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.

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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 School-Based 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.

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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 nonsmokers, they can also reduce the risk of acquiring respiratory disease by moderating their intake of grilled food (inihaw) and wearing masks in areas 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.

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