Questions on Smoking, Tobacco Use and Health

Tobacco use accounts for the deaths of an average of one person every six seconds.

Smoking is the largest cause of preventable death in the world. Don’t let yourself or your family
become the next victim.

Is there a safe way to smoke cigarettes?

No. All cigarettes can damage the human body. Any smoking is dangerous. The cigarette is the only legal
product whose advertised and intended use — smoking — is known to harm the body and cause cancer.

Some people think that switching from high–tar and high–nicotine cigarettes to those with low tar and
nicotine makes smoking safer, but this is not true. When people switch to brands with lower tar and
nicotine, they often end up smoking more cigarettes, or more of each cigarette, to get the same nicotine
dose as before.

Smokers have been led to believe that “light” cigarettes have lower health risk and are a good option to
quitting. A low–tar cigarette can be just as harmful as a high–tar cigarette because a person often takes
deeper puffs, puffs more often, or smokes them to a shorter butt length.

Are menthol cigarettes safer than those without menthol?

Menthol only adds to the flavor of the cigarettes. It does not make the cigarettes any less dangerous. In
fact, menthol cigarettes may even be more dangerous. The added menthol produces a cooling sensation in
the throat when the smoke is inhaled. It also decreases the cough reflex and covers the dry feeling in the
throat that smokers often have. People who smoke menthol cigarettes can inhale deeper and hold the
smoke in longer.

Is cigarette smoking really addictive?

Yes. The nicotine in cigarette smoke causes an addiction to smoking. Nicotine is an addictive drug just like
heroin and cocaine.

What are the normal reactions after you quit?

Difficulty in concentration or dizziness because your brain needs to get used to having more oxygen.
Cough and runny nose as your lungs get rid of all the dirt and germs that had accumulated inside while you
were smoking. Strong craving for cigarettes while your body gets rid of the nicotine. Tingling sensations in
your arms and legs as your blood circulation returns to normal

Not everyone will get these withdrawal symptoms but don't lose heart if you do. They will disappear in one
or two weeks and they are actually signs that you are getting better.

Am I at risk if I puff the cigarette without inhaling the smoke?

Yes. Many chemicals in the cigarette smoke (including nicotine) can be absorbed through the mouth, nose
and skin. The smoke that you blow out stays in the surrounding air. When you take your next breath, it
goes straight into your lungs, without you realizing it.

What does nicotine do?

In large doses, nicotine is a poison and can kill by stopping a person’s breathing muscles. Smokers usually
become dependent on nicotine and suffer physical and emotional (psychological) withdrawal symptoms
when they stop smoking. These symptoms include irritability, nervousness, headaches and trouble
sleeping. The true marker for addiction, though, is that people still smoke even though they know smoking
is bad for them — affecting their lives, their health and their families and friends in unhealthy ways.
Who is most likely to become addicted?

Anyone who starts smoking is at risk of becoming addicted to nicotine. Studies show that cigarette smoking
is most likely to become a habit during the teenage years. The younger a person is when he or she begins
to smoke, the more likely he or she is to become addicted to nicotine.

Why do smokers have “smoker’s cough”?

Cigarette smoke contains chemicals that irritate the air passages and lungs. When a smoker inhales these
substances, the body tries to protect itself by making mucus and coughing. The early morning smoker’s
cough happens for many reasons. Normally, tiny hair–like formations (called cilia) beat outward and sweep
harmful material out of the lungs. Cigarette smoke slows the sweeping action, so some of the poisons in
the smoke stay in the lungs, and mucus stays in the airways. While a smoker sleeps, some cilia recover
and begin working again. After waking up, the smoker coughs because the lungs are trying to clear away
the irritants and mucus built up the day before. The cilia will completely stop working after they have been
exposed to smoke for a long time. When this happens, the smoker’s lungs are even more exposed and
prone to infection and irritation.

The same noxious chemicals that cause the simple smoker’s cough can lead to far more serious conditions
such as bronchitis, emphysema, pneumonia and lung cancer.

Why do I cough more after I've quit smoking?

Your lungs start to function properly again and are working to clear tar, dead cells and extra mucus
accumulated from the cigarettes.

One husband was only 30 years old when he suffered from a stroke. The doctor said that smoking
is the main cause of his stroke. How can smoking actually cause stroke?

Smoking causes a build–up of fatty deposits in the blood vessels, resulting in narrowing and blockage of
the vessels. If the blood supply in these vessels leading to the brain is blocked, the surrounding brain cells
will die, resulting in a stroke.

I've heard that smoking causes a fatty build–up in the blood vessels. But how is this so when fat is
not an ingredient in cigarette smoke?

The moment you light a cigarette, thousands of poisonous chemicals in the cigarette smoke enter your
body and are absorbed into the bloodstream. Some of these chemicals make your blood vessel walls
sticky, damaging them, and causing them to collect the tiny fatty deposits that float in the bloodstream. The
more you smoke, the more the fatty deposits build up.

How does smoking cause a heart attack? Is it similar to how smoking causes stroke?

Yes. Similar adverse effects take place when the blood vessels leading to our heart are blocked by fatty
deposits. This cuts off the blood supply to our heart muscles, killing the tissue. As a result, a heart attack
occurs.

How many cigarettes do I need to smoke to get lung cancer?

Lung cancer can begin from cell damage caused by smoking just ONE cigarette.

Research has found that one of the cancer-causing substances in cigarette smoke (benzopyrene) directly
attacks and damages the p53 gene which blocks cancer and prevents cancer cells from growing. When
cancer threatens a lung cell with a damaged p53 gene, a deadly tumour starts to grow.
Can quitting really help a lifelong smoker?

Yes. It is never too late to quit smoking. The sooner you quit, the more you can reduce your chances of
getting cancer and other diseases. Within minutes of smoking the last cigarette, your body begins to restore
itself.

Suppose I smoke for a while and then quit?

Smoking begins to cause damage right away and is highly addictive. Some studies have found nicotine to
be as addictive as heroin or cocaine.

Do filters reduce the dangers of cigarette smoking?

Cigarette filters may trap part of the tar and nicotine, but they do not remove any poisons from the cigarette
smoke.

What are the control measures of tobacco?

Effective Tobacco Control Measures
M: Monitor tobacco use and prevention policies.
P: Protect people from tobacco smoke.
O: Offer help to quit smoking.
W: Warn about the dangers of tobacco.
E: Enforce bans on tobacco advertising, promotion and sponsorship.
R: Raise taxes on tobacco.

What are the problems with tobacco?

Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary
disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for
tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.

Is tobacco banned in the Philippines?

Executive Order No. 26, entitled Providing for the Establishment of Smoke-Free Environments in Public
and Enclosed Places, was issued by Philippine President Rodrigo Duterte on May 16, 2017. This executive
order invoked the Clean Air Act of 1999 and the Tobacco Regulation Act of 2003 to impose a nationwide
ban on smoking in all public places in the Philippines. The ban replicates on a national level an existing
ordinance in Davao City that Duterte created as mayor in 2002. The order took effect on July 23, 2017, 60
days after its publication in a newspaper. The law prohibits smoking in public places except in
designated smoking/vaping areas (DSVAs).

7 Shocking Facts About the Risks of Smoking

 Tobacco is a killer.
 It increases your chance of dying.
 Smoking 1 cigarette can take 11 minutes off your life.
 Smoking is not only a killer, but a serious cause of illness.
 Smoking affects fertility.
 It gives you bad breath.
 Over 80% of people in the UK don't smoke.
STATE OF SMOKING IN THE PHILIPPINES

SMOKING RATE: 24.7% (2019)

TOBACCO USE RATE: 23.8 % (2015)

TOBACCO USE AND TRENDS

 In 2019, 24.7% of adults aged 15 and above in Philippines smoked cigarettes.
 There are 19.9 million smokers in the Philippines, 16% (approximately 3 million) of whom were
female.
 Smoking rates in the Philippines are higher among men (40.9%) versus women (8.2%).
 Youth (13-15 years old) prevalence rates for cigarettes have increased slightly from 8.9% in 2011 to
10.8% in 2019. Prevalence rates were higher for boys versus girls.
 In 2019, 14.1% of youth used electronic cigarettes. This was higher than the prevalence rate for
cigarette use among youth.

HEALTH AND ECONOMIC BURDEN FROM TOBACCO USE:

 The health burden from tobacco use increased by 13.8% between 2009 and 2019 (3.1 million
Disability-adjusted life years (DALYs) to 3.5 million DALYs), making tobacco the leading risk factor
in Philippines. During that period, tobacco-attributable deaths increased by 16.6% from 96,186 to
112,112 in 2019.
 In 2016, economic cost of smoking-attributable diseases was estimated as 44.6 billion PHP ($ 858
million USD) for Philippines.

REGULATORY ENVIRONMENT:
 Philippines became a party to the WHO Framework Convention for Tobacco Control (WHO FCTC)
in 2005.
 Since then, demand reduction measures embodied by the MPOWER framework for cessation
programs, health warnings, and monitoring for combustible tobacco products were evaluated as
‘complete’ for Philippines by the WHO in 2021. Mass media and advertising bans were evaluated as
‘moderate’ and measures for smoke-free environments were evaluated as ‘minimal.’
 The sale and use of e-cigarettes and heated tobacco products are legal and regulated in the
Philippines.
 In 2020, Philippines levied differential excise taxes on nicotine products, where a higher rate of P55
was taxed on a pack of 20 cigarettes, P30 for a pack of 20 sticks of Heated Tobacco Products
(HTPs), P47/ml for Electronic Nicotine Delivery Systems (ENDS) with nicotine salt, and P55/10ml
for classic nicotine vapor products as of 2022, with a further increase scheduled for 2023.

TOBACCO PRODUCTION AND DIVERSIFICATION

 In 2020, Philippines produced 52,400 tons of tobacco, representing a nearly 36% reduction in
tobacco production since 1990. The area harvested for tobacco also shrank from 632,000 ha in
1990 to 261,000 ha in 2009. However, by 2020, the area harvested for tobacco increased to
289,000 ha.
 In 2013, 15% of incremental excise tax revenues from tobacco and alcohol taxes are earmarked for
economic development projects in tobacco-growing provinces, mainly to provide tobacco farmers
with alternative means of livelihood.
 Revenues earmarked for tobacco-growing communities amounted to P15.81 billion in 2018. The
majority of these funds went to local governments from Northern Luzon. Seventy percent (70%) of
tobacco in this country is produced in the Ilocos Region: Ilocos Norte, Ilocos Sur, La Union and
Pangasinan.