Tobacco control advocate Mary Assunta needed only to sit through a congressional meeting in the Philippines to feel the forces at work against her cause in a country where over 17 million people or almost a third of the adult population smoke.
“I was quite surprised to see some of the congressmen present there and was particularly taken aback by some of the comments made,” said Assunta, a Malaysian national based in Australia, who in 2008 attended a technical committee meeting as an invited resource person at the House of Representatives.
She was hosted in Manila by a nongovernment organization that was supporting a House bill requiring cigarette packs to show graphic health warnings, mainly photos of human organs gnawed by nicotine-induced cancer and other diseases.
“The question (during the meeting) was how addictive cigarettes are. And there was this man, for example, who had a medical background and he was challenging the addictive nature of anything. His point was that anything taken in excess is bad. He drew some really awkward analogies: eating too much rice or drinking too much water can be bad. It was quite strange to hear something like that from someone who would know the hazards of smoking,” Assunta said.
For a mere technical committee meeting, the discussions drew quite a big attendance, grew “quite intense” and were even marked by “table-thumping,” she said.
At the Apact conference, the peculiarities of the Philippine situation earned special mention in the presentation made by Dr. Ian Olver, the CEO of Cancer Council Australia, who said:
“Philip Morris Philippines sells packs with text-only warnings to Filipinos, but exports packs with graphic warnings to Thailand. However, when the Philippine government tried to introduce graphic warnings to Filipinos, (the company) is suing the government.”
“That’s the sort of anomaly there,” Olver later told the Inquirer. “That’s how hard the tobacco industry will fight.”
“If the law allows them to win, then perhaps the Philippines has to look at its own law,” he said.
“I thought it was a (forum) for exploring all avenues, but the issues that were raised were not even technical and they were attacking the bill. There was even a suggestion to drop the phrase ‘graphic warnings’ from the title of the bill and have it replaced by something more generic—and we all know that won’t work.”
“This may not be an accurate assessment of the situation because it was a snapshot in a long process and I only attended one meeting,” Assunta said. “(But) it was quite clear that the tobacco industry had great influence on some of the members of that technical committee and that it was reflected in the way the congressmen behaved.”
Not surprisingly, Assunta, a senior policy adviser of the Bangkok-based Southeast Asia Tobacco Control Alliance (SEATCA), was never asked for her views during the meeting. And all that huffing and puffing eventually choked the graphic warning bill.
Two years later, at an international summit that gathered some 700 delegates from 41 countries, the Philippine record in curbing smoking provided a stark example of what advocates like Assunta call “tobacco industry interference” in the government’s duty to safeguard people’s health.
Held in Sydney
from Oct. 6 to 9, the 9th Asia Pacific Conference on Tobacco or Health (Apact 2010) served as an occasion to assess how the 171 signatory nations, including the Philippines, had complied with the Framework Convention on Tobacco Control (FCTC), the first international treaty initiated by the World Health Organization (WHO).
Ratified by the Philippine Senate in 2005, the treaty essentially maintains that tobacco—said to be the cause of one death every six seconds around the world—should not be advertised, subsidized, and glamorized.
At the four-day conference, attention was inevitably drawn to the lone superpower of the Philippine tobacco industry—the company that resulted from the merger early this year of the global titan Philip Morris and the Lucio Tan-owned Fortune Tobacco, makers of the local brands Hope and Fortune.
With that union, Philip Morris Fortune Tobacco (PMFTC) was seen cornering up to 90 percent of the domestic market.
Cheapest in the region
Advocates attribute to strong tobacco industry lobbying the fact that Philippine taxes on cigarettes remain pegged at only 30 percent of the retail price, making the product one of the cheapest in the Asia-Pacific region. They compare this to 70 percent in Thailand, 67 percent in Bangladesh, 77 percent in Sri Lanka, 60 percent in India, 54 percent in Malaysia, and 45 percent in Vietnam.
Even Indonesia, which is one of the only two countries that have yet to ratify the FCTC (the other being the United States), imposes a tax rate higher than that in the Philippines at 37 percent. China, the single biggest cigarette market in the world, taxes cigarettes at 39 percent, again higher than on those sold to Filipinos.
The FCTC itself doesn’t prescribe a minimum tax rate but is mainly wary of making cigarettes “affordable to young people,” Assunta explained in an interview with the Inquirer.
Australia taxes cigarettes at 68 percent—and has also become a cause for celebration among anti-tobacco campaigners for setting legal precedents for other governments.
Canberra announced in April that it will put cigarettes in plain packaging—devoid of all seductive colors, logos or other “cool,” youthful imagery—starting in 2012.
Australia banned all forms of cigarette ads in the 1970s, and the introduction of plain packaging is considered the next step in eliminating one of the last remaining mediums used by cigarette makers to promote their product.
According to SEATCA, the Philippines has only been “partially” compliant of FCTC guidelines on cigarette advertising and packaging, particularly on the use of graphic picture warnings whose supposed shock value is considered an added deterrent to smoking.
The Philippines banned cigarette advertising on TV, radio and print media in June 2008, but tobacco fighters remained unsatisfied since ads were still allowed at the point of sale (actual stores), from sari-sari retail outlets to the duty free shop at the Ninoy Aquino International Airport.
Tobacco companies also continue to benefit from indirect forms of advertising when they sponsor concerts, parties and sporting events, they said.
As to graphic health warnings, advocates continue to fight for every inch, literally. The FCTC maintains that such disturbing photos should be visible on a space covering at least 50 percent of the cigarette pack.
Yet packaging in the Philippines conveys only written warnings, and the text occupies a mere 30 percent of the front side of the pack. In contrast, Brunei, Malaysia, Singapore and Thailand have put both written and picture warnings on the front and back, while Vietnam requires written warnings on both sides of the pack.
In May this year, citing the Consumer Act and FCTC, then Health Secretary Esperanza Cabral issued an administrative order for cigarettes sold in the Philippines to finally contain picture warnings.
What followed was a legal skirmish that had a whiff of irony.
PMFTC and other players—La Suerte, Mighty Corp., and Japan Tobacco Inc. (Phils)—asked five local courts to block Cabral’s move. According to one of their arguments, the country’s Tobacco Regulation Act of 2003 (passed two years before the Philippines ratified the FCTC) only called for written warnings, hence the Department of Health would bypass Congress if it requires graphic warnings as well.
Of the five courts, two—one in Marikina City and another in Bulacan province—have issued preliminary injunctions stopping the health department order, the group HealthJustice reported to delegates in Sydney.
A court in Parañaque City declared the order null and void, while a Pasig City court has yet to rule on the matter. Big Tobacco has so far only lost in Tanauan City, Batangas province, where a court had dismissed the petition against the health department order.
Apact 2010 president Dr. Harley Stanton, an Australian scientist who spent four years in Manila working for the WHO’s tobacco control initiatives in the region, called the tobacco industry’s legal maneuver “a tragic intrusion into a very important imperative in public health.’’
“It is part of the delaying tactics. But I believe (having graphic warnings) is no longer a matter of ‘if’ but ‘when,’” said Stanton, who was based in Manila from 1999 to 2003.
“For the Philippines, why not make it sooner rather than later?” said Stanton, who to this day continues to praise the “Yosi Kadiri” mascot campaign launched by then Health Secretary Juan Flavier.
He said graphic warnings won’t cost the government and are actually cheap for the tobacco companies to do. “So I find it so blatantly hollow that the tobacco industry will take what they know are legal measures—they got all the money for lawyers and public relations experts—to stall the progress on this issue.”
Stanton also obliged when asked to weigh the prospect of the anti-tobacco drive in the Philippines now that it has a leader who smokes and apparently has no plans of quitting.
“I can’t influence (President Benigno Aquino III) but I would encourage people to look beyond the immediate addiction which he has to tobacco and (work for) a future country where tobacco would have much less of a role in society,” Stanton said.
“Sometimes people who are addicted know the real power (of their addiction) and they don’t always oppose the best in terms of legislation. Sometimes they can be supportive because they know the power,” he said.
But Stanton ultimately expressed high hopes for the country’s most popular smoker, the President: “He will quit, but the question is when will he quit. Will he quit before it kills him or continue on as a smoker and have the damage from there?”
A 2008 study placed the number of smokers in the Philippines at 17.3 million, representing 28.3 percent of the adult population.
According to HealthJustice, some 90,000 Filipinos die of tobacco-related diseases each year and annual health costs and productivity losses linked to smoking in the Philippines range between $2 million and $6 million.