion and Con­trol of Non­com­mu­ni­ca­ble Dis­eases (NCDS) ear­lier rec­om­mended that the Philip­pines in­crease to 21 years old the min­i­mum age for pur­chas­ing tobacco prod­ucts, which is cur­rently set at 18 years old.

“We ap­prove of [this rec­om­men­da­tion] be­cause there is a higher risk for one to have lung can­cer if he starts smok­ing at a younger age,” Ramos said at the launch of the Philip­pine ob­ser­vance of Lung Can­cer Aware­ness Month.

Young smok­ers

Ramos said that apart from rais­ing the min­i­mum age of smok­ing, there should be strict im­ple­men­ta­tion of the min­i­mum age pol­icy, as “stud­ies show that as early as Grade 5 chil­dren are al­ready in­tro­duced to smok­ing.”

The 2015 Global School­based Health Sur­vey con­ducted on the watch of the De­part­ment of Health showed that at least 12 per­cent of stu­dents age 13 to 15 are smok­ers. This is de­spite the reg­u­la­tion lim­it­ing the sale of cig­a­rettes to per­sons 18 years old and above.

The UNIATF also sug­gested a ban on the sale of sin­gle-stick cig­a­rettes, as “smok­ing preva­lence is still great­est among peo­ple with low in­come, who smoke cheap tobacco.”

Rise in lung can­cer

The UNIATF said that due to smok­ing—as well as binge drink­ing, lack of phys­i­cal ac­tiv­ity and un­healthy diet— Filipinos de­velop NCDS, such as can­cer, and car­dio­vas­cu­lar and res­pi­ra­tory dis­eases. It es­ti­mated that be­cause of NCDS the Philip­pines loses P756.5 bil­lion an­nu­ally in health care costs and re­duced pro­duc­tiv­ity.

Data from the World Health Or­ga­ni­za­tion’s In­ter­na­tional Agency for Re­search on Can­cer showed that in the Philip­pines, there were 17,255 new cases of lung can­cer re­ported last year. There were more suf­fer­ers of breast can­cer—24,798 new cases in 2018—but lung can­cer cases re­sulted in more deaths with 15,454.

The Cen­ters for Dis­ease Con­trol and Pre­ven­tion in the United States listed smok­ing as the top risk fac­tor for lung can­cer. It noted that com­pared to non­smok­ers, smok­ers are 15 to 30 times more likely to ac­quire and die from the dis­ease.

Anna Marie Pas­cual-pan­gani­ban, a med­i­cal on­col­o­gist at St. Luke’s Med­i­cal Cen­ter, said a smoker who is able to kick the habit within five years re­duces by half the like­li­hood of death from lung can­cer.

Pack year

In a decade, “the risk of him dy­ing from lung can­cer and heart at­tack is the same as that of a non­smoker’s.”

But be­cause lung can­cer doesn’t ex­hibit symp­toms in its ear­li­est stages, she said, it is im­por­tant for one to be tested as early as 50 years old or if one has at least 20 or more “pack years” of smok­ing. A pack year is com­puted by mul­ti­ply­ing the num­ber of packs one per­son con­sumes per day by the num­ber of years he or she had been smok­ing.

En­force smok­ing ban

Pan­gani­ban said there is no guar­an­tee for a non­smoker to be deemed safe from lung can­cer.

A fam­ily his­tory of lung can­cer and se­cond­hand smok­ing in­crease the like­li­hood of one suf­fer­ing from the dis­ease.

Jorge Ig­na­cio of the Philip­pine Gen­eral Hos­pi­tal said that for non­smok

ers, they can also re­duce the risk of ac­quir­ing res­pi­ra­tory dis­ease by mod­er­at­ing their in­take of grilled food (in­i­haw) and wear­ing masks in with high lev­els of air pol­lu­tion.

He added that the govern­ment should also strictly en­force the ban on smok­ing in pub­lic places to re­duce peo­ple’s ex­po­sure to se­cond­hand smoke.

Ig­na­cio said it took about a decade for the United States to see the ef­fects of an­ti­smok­ing ini­tia­tives in re­duc­ing lung can­cer cases.

Given the cur­rent pace and the way the cam­paign against smok­ing is im­ple­mented, he said, the Philip­pines would prob­a­bly need more than 10 years to see the re­sults of such ini­tia­tives.

“The prob­lem is smok­ers are find­ing ways ... We need to in­ten­sify our cam­paigns, our smok­ing ces­sa­tion pro­gram. It has to be more solid,” Ig­na­cio said.

—REM ZAMORA

IT STARTS WITH A STICK A young boy (right) gets an early start at smok­ing as other street chil­dren look on in this 2015 photo taken in Pasay City.

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