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Where there's smoke...

The danger of secondhand smoke is more insidious than we think.

by Korina Tanyu, M.D.


These days, the term “secondhand smoke” is not so alien. But awareness of its dangers still needs to catch on.

Passive smoking

Secondhand or passive smoking is the inhalation of smoke by persons other than the intended “active” smoker. The offender is a mixture of gases and fine particles from smoke exhaled from a burning cigarette, cigar or pipe. It contains more than 7,000 chemical compounds, 250 of which are known to be harmful. At least 69 of these are known to be carcinogenic or cause cancer.

In 2004, around 603,000 people died prematurely due to secondhand smoke. Of all the deaths attributed to secondhand smoke, 28 percent occurred in children and 47 percent were women. The Department of Health (DoH) says 23.9 million Filipinos are exposed to tobacco smoke daily, with 66.7 percent of workers exposed to secondhand smoke in worksites, and 75.7 percent exposed to secondhand smoke where there is no anti-smoking policy.

This is not surprising in a country hailed by the American Cancer Society and World Lung Foundation as among the top smokers in the world. Of the nearly one billion smokers worldwide, the Philippines contributes 17.3 million smokers aged 15 and up, according to the 2009 Global Adult Tobacco Survey.


Tobacco kills nearly six million people each year, of whom more than five million are users and ex-users, and more than 600,000 are non-smokers exposed to secondhand smoke. The Philippine Cancer Society reports that each year, about 3,000 non-smoking adult Filipinos die of lung cancer as a result of breathing secondhand smoke.

An array of maladies

Smokers are at risk for several diseases, including cancers, cardiovascular diseases and respiratory diseases. However, several studies have shown that secondhand smoke or passive smoking can also cause the same diseases associated with smoking. The International Agency for Research on Cancer concluded in 2004 that secondhand smoking is carcinogenic to humans. In adult non-smokers, secondhand smoking increases the risk of lung cancer by as much as 30 percent.


Manuel Silos, M.D., a pulmonologist from the Medical City in Pasig, adds that secondhand smoking has detrimental effects to other organs in the body aside from the lungs. There is an increased risk of heart disease by 25 to 30 percent, as well as an increased risk for myocardial infarction or heart attack especially in those with pre-existing heart disease. Active or passive smoking contributes to chronic rhinosinusitis, as well as triggers asthma attacks. Infants and children who are exposed to secondhand smoke are at risk for sudden infant death syndrome, acute respiratory infections, ear problems, and more severe asthma. Smoking by parents causes respiratory symptoms and slows lung growth in their children.

Dr. Silos says the amount of harm secondhand smoke causes is related to exposure. The longer one is exposed to it, the greater the harm. As an example, occupations which involve exposure to cigarette smoke are at higher risk, such as bartenders or waitresses in establishments that allow smoking.

Smoke screens

Despite what the name suggests, we do not have to suffer passive smoking in silence. Proactive measures can be taken where defensive breathing is probably our best offense. The government recognized this in passing the Tobacco Regulation Act of 2003 (Republic Act 9211), which prohibits the carrying of any lighted tobacco product in public vehicles, schools, health centers, elevators, cinemas, malls and places where fire hazards are present. Smoking is also banned in recreational facilities for minors, with fines imposed for violators.

The DoH mandates that all cigarette packs carry a prominently displayed caveat, “Cigarette smoking is dangerous to your health.” While it’s a step in the right direction, graphic health warnings—pictures that depict the gruesome effects of the habit, which have been proven more effective in discouraging smoking—have yet to be implemented.

Some cities in the Philippines have taken the anti-smoking campaign a step further. The Metro Manila Development Authority (MMDA) apprehends those smoking in public areas with a fine or a required viewing of a video on smoking cessation. Davao City has been successful in implementing a smoking ban for 10 years now. Other Philippine cities with a smoke-free campaign include Legazpi City, Albay and Iloilo City.

Our lawmakers are in the process of tackling the restructured Sin Tax Bill. Once passed, higher taxes on tobacco and alcohol will be imposed—which will not only discourage smokers, but also generate much-needed revenue for the government. Cigarettes sold in the Philippines are among the cheapest in the world, because most other countries already have sin taxes in place. It is fervently hoped that this important bill makes its way past political roadblocks and resistance from tobacco companies, so we can all breathe a little easier.

Laws are not enough to keep us from avoiding secondhand smoke. How do we protect ourselves? Read more in the August issue of HealthToday, out now in bookstores and newsstands.

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