“A cigarette is the only consumer product which, when used as desired, kills its consumer.” –– Dr. Gro Harlem Brundtland, former WHO director-general.
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Just a few days before the Philippines joined the international community in observing World No Tobacco Day last May 31, President Rodrigo R. Duterte signed the Executive Order (EO) 26 making true to his campaign promise of imposing a smoking ban throughout the country.
Through this presidential order, all public places in the country will now be 100% smoke-free. “There will be nobody smoking in public places anymore, whether indoor or outdoor. Parks, bus stations, and even in vehicles. All these are considered public places,” explained Health Secretary Pauline Jean Ubial.
According to Dr. Ubial, the EO replicates the existing ordinance in Davao City that was implemented since the time of Duterte as city mayor. “What is being done in Davao is set to be done nationwide,” she pointed out.
Smoking is strictly prohibited in Davao City. You won’t see people puffing cigarettes while striding along the sidewalks. You won’t see children selling cigarettes in heavily traffic streets. Even inside the public utilities, cinemas, malls, restaurants, and bars.
People are also strictly prohibited to smoke in public gatherings like concerts, rallies, and parades. The cemetery, markets, terminals and public places are not excluded.
Damn, smokers may say. But wait, there are few places in Davao City where you can smoke to your heart’s content. These are in your own residence or in someone’s, in private vehicles, and designated outdoor smoking areas. “If you want to smoke, find a place where it is allowed,” Duterte said.
Designated smoking areas
The EO recently signed by Duterte has enumerated the requirements needed for designated smoking areas (DSA) as well as areas that could not be used as such. The standards are as follows:
1. DSAs should have no opening that will allow air to escape from the DSA to smoke-free area of the building or conveyance, except for a single door equipped with an automatic door closer, provided that, if the DSA is not located in an open space, such door shall open directly towards a non-smoking buffer zone.
2. DSAs should be located in or within 10 meters from entrances, exits, or any place where people pass or congregate, or in from of air intake ducts.
3. The combined area of the DSA and the buffer zone should not be larger than 20% of the total floor area of the building or conveyance, provided that in no case shall such area be less than 10 square meters.
4. The ventilation system for the DSA other than in an open space and for the buffer zone shall be independent of all ventilation systems servicing the rest of the building or conveyance.
5. The DSA shall have the following signs which are highly visible and prominently displayed: (a) “Smoking Area,” (b) Graphic health warning on the effects of tobacco use; and (c) prohibition on the entry of persons below 18 years old.
6. Other standards and specification to better ensure a smoke-free environment as may be prescribed by the Inter-Agency Committee Tobacco under Republic Act 9211 that such standards and specifications are consistent with the order and that persons-in-charge are given 60 days to comply.
Aside from banning minors inside the DSA, they are not also allowed inside the buffer zone. More importantly, no building or conveyance shall have more than one DSA.
Among the areas that cannot be used as DSAs are: centers of youth activity such as schools, youth hostels and recreational facilities for minors; elevators and stairwells; fire-hazard locations such as gas stations and storage areas for flammable liquids, gas, explosives or combustible materials; buildings and premises of hospitals, medical, dental and optical clinics, health centers, nursing homes, dispensaries and laboratories; and food preparation areas.
Duterte reportedly signed the no-smoking policy in the country because he believes smoking does not only brings diseases to smokers but also to those who inhale the deadly smokes which cigarettes and tobaccos emit.
Tobacco, when being smoked, is considered as one of man’s greatest killers. “Each year, smoking-related illnesses cause the most number of deaths in the Philippines,” said Dr. Willie T. Ong, an internist/cardiologist, book author, and newspaper columnist. “What is worse is that smokers actually hurt the non-smokers around them by letting them inhale its toxic fumes.”
Every year, 87,600 Filipinos die of smoking-related ailments that include lung cancer and chronic lung diseases. “(Smoking) is essentially a man-induced disaster that is causing more deaths than all the fatalities due to natural calamities, vehicular accidents, rebellion and all other disasters, either natural or man-caused,” reiterates Dr. Rafael R. Castillo, one of the country’s top cardiologists.
A study done by the Food and Nutrition Research Institute shows that 47% of Filipino males and 16% of females are smokers, one of the highest worldwide. Moreover, 33% of Filipino minors are already smoking by age fourteen.
This is the reason why the presidential order prohibits selling, distribution and purchasing of tobacco products to minors. The advertisement of tobacco products within 100 meters from the perimeters where most minors congregate is banned.
Deadly diseases
History records showed that tobacco was introduced in the Philippines in the late 16th century during the era of Spanish colonization when the Augustinians brought cigar tobacco seeds to the colony for cultivation. In 1686, William Dampier visited Mindanao and observed that smoking was a widespread custom.
Cigarettes, one of the most popular forms of tobacco, are poison, anti-smoking groups declared. Their main component, as one health advocate eloquently puts it, are “tobacco which kills and nicotine which is addictive.” Dr. Halfdan Mahler, former director-general of the World Health Organization (WHO), likened tobacco use to “slow-motion suicide.”
“Smokers are people who hard to convince,” Dr. Ong said, but adding that that there are over 70,000 scientific articles to prove that smoking damages a person’s heart, lungs, esophagus, stomach, bowels, prostate, and predisposes a person to all kinds of cancers. “It’s been proven beyond any doubt,” he said.
Unknowingly, cancer, particularly lung cancer, is just one of the many diseases smokers are likely to get. Here are more:
Emphysema. Emphysema is one of a group of lung diseases referred to as chronic obstructive pulmonary disease (COPD) that can interfere with normal breathing. Other diseases that come under COPD include asthma and chronic bronchitis.
Emphysema is a widespread disease of the lungs and people having this illness are particularly vulnerable to pneumonia, bronchitis, and other lung infections.
Smokers are also likely to suffer from cardiovascular problems such as heart failure. “Slow drowning” is how some doctors describe those who die from emphysema.
Heart attack. A person’s chance of getting a heart attack increases by threefold if he smokes. Medical science says smoking promotes the hardening of the arteries and reduces the oxygen-carrying capacity of the blood.
“Cells in the heart muscle that do not receive enough oxygen-carrying blood begin to die,” says Dr. Rafael D. Castillo, a cardiologist who works at the Manila Doctor’s Hospital. “The more time that passes without treatment to restore blood flow, the greater the damage to the heart.”
Rheumatoid arthritis. Arthritis may be the oldest known ailment on earth. Mummies uncovered in Egypt had it, prehistoric man had it, dinosaurs had it. There are several forms of arthritis and the most common is rheumatoid arthritis.
Rheumatoid arthritis occurs when the body’s immune systems attacks the joints leaving sufferers in severe pain and with reduced mobility. Initial analysis of data from a research done by the Stanford University showed that smoking is a risk factor for developing rheumatoid arthritis among men.
Impotence. Until the early 1970s, experts thought that most erection problems pointed to underlying problems in the psyche. Today, the medical community recognizes that almost half of all impotent men have a physical or structural problem that’s at least partly responsible.
Take smoking, for instance. Smoking has also been observed to cause slower penile erection among men because excessive nicotine in the bloodstream “causes constriction of the penile artery, the blood vessel necessary in male erection,” to quote the words of Dr. Priscilla Tablan, a chest physician at the Lung Center of the Philippines. She also said smoking might seriously hamper a man’s potency or ability to sire children.
Snoring. “Thou dost snore distinctly,” wrote William Shakespeare in The Tempest. “There’s meaning in thy snores.” Men are more likely to snore than women. In the Philippines, for instance, snoring affects approximately 50 percent of men and only 20 percent of women.
Snuff snoring by snuffing cigarettes. “Smokers tend to be snorers,” says Dr. Earl V. Dunn, a researcher at the University of Toronto, Sunnybrook Medical Center Sleep Laboratory. “So, stop smoking.”
Cervical cancer. “Cervical cancer cases in developing countries of the region are almost four times more numerous than in developed countries,” reported Dr. Gauden Galea, cancer specialist. In the Philippines, more than 4,000 new cases are reported each year.
According to the Singapore Cancer Society, some of the risk factors associated with cervical cancer include: sexual intercourse at an early age; multiple sex partners; genital infections such as herpes and human papilloma virus (HPV); and first pregnancy before the age of 20.
Osteoporosis. Cigarette smoking lowers estrogen levels, says Dr. Kenneth Cooper, author of the book, Preventing Osteoporosis. And women with lower estrogen levels are at increased risk for developing osteoporosis. Literally “porous bones,” osteoporosis is a “thinning” of the bones that occurs when the calcium that keeps them strong has seeped out.
Osteoporosis is less common among men for reasons that men have larger skeletons. Men’s bone loss starts later in life and progresses more slowly. The male species do not experience the rapid bone loss that affects women when their estrogen production drops as a result of menopause.
Quit smoking
Generally, people who smoke are advised to quit smoking – if they want to live longer and spare others from secondhand smoke. While most of them fail, there are few who were able to do so. Emmanuel Piñol, the current secretary of the Department of Agriculture, is one of the chosen few. He used to consume three packs of cigarettes a day. “Not a single stick of cigarette has ever touched my lips for the last 18 years,” he said.
It all started on September 20, 1998 when his daughter asked her what she wanted for her birthday. “I want you to stops moking,” she told him. It was a birthday request he couldn’t refuse. So, he quit smoking.
Today, he doesn’t smoke anymore although he could still imagine the smell of tobacco. “But I could easily control myself,” he said.
When it comes to smoking, it is usually those who quit who emerge winners. Dr. Ong said a person who quits smoking will immediately get his rewards instantly. Citing a study done by the American Lung Association, Dr. Ong said the health benefits of quitting will “begin just 20 minutes after your last cigarette. Your blood pressure and heart rate will decrease, and the oxygen content of your body will increase.”
After the first day of quitting, a previous smoker’s risk of suffering a heart attack will be reduced. On the second day, his nerve endings will start to heal and his ability to smell and taste will improve. Between 2 weeks and 3 months after quitting, his blood circulation will improve. His cough will be lessened and walking will become easier. Soon, his lung function will improve dramatically.
“By the time you reach 15 years of never touching a cigarette, your risk of dying will be the same as a non-smoker,” Dr. Ong pointed out. “This just goes to show that the ill effects of smoking are serious and deadly. Quit early and quit now. Quit while you are still young to obtain the full health benefits from quitting.”
But quitting smoking is easier said than done. “Some people can quit smoking just like that and suffer no side effects,” Dr. Ong noted. “However, for others, it can be a difficult process.”
Dr. Ong cited three factors responsible for the difficulty in quitting. “Knowing these factors will help you prepare yourself for the quitting process,” he said.
The factors were: (1) the number of cigarettes being smoked each day, (2) the people who smoke around the person who want to quit, and (3) the real reason on why the person smokes. “It could be due to peer pressure or for weight control,” Dr. Ong said of the latter.
“If you really want to quit smoking, you must identify the situations that trigger you to smoke, and do your best to avoid them,” Dr. Ong suggested.
Lethal smoke
What makes cigarette smoking so deadly? Well, it contains about 4,000 chemical agents, including over 60 cancer-causing chemicals. In addition, many of these substances, such as carbon monoxide, tar, arsenic, and lead, are poisonous and toxic to the human body.
Nicotine is a drug that is naturally present in the tobacco plant and is primarily responsible for a person’s addiction to tobacco products, including cigarettes. During smoking, nicotine is absorbed quickly into the bloodstream and travels to the brain in a matter of seconds. Nicotine causes addiction to cigarettes and other tobacco products that is similar to the addiction produced by using heroin and cocaine.
Carbon dioxide, on the other hand, interferes directly with the ability of red blood cells to carry oxygen. This causes shortness of breath, lack of endurance, and promotes and accelerates narrowing and hardening of the arteries.
And so it came to pass that two Martians were sent to planet Earth on a mission. When they returned home, they submitted this report to the committee: “The Earth people have an odd practice. They light a fire at the end of a poisonous substance and then suck the smoke into their body. This results in much sickness and even death. The habit is also very expensive. Strange, those Earth people!”
