Rejoinder on the ‘sin tax’ bill

We want to be acknowledged as the leader in many things in Southeast Asia, but being the No. 1 smoking country in Southeast Asia is definitely not one of them. Unfortunately, this is so, as Health Secretary Ike Ona explained to our good senators who were present during one of the Senate hearings on the sin tax bill.

He presented World Health Organization (WHO) data showing that every Filipino smoker consumes 1,073 sticks every year, the highest in Southeast Asia. And one likely reason for this is the relatively low prices of cigarette and cigarette taxes in the Philippines.

“What is disturbing is the high prevalence of smoking among young Filipino girls and boys,” Sec. Ona told the senators. Of tobacco users in the Philippines, 17.5 percent are girls and 28.3 percent are boys aged 13-15 years. This is highest in Southeast Asia. It is also well established that early smoking will lead to earlier onset of smoking related noncommunicable diseases.

More vulnerable

Sec. Ona and Prof. Tony Dans of the University of the Philippines, also tried to correct the misconception that smoking-related diseases are predominant only in the affluent members of society. Nothing can be farther from the truth because fact is, the poor suffer the most number of deaths from smoking-related noncommunicable diseases like heart diseases, strokes and cancers. Based on a Lancet article authored by Dr. Dans and his colleagues in 2011, the poorest members of society smoke more than the richer sectors.

“This makes them more vulnerable to smoking related noncommunicable diseases,” explained the health chief. He added that there are about 50,000 deaths per year attributed to smoking, which is more than what is caused by diabetes, hypertension, obesity and high cholesterol, based on the National Nutrition and Heart Survey done in 2008.

Worldwide, smoking is a risk factor for six of the eight leading causes of preventable deaths. Again, these diseases are predominantly present in low- to middle-income countries. In the Philippines, tobacco is a major culprit causing the top four killers, which are heart attacks, strokes, chronic obstructive lung diseases such as emphysema and bronchitis; and cancer of the lungs, airways and gastrointestinal tract.

Financial burden

Our legislators, who seem to think that the revenues from tobacco are enough reason to justify protecting the industry in the country, can’t apparently understand that the financial burden smoking is causing the country is much more than the revenues it’s generating. The total annual cost of the four leading smoking-related disease, namely, lung cancer, chronic obstructive pulmonary disease, coronary artery disease and cardiovascular disease is at least P177 billion. In fact, Sec. Ona and other experts believe that this amount “is still an underestimation, considering that there are 39 other diseases related to smoking.”

Sec. Ona cited Thailand as a success story of how a country can benefit from a sin tax law. Starting in 1991, it progressively increased the tax rate on tobacco in a series of eight steps, increasing the retail prices of cigarettes up to 400 percent. Smoking rate in Thailand decreased from 30 percent in 1992 to 18 percent in 2007.  And yet, the country’s annual tobacco tax revenues almost tripled during this period.

Still thriving

The tobacco industry in Thailand is still thriving—if that’s what some local legislators are concerned about—but what they should find a more compelling reason to pass the bill if they truly have their countrymen’s best interest at heart is the number of lives that would be saved. In Thailand, it is estimated that in 2006, there were 31,867 fewer smoking attributable deaths that resulted from their sin tax law. By 2026, they estimate a total of 319,456 lives saved by the reduction in smoking rate in their country.

Using a simulation model here, a larger number of deaths is expected to be prevented. Within a 10-year period alone, more than a hundred thousand Filipino lives could be saved.

From the health and economic perspectives, it seems to be a “no-brainer” whether or not our senators should pass the bill. But as in many things in the real world, what requires the least mental effort may seem so complicated with all the entanglements of conflicting interests.