National Tobacco Control Strategy Philippines
National Tobacco Control Strategy Philippines
National Tobacco Control Strategy Philippines
CONTENTS
PHILIPPINE NATIONAL TOBACCO CONTROL STRATEGY
EXECUTIVE SUMMARY
oncommunicable diseases (NCDs) are dened as diseases of long duration and are
generally slow in progression. They are the leading causes of adult mortality and morbidity worldwide.1
Noncommunicable Diseases in the Southeast Asia Region: 2011 Situation and Response
UN Summit on NCDs-Political Declaration, September 2011
3
Health Statistics, Department of Health (DOH-NEC 2004)
4
Tobacco in the Philippines: Comprehensive Country Prole (Draft.) July 2010
2
Globally, tobacco use is the leading preventable cause of death and its effects health, social,
and economic are devastating. In the Philippines, the annual productivity losses from premature deaths for four smoking-related diseases - lung cancer, cardiovascular diseases, coronary
artery disease, and chronic obstructive pulmonary diseases ranged from US$ 65.4 million to
US$ 1.08 billion using the conservative Peto-Lopez estimates (Tobacco and Poverty Study in
the Philippines, GATS 2009). If current global trends continue, it is likewise estimated that tobacco will kill more than eight million people annually by 2030, with three-quarters of deaths
being in low and middle-income countries.5
According to the World Health Organization (WHO), one-third of the worlds smokers reside in
the Western Pacic Region (WPR), which comparatively has the greatest number of smokers
among the other ve WHO regions.5 The Philippines, being a tobacco-growing country, is one
of the countries in the Western Pacic Region with high prevalence of tobacco use. The 2009
Philippines Global Adult Tobacco Survey (GATS) shows that overall, 28.3% (17.3 million) of the
population aged 15 years old and over in the Philippines currently smoke tobacco.6
The Philippines started tobacco control efforts in 1987 and since then, despite the strong lobbying of the tobacco industry, the country successfully passed the Republic Act 9211 (Tobacco Regulation Act of 2003) on June 23, 2003 as the rst comprehensive national legislation
on tobacco control. Among the main thrusts of the law are: (a) Promotion of a healthful environment; (b) Dissemination of information regarding the health risks associated with tobacco
use; (c) Regulation and subsequent ban of all tobacco advertisements and sponsorships; (d)
Regulation of the labeling of tobacco products; and (e) Protection of the youth from starting a
life-long addiction to tobacco use by prohibiting the sale of tobacco products to minors.
The WHO WPR had also developed the rst Regional Action Plan (RAP 1990-1994) for the
Tobacco Free Initiative in the early 90s. Since then, there has been a continuous progress in
tobacco control initiative in the Region highlighted by the entry into force of the WHO Framework Convention on Tobacco Control (WHO-FCTC) in 2005.
The Philippines, being in the WPR and an eligible Party to the WHO-FCTC, is obligated to
implement the treaty in order to realize the vision of the people, the communities, and the
environments in the Region to be freed from tobacco.5 The Philippines became a signatory
to FCTC on September 23, 2003. The Senate of the Philippines, in turn, ratied this treaty on
June 06, 2005.
From the treatys rst preambular paragraph, which states, the Parties to this Convention
are determined to give priority to their right to protect public health, the treaty has been
the most widely embraced treaty in the history of the United Nations that acknowledges the
5
6
Regional Action Plan for Tobacco Free Initiative in Western Pacic Region, 2010-2014
Philippines 2009 Global Adult Tobacco Survey (GATS)
right of all people to the highest standard of health.7 Now with 174 countries as parties to the
convention (WHO-FCTC report, 2012), the treaty focuses on marketing bans, public awareness,
raising taxes, preventing sales to minors, and control of the illicit trade of tobacco products.8
The full implementation of the WHO-FCTC can only be achieved through engagement of all
relevant sectors of government, civil society, and non-government organizations to take action within their social, cultural, occupational, and political networks and spheres of inuence.5
Through a national initiative between May 3 and 12, 2011, a group of 14 national, international,
and WHO health experts, in collaboration with a team from the DOH, held individual interviews
with 128 individuals representing 78 institutions in order to assess the countrys tobacco control efforts in implementing the WHO-FCTC.9
The assessment team reviewed the existing tobacco epidemiologic data as well as the status
and present development efforts of key tobacco control measures undertaken by the government in collaboration with other sectors. The assessment team has perceived the following to
be the most signicant challenges to continued progress of tobacco control in the Philippines:
(1) Cigarettes are highly affordable in the Philippines, largely due to low taxes and a complex
tax structure; (2) Effective local government efforts for creating smoke-free environments exist and non-governmental organizations are making important contributions; (3) The lack of
a coordinated national cessation infrastructure/system and cessation providers hampers the
implementation of the national cessation policy; (4) Mass media activities are irregular and use
weak, ineffective content; (5) Graphic health information on all tobacco packages (introduced
by DOH AO 2010-0013) can be implemented even though court cases are pending; and (6)
The National Tobacco Control Strategy (NTCS 2011-2016) and Medium Term Plan (MTP 20112013) are still to be developed.9
Following the National Capacity Assessment for Tobacco Control, the Philippine National Tobacco Control Strategy for 2011-2016 (NTCS 2011-2016) was developed by the team of experts
from the Department of Health and other sectors of the government, with the structure and
content of the plans being consistent with the strategic approach of the WHO-FCTC. The Vision is to achieve and reinforce a social environment that will help build a Tobacco-free Philippines: Healthier People, Communities, and Environments through well-planned and denite
strategies; and the Mission is to advocate, enable, and mobilize multi-sectoral support for
stronger tobacco policies and programs in line with the WHO-FCTC.
The three main Strategies are to focus on the following: (1) promote and advocate for the
complete implementation of WHO-FCTC in the country; (2) mobilize for public action; and
(3) strengthen the organizational capacity. The rst strategy will largely be dependent on the
Manual for the Implementation of RA 9211 (Tobacco Regulation Act of 2003), UP College of Law Development Foundation, 2010
Council on Foreign Relations: Global Action on Non-Communicable Diseases, September 2011
9
Joint National Capacity Assessment on the Implementation of Effective Tobacco Control Policies in the Philippines, May 2011
8
two other strategies. Specic strategies under strategies 2 and 3 were determined based on
the gaps identied by the following: a) National Capacity Assessment team; b) the WHO-RAP
country actions and indicators; and c) WHO-MPOWER package, the last item of which refers
to a series of six proven policies aimed at reversing the global tobacco epidemic.
Under Strategy 2, sub strategies were laid down on: (1) Legislation and Policies; (2) Tobacco
Taxation; (3) Governance and Local Enforcement; and (4) Alliances and Partnerships.
As for Strategy 3 the NTCS species the following: (1) Investment Planning and Resource
Management (Medium term Plan on Tobacco Control); (2) Leadership Training and Human
Resource Development; (3) Surveillance, Monitoring and Knowledge Management; (4) Public
awareness, education, communication and advocacy; and (5) Smoking cessation and tobacco
dependence treatment.
The National Tobacco Control Strategy reects the governments political commitment for
the complete implementation of the WHO-FCTC to protect public health from the devastating effect of tobacco use; it builds on the premise that future generations of Filipinos will be
given the right to live in a protected environment and communities freed from the bondage of
tobacco use and relieved from the socio-economic burden of tobacco-related diseases.
INTRODUCTION
he World Health Organization (WHO) estimates that about 4 million people die every
year of tobacco-related diseases.10 If current global trends continue, it is estimated that
tobacco will kill more than eight million people annually by 2030, and three-quarters of
these deaths will be in low and middle-income countries.11
One-third of the worlds smokers reside in the Western Pacic Region (WPR), which comparatively has the greatest number of smokers among the other ve WHO regions.5 The
Philippines, being a tobacco growing country, is one of the countries in the Western Pacic
Region with high prevalence of tobacco use with over 81 billion cigarettes being sold in the
Philippines in 2008.2
The many social, economic, and health burdens from tobacco use pose a major challenge
to the Philippine government to strengthen its tobacco control efforts. Tobacco kills approximately 87,600 Filipinos per year (240 deaths every day), one-third of them men in the
most productive age of their lives.9 In 2005, the economic costs of tobacco use were over
PHP148 billion while the revenue from tobacco industry was about PHP25.65 billion.9
All eligible parties in the WPR have ratied the WHO Framework Convention on Tobacco
Control (WHO-FCTC), the rst public health treaty negotiated under the auspices of WHO.
The treaty is an instrument that reaffirms the right of all people to the highest standard of
health (Preamble to the Constitution of the WHO, 1946).
10
11
The Philippines, being an eligible Party in the WPR, is bound to meet the obligations to the
WHO-FCTC and to develop an effective national tobacco control program. The Philippine National Tobacco Control Strategy is the countrys response to protect public health from the
damaging effects of tobacco use. The time to act is NOW.
12
vascular diseases. An estimated six million people die from tobacco use each year, causing
nearly 10% of all deaths worldwide, two million more than AIDS, malaria, and tuberculosis
combined.16
Smoking kills up to half of all lifetime users.17 It is an epidemic that kills ten Filipinos every
hour.18 Tobacco use was responsible for over 58 thousands deaths or nearly 12% of all deaths
in the Philippines in 2004, according to the WHO calculations. Almost 80% of these deaths
caused by tobacco was among men.19 An estimated 6-8% of all deaths in the country are
attributable to the four tobacco-related diseases causing between 23,000-35,000 tobaccorelated deaths per year.
These damaging effects of tobacco to life will continue until its use is controlled. Urgent action must be taken to reduce and reverse the morbidity and mortality from tobacco-related
diseases.
16
20
The Government of the Philippines continues to coordinate and implement the tobacco control policies mainly through the Department of Health (DOH). Despite the fact that unofficial
initiatives for tobacco control at the DOH started back in 1994 as part of the Noncommunicable Diseases Control Program, it was only in 2007 when the DOH officially designated the
National Centre for Diseases Prevention and Control (NCDPC) as the coordinating unit for
tobacco control.21
The DOH, together with the other agencies of the government, has issued administrative orders and joint memoranda to address the problem on tobacco use. Administrative Order
2007-0004 or the National Tobacco Prevention and Control Program (NTPCP) was issued to
dene the roles and responsibilities of the different offices under DOH and of other departments. The lead office for tobacco control is the DOH-National Center for Disease Prevention
and Control (NCDPC).
In 2009, the DOH started implementing the Bloomberg Project entitled, Moving to the Next
Level in the Philippines: Complete Implementation of the WHO-Framework Convention on Tobacco Control (WHO-FCTC.) The project is tasked to supplement the countrys tobacco prevention efforts, in congruence with the DOH-National Center for Health Promotion (NCHP),
and to enforce of WHO-FCTC effectively.
The key initiatives of the project include the development of a comprehensive National Tobacco Control Strategy (NTCS 2011-2016) and Medium Term Plan (MTP 2011-2013), creation
of the National Tobacco Control Coordinating Office (NTCCO) within the DOH, as well as the
formation of the DOH Tobacco Control Team (TCT) and Sector-Wide Anti-Tobacco (SWAT)
Committee and its 11 Sub-committees for the implementation of WHO-FCTC provisions. The
NTCCO is in charge of working with other sectors of the DOH to synchronize tobacco control
efforts. The Development Academy of the Philippines (DAP), through the DOH- Bloomberg
Initiative Project OC-401, was commissioned to facilitate the development of the National
Tobacco Control Strategy (NTCS) for 2011-2016 through the DOH-NCHP starting May 2011.
Among the other DOH initiatives are: (1) Passage of Administrative Order (AO No. 122 s. 2003)
on Smoking Cessation Program to Support the National Tobacco Control and Healthy Lifestyle in 2003; (2) Passage of Administrative Order (AO 2009-0010) promoting a 100%
Smoke-free environment in 2009, which became the basis of the DOH Red Orchid Awards;
(3) Issuance of an Administrative Order (AO No. 2010-0013) on Graphic Health Information
in 2010; (4) Passage of Department Circular 2011-0101 which has set rules and regulations of
the Food and Drug Administration (after Administrative FDA Act 9711-2009) tasking the FDA
(under its article III) to regulate tobacco; and (5) Formulation of the National Tobacco Control
Strategy (NTCS 2011-2016) in 2011.
21
Joint National Capacity Assessment on the Implementation of Effective Tobacco Control Policies in the Philippines, May 2011
The Universal Health Care (UHC), which is the health agenda of the present administration, is
directed towards ensuring the achievement of the health system goals of better health outcomes, sustained health nancing, and responsive health system by ensuring that all Filipinos,
especially the disadvantaged group in the spirit of solidarity, have equitable access to affordable health care. Among the strategic thrusts of UHC is the achievement of the MDG max
targets on lifestyle-related Noncommunicable diseases such as cerebro-vascular diseases,
diabetes mellitus, chronic obstructive pulmonary diseases, and cancers. This makes tobacco
control and prevention strategies one of the cornerstones in achieving the National Objectives
for Health (NOH) of the DOH on NCDs.
Aside from DOH, other government agencies have been involved in tobacco control. The Civil
Service Commission (CSC), an independent constitutional body played fundamental role in
recent years by issuing several joint memoranda with the DOH. Similarly, the Land Transportation Franchising Regulatory Board (LTFRB), Philippine National Police (PNP), Development
Academy of the Philippines (DAP), and Metropolitan Manila Development Authority (MMDA)
played key roles focusing on smoke-free places initiatives. Using the existing communication
materials, they contributed to awareness-raising-campaigns and smoking-cessation activities.22
At the sub-national level, the local government units (LGUs) also play an important role in the
law implementation and have the mandate to ensure proper enforcement of RA-9211 along with
members of the Philippine National Police (PNP) and other stakeholders. The DOH regional
structures (Centers for Health Development) conduct tobacco control activities through their
focal point for health promotion and for NCDs, especially in those regions/districts where local
ordinances for creating smoke-free environments were introduced and enforced.23 (Please see
Annex 1 for the LGU tobacco interventions and best practices).
22
23
National Capacity Assessment on the Implementation of Effective Tobacco Control Policies in the Philippines, May 2011
Ibid.
Introduced effective mechanisms to monitor the inuence of the tobacco industry on government
Achieved great progress of local government in passing smoke-free ordinances that do
not allow smoking areas indoors and in public places
In addition, the countrys DOH officials and its strong and vibrant civil society organizations
have committed themselves to tobacco control.
Furthermore, the assessment team has perceived that the progress achieved in tobacco control in the Philippines can and must be accelerated.
The Assessment Team considers the following to be the most signicant challenges to continued progress of tobacco control in the Philippines:
1. RAISE TAXES AND PRICES OF TOBACCO
Cigarettes are highly affordable in the Philippines, largely due to low taxes and a complex tax
structure. Little of the revenue from these taxes has been used for health purposes, and health
consequences of the existing tobacco tax system appear not to be fully appreciated by policy
makers.
2. PROTECT PEOPLE FROM TOBACCO SMOKE
Effective local government efforts for creating smoke-free environments exist and non-governmental organizations are making important contributions. However, there is a lack of nancial and technical support necessary for the sustained countrywide reach required to deliver
potentially large health benets.
3. OFFER HELP TO QUIT TOBACCO USE
There is a need for a coordinated national cessation infrastructure/system; in addition, the lack
of cessation providers hampers the implementation of the national cessation policy.
4. WARN PEOPLE ABOUT THE DANGERS OF TOBACCO
Mass media activities are irregular and use weak, ineffective content.
Graphic health information on all tobacco packages (introduced by DOH AO 2010-0013) can
be implemented even though court cases on this issue are pending.
2.
3.
4.
5.
Simplify the existing tobacco tax structure, signicantly raise tobacco product excise taxes, and index taxes to ination in order to raise tobacco product prices and reduce tobacco
use. Also, earmark revenues from tobacco taxes for health priorities.
At least double the number of LGUs with 100% smoke-free policy initiatives (no designated smoking areas indoors) through dedicated nancial and technical support and active
involvement of non-governmental organizations.
Develop a coordinated national cessation infrastructure that incorporates both population
and clinical approaches in a stepwise manner; build on and augment existing resources
and service delivery mechanisms; commence implementation in those LGUs where the
demand for cessation already exists and where smoke-free policy support is strong.
Initiate a sustained programme of quarterly public awareness campaigns with content
proven as effective in the Philippines.
Given the scientic evidence supporting the use of graphic health information, the DOH
should encourage and support LGU implementation.
6.
Finalize and officially make a National Strategy and Plan of Action that will be reviewed
regularly. Key highlights of the Plan of Action would include:
a. A full-time staff in charge of the National Tobacco Control Coordination Office
(NTCCO) and dedicated staff and focal points from the different DOH offices. Food
and Drug Administration (FDA) and Philippine Health Insurance Corporation (PhilHealth) have a key role in the implementation and enforcement of tobacco control
measures and should be fully involved in the implementation process.
b. A dedicated regular budget allocated for the NTCCO and relevant offices.
c. The Sector-Wide Anti-Tobacco (SWAT) Committee as an official national body
with clear composition and mandate to direct and facilitate the implementation
and reporting of Philippines legal binding obligations to the WHO-FCTC.
d. Mechanisms of collaboration established with local governments and key stakeholders including the civil society with the exception of the participation of the
representatives from the tobacco industry.
The full implementation of the WHO-FCTC can only be achieved through engagement and
partnerships with all relevant sectors of government, civil society and non-government
organizations. The Philippine National Tobacco Control Strategy (NTCS 2011-2016) is the
governments response to its political commitment for the complete implementation of the
WHO-FCTC.
Following the National Capacity Assessment for Tobacco Control, the DOH-NCHP in partnership with DAP held a series of expert consultation workshops through the DOH- Bloomberg
Initiative Project OC-401, where representatives from the government agencies, advocacy
groups, NGOs and local government units (LGUs) participated and provided inputs to the
planning for the Philippine National Tobacco Control Strategy for 2011-2016 (NTCS 20112016). (See Annex 11 for the list of participants in the Consultation workshops.)
The planning commenced on May 25-26, 2011 with the Experts workshop on Drafting the
National Tobacco Control Strategy; this was followed by three other Regional workshops
for Luzon, the Visayas, and Mindanao.
The workshops took into consideration the following documents to achieve the overall objectives of the plan and to come up with the National Tobacco Control Strategy:
1. Regional Action Plan (RAP) for Tobacco Free Initiatives for WPRO (2010-2014). This
plan is a product of consultative activities that began in August 2008 to sustain action on the implementation of WHO-FCTC. It consists of a comprehensive plan of action
which puts emphasis on the importance of setting indicators and targets for all levels for
tobacco control and on strengthening national coordinating mechanisms of countries.
2. The MPOWER package. This is a set of six proven policies aimed at reversing the global
tobacco epidemic and includes: Monitor tobacco use and prevention policies; Protect people from tobacco smoke; Offer help to quit tobacco use; Warn about the dangers of tobacco; Enforce bans on tobacco advertising, promotion, and sponsorship; and Raise taxes
on tobacco. The package was identied in 2008 to serve as a platform to support the
implementation of WHO-FCTC in countries.
3. Report of the National Capacity Assessment for Implementing WHO-FCTC in May 12,
2011. This contains the recent ndings of the National Assessment Team which showed signicant challenges and progress of the tobacco control programmes implementation in the
country. The Team used the MPOWER package as guide or reference for the assessment.
4. UN Summit on NCDs-Political Declaration, September 2011. This contains the draft resolution on the Political Declaration of the High-level Meeting on the Prevention and Control
of Noncommunicable Diseases during the United Nations General Assembly on 19 to 20
September 2011. The resolution aimed to address the prevention and control of noncommunicable diseases worldwide, with a particular focus on developmental and other challenges and social and economic impacts of NCDs, particularly for developing countries.24
Following the renement of the outputs of the ve (5) consultative workshops together with
the result of the National Capacity Assessment for Tobacco Control in May 2011, and another
consultative meeting on the Finalization of the NTCS and Development of Monitoring and
Evaluation (M & E) Framework in February, 2012, the result was the nal NTCS 2011-2016 which
included all outputs during the consultation process. (See Figure 1)
The Vision is to achieve a Tobacco-free Philippines: Healthier People, Communities, and Environments, with a realistic view of a nation freed from the bondage of tobacco use and
people relieved from the burden of tobacco-related diseases through well-planned and welldened strategies.
The Mission is to advocate, enable, and mobilize multi-sectoral support for stronger tobacco
policies and programs in line with the WHO-FCTC.
To achieve these, two primary goals were identied, namely: (1) to attain the lowest possible
prevalence of tobacco use and (2) to attain the highest level of protection from secondhand
smoke (SHS).
In order to attain the rst goal of having the lowest possible prevalence of tobacco use, two
objectives have been identied: (1a) reduce the prevalence of adults current tobacco use by
2% per year and (1b) reduce the prevalence of youths current tobacco use by 2% per year.
24
Noncommunicable Diseases in the Southeast Asia Region: 2011 Situation and Response
For the second goal, which is to attain the highest level of protection from secondhand smoke
(SHS), two objectives have been identied: (2a) increase the level of protection from secondhand smoke by 2% per year among adults and (2b) increase the level of protection from
secondhand smoke by 2% per year among 13-15 years old (y/o).
Three (3) main Strategies were also determined, namely: (1) promote and advocate for the
complete implementation of WHO-FCTC in the country; (2) mobilize for public action; and (3)
strengthen the organizational capacity.
STRATEGY 1: This overarching strategy aims to promote and advocate at the highest levels of
government the complete implementation of the WHO-FCTC.
This overarching strategy can only be achieved when strategies 1 and 2 are implemented.
Strategy 2 was further broken down into four (4) sub strategies, Strategy 3 into other ve (5)
sub strategies (see below).
Specic objectives, action plans, and indicators under Strategies 2 and 3 were based
on the countrys needs consistent with the WHO-FCTC and WHO RAP for 2010-2014.
The results of the Experts and Regional Consultation Workshops, the recommendations by the National Capacity Assessment team, and the WHO MPOWER packages
were also used as bases for the formulation of the strategies. (See Annexes 8, 9 and
10 for details.)
MISSION
To advocate, enable and mobilize multi-sectoral support for stronger tobacco policies and programs in line with WHO FCTC
VISION
TOBACCO-FREE PHILIPPINES: HEALTHY PEOPLE, COMMUNITIES, AND ENVIRONMENTS
GOAL 1:
Attain the lowest possible prevalence of tobacco use
GOAL 2:
Attain the highest level of protection from second-hand smoke
Objective 1a:
To reduce prevalence of adults and youths current tobacco
use by 50% from the most recent baseline
Objective 2a:
To increase level of protection from secondhand smoke by 2%
per year among adults
Objective 1b:
To reduce prevalence of youths current tobacco use by 2%
per year
Objective 2b:
To increase level of protection from secondhand smoke by 2%
per year among 13-15 y/o
STRATEGY 1:
Promote and advocate for the complete implementation of the WHO FCTC in the country from 2011 to 2016
STRATEGY 2:
Mobilize and empower policy makers, tobacco control
advocates and communities towards complete
implementation of WHO FCTC
2.1 Tobacco Taxation
2.2 Packaging & Labeling
2.3 Illicit Trade
2.4 Alternative Livelihood
2.5 Addressing Tobacco Industry Interference
STRATEGY 3:
Strengthen organizational capacity of the Tobacco Control
Program and protect the public policies and interests from
tobacco industry interference
3.1 Strengthen multi-sectoral coordination mechanism for the
implementation of tobacco control
3.2 Leadership training and human resource development
3.3 Surveillance, monitoring, and knowledge management
3.4 Public awareness, IEC, and advocacy
3.5 Smoking cessation and tobacco dependence treatment
25
Source: RAP for the Tobacco Free Initiative in the WPR (2010-2014)
Key Actions
2.1.1 Develop tracking and monitoring
system for illicit trade of tobacco
products
Performance Indicators
Policy for the infrastructure
and system in place
Data available for action
Passage of legislation
Increased percentage of
proportion of revenue from
tobacco taxes allocated to
health promotion and social
health insurance coverage
Tobacco taxes revenues
allocated for health
priorities, and included in the
consolidated tobacco tax bill
Health Promotion Foundation
(HPF) established with
funding from tobacco tax
(included in the legislation)
Specic objectives:
To implement and enforce laws and
2.3.2 Develop guidelines for effective
policies through national coordinating
monitoring of TAPS based on
mechanisms or their equivalent,
WHO-FCTC
protect policies and programmes
from the inuence and interference
of the tobacco industry, and promote
good governance measures (i.e.
strategic vision, participation,
transparency and accountability,
with specic reference to healthy
cities, and islands, communities, and
settings) to achieve tobacco control.15
Alliance and partnership
Specic objective:
To work with relevant tobacco
control stakeholders to achieve
comprehensive and sustainable
tobacco control and avoid
interference form the tobacco
industry.15
Guidelines on monitoring
TAPS ban
Memorandum of
Understanding (MOU) signed
MOU signed
Performance Indicators:
Policy for the infrastructure and system in place
Data available for action
Regional Action Plan for Tobacco Free Initiative in Western Pacic Region, 2010-2014
27
ducing the attractiveness of tobacco products, reducing their addictiveness (or dependence
liability), or reducing overall toxicity (WHO-FCTC).
Performance Indicator:
Policy approved and implemented
2.1.3 Push for legislation of packaging and labeling pending in the Congress27
DOH issued Administrative Order 2010-13 (AO 2010-0013) in May 2010. This Order enables
DOH to implement rotating evidence-based Graphic Health Information (GHI) (30% of front
and 60% of back of package). The AO requires Graphic Health Information on tobacco product
packages, adopting measures to ensure that tobacco product packaging and labeling do not
promote tobacco by any means that are false, misleading, deceptive, or likely to create an erroneous impression and matters related thereto.
Despite the tobacco industrys interference, the DOH may push forward on implementing pictorial health warnings. It has the authority to implement the AO in all jurisdictions except those
that are currently under legal dispute. By virtue of the Constitution and the Administrative
Code of 1987, DOH has the authority to ensure propagation of health information. Pending
nal resolution of court cases, DOH could assert its authority everywhere except in Tanauan,
Southern Luzon, Malolos, Central Luzon and in the Metro Manila cities of Marikina, Pasig, and
Paraaque.
DOH argues that the legal basis of the AO is both the Consumer Protection Act, a national law,
and made consistent with WHO-FCTC and its guidelines.
Performance Indicator:
Passage of legislation
2.1.3.1 Review and study how to enforce AO 2010- 0013 (Graphic Health Information)
DOH should issue guidelines on Graphic Health Information (GHI) and misleading descriptors; ensure that effective, distinct, and highly visible graphic health information is placed on
tobacco product packages; and ensure that tobacco product packaging and labeling do not
promote a tobacco product by any means that is false, misleading, deceptive, or likely to create an erroneous impression about the product and its characteristics, health effects, hazards,
or emissions.
27
Given the scientic evidence supporting the use of graphic health information, LGUs should be
encouraged to implement and promote this initiative with support from DOH.
Performance Indicator:
Recommendations for action on how to enforce AO 2010- 0013 (Graphic Health
Information)
Performance Indicator:
Draft bills amending RA 9211 submitted to Congress
Increase the number of national government agencies and other government institutions
adopting and implementing Joint Memorandum Circular-Civil Service Commission and
DOH (CSC-DOH JMC No. 2010-01) policy and guide; and
2. Forge partnership with other relevant agencies not covered by the JMC to adopt Article 5.3.
Performance Indicators:
WHO-FCTC Article 5.3 incorporated in Tobacco Control ordinances in
50% of cities and municipalities
Legislative proposal submitted to Congress on areas where WHOFCTC 5.3 are not covered by JMC and other laws.
gap between higher and lower priced classes of cigarettes. Replacing the Philippines existing
multi-tiered specic cigarette excise tax structure with a uniform specic tax on all cigarettes
would eliminate opportunities for tax avoidance through misclassication of brands and send
the clear message that all cigarettes are equally harmful.
Eight bills addressing tobacco product taxation have been led in the current Congress that
would address the problem of highly affordable cigarettes in the Philippines by signicantly
increasing taxes and greatly simplifying the existing, complex tax structure; such tax increases will prevent smoking initiation, promote cessation, lower consumption among continuing
smokers, and reduce the death, disease, and economic costs that result from smoking.
Performance Indicators:
Law passed with the following elements:
Increase in Tobacco Taxes
Index of price for ination
Unitary tax rate
Removal of price classication freeze (1996)
2.2.2 Allocate from tobacco taxes revenues for health priorities, social health insurance coverage, and health promotion30
Earmarking of tobacco tax revenues for health purposes has been small in recent years 2.5%
of the new tax revenues from the 2008 tax increase was earmarked for Philippine Health Insurance (PhilHealth) and 2.5% was earmarked for disease prevention. Discussions are ongoing
about expanding the earmarking of tobacco tax revenues to attain the Millennium Development Goals and establish effective health promotion mechanisms and structures. Of particular
interest is the earmarking of tobacco tax revenues for health sector reform and a universal
health care program.
These efforts should take into account the changing patterns of disease associated with economic development and concerns about the health and other inequities that are exacerbated
by tobacco use. This includes dedicating a portion of tobacco tax revenues for comprehensive
tobacco control programs that include, but are not limited to: supporting community level
interventions; engaging in public education campaigns about the harms from tobacco use;
providing support to smokers trying to quit smoking; and preventing young people from taking up tobacco use.
30
This strategy shall ensure that the percentage of revenues as agreed by Department of Budget
and Management (DBM) and DOH from tobacco taxes is allocated for tobacco control programs, specically for health priorities, social health insurance coverage, and health promotion.
Performance Indicators:
Increased percentage of proportion of revenue from tobacco taxes
allocated to health promotion and social health insurance coverage
Tobacco taxes revenues allocated for health priorities, and included in
the consolidated tobacco tax bill
Health Promotion Foundation (HPF) established with funding from
tobacco tax (included in the legislation)
Performance Indicator:
100% increase in licensing fee/business permit in 50% of LGUs
2.2.4. Strengthen the multi-disciplinary mechanism to implement and monitor a strategy for
effective tobacco tax and pricing to reduce tobacco consumption32
Philippine tax administrators capacity for tracking and tracing should be further strengthened
by licensing all involved in tobacco production and distribution, and resources should be allocated to enforcing tax policies.
Several steps should be undertaken to strengthen tobacco tax administration in the Philippines. A well-established monitoring system should be put in place, one that employs new
technologies for monitoring the production and distribution of tobacco products. These new
technologies include adoption of the new generation of more sophisticated, hard-to-counterfeit tax stamps and a tracking-and-tracing system that can follow tobacco products through
the distribution chain.
31
32
This strategy would create a proactive and working multi-disciplinary body that shall develop,
implement, and monitor a strategy for effective tobacco taxation and pricing which would result in reduced tobacco consumption. The body should collaborate with other partners, especially non-governmental organizations and media, to gain support for tobacco tax measures.
Performance Indicator:
Monitoring tool/s and results
Performance Indicator:
25% of municipalities and cities enforcing TAPS ban
33
34
There are certain provisions included in the Tobacco Act that may be enforced nationwide by
DOH FDA (e.g., ban of TAPS on internet, TV, radio, cross-border TAPS, etc.), while at the local
level the DOH-CHD teams, in collaboration with the LGUs, could focus on their areas of authority within the respective jurisdictions.
The DOH should take leadership in the development of monitoring tools to collect information
on TAPS restrictions enforcement actions, monitoring compliance that can be implemented at
local levels by the regional DOH CHD regulatory officers and local health workers, in collaboration with LGU enforcing agents with reporting duties to the DOH and the public.
Inspection check lists should include TAPS ban and eventually, the score cards could add
indicators on TAPS. Action on law violations and monitoring of compliance could be shared
between central and regional levels.
Performance Indicator:
Guidelines on monitoring TAPS ban
Performance Indicators:
Memorandum of Understanding (MOU) signed
RTCN/RCTC in all regions
provisions. This committee has no tobacco industry representation and addresses the country
public health interests by having a comprehensive scope, membership, and operational implementation targets on the various WHO-FCTC articles.
Eleven sub-committees of this sector wide structure were organized and are already operational with terms of reference (TOR) dening scope of work and expected outputs. SWAT
members are government stakeholders, civil societies, and the academia. The tobacco industry and its front groups were not invited to be part of SWAT.
In this regard, DOH needs to clearly and formally dene the SWAT mandate, roles, and membership; ensure clear policies to prevent tobacco industry participation and interference with
its work; and enable collaboration with other government authorities in both decision taking
and technical levels. (See Annexes 2 and 3 for the composition of the SWAT sub-committees).
Performance Indicator:
Memorandum of Understanding (MOU) signed
Table 2 below presents the specic objectives, key action points, and indicators of the different strategies under Strategy 3.
Key Actions
Performance Indicators
Strategies
Key Actions
3.1.4 Establish incentive mechanisms for
LGUs with strong Tobacco Control
efforts (i.e., Red Orchid Award)
Ensure funding for the incentives
Performance Indicators
Red Orchid Award (ROA)
sustained
Database of TC leaders/
advocates produced from the
training programs with the
goal of successfully enacting
TC ordinance
Number of TC researches
included in the NUHRA
Strategies
3.4 Public awareness,
education, communication, and
advocacy
Specic Objectives:
To inform different audiences of
(a) the hazards of tobacco use
and exposure and (b) effective
interventions; and to mobilize
stakeholders to change social
norms and eventually eliminate
tobacco use in society.15
Key Actions
Performance Indicators
Performance Indicators:
Budget included in General Appropriations Act (GAA)
3.1.2 Establish mechanisms for collaboration with other key stakeholders (which include
government and non-government) regarding funding for tobacco control initiatives
To ensure that all activities and outputs are implemented and accomplished based on the
agreed timeline, there is a need to work towards and advocate for increasing the current levels
of funding for tobacco control and expanding the sources of funds, to include but not limited
to, national and local government budgets, contributions from external support organizations,
and funds from the private sector, community, and social health insurance. (RAP for Tobacco
Free Initiative in the WPR, 2010-2014)
Performance Indicators:
Written guidelines for collaboration
Memorandum of Understanding (MOU)
3.1.3 Strengthen the capacity of local governments to include Tobacco Control in their Annual Investment Plan for Health (AIPH)37
The DOH should ensure dedicated and regular funding for tobacco control within the DOH
budget, at the central and regional levels, based on needs identied by the NTCCO/NCHP and
the regional tobacco control structures. As the Local Government Units (LGUs) are currently in
the frontline of collaboration with the DOH-Centers for Health Development (DOH-CHDs) for
implementing various policies, they should also dedicate tobacco control funding on a regular
basis as part of their province-, municipality- or city-wide investment plans for health.
36
37
Performance Indicators:
Template of Tobacco Control Annual Investment Plan for Health
Inclusion of Tobacco Control (TC) activities with dedicated budget in
Annual Investment Plan (AIP) of LGUs
No. of LGUs with TC included in the AIP
No. of LGUs with TC Committee
3.1.4 Establish incentive mechanisms for LGUs with strong Tobacco Control efforts (i.e., Red
Orchid Award) and ensure funding for the incentives38
The DOH should collaborate with the LGUs, they being the essential players in advancing the
WHO-FCTC compliance in the Philippines, and strongly support their efforts in tobacco control.
Apart from enforcement work and local initiatives for raising awareness, major opportunities
of the LGUs should include increasing collaboration with local health services in providing cessation support (toll free quit lines) and coordinating initiatives with civil society.
Also, the collaboration regarding the Red Orchid Award strategy39 should include evaluation
of multi-sectoral participation and of local impact. Regular funding from local governments
should be made available for tobacco control implementation and enforcement initiatives. PhilHealth could be pursued as a possible source of funds for the LGUs tobacco control activities.
Performance Indicators:
Red Orchid Award (ROA) sustained
Grants to LGUs effectively implementing Tobacco Control
prepared by the DOH Health Human Resource Development Bureau (DOH-HHRDB) and enhanced by partners from academe and civil society, in the form of training of trainers. Concrete
enforcement of TAPS restrictions is yet to be part of the training. Other organizations have
conducted training of the police officers (FIDS, etc.). Reports of evaluation of training have not
yet been made available as of this writing.
The DOH CHDs collaborate with the local government authorities (LGUs) for covering training
needs for health workers in their jurisdiction, mostly limited to smoke-free policies, while cessation services and awareness raising campaigns are still not fully addressed.
Performance Indicators:
No. of training programs conducted
Database of TC leaders/advocates produced from the training
programs with the goal of successfully enacting TC ordinance
41
Collaborate with World Health Organization (WHO) in the development of general guidelines or procedures for dening collection, analysis, and dissemination of tobacco-related
surveillance data;
Initiate and cooperate with competent international and regional intergovernmental organizations and other bodies in the conduct of research and scientic assessments;
Promote and strengthen the training of and the support for all those engaged in tobacco
control activities, including research, implementation and evaluation;
Facilitate/Provide inputs in the development of the national surveillance system for determining the magnitude and patterns of determinants and other social, economic, and
health indicators related to the consequences of tobacco consumption and exposure to
tobacco smoke;
Facilitate nancial and technical assistance from international and regional intergovernmental organizations and other bodies for epidemiological surveillance and information
exchange; and
Provide an opportunity for exchange of information on the results of research studies and
surveys among the members of the sub-committees.
Performance Indicators:
National research surveillance, monitoring, and evaluation agenda
developed
No. of TC researches included in the NUHRA
3.3.2 Ensure funding support for the conduct of the research surveillance and monitoring
agenda
FCTC Article 20 (#3) states that The Parties to the Convention recognizes the importance of
nancial and technical assistance from international and regional intergovernmental organizations and other bodies where each shall endeavor to establish progressively a national system
for the epidemiological surveillance of tobacco consumption and related social, economic, and
health indicators.
FCTC Article 20 (#5) also states that Parties should cooperate with regional and international
organizations and nancial and development institutions, to promote and encourage provision
of technical and nancial resources to the Secretariat to assist developing country Parties and
Parties with economies in transition to meet their commitments on research, surveillance, and
exchange of information.
Performance Indicators:
Inclusion in the DOH as well as other agencies (development partners) funding
for research agenda
Inclusion of TC research in NUHRA budget
Number of development partners providing funding support for the agenda
dependent on external sources. This is relevant especially in the case of GATS, which in its
present form is an expensive survey.
Adult prevalence data is a key to monitor the tobacco epidemic. However, the existing surveys
to measure adult prevalence use methodologies that produce non-comparable data. Global
Adult Tobacco Survey (GATS), which is an internationally validated survey, is not sustainable
in its present form.
The national assessment team recommends the use of the Core Adult Tobacco Survey (CATS),
which was developed by the WHO Western Pacic Regional Office (WPRO) based on the
GATS survey under the framework of Tobacco-Free Plan-It. In this way, periodic tobacco surveillance data will be collected with no need for additional funding and made available to the
institutions responsible for implementing the tobacco control policies.
Performance Indicator:
GYTS, GATS, National Nutrition and Health Survey
Performance Indicator:
No. of policy issuances using as evidence surveillance, monitoring, evaluation
research data
43
44
According to the DOH Department Order (DO) No. 29 of February 7, 2011, NEC has the mandate to develop and institutionalize a national reporting and surveillance for the tobacco control program. In this regard, NEC needs to seek for additional partners support and use their
capacity through the work of the SWAT subcommittee on surveillance.
Performance Indicators:
No. of policy issuances using as evidence surveillance, monitoring, evaluation
research data
Prepare an integrated and cohesive plan for communication, education, and training on
Tobacco Control in coordination with the other sub-committees on FCTC Articles;
Establish an infrastructure to support education, communication, and training;
Facilitate leveling of key messages on tobacco control among the stakeholders and advocates for tobacco control;
Use all available means to raise awareness, provide enabling environments, and facilitate
behavioral and social change;
Actively involve the civil society in the relevant phases of public awareness programs;
Ensure that education, communication, and training programs include a wide range of
information on tobacco industry, its strategies, and its products; and
Monitor, evaluate, and revise education, communication and its measures.
Performance Indicator:
Evidence-based communication plan implemented (Effective implementation of
communication and advocacy plan through Knowledge Attitude and Practice or
KAP surveys)
45
Performance Indicator:
Regular budget on IEC for Tobacco Control (inclusion in the DOH-National
Center for Health Promotion (NCHP) as well as other development
agencies funding for such plan)
professional societies could also designate cessation trainers to handle cessation capacity
building in the private sector. The DOH should adopt a set of standardized national training
modules and tools.
Performance Indicators:
National Clinical Practice Guidelines (CPGs) for smoking cessation
developed and fully implemented
No. of health workers trained on CPGs
3.5.2 Establish/strengthen the infrastructure and referral system for tobacco dependence
treatment and other related services
There is a need for a coordinated national cessation infrastructure that incorporates both population and clinical approaches in a stepwise manner, and builds on and augments existing resources and service delivery mechanisms. The program shall start with LGUs with Smoke-Free
ordinance and with existing demand and/or program for tobacco cessation.
There is a need to strengthen the smoking cessation infrastructure and referral system for providing smoking cessation and tobacco dependence treatment strategy, especially among LGUs.
Opportunities to integrate these smoking cessation guidelines into relevant health and other
programs (i.e., cancer control programs, maternal and child health programs, TB control programs, as well as poverty alleviation programs, workplace wellness programs, social welfare
programs) should be explored and utilized.
Performance Indicators:
Policy for treatment and referral for tobacco dependence treatment and related
services
No. of functional smoking cessation clinics
No. of TB DOTS facilities with integrated smoking cessation services
48
RA 9211 mandates PhilHealth to cover outpatient cessation counseling for minors, but this remains unimplemented. Moreover, neither nicotine replacement therapies nor non-nicotine based
cessation drugs are included in the national formulary (a pre-requisite for PhilHealth coverage).
This presents a signicant nancial barrier for smokers who want to quit, many of whom belong
to the lower socio-economic classes and rely on PhilHealth to cover the costs of preventive health
care. PhilHealth maintains that it is waiting for the DOH to officially issue cessation clinical practice guidelines before it can establish the coverage rules for cessation services. At present, private
health insurance companies do not include cessation in their list of covered services.
PhilHealth should expand the insurance coverage to cover a package of evidence-based essential cessation services that includes brief advice at the primary health care level, access to
intensive counseling such as through a national quit line and, to the extent possible, pharmacotherapy for those who are heavily addicted to tobacco.
Performance Indicators:
Financing scheme on the treatment of tobacco dependence developed
and implemented
No. of smokers who availed of the benet
No. of facilities that availed of the benet
DOHN-CDPC
DOJ
DOLE
DOST
DOTC-LTFRB
DSWD
DTI
DTI-BTRCP
ESHUT
FCAP
FDA
GATS
GYTS
GHI
HJ
HSO
IACT
IEC
IPCAP
ITGA
JMC
JTI
KBP
LCP
LGU
LTFRB
MIAA
MMDA
MTP
NBI
NCDPC
NCAC
NCD
NCHP
NGO
NTA
NTCCO
NTPCP
NTRC
NYC
OSG
OSHC
PAP
PCCP
PCG
PCHRD
PCP
PCS
PGH
PHIC
PIA
PLC
PLCPD
PMI
PMFTC
PMA
PNP
PN
POS
PSC
PTGA
R.A.
RAP
SAMMEC
SDA
SEATCA
SHS
SMIC
SWAT
TAPS
TCT
TESDA
TWG
UHC
ULAP
UPCLDF
UPCPH
WHO
WHO-FCTC
WPRO
GLOSSARY OF TERMS
Behavioral support39 - refers to support, other than medications, aimed at helping people stop
their tobacco use. It can include all cessation assistance that imparts knowledge about tobacco use and quitting; provides support and teaches skills and strategies for changing behavior.
Brief advice40 - refers to advice to stop using tobacco; usually takes only a few minutes; and
given to all tobacco users, usually during the course of a routine consultation or interaction.
Contents41 - refers to constituents with respect to processed tobacco; and ingredients with
respect to tobacco products.
Design feature42 - a characteristic of the design of a tobacco product that has an immediate
causal link with the testing and measuring of its contents and emissions. For example, ventilation holes around cigarette lters decrease machine-measured yields of nicotine by diluting
mainstream smoke.
Emissions43 - substances that are released when the tobacco product is used as intended.
For example, in the case of cigarettes and other combusted products, emissions are the substances found in the smoke. In the case of smokeless tobacco products for oral use, emissions
are the substances released during the process of chewing or sucking; in the case of nasal use,
emissions refer to substances released by particles during the process of snuffing.
Expanded tobacco44 - is tobacco that has been expanded in volume by quick volatilization of
a medium such as dry ice.
Framework Convention on Tobacco Control45 - is the rst international treaty negotiated under the auspices of World Health Organization which represents a paradigm shift in developing a regulatory strategy to address addictive substances. In contrast to previous drug control
treaties, the WHO-FCTC asserts the importance of demand reduction strategies as well as
39
WHO Framework Convention on Tobacco Control: Guidelines for Implementation (Article 5.3; Article 8; Articles
9 and 10; Article 11; Article 12; Article 13; and Article 14. 2011 edition;; p 114.
40
Ibid p. 114
41
Ibid p. 34
42
Ibid p. 35
43
Ibid p. 35
44
Ibid p. 35
45
World Health Organization. WHO Framework Convention on Tobacco Control, WHO Press: Geneva. 2005.
supply issues. The WHO-FCTC was developed in response to the globalization of the tobacco
epidemic. The spread of the tobacco epidemic is facilitated through a variety of complex
factors with cross-border effects, including trade liberalization and direct foreign investment.
Graphic Health Information46 - refers to statements, and/or other information with accompanying full-color picture or pictograms, describing the contents and ingredients of tobacco
products. It also gives information regarding health dangers and problems related to tobacco
products, tobacco consumption, exposure to tobacco smoke, and/or other effects of tobacco
use.
IAC-T47 refers to the Inter-Agency Committee on Tobacco established under Section 29 of
RA 9211.
IAC-T Member Agencies/Organization48 refers to the agencies/organizations which compose the Inter-Agency Committee on Tobacco under Section 29 of RA 9211.
Illicit trade49 refers to any practice or conduct prohibited by law which relates to production,
shipment, receipt, possession, distribution, sale or purchase, including any practice or conduct
intended to facilitate such activity.
Indoor or Enclosed Areas50- indoor (or enclosed) areas include any space covered by a
roof or enclosed by one or more walls or sides, regardless of the type of material used for the
roof, wall or sides, and regardless of whether the structure is permanent or temporary.
Ingredients51 - include tobacco; components (e.g. paper, lter), including materials used to
manufacture those components; additives; processing aids; residual substances found in tobacco (following storage and processing); and substances that migrate from the packaging
material into the product. Contaminants are not part of the ingredients.
Promotion of tobacco cessation52 - refers to population-wide measures and approaches that
contribute to stopping tobacco use, including tobacco dependence treatment.
Public Places53 - these shall cover all places accessible to the general public or places for collective use, regardless of ownership or right to access.
46
Republic of the Philippines. DOH Office of the Secretary. AO No. 2010-0013 Requiring Graphic Health Information on Tobacco Product Packages, Adopting Measures
to Ensure that Tobacco Product Packaging and Labeling do not Promote Tobacco by Any Means that are False, Misleading, Deceptive or Likely to Create an Erroneous
Impression, and Matters Related Thereto. Sta. Cruz, Manila. 2010
47
R. A. No. 9211 (Tobacco Regulation Act of 2003); Inter-Agency Committee-Tobacco Memorandum Circular No. 01 s2004: Monitoring and Enforcement Guidelines of the
Tobacco Regulation Act and its Implementing Rules and Regulations. 2008.
48
Ibid p. 2
49
World Health Organization. WHO Framework Convention on Tobacco Control; WHO Press: Geneva; 2005.
50
WHO Framework Convention on Tobacco Control: guidelines for implementation Article 5.3; Article 8; Articles 9 and 10; Article 11; Article 12; Article 13; Article 14 - 2011
edition.
52
Ibid p. 35
53
WHO Framework Convention on Tobacco Control: Guidelines for Implementation Article 5.3; Article 8; Articles 9 and 10; Article 11; Article 12; Article 13; Article 14 - 2011
edition. P.114
Public transport54 - this shall include any vehicle used for the carriage of members of the public, usually for reward or commercial gain. This would include taxis.
RA 921155- this refers to Republic Act No. 9211, otherwise known as the Tobacco Regulation
Act of 2003.
Reconstituted tobacco56 - is a paper-like sheet material comprised mainly of tobacco.
Secondhand tobacco smoke or environmental tobacco smoke57 - refers to the smoke emitted from the burning end of a cigarette or from other tobacco products usually in combination
with the smoke exhaled by the smoker.
Smoke free air58 - refers to air that is 100% smoke free. This denition includes, but is not limited to, air in which tobacco smoke cannot be seen, smelled, sensed or measured.
Smoking59 - refers to the act of being in possession or control of a lit tobacco product regardless of whether the smoke is being actively inhaled or exhaled.
Tobacco addiction/dependence60 - refers to a cluster of behavioral, cognitive, and physiological phenomena that develop after repeated tobacco use and that typically include: a strong
desire to use tobacco; with difficulties in controlling its use; with persistence in tobacco use
despite harmful consequences; with a higher priority given to tobacco use than to other activities and obligations; with increased tolerance; and sometimes with a physical withdrawal
state.
Tobacco advertising and promotion61 - refers to any form of commercial communication, recommendation, or action; the aim of which is to effect or likely to effect promoting a tobacco
product or tobacco use either directly or indirectly
Tobacco cessation62 - refers to the process of stopping the use of any tobacco product, with
or without assistance.
54
WHO Framework Convention on Tobacco Control: Guidelines for Implementation Article 5.3; Article 8; Articles 9 and 10; Article 11; Article 12; Article 13; Article 14 - 2011
edition. P. 22
55
WHO Framework Convention on Tobacco Control: Guidelines for Implementation Article 5.3; Article 8; Articles 9 and 10; Article 11; Article 12; Article 13; Article 14 - 2011
edition P. 23
56
WHO Framework Convention on Tobacco Control: Guidelines for implementation Article 5.3; Article 8; Articles 9 and 10; Article 11; Article 12; Article 13; Article 14 - 2011
edition. P. 35
57
Ibid. P. 21-22
58
Ibid p.22
59
Ibid p. 22
60
WHO Framework Convention on Tobacco Control: Guidelines for implementation Article 5.3, Article 8, Articles 9 and 10, Article 11, Article 12, Article 13 and Article 142011 edition. P. 114
61
World Health Organization. WHO Framework Convention on Tobacco Control; WHO Press: Geneva. 2005.
62
WHO Framework Convention on Tobacco Control: Guidelines for implementation Article 5.3, Article 8, Articles 9 and 10, Article 11, Article 12, Article 13 and Article 14- 2011
edition. P. 114
Tobacco Control63 refers to a range of supply, demand and harm reduction strategies that
aim to improve the health of a population by eliminating or reducing their consumption of
tobacco products and exposure to tobacco smoke.
Tobacco dependence treatment64 - refers to the provision of behavioural support, medications, or both to tobacco users, to help them stop their tobacco use.3
Tobacco user65 - refers to a person who uses any tobacco product.
Tobacco Industry66 shall refer to organizations, entities, associations, individuals and others
who work for or in behalf of tobacco manufacturers, wholesalers, distributors, importers of
tobacco products, growers, and other individuals, or organizations that work to further the
interest of the tobacco industry, such as front groups and retailers.
Tobacco Products67 refers to products entirely or partly made of leaf tobacco as raw material, which are manufactured to be used for smoking, sucking, chewing, or snuffing, or by any
other means of consumption.
Tobacco Sponsorship68 refers to any form of contribution to any event, activity or individual
with the aim, effect or likely effect of promoting a tobacco product or tobacco use either directly or indirectly.
63
World Health Organization. WHO Framework Convention on Tobacco Control. WHO Press: Geneva. 2005. 4
WHO Framework Convention on Tobacco Control: Guidelines for implementation Article 5.3, Article 8, Articles 9 and 10, Article 11, Article 12, Article 13, and Article 142011 edition. P. 114
65
WHO Framework Convention on Tobacco Control: Guidelines for implementation Article 5.3, Article 8, Articles 9 and 10, Article 11, Article 12, Article 13, and Article 142011 edition. P. 114
66
Republic of the Philippines. Department of Health. Office of the Secretary. Department Memorandum No. 2010-0126: Protection of the Department of Health including
all of its Agencies Regional Offices, Bureaus or Specialized/Attached Offices/Units against Tobacco Industry Interference. Sta. Cruz, Manila. 2010. 2
67
Republic of the Philippines. Department of Health. Office of the Secretary. Administrative Order No. 2010-0013: Requiring Graphic Health Information on Tobacco
Product Packages, Adopting Measures to ensure that Tobacco Product Packaging and Labeling do not Promote Tobacco by Any Means that are False, Misleading,
Deceptive or Likely to Create an Erroneous Impression, and Matters Related Thereto:. Sta. Cruz Manila, 2010.
68
World Health Organization. WHO Framework Convention on Tobacco Control. WHO Press: Geneva. 2005 4
64
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NTCS 2011-2016
ANNEXES
ANNEX 1
government sectors, including the National Tobacco Administration of the Department of Agriculture (DA) as well as representatives of the tobacco industry.
Interagency Committee on Tobacco (IAC-T) Members:
1. Department of Trade and Industry (Chair)
2. Department of Health
3. Department of Justice
4. Department of Agriculture
5. National Tobacco Administration
6. Department of Environment and Natural Resources
7. Department of Education
8. Department of Science and Technology
9. Bureau of Customs
10. Bureau of Internal Revenue
11. Philippines Tobacco Institute
12. FCTC Alliance Philippines (FCAP)
In 2007, the DOH issued Administrative Order 2007-0004 or the National Tobacco Prevention and Control Program (NTPCP) to dene the roles and responsibilities of the different
offices under DOH and of other departments. The lead office for tobacco control is the DOHNational Center for Disease Prevention and Control (NCDPC).
In 2009, the DOH started to lodge major roles and responsibilities to the DOH-National Center
for Health Promotion (NCHP). The NCHP started with its Health Promotion Plan called Anti-Tobacco Behavior Program (ATBP). The ATBP Program has four-pronged strategies, namely: (1)
rally the inuential people through political advocacy and social mobilization; (2) re-orient providers of health and social services through networking and partnership; (3) involve the youth
through education and entertainment; and (4) bombard the media through social marketing.
Besides the ATBP Program, the DOH-NCHP launched the Red Orchid Award, which aims to
search for the national, regional, and local offices that implement a 100% tobacco-free environment. The NCHP also joined the Planning Meeting of the ASEAN Focal Points on Tobacco
Control (AFPTC), which has the goal of ensuring that effective tobacco control measures are
in conformity with the ASEAN Social Cultural Blueprint.
The AFPTC, encompassing a two-year action plan on four (4) key tobacco control issues,
tasked each member to take a lead in the enforcement of the activities. The issue assigned to
the Philippines and its partner, Lao, is the Tobacco Advertising, Promotion, and Sponsorship
(TAPS).
In 2009, the DOH started implementing the Bloomberg Project entitled, Moving to the Next
Level in the Philippines: Complete Implementation of the WHO-Framework Convention on
Tobacco Control (WHO-FCTC). The project is tasked to supplement the country's tobacco
prevention efforts, in congruence with the DOH-NCHP, and to enforce WHO-FCTC effectively.
The key initiatives of the project include the development of a comprehensive National Tobacco Control Strategy (2011-2016) and Medium Term Plan (2011-2013), creation of the National
Tobacco Control Coordinating Office (NTCCO) within the DOH, and formation of the DOH Tobacco Control Team (TCT) and eleven Sector-wide Anti-Tobacco (SWAT) sub-committees for
the implementation of WHO-FCTC provisions. The NTCCO is in charge of working with other
sectors of the DOH to synchronize tobacco control efforts. The division of functions, outlined
in DO 2011-0029, is split among the different offices in accordance with their role in the DOH.
The health agenda of the present administration focus on Universal Health Care (UHC), which
promotes healthy lifestyle for the prevention of noncommunicable diseases; hence, tobacco
prevention is included in the National Objectives for Health (NOH) of the DOH.
Other government initiatives include: (1) the passage of FDA Law (RA 9711) in 2009; (2) issuance of Administrative Order No. 13 on Graphic Health Information in 2010; and (3) formulation of the National Tobacco Control Strategy (NTCS 2011-2016) in 2011.
The DOH-NCHP partnered with the Development Academy of the Philippines (DAP) to facilitate the development of the National Tobacco Control Strategy (NTCS) for 2011-2016. Through
the DOH- Bloomberg Initiative Project OC-401, DAP had undertaken a series of consultation workshops starting May 2011, with experts consultation workshop, three regional (Luzon,
Visayas, and Mindanao) workshops, technical working group workshop, and another consultative meeting on the Finalization of the NTCS and Development of Monitoring and Evaluation (M&E) Framework in 2012. Representatives from government agencies, advocacy groups,
NGOs and local government units (LGUs) participated in the workshops and provided inputs
to the NTCS, which will serve as a strategy map to achieve the desired goals of the National
Tobacco Control Program.
Aside from DOH, other government agencies have been involved in tobacco control. The Civil
Service Commission (CSC), an independent constitutional body, played a fundamental role in
recent years by issuing several joint memoranda with the DOH. Similarly, the Land Transportation Franchising Regulatory Board (LTFRB), Philippine National Police (PNP), Development
Academy of the Philippines (DAP), and Metropolitan Manila Development Authority (MMDA)
played key roles focusing on smoke-free places initiatives. Using the existing communication
materials, they contributed to awareness-raising campaigns and smoking cessation activities.3
National Capacity Assessment Report for Tobacco Control The Philippines, May 2011
tivities through their focal point for health promotion and for NCD, especially in those regions/
districts where local ordinances for creating smoke-free environments were introduced and
enforced.
These staff are usually oriented and trained by DOH Central Office. The DOH organizes training
of trainers (TOT) for health workers at regional level and then regional DOH staff organizes
training at provincial, municipal, city, and barangay level. Several training workshops were
organized every year mainly on the policies in MPOWER package as well as some cessation
workshops.
In addition, training of policy makers is conducted by the DOH. The DOH regional offices also
conduct training for the local government units.
Most of the enforced legislation on exposure to SHS has been done in Local Government Units
(LGUs). Among the LGUs with existing Anti-Smoking Ordinances or that have passed smokefree legislation are the cities in the National Capital Region: Makati, Manila, Pasay, Marikina, and Quezon City; Legaspi City in Southern Tagalog Region; Cebu City in Central Visayas
Region; Iloilo City in Western Visayas Region; and Davao City in Eastern Mindanao Region.
Recently, municipalities in Talisayan, Misamis Oriental in Northern Mindanao Region and in
Amlan, Negros Oriental in Central Visayas Region have passed and implemented 100% smokefree jurisdictions. In addition, the FCAP reports that several municipalities and cities in Luzon,
Visayas, and Mindanao have initiatives under review calling for smoke-free ordinances and/or
administrative orders banning smoking in public places, invoking 100% smoke-free jurisdictions1. (Please also refer to Annex 5 for the list of LGUs with Smoke-free Ordinances).
The Local Government Best Practices (Source: DOH)
1. Nueva Vizcaya Ordinance No 2010-049: Smoking is prohibited in enclosed or partially
enclosed public places, workplaces, public outdoor spaces, public conveyances, or other
public places.
2. Amlan Municipal Ordinance No. 3 s. 2009: No person shall smoke in any part of any enclosed or partially enclosed public place, workplace, including bars and restaurants, form
of public conveyance or public outdoor space.
3. Umingan Municipal Ordinance No. 24 s. 2008: No person shall smoke in any part of any
enclosed or partially enclosed public place, workplace, including bars and restaurants,
form of public conveyance or public outdoor space.
4. Talisayan Municipal Ordinance No. 724-2008: It shall be unlawful for any person to smoke
or for a person in charge to allow smoking in enclosed or partially enclosed public places
and public facilities, public places, all forms of public conveyances, workplaces, public
outdoor spaces.
ANNEX 2
SWAT Sub-committees
SWAT 5.3
SWAT 6
SWAT 8
Sub-committee on Smoke-free
SWAT 9 & 10
SWAT 11
SWAT 12
Sub-committee on Education,
Communication, Training, and Public
Awareness
SWAT 13
Sub-committee on Tobacco
Advertising, Promotion, and
Sponsorship
SWAT 14
Sub-committee on Tobacco
Dependence Treatment
SWAT 15
SWAT 17&18
Sub-committee on Alternative
Livelihoods
Department of Agriculture
SWAT 20
ANNEX 3
Project Director
(Undersecretary for Policy,
Service Delivery and Regulation
Cluster)
SWAT Committee
SWAT Sub-Committees on
WHO-FCTC Articles 5.3, 6, 8,
9/10, 11, 12, 13, 14, 15, 17/18, 20 (11
Sub-Committees)
FCTC
Article
SWAT COMMITTEES
LEAD AGENCY
MEMBER AGENCIES
CSC
DOH-NCHP
Article 6
DOH-HPDPB
DOF
Article 8
Smoke-Free
DOH-HPDPB
PMA
CSC
Article 9 & 10
Regulation of Content/
Disclosure
DOH (FDA)
DDB
Article 11
DOH (FDA)
DTI-BTRCP
Article 12
Education, Communication,
Training & Public Awareness
DOH (NCHP)
DepEd
AdBoard
Article 13
DOH (FDA)
DOJ
Article 14
Tobacco Dependence
Treatment
DOH (NCDPC)
LCP, FCAP
Article 15
BOC
DOH (Legal Service)
Alternative Livelihood
DA
DOLE
DOH (NEC)
Article 5.3
Article 17&18
Article 20
Source: Bloomberg Initiative Project OC-401, National Center for Health Promotion, DOH
DOH Red Orchid Awards 2011: Special Citation on Implementation of 100% Tobacco-Free
Environment in Government Offices, Hospitals, CHDs, Provinces, Cities, and Municipalities
(Source: DOH)
1. Government Offices:
MMDA
DepEd - Reg. 1
LTO - Reg. 10
CSC Reg. 1
Pop Com CAR
DTI CAR
2. CHDs: SOCCSKSARGEN, Cagayan Valley, Eastern Visayas, MIMAROPA, CAR, Bicol, and Metro Manila
3. Hospitals:
Cotabato Regional & Medical Center
Ospital ng Palawan
Luis Hora Memorial Regional Hospital
Tagaytay Treatment & Rehabilitation Center
Quirino Memoril Medical Center
Western Visayas Sanitarium
Mariano Marcos Memorial Medical Center
Corazon Locsin Montelibano Regional Hospital
4. Province: Nueva Vizcaya Province
5. Cities: Maasin City, Davao City, Roxas City, Balanga City, Legaspi City
6. Municipalities: Amlan, Negros Oriental; Calatrava, Romblon; Pintuyan, Southern Leyte;
Alamada, North Cotabato; Talisayan, Misamis Oriental; Tantangan, South Cotabato; Naval,
Biliran; Dupax del Norte, Nueva Vizcaya; Buenavista,Guimaras; Veruela, Agusan del Sur;
Solano, Nueva Viscaya; Calauag, Quezon
National Center for Disease Prevention and Controls passage of DOH issuances, specically the National Tobacco Prevention and Control Program AO 2007-0004;
National Center for Disease Prevention and Controls leadership in tobacco cessation programs in some DOH hospitals and medical centers; and
RA 9211 implementation in 12 pilot provinces by the Health Policy Development and Planning Bureau.
ANNEX 4
Year
Document
Detail
2008
2009
AO 2009-0004
(administrative order)
2009
DOH DM 2009-0142
(department
memorandum)
2010
DOH DM 2010-0126
(department
memorandum)
2010
CHED Memorandum
from the Executive
Director dated 14
January 2010
2010
2010
Year
Document
Detail
2011
DOH DO 2011-0029
(department order)
2011
DC 2011 0101
ANNEX 5
Law/ Policy
Policy Details
Declares the right of every citizen to breathe clean air, prohibits smoking
inside enclosed public places including public vehicles and other means of
transport, and directs local government units to implement this provision.
Commission on Higher
Education (CHED) M.O. No. 63,
s. 2007
Department of Transportation
and Communication (DOTC)Land Transportation
Franchising and Regulatory
Board (LTFRB) M.C. No. 2009036
Imposes a 100% Smoke-Free Policy on all public utility vehicles and public
land transportation terminals.
Department of Health
Administrative Order (AO)
No. 2009-0010
Law/ Policy
Policy Details
Department of Education
Order No. 73 s. 2010
Religious Rulings
Islamic Fatwa on Smoking issued by the Supreme Council of Darul Ifta of the
Philippines declaring that cultivating, selling, smoking tobacco or cigarette is
haram (forbidden).
ANNEX 6
Policy Details
R.A. 9211
Dept of Health
Department
Memorandum No.
(DOH DM No. 2009-0142)
RA 9211 Inter-Agency
Committee on
Tobacco
Memorandum
Circular
(I-ACT MC No. 1 s.
2008)
Policy Details
DILG Memorandum
Circular2007-126
ANNEX 7
A. Background
The WHO Framework Convention on Tobacco Control (WHO-FCTC) was adopted by the 56th
World Health Assembly in May 2003 and became an international law on 27 February 2005. It
opened for signature from 16 to 22 June 2003 in Geneva, and thereafter at the United Nations
Headquarters in New York, the depository of the treaty, from 30 June 2003 to 29 June 2004
(WHO- FCTC 2003).
Now with 174 countries as parties to the convention (WHO-FCTC report, 2012), the treaty
focuses on marketing bans, public awareness, raising taxes, preventing sales to minors, and
control of the illicit trade of tobacco products(Council on Foreign Relations: Global Action on
Non-Communicable Diseases, 2011).
The FCTC calls for countries to establish programs for national, regional, and global tobacco
surveillance. It has initiated the formulation of policies in different parts of the globe focusing
on the health implications of tobacco and on the importance of tobacco control. It also encourages countries to develop and implement tobacco control action plans to include public
policies, such as bans on direct and indirect tobacco advertising, tobacco taxes and price increases, promoting smoke-free public places and workplaces, and including health messages
on tobacco packaging.
The Philippines became a signatory on 23 September 2003 and the Senate in turn ratied this
treaty on 06 June 2005. .
implemented at the national, regional, and international levels in order to reduce continually
and substantially the prevalence of tobacco use and exposure to tobacco smoke (WHO-FCTC
2005).
The WHO-FCTC is divided into core demand reduction provisions and core supply reduction
provisions.2
Source: DOH
ANNEX 8
3. Earmarking of tobacco tax revenues for health purposes has been small in recent years
2.5% of the new tax revenues from the 2008 tax increase was earmarked for PhilHealth and
2.5% was earmarked for disease prevention.
4. Earmarked funds are distributed to local governments and used for a variety of activities,
including infrastructure development and efforts to improve tobacco farming. None of the
funds, however, are directly returned to tobacco farmers or are used for programs that
support tobacco farmers efforts to move out of tobacco farming and into alternative livelihoods.
5. The price classication freeze maintains the price classication of old cigarette brands (i.e.,
those brands classied on or before January 1, 1997, listed in Annex D of Republic Act 8240
and amended by Republic Act 9334).
Current Tobacco Tax Structure
i) Cigarettes packed by hand (each pack with 30 pieces)
ii) Cigarettes packed by machine (each pack with 20 pieces)
NRP below PhP 5 per pack (low-priced)
NRP of PhP 5 to PhP 6.50 per pack (medium-priced)
NRP above PhP 6.50 to PhP 10 per pack (high-priced)
NRP of above PhP 10 per pack (premium-priced)
PhP 2.72
PhP 2.72
PhP 7.56
PhP 12.00
PhP 28.30
6. The freeze xes the tax according to the brands net retail prices as of October 1, 1996. Even
if the actual net retail price exceeds the range corresponding to its original price class, it
remains in its original price class and is taxed at a rate which is lower than if it were taxed
according to its current net retail price.
2. Effective local government efforts for creating smoke-free environments exist and nongovernmental organizations are making important contributions. However, there is a lack
of nancial and technical support necessary for the sustained countrywide reach required
to deliver potentially large health benets (FCTC Art 8).
Some LGU ordinances have achieved consistency with WHO-FCTC Art. 8 Guidelines by requiring 100% smoke-free indoor public places (i.e,. without designated smoking areas). These
promising practices are supported by the DOH, but they have not yet been fully exploited for
optimal health gain. This may be because (i) some proven initiatives (such as the smoke-free
initiative implemented by CHD for Metro Manila) have not been maintained beyond the rst
phase or taken to the necessary scale; and/or (ii) variability in the quality of ordinances and lack
of electronic data systems for comparability of enforcement and compliance data are undermining progress; and (iii) in some cases, data are being provided (e.g., by CHD-MM to LGUs)
but apparently are not being utilized for enforcement action. Smoke-free policy measures can
be included within licensing arrangements at national and local levels, but these are not always
utilized; an example is the LGU role of licensing local businesses it is important but underutilized.3
b. Key Findings on WHO-FCTC Article 8 Implementation
(FCTC Article 8: Protection from exposure to tobacco smoke (protection from SHS)
1. Scientic evidence has rmly established that there is no safe level of exposure to secondhand tobacco smoke (SHS), a pollutant that causes serious illnesses in adults and children.
There is also indisputable evidence that implementing 100% smoke-free environments is the
only effective way to protect the population from the harmful effects of exposure to SHS.
2. Despite existing smoke-free national and local policies, social norms supportive of smoke
free environments and specic institutional policies are not yet strongly promoted and supported.
3. Despite the prime opportunities for many of the national agencies to use national policy
directives (such as M.C.17) to develop, implement, and monitor agency-specic smoke-free
policies covering their own premises, employees and (as relevant) members of the public,
not all of these agencies have yet done so. Examples include: a) Civil Service Commission
(CSC); b) Department of National Defense (DND); c) Occupational Safety and Health Centre (OSHC); d) Department of Labor and Employment (DOLE); and e) Philippine National
Police (PNP).
4. Effective Local Government Units (LGUs) efforts lack technical support and nancial sustainability.
5. Existing national policies for smoke-free environments are not being enforced or monitored.
6. Current laws allowing the establishment of designated smoking areas in public places do
not effectively protect public health.
7. RA 9211 specically mentioned air conditioning and ventilation standards in accordance
with Presidential Decree No. 1096 or the National Building Code and with the Philippine
Society of Mechanical Engineers Code. These are clearly and evidently outdated guidelines
in relation to the WHO-FCTC provisions.
8. The health services sector is not yet fully involved in smoke-free policy implementation and
in mobilizing public support for it.
9. Medical bodies such as the Philippines Medical Association (PMA) and the Philippines
Ambulatory Paediatrics Association (PAPA), although having important leadership roles to
PHILIPPINE NATIONAL TOBACCO CONTROL STRATEGY 97
offer through their own policies and position statements, have not exerted sufficient efforts
to inuence medical training curricula and continuing medical education (CME) accreditation processes.
10. Some LGU ordinances have achieved consistency with WHO-FCTC Art. 8 Guidelines by
requiring 100% smoke-free indoor public places (i.e., without designated smoking areas).
These promising practices are supported by the DOH, but they have not yet been fully exploited for optimal health gain. This may be because (i) some proven initiatives (such as the
smoke-free initiative implemented by CHD for Metro Manila) have not been maintained beyond the rst phase or taken to the necessary scale; and/or (ii) variability in the quality of
ordinances and lack of electronic data systems for comparability of enforcement and compliance data are undermining progress; and (iii) in some cases, data are being provided (e.g., by
CHD-MM to LGUs) but apparently are not being utilized for enforcement action. Smoke-free
policy measures can be included within licensing arrangements at national and local levels,
but these are not always utilized; an example is the LGU role of licensing local businesses it
is important but underutilized.
3. The lack of a coordinated national cessation infrastructure/system and cessation providers hampers the implementation of the national cessation policy (FCTC Art 14).
A national cessation policy that is unimplemented is a major gap in tobacco control efforts in
the Philippines. Cessation programs exist, but these are few in number, are institution-based
with no mechanisms to link to the community at large, and run independently of each other.
The emphasis is on clinical models of service delivery rather than on population approaches to
cessation. There is no national quit line. The lack of cessation providers, especially within the
public sector, is perceived as a barrier to the full implementation of smoke-free laws, because
smokers in settings that mandate smoke-free policies have limited access to assistance with
quitting. Moreover, cessation drugs are of limited availability.3
c. Key Findings on WHO-FCTC Article 14 Implementation
(FCTC Article 14: to promote cessation and the treatment of tobacco dependence)
1. In response, the DOH issued Administrative Order (AO) No. 122 specifying guidelines to implement a National Smoking Cessation Program within all DOH offices, attached agencies,
DOHretained hospitals and health facilities and xed or mobile units.
2. Only ten pilot areas had implemented cessation clinics and only two were operationalized.
The establishment of smoking cessation clinics nationwide was a strategic area of work for
the DOH in the National Objectives for Health 2006-2010.
3. The various existing cessation clinics also are not linked to each other or to health professionals offering brief advice, in any systematic way, with the exception of a few members
of the Philippine College of Chest Physicians (PCCP) that have established cessation programs where lung specialists oversee cessation pharmacotherapy.
4. Establishing a coordinated national cessation system in a developing country setting like
the Philippines requires an incremental approach that balances evidence-based population
and clinical interventions.
4. Mass media activities are irregular and use weak, ineffective content (FCTC Art 12)
Campaigns developed and conducted by the DOH are generally done only in May (World No
Tobacco Day) and June (No Smoking Month). Substantial evidence from other countries suggests campaigns must be done multiple times per year with sufficient reach and frequency
in order to effectively promote behavior change. Additionally, IEC materials do not generally
make use of graphic imagery about the harms of tobacco. International evidence suggests that
graphic campaigns showing the physical and emotional harms of tobacco are most effective
in increasing knowledge, changing attitudes, and prompting behavior change. An extensive
pre-testing project conducted in 2008 conrmed such messages and specic materials are
effective with Filipino audiences. Other than through one campaign conducted by CHD-Metro
Manila in 2008, the study results and associated materials have been largely underutilized.3
WHO FCTC Article 12 requests Parties to promote and strengthen public awareness of tobacco control issues, using all available communication tools, as appropriate. Consistent with
other provisions of the WHO Framework Convention on Tobacco Control and the intentions of
the COP to the Convention, specic guidelines were adopted to assist Parties in meeting their
obligations under Article 12 of the Convention.
DOH Administrative Order (AO) 58 (2001) further claried the role of the National Centre for
Health Promotion (NCHP), establishing it as the communication arm of DOH and a clearing
house for all health-related information. DOH AO 58 is in the process of revision to specify the
role the private sector can play in disseminating such health information.
d. Key Findings on WHO-FCTC Article 12 Implementation
FCTC Article 12 (Education and Communication)
1. Anti-tobacco advertising in mass media is not sustained and conducted regularly. The antitobacco campaigns developed and conducted by DOH are generally related to the World
No Tobacco Day in May and to the No Smoking Month in June. However, similarly to warnings on cigarette packages, persons over 65, those with no formal education, and those in
the poorest wealth quintiles were least likely to have noticed anti-tobacco messages.
PHILIPPINE NATIONAL TOBACCO CONTROL STRATEGY 99
2. DOH does not have enough funding to conduct effective national mass media campaigns.
DOH has limited nancial resources (approx. PHP10 million) to produce materials and purchase air time; as such, materials are supplied to regions but not in sufficient quantity and
no national campaign is possible with existing funds. Please see comment on page 52
3. The DOH should pursue the expansion of the nancial resources to produce and air mass
media campaigns. A possible means to mobilize more resources to produce and air mass
media campaigns could be through the designation of a part of tax revenues to this purpose.
4. The DOH should pursue alternative channels for disseminating warning information. Different communication techniques can complement each other, such as advertising plus public
relations, community-based campaigns and events. The impact of the whole can be much
greater than the sum of the parts.
5. Graphic Health Information on all tobacco packages (introduced by DOH AO 2010-0013)
can be implemented even though court cases are pending. (Art 11, 13)
The DOH has the authority to implement the AO in all jurisdictions except those that are currently under legal dispute. Local government units may also implement the AO in accordance
with the Local Government Code, Section 16, which states that local government units shall
exercise their powers to promote general welfare including health and safety.3
FCTC Article 11 focuses on tobacco packaging and labelling measures, specically ensuring
maximum visibility of health warnings and messages on tobacco products. It indicates that
health warnings and messages be large, clear, visible and legible, and should be 50% or more
but no less than 30% of the principal display areas. Parties should consider the use of pictorial
health warnings positioned on principal display areas (on both the front and back of each unit
packet; and at the top rather than at the bottom to increase visibility) of products packaging.
It shall also be in full color rather than black and white, with rotating messages.
Rotation of health warnings and messages and changes in their layout and design are important to maintain saliency and enhance impact. (Parties should consider establishing two or
more sets of health warnings and messages to alternate after a specied period, such as every
12-36 months). Parties should provide phase-in-period for rotation between sets of health
warnings and messages, during which time both sets may be used concurrently.
Pictorial warning labels inuence initiation and motivate tobacco users to quit. In the Philippines, 38% of current smokers who recalled seeing pack warnings (text only) had thought
about quitting because of the warning label.
Currently, RA 9211 governs the implementation of health warnings on cigarette packs. The law
states that rotating text warnings are required (30% of front display) and no other printed
warnings shall be placed on packages of tobacco products. It also states such warnings should
be in either English or Filipino.
The following warnings are mandated: "GOVERNMENT WARNING: Cigarette Smoking is Dangerous to Your Health"; "GOVERNMENT WARNING: Cigarettes are Addictive"; "GOVERNMENT
WARNING: Tobacco Can Harm Your Children"; "GOVERNMENT WARNING: Smoking Kills."
Tobacco control advocates have proposed bills to legislate graphic warnings but those bills
were not passed into law (e.g., House Bill 3364, the Graphic Health Information Bill - rejected
by the Committee of Health in 2008 on the basis of economic arguments that would affect the
livelihood of tobacco farmers).
To harmonize this RA 9211 provision with WHO-FCTC Article 11, and to ensure product packaging and labeling does not promote tobacco by any means that are false, misleading, deceptive or likely to create an erroneous impression, DOH issued Administrative Order 2010-13 (AO
2010-13) in May 2010. This Order enables DOH to implement rotating evidence-based Graphic
Health Information (30% of front and 60% of back of package), which are more effective and
can be more easily understood by segments of the population that are illiterate or cannot read
English.
The tobacco industry subsequently led lawsuits in ve venues asserting that the order is
unconstitutional based on the fact that international law such as WHO-FCTC must be implemented by legislation, not administrative order. DOH argues that the legal basis of the AO is
both the Consumer Protection Act, a national law, and made consistent with WHO-FCTC and
its guidelines. (Please see National Capacity Assessment For Tobacco Control, Philippines,
May 2011- Annex II on p. 62)
e. Key Findings on WHO-FCTC Article 11 Implementation
(FCTC Article 11: Packaging and labelling of tobacco products)
1. DOH has a clear mandate in all matters related to public health and is defending this mandate in court and through advocacy.
The Food and Drug Administration (FDA) has the authority to issue licenses and regulate any
product that impacts the health of Filipino citizens (RA 9711). Also, the Interagency Committee
on Tobacco Memorandum Circular No.1 designates DOH as being responsible for warnings on
cigarette packs.
Despite the tobacco industrys interference, the DOH may push forward on implementing pictorial health warnings. By virtue of the Constitution and the Administrative Code of 1987, DOH
has the authority to ensure propagation of health information. Pending nal resolution of
court cases, DOH could assert its authority everywhere except in Tanauan, Southern Luzon;
Malolos, Central Luzon; and in the Metro Manila cities of Marikina, Pasig, and Paraaque.
While the tobacco industry is still allowed to advertise tobacco at the point of sale, the Filipinos are not getting the health warnings on the danger of these products.
This is a critical marketing point for the tobacco industry. Point-of-sale advertising is a powerful form of advertising used by the tobacco industry to sell its products and is especially
effective with youth and smokers trying to quit. Evidence shows that increases in counteradvertising reduce consumption.3
WHO-FCTC Article 13 states that "parties recognize that a comprehensive ban on advertising, promotion, and sponsorship would reduce the consumption of tobacco products." Article
13 focuses on achieving comprehensive bans, removing point-of-sale (POS) advertising and
dealing with cross-border and other non-traditional forms of advertising and promotion.21
f. Key Findings on WHO-FCTC Article 13 Implementation
FCTC Article 13: Ban on tobacco advertising, promotion, and sponsorship (TAPS)
1. The enforcement of the current restrictions on the tobacco advertising, promotion, and
sponsorship is weak, mainly due to poor clarication of designated agencies' roles and
functions, and lack of strong enforcement mechanism.
2. Violations of TAPS restrictions are many. Based on the current legislation there is no other
permission for placing advertisements other than at the point-of-sale (POS); therefore, there
is a signicant number of respondents that were exposed to tobacco advertisements in
other places than the POS. This may be attributed to the poor enforcement of the TAPS ban.
3. Local implementation of TAPS restrictions is possible but not yet implemented in many regions. At local levels, the enforcement falls under the authority of the DOH-CHD regulatory
officers as well as under the city and municipal officials (Mayors police force as well the
local PNP police officers) in the form of local ordinances.
4. So far, the assessment team could nd only one Joint Memorandum Circular (JMC) between DOH and DILG (DOH CHD 4A and DILG 4A/2010) covering Region 4A. The model
provided by this JMC as a local instrument in implementing the Tobacco Act does include
most of the components of a concrete enforcement mechanism, apart from the require-
ment on sharing data and reporting among institutions and to the public. At the moment
there are currently only few local jurisdictions that have introduced and started implementation of local ordinances.
5. The regional / provincial performance score cards do not include TAPS. Police officers
(Mayor and PNP) are not enforcing TAPS except in some committed LGUs that included
TAPS restrictions in the local ordinances with more clear enforcing mechanism.
6. Active participation of citizens in enforcement is not utilized. No complaint hotline exists, although the mode for the local ordinances recommends the introduction of such a phone line.
7. No specic training on TAPS enforcement exists. The training under the broad framework
of MPOWER is conducted by core trainers from the DOH Central Office in partnership with
civil society based on a module prepared by the Health Human Resource Development
Bureau (HHRDB) and enhanced by partners from academe and civil society in the form of
training of trainers -TOT (and yet the concrete enforcement of TAPS restrictions is not part
of it). Please see pp 55 for other comment
8. Dedicated funds for enforcing, monitoring, and evaluating the impact of the TAPS restrictions seem not to be allocated. Whether they exist or not, reports are not made available
to the assessment team.
9. Potential for active coalition on TAPS exists. Governmental agencies (FDA, PNP), in collaboration with WHO CO as well as NGO community (FCAP, FIDS, etc.), run grant projects
with international funding that include TAPS in their objectives (basically advocacy for a
stronger enforcement of RA 9211) but are not mainstreamed into the national tobacco control coordination initiatives of the DOH.
10. The Philippines has not met the ve-year deadline for undertaking a comprehensive TAPS
ban.
11. The restrictions on tobacco advertising, although very comprehensive, still allow an exception: advertising at the points-of-sale (POS). Point-of-sale tobacco promotion including
cigarette displays is a powerful form of advertising that is especially effective with youth
and smokers trying to quit. Currently the tobacco industry takes full advantage of the misinterpretation of the law as allowing advertisements at the POS and even circumvents the
current legal requirements by placing advertisements at both inside and outside the POS.
12. Moreover, the current law does not require a health warning to be placed at the POS as
counter advertising measure to the existing tobacco advertising. The restrictions on tobacco promotion and sponsorship still allow many exceptions. Various exceptions are allowed
by law based on age of audience and location of the promoting action.
PHILIPPINE NATIONAL TOBACCO CONTROL STRATEGY 103
13. Also, although DOH Memorandum 2009-0142 restricts sponsorship of any sport, concert,
cultural, or art event, it still allows mentioning the name of the company in the roster of
the sponsors, and the applications for sponsorship and promotion are banned only within
the scope of the DOH authority.
14. The National Tobacco Control Strategy (2011-2016) and Medium Term Plan (2011-2013)
are still to be developed. Coordination and funding mechanisms are not yet dened and
regularly allocated and the Sector-Wide Anti-Tobacco (SWAT) Committee has yet to be
officially constituted.
Experiences in different sectors and in several countries have shown that a national plan of
action based on the WHO-FCTC provisions and addressing the countries specicities provides
a roadmap for a common vision on tobacco control strategies.
The national strategy and plans will also serve as a basis for similar exercises at sub-national
level. Dedicated funds, clear mechanisms of collaboration, and the involvement of the different health and non-health stakeholders are keys for successful outcomes.3
B. KEY RECOMMENDATIONS
1. Simplify the existing tobacco tax structure, signicantly raise tobacco product excise taxes, and index taxes to ination in order to raise tobacco product prices and reduce tobacco
use; earmark revenues from tobacco taxes for health priorities.
The existing tax structure should be simplied by eliminating the price classication freeze and
by reducing the number of price tiers with the goal of applying a uniform tax on all cigarettes.
Tobacco taxes should be increased signicantly in order to raise prices and reduce tobacco
use, with a goal that tobacco excise taxes account for 70% of prices. Tobacco taxes should be
regularly increased with ination so as to maintain the value over time. The revenues generated by these taxes should be used for health purposes, including universal health coverage,
health promotion, and tobacco control. The DOH should strengthen its capacity and evidence
in order to provide technical advice to inuential policy makers who make decisions regarding
tobacco taxes.3
a. Key Recommendations on Taxation
1. Simplify the existing tobacco tax structure, signicantly raise tobacco product excise taxes,
and index taxes to ination in order to raise tobacco product prices and reduce tobacco use.
Replace the Philippines existing multi-tiered specic cigarette excise tax structure with a
uniform specic tax on all cigarettes.
2. Earmark tobacco tax revenues for health purposes, including health promotion and tobacco control. These efforts should include dedicating a portion of tobacco tax revenues for
comprehensive tobacco control programs. There must be a clear process for transferring
earmarked tobacco tax revenues from the excise revenue to ensure that the funds are used
for the intended purposes.
3. Earmark tobacco tax revenues for programs that help those employed in tobacco dependent sectors make the transition to alternative livelihoods.
4. Strengthen tobacco tax administration, increase enforcement, and tax duty free sales of
tobacco products in order to reduce tax evasion and avoidance. Put in place a well-established monitoring system that employs new technologies for monitoring the production
and distribution of tobacco products. These new technologies include adoption of the new
generation of more sophisticated, hard-to-counterfeit tax stamps and a tracking-and-tracing system that can follow tobacco products through the distribution chain.
5. Sustain and expand efforts to support the tobacco tax reforms and health promotion nancing mechanisms by building further capacity and generating further evidence with the
support of stakeholders such as the academe, civil society organizations (CSOs), and other
pertinent government agencies.
2. At least double the number of LGUs with 100% smoke-free policy initiatives (no designated smoking areas indoors) through dedicated nancial and technical support and with
the active involvement of non-governmental organizations.
These 100% smoke-free LGU initiatives should be sustained through: (i) public awareness programs, (ii) dedicated staffing, (iii) training and capacity building, (iv) data systems to underpin
compliance monitoring and evaluation, and (v) development of business licensing models as
sustainable means of promoting smoke-free environments.3
b. Key Recommendations on Smoke-Free Policies
1. The Department of Health and other national government agencies should provide stronger
commitment and leadership to promote social norms in support of 100% indoor smoke-free
environments.
2. Local governments should expand and sustain their smoke-free policy initiatives through
dedicated nancial and technical support for: (i) public awareness programs, (ii) dedicated
staffing; (iii) training and capacity building, (iv) data systems to underpin compliance monitoring and evaluation, and (v) development of business licensing models as a sustainable
means of promoting smoke-free environments.
3. The DOH should pursue collaboration with all relevant stakeholders for ensuring that the
Republic of the Philippines meet its obligations under the WHO-FCTC Article 8, which requires the adoption of effective measures to protect people from exposure to tobacco
smoke in (1) indoor workplaces, (2) indoor public places, (3) public transport, and (4) as
appropriate in other public places.
4. The DOH should take the leadership in proposing amendments of the national laws and
policies and facilitate the debate in the government and Parliament as well as with the
public to strengthen the implementation of smoke-free policy.
3. Develop a coordinated national cessation infrastructure that incorporates both population and clinical approaches in a stepwise manner, and build on and augment existing resources and service delivery mechanisms. Commence implementation in those LGUs where
the demand for cessation already exists and where smoke-free policy support is strong.
Establishing a coordinated national cessation system in the Philippines requires an incremental
approach that balances evidence-based population and clinical interventions with brief advice, intensive counseling, and when appropriate, drug therapy. Because health service delivery is a direct function of LGUs, this tiered cessation system should exist within each LGU and
implemented rst in those LGUs with a high demand for cessation and have strong smokefree and other tobacco control policies. Counseling formats other than face-to-face programs,
such as quit lines, should be considered especially as demand for cessation services increases.
The cessation aids covered by health insurance need to be incorporated into the national formulary.
c. Key Recommendations on Tobacco Cessation
1. Initiating this cessation system should be implemented rst in those LGUs where the demand for cessation already exists, reinforced by sound smoke-free and other tobacco control policies.
2. Making cessation drugs more available should be addressed. These cessation aids need to
be incorporated into the national formulary.
3. A standard set of tobacco cessation practice guidelines and service delivery models should
be nalized, endorsed, and widely promoted. Opportunities to integrate these guidelines
into relevant health and other programs (i.e. cancer control programs, maternal and child
health programs, TB control programs, as well as poverty alleviation programs, workplace
wellness programs, social welfare programs) should be explored and utilized.
4. Additional health providers should be actively recruited in identifying tobacco users who
are ready to quit and providing brief advice.
106 DEPARTMENT OF HEALTH (DOH) - PHILIPPINES
5. DOH efforts on training of trainers such as those initiated in several Centers for Health Development (CHD) should be continued.
6. Tobacco cessation should be framed as a core prevention intervention, and incorporated
into other related covered benets, such as primary health care, tuberculosis Directly Observed Treatment Strategy (TB-DOTS) package, and maternity care.
4. Initiate a sustained program of quarterly public awareness campaigns with content proven as effective in the Philippines.
Campaigns should be done several times per year in order to have an impact on the population. The sustained program must go beyond health observances such as World No Tobacco
Day and No Smoking Month. A 2008 research study tested and found 10 specic international campaigns to be effective with Filipino audiences. Adapting these materials could substantially reduce production cost and development time for DOH. Ideally, national campaigns
should be developed and aired through government associated media, paid media, and DOH
networks. Alternatively, DOH can take the lead in developing campaign packages that can be
disseminated to the regions and through its own networks. It can provide technical assistance
in aspects of production, media planning, and campaign evaluation.3
5. Given the scientic evidence supporting the use of Graphic Health Information, LGU implementation should be encouraged and supported by the DOH.
Local governments have the authority to implement administrative orders under the local government code. In the longer term, propose a bill that enacts the best-practice use of Graphic
Health Information into law.3
d. Key Recommendations on Graphic Health Information (GHI)
1. The DOH in collaboration with the other relevant government agencies should assert authority prominently in defense of the health of the Filipino people.
The department should continue to pursue its legal position and seek opportunities to
publicize the evidence-based rationale for graphic pack warnings, as well as to expose misinformation of the industry.
2. The DOH should implement the pictorial health warnings established through DOH AO
2010-13 among the tobacco companies that have not led for an injunction and in all jurisdictions except those that are currently under legal dispute.
3. The LGUs should use their legal competencies to ensure placement of counter advertising/
health warnings at the point-of-sale.
PHILIPPINE NATIONAL TOBACCO CONTROL STRATEGY 107
In the short term, while the point - of - sale tobacco advertising is still allowed, the DOH
could develop a model ordinance for LGUs to place large, visible health warnings at point
of sale and LGUs, under the Local Government Code. In a longer term strategy the DOH
should initiate and propose an amendment to the national law to ban completely the tobacco advertising at the point-of-sale.
e. Key Recommendations on TAPS ban
1. Under its leadership and coordination, DOH should strengthen the enforcement mechanism
of the current TAPS restrictions, through coordinated action at local jurisdictions.
2. The DOH should take leadership in the development of monitoring tools to collect information on TAPS restrictions enforcement actions, monitoring compliance that can be
implemented at local levels by the regional DOH CHD regulatory officers and local health
workers in collaboration with local LGU enforcing agents regarding efforts for enforcing the
smoke-free environments at the LGU level. Inspection check lists should include TAPS ban,
and eventually the score cards could add indicators on TAPS.
3. The central and regional levels should share in the allocation of dedicated funds and human
resources to enhance enforcement of TAPS restrictions.
4. The FDA should pursue immediate issuance of the RA 9211 implementing rules and regulations and operational guidelines. According to its current mandate, the FDA should ensure
that information concerning TI marketing strategies are regularly collected and made available to the implementing agencies and then eventually to the public.
5. DOH should conduct regular training for its regulatory officers as well as the police force.
The training strategy, which should focus on the TAPS ban enforcement, should also include
regular evaluation of effectiveness and performance.
6. FCTC Alliance Philippines (FCAP) and other non government organizations (NGOs) should
increase their efforts for awareness building and advocacy for reporting law violations at
grass roots levels and in the communities.
7. Relying on its current formal mandate for monitoring and enforcing a ban on TAPS, the DOH
should advocate for it and take the lead in initiating and proposing a complete ban on TAPS,
without any exceptions.
8. The DOH, having been mandated by the IAC-T Memorandum Circular No. 01 on the Monitoring and Enforcement Guidelines of the Tobacco Regulatory Act of 2003 as a pilot agency
responsible for monitoring and enforcing the TAPS ban, should initiate it through concrete
plan of action with a concrete time frame.
9. Any display of tobacco products at point-of-sale constitutes advertising and promotion. In
view of this, DOH should remove the advertising permissions at the POS by amendment of
RA 9211 which may be pursued on medium term period. Meanwhile, the LGUs may resolve
this gap on TAPS ban through the inclusion of the ban on TAPS at POS in the local ordinances, monitored and enforced by LGUs in collaboration with DOH-CHDs.
6. The DOH should nalize and officially make a National Strategy and Plan of Action that
will be reviewed on a regular basis. Key highlights of the Plan of Action would include:
a. A full-time staff in charge of the National Tobacco Control Coordination Office (NTCCO)
and dedicated staff and focal points from the different DOH offices. FDA and PhilHealth
have a key role in the implementation and enforcement of tobacco control measures and
should be fully involved in the implementation process.
b. A dedicated regular budget both allocated on the NTCCO and relevant offices.
c. The Sector-Wide Anti-Tobacco (SWAT) Committee positioned as an official national body
with clear composition and mandate to direct and facilitate the implementation and reporting of Philippines legal binding obligations to the WHO-FCTC.
d. Mechanisms of collaboration established with local governments and key stakeholders
including the civil society with the exception of the participation of the representatives
from the tobacco industry.
e. DOH needs to clearly and formally dene the SWAT mandate, roles, and membership;
ensure clear policies to prevent tobacco industry participation and interference with its
work; and enable collaboration with other government authorities in both decision taking
and technical levels.
A cessation resources mapping should precede the establishment of the cessation infrastructure/system at the local level, and existing cessation resources should be absorbed or incorporated within the tiered system.
Counseling formats other than face-to-face programs should be considered, especially
as demand for cessation services increases.
Making cessation drugs more available should be addressed. These cessation aids need
to be incorporated into the national formulary.
2. Finalize, endorse, and widely promote a standard set of tobacco cessation practice guidelines and service delivery models.
3. Incorporate cessation training into the mandatory curricula and ongoing capacity building
initiatives of health professionals.
4. Expand PhilHealth insurance coverage to cover a package of evidence-based essential cessation services that includes brief advice at the primary health care level, access to intensive counseling such as a national quit line and, to the extent possible, pharmacotherapy
for those who are heavily addicted to tobacco.
5. Promote cessation with systematic advocacy campaigns.
V. Warn People about the Dangers of Tobacco
1. Packaging and Labelling
a. The DOH, in collaboration with other relevant government agencies, should assert authority
prominently in defense of the health of the Filipino people.
b. The DOH should implement the pictorial health warnings established through DOH AO
2010-13 among tobacco companies that have not led for an injunction and in all jurisdictions except those that are currently under legal dispute.
c. The DOH should invest in the FDA for upgrading its capacity to fulll its responsibilities and
coordinate related work with the Department of Interior and Local Government (DILG).
d. The LGUs should use their legal competences to ensure placement of counter-advertising/
health warnings at the point-of-sale (POS).
2. Public Awareness and Mass-Media Campaigns
a. The DOH should go beyond World No Tobacco Day, integrating media campaigns to the
wider tobacco control program as part of a long-term strategic plan.
b. The DOH should pursue the expansion of the nancial resources to produce and air mass
media campaigns
c. The DOH should focus on using a campaign content that works.
d. The DOH should pursue alternative channels for disseminating warning information.
VI. Enforce Bans on Advertising, Promotion, and Sponsorship
1. Strengthen the enforcement mechanism of the current TAPS restrictions, through coordinated action at local jurisdictions, under the DOH leadership and coordination.
2. Relying on its current formal mandate for monitoring and enforcing a ban on TAPS, the
DOH should advocate for it and take the lead in initiating and proposing a complete ban on
TAPS, without any exceptions.
VII. Raise Tobacco Taxes and Prices
1. Simplify the existing tobacco tax structure, signicantly raise tobacco product excise taxes,
and index taxes to ination in order to raise tobacco product prices and reduce tobacco use.
2. Earmark tobacco tax revenues for health purposes, including health promotion and tobacco
control.
3. Earmark tobacco tax revenues for programs that help those employed in tobacco-dependent sectors make the transition to alternative livelihoods.
4. Strengthen tobacco tax administration, increase enforcement, and tax duty free sales of
tobacco products in order to reduce tax evasion and avoidance.
5. Sustain and expand efforts to support the tobacco tax reforms and health promotion nancing mechanisms by building further capacity and generating further evidence with
the support of stakeholders such as the academe, CSOs, and other pertinent government
agencies.
(Note: Complete ndings and recommendations by the National Assessment Team can be accessed in the National Capacity Assessment Report for Tobacco Control The Philippines, May
2010)
ANNEX 9
Moving towards the next level: complete implementation of the WHO Framework Convention
on Tobacco Control
VISION: Tobacco-free people, communities, and environments
MISSION: To advocate, enable, and support complete implementation of the WHO Framework
Convention on Tobacco Control
GOAL: To attain the lowest possible tobacco use prevalence and the highest level of protection from second-hand smoke
APPROACHES:
2.1 Legislation and Policies in compliance with FCTC
Specic Objective:
To develop legislation and related policies, regulations, ordinances administrative issuances
and other measures to ensure timely compliance with all provisions of the WHO-FCTC, with
specic reference to WHO-FCTC articles that have deadlines, approved guidelines, or protocols. Legislation and policy components are clearly stated in national action plans.
RAP Country Indicators:
Measures to protect public health from commercial and vested interests of tobacco industry are in place and in accordance with WHO-FCTC Article 5.3 and its guidelines
Legislation and policy on protection from exposure to SHS compliant with the denition
of 100% indoor SF settings in accordance with Article 8 and its guidelines
Legislation and policy on packaging and labelling are in accordance with deadlines for
compliance and in accordance with the provisions of Article 11 and its guidelines
Legislation and policy on comprehensive ban on TAPS are in accordance with deadlines
for compliance and in accordance with Article 13 and guidelines
RAP country actions and current Philippine status:
RAP COUNTRY ACTIONS
PHILIPPINES
(-)
(-)
(-)
PHILIPPINES
PHILIPPINES
N/A
(-)
PHILIPPINES
On track
Limited
Limited
PHILIPPINES
(-)
(-)
Limited
(-)
PHILIPPINES
(-)
(-)
(-)
(-)
(-)
PHILIPPINES
Not sure
PHILIPPINES
(-)
(-)
(+)
PHILIPPINES
(-)
(-)
(-)
(-)
ANNEX 10
O
1. Legislation and policies
Focus on smoke-free legislation in LGUs;
review RA 9211 and amend; implement
Article 5.3 and guidelines
W
3. Governance and enforcement
2. Tobacco taxation
Develop a strategic national
communication plan to Include GHW,
smoke-free and Article 5.3
Framework for interface between the RAP 2010-2014 and MPOWER in countries
The MPOWER package is a series of six proven policies aimed at reversing the global tobacco
epidemic and include: Monitor tobacco use and prevention policies; Protect people from tobacco smoke; Offer help to quit tobacco use; Warn about the dangers of tobacco; Enforce
bans on tobacco advertising, promotion, and sponsorship; and Raise taxes on tobacco. (GATS
2009)
PHILIPPINE NATIONAL TOBACCO CONTROL STRATEGY 125