COMMUNITY AND PUBLIC HEALTH FOR MEDICAL TECHNOLOGY MTY1204 | SY 2022-2023 | Transcribed by: Princes Mae O. Baximen TOBACCO SMOKING • • • • • • • • • • • • TOBACCO Tobacco smoking is a major preventable cause of premature death and disease worldwide. Tobacco kills more than 8 million people each year. Around 80% of the world’s 1.1 billion smokers live in low- and middle-income countries. TOBACCO PRODUCTS Cigars, cigarillos, and other combustible products (excluding cigarettes) o Any combustible tobacco product that is designed to be smoked – other than cigarettes. E-cigarettes and other Electronic nicotine deliver systems (ENDS) products o Electronic and/or battery-operated devices designed to deliver an inhaled dose of nicotine or other substances. Hookah, shisha, and water pipes o A single or multi-stemmed instrument for vaporizing and smoking flavored tobacco or other products in which the vapor or smoke is passed through a water basin. Loose tobacco leaf o Including roll your own (RYO) tobacco for hand rolling cigarettes and pipe tobacco. Smokeless tobacco products o Tobacco products that are used by means other than smoking, such as chewing, sniffing, or placing between the teeth and gum. REASON WHY PEOPLE USED TOBACCO? Social Relaxation Peer pressure Look older • • • Try something new Bored Cultural HARMFUL CHEMICALS OF TOBACCO • Tobacco smoke contains around 7,000 chemicals. • Many use of these are poisonous and over 60 are known to be carcinogenic. WHAT MAKES CIGARETTES SO TOXIC AND DANGEROUS? • 1,3-Butadiene – a chemical used to manufacture rubber. It is considered to be a carcinogenic chemical that can cause certain blood cancers. • Arsenic – used to preserve wood. Some arsenic compounds have been linked to cancer of the lung, skin, liver, and bladder. • Benzene – used to manufacture other chemicals. It can cause cancer, particularly leukemia, in humans. • Cadmium – a metal to make batteries. Cadmium and cadmium compounds can cause lung cancer and have been associated with kidney and prostate cancer. • Chromium VI – used to make to make alloy metals, paint, and dyes. Chromium VI compounds cause lung cancer and have been associated with cancer of the nose and nasal sinuses. • Formaldehyde – used to make other chemicals and resins. It is used as a preservative. Formaldehyde causes leukemia and cancer in respiratory tissues. • Polonium-210 – a radioactive element that has been shown to cause cancer in animals. • Tar – not one single chemical, instead, it describes several chemicals that are in tobacco smoke. It leaves a sticky, brown residue on your lungs, teeth, and fingernails. CARBON MONOXIDE AND NICOTINE: A DANGEROUS DUO • Carbon monoxide – a harmful gas you inhale when you smoke. Once in your lungs, it’s transferred to your bloodstream. Carbon monoxide decreases the amount of oxygen that is carried in the red blood cells. It also increases the amount of cholesterol that is deposited into the inner lining of the arteries which, over time, can cause the arteries to harden. This leads to heart disease, artery disease, and possibly, heart attack. • Nicotine – a dangerous and highly addictive chemical. It can cause an increase in blood 1|BAXIMEN, P.M. COMMUNITY AND PUBLIC HEALTH FOR MEDICAL TECHNOLOGY MTY1204 | SY 2022-2023 | Transcribed by: Princes Mae O. Baximen TOBACCO SMOKING • • • • • • • pressure, heart rate, flow of blood to the heart and a narrowing of the arteries (vessels that carry blood). Nicotine may also contribute to the hardening of the artery walls, which in turn, may lead to a heart attack. This chemical can stay in your body for 6 to 8 hours depending on how often you smoke. Also, as with most addictive substances, there are some side effects of withdrawal. And some e-cigarettes and tobacco products deliver even more nicotine than traditional cigarettes. TOBACCO EXPOSURE Firsthand smoke – consuming tobacco products directly. Secondhand smoke – smoke that comes from the burning end of a cigarette, cigar or pipe. Thirdhand smoke – invisible tobacco “dust” (or chemical) that settles in the environment and stays there even after a cigarette has been put out. BURDEN OF TOBACCO USE 240 Filipinos die daily due to tobacco-related diseases. ECONOMIC IMPACT OF TOBACCO Although government revenue from tobacco taxed is about Php23 billion annually, economic losses due to productivity and health care costs of the top 4 leading NCDs (CA, CVD, COPD, and Diabetes) are conservatively estimated at Php140 billion annually. • Tobacco smoke can trigger an attack or make an attack worse. • Smoking causes about 80% (or 8/10) of all deaths from chronic obstructive pulmonary disease (COPD). • Smokers are about 12 or 13 times more likely to die from COPD than nonsmokers. • Smokers suffer more frequently from severe bronchitis and emphysema (a disease where the chemicals in tobacco smore severely damage the lining of the lungs and make it difficult to breathe). SMOKING AND CANCER • Cigarette smoking causes most cases of lung cancer. • Smoking can cause cancer almost anywhere in your body. • Smoking also increases the risk of dying from cancer and other diseases in cancer patients and survivors. • Every cigarette stick smoked, a smoker loses 5 to 10 minutes of his/her life and also endangers the lives of the innocent people around him/her. PREVALENCE OF TOBACCO USE PREVALENCE OF TOBACCO USE IN THE PHILIPPINES • 2013: 1 in 4 adults are current smokers. o Men smoke 11.3 cigarettes per day. o Women smoke 7.9 cigarettes per day. • Average age of initiation of smoking among ever daily smokers: o 17.4 years for men o 19.1 years for women SNOKING AND CARDIOVASCULAR DISEASE Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular disease. Smoking damages blood vessels and can make them thicken and grow narrower. SMOKING AND REPIRATORY DISEASE 2|BAXIMEN, P.M. COMMUNITY AND PUBLIC HEALTH FOR MEDICAL TECHNOLOGY MTY1204 | SY 2022-2023 | Transcribed by: Princes Mae O. Baximen TOBACCO SMOKING TOBACCO SMOKING (ACTIVE AND PASSIVE) • 2009: 36.9% (6.1 million) Filipino workers were exposed Secondhand Smoke at work. • • • • PROGRESS IN REDUCING TOBACCO USE IN THE PHILIPPINES BASED ON GATS • Increase the tax on tobacco products on an incremental basis. • Develop and implementation by LGU of tobacco ordinances compliant with the Framework Convention on Tobacco Control (FCTC). • Development of a recognition system “Red Orchid Awards for 100% Tobacco Free Environment” for LGU, government agencies and hospitals complying with FCTC obligations. Placement of graphic health information on billboards, tarpaulins, and posters. Development and implementation of the National Tobacco Control Strategy (2011-2016) to accelerate implementation of FCTC. Implementation of the total prohibition of tobacco advertising, promotion, and sponsorship by LGUs. LAWS TOBACCO REGULATION ACT OF 2003 Republic Act 9211 1. Promotion of a healthful environment. 2. Provision of information to the public on health risks associated with cigarette smoking and tobacco use. 3. Regulation and subsequent banning of all tobacco advertisements and sponsorships. 4. Regulation of placing health warning labels on tobacco products. 5. Prohibition of the sale of tobacco products to minors. 6. Provision of assistance and encouragement for Filipino tobacco farmers to cultivate alternative agricultural crops to prevent economic dislocation. 7. Creation of an Integrated Committee on Tobacco (IAC-Tobacco) to oversee the implementation of the provisions of this Act. 3|BAXIMEN, P.M. COMMUNITY AND PUBLIC HEALTH FOR MEDICAL TECHNOLOGY MTY1204 | SY 2022-2023 | Transcribed by: Princes Mae O. Baximen TOBACCO SMOKING • THE SIN TAC REFORM LAW Republic Act 10351 o It was signed into law on December 12, 2012 in Malacañang (under the Aquino administration). o It helps finance the Universal Health Care program of the government. THE GRAPHIC HEALTH WARNINGS LAW • Republic Act 10643 o Signed into law on July 15, 2014. o The Purpose of the law are to: ▪ Include graphic health warnings that effectively warn the devastating effects of tobacco use and exposure to secondhand smoke. ▪ Remove misleading or deceptive numbers or descriptions like “low tar”, “light”, “ultralights” or “mild” which convey or tend to convey that a product or variant is healthier, less harmful or safer. DEPARTMENT OF EDUCATION – DEPARTMENT ORDER NO. 33 S 2003 • Part of Youth Smoking Prevention Program • This order prohibits smoking and the sale of cigarettes and other tobacco products inside public and private school campuses, buildings, offices, including the premises and buildings of the division, regional, and national offices. EXECUTIVE ORDER NO. 26 S 2017 • It was signed by Pres. Rodrigo Duterte last May 16, 2017. • “Providing for the establishment of smoke-free environments in public and enclosed spaces.” • WHO GLOBAL ACTION PLAN Vision: A world free of the avoidable burden of NCDs. • Goal: To reduce the preventable and avoidable burden of morbidity, mortality, and disability due to NCDs by means of multisectoral collaboration and cooperation at national, regional, and global levels, so that populations reach the highest attainable standards of health and productivity at every age and those diseases are no longer a barrier to well-being or socioeconomic development. • People of ALL ages who have already developed smoking-related health problems can still benefit from quitting. Time of quitting smoking At about 30 At about 40 At about 50 At about 60 After the onset of lifethreatening disease Benefits in comparison with those who continue Gain almost 10 years of life expectancy. Gain 9 years of life expectancy. Gain 6 years of life expectancy. Gain 3 years of life expectancy. Rapid benefit people who quit smoking after having a heart attach reduce their chances of having another heart attack by 50%. 4|BAXIMEN, P.M.
