Young smokers
The Young Adult and Fertility Sexuality Study (YAFS), conducted by the University of the Philippines Population Institute (Uppi), is the most comprehensive youth survey in the Philippines. The last one was conducted in 2002, with results released in 2004. YAFS-4, with more than 19,000 respondents nationwide, was conducted in 2013, with some of the results released two weeks ago.
Last week I wrote about the most alarming finding from this latest YAFS: an almost tripled increase in the numbers of teenage mothers (aged 15 to 19). Today let’s examine the best news coming out of the survey: use of cigarettes, alcohol and drugs seems to be on the decline among young Filipinos.
Here are the raw statistics:
Current smokers among the young declined from 21.6 percent in 1994 to 20.9 percent in 2002 and 19.7 percent in 2013. Among males, the percentage of currently smoking youth dropped from 40.4 percent in 1994 to 35.4 percent in 2013. Among females, current smokers went from 4.2 percent in 1994 to 5.9 percent in 2003 and then dropped to 4.7 percent in 2013. Note that the last figure for females is still higher than in 1994.
For current drinkers, the incidence was 37.4 percent in 1994, 41.4 percent in 2002 and 16.6 percent in 2013.
The percentage of youth who have ever used drugs went from 5.7 percent in 1994 to 10.6 percent in 2002, but dropped to 3.9 percent in 2013.
Uppi includes smoking, drinking and drug use in its survey because even if these are “nonsexual risk behaviors,” these can affect a person’s sexual decisions and practices. It will release more statistics in the weeks ahead, and I’m hoping to get more details on these risk behaviors. Today I thought we should look at the cigarette use.
I am happy to see the declines, which have been reported as well in other studies of the Department of Health and the Global Youth Tobacco Survey, but I still worry that the declines are too slow. We’re talking about large numbers of young people. Using the statistics from YAFS and applying these to the current population of young people aged 15 to 24, we would have 3.6 million young male smokers and 465,000 young female smokers.
That’s still a bonanza for the tobacco industry because studies worldwide show that once young people start smoking, that will mean years, even a lifetime, of addiction. Dependency on nicotine is serious, as difficult as with “hard” drugs, making it very difficult to stop. The health problems we hear about in antismoking campaigns—mainly cardiovascular disease, lung disease, cancers—come from the other ingredients of tobacco, but it is nicotine that keeps people hooked.
Glamour and more
We need to look at why young people are still picking up the habit. Even at UP, which is supposed to have the brightest young people, many of the students, and faculty, still smoke.
We need to look at the meanings of smoking. In my student days—the 1970s, seemingly quite ancient for students today—smoking had many meanings. For the burgis or bourgeoisie (jologs today), it was a sign of status and sophistication, especially if one used “blue seal” (imported, smuggled) brands. For the activists, it was a sign of commitment to the movement, smoking to keep awake during DGs (discussion groups) and long nights of working on manifestos and newsletters. For the professors, it was a sign of learning, especially if one used a pipe. Smoking was permitted in classrooms, and I still run into students who remember how heavily I smoked while lecturing; some even joke that smoke came out of my ears.
Times do change. Smoking incidence is dropping rapidly among the upper classes, and is seen as almost vulgar. But the middle and lower classes still think it’s glamorous to smoke. Among young people in the outsourcing industry (for example, call centers), smoking incidence is also very high, and is seen as a way of reducing work-related stress.
We need to probe more deeply into young people’s reasons for smoking, and their knowledge of the risks, which I suspect are still underestimated. I still hear them arguing that they have lolos or lolas who lived to a ripe old age even as smokers. Antismoking advocates need to be clearer that there is a genetic component to the risks for cancer—so, yes, some people will smoke till they’re 100 and not come down with cancer. But they end up with all kinds of cardiovascular and respiratory illnesses, including emphysema which, when serious, produces the constant feeling of drowning.
Gender and smoking
Young people feel invincible when it comes to disease, so we may need to look into the gender angle. For both males and females, we can appeal to youthful vanity. Inhaling smoke several hundred times a day, and pursing the lips, create a distinct smoker’s face which is not very appealing, exacerbated by another effect of smoking: premature wrinkling.
Then there’s the sexuality angle. Brazil has a great warning on its cigarette packages showing a woman with her thumbs down, while in the background is a man looking downward, dejected and rejected. The message: Smoking increases risks for erectile dysfunction disorder. In Filipino it sounds more ominous: nakakabaog, which means both impotent and infertile.
There’s still another image that needs to be challenged: that of a smoker being macho. I was grappling with the question of where the macho smoker image was coming through, given that movies and TV shows have reduced their depiction of smoking. It came to me one day, after reading that the large American drugstore chain, CVS, had announced that it would stop selling cigarettes. I decided to check a nearby Mercury Drug store and as I drove up, I spotted a security guard at the driveway, looking very dapper… and smoking away. I was glad to find out that the chain does not sell cigarettes, but it should also get their guards not to smoke, especially in public view. It isn’t just Mercury. I’ve become more conscious now of the high numbers of security guards who smoke, often while on duty.
Think now of a boy in the streets or the slums looking for role models. He sees Tatay and other men in the community smoking, and this will influence him to pick up the habit. But a smoking security guard, or policeman—really anyone in uniform, including rebel soldiers in rural areas, another group that chain-smokes—is even more dangerous in projecting not just machismo but also power and domination. For upper-class kids these men in uniform are just employees, but for a poor kid these are idols to be emulated.
We have to work harder to stop young people from picking up the habit. That includes e-cigarettes, which may be smokeless but whose main ingredient is the highly addictive nicotine. If we don’t work harder on reducing the number of young smokers, the costs of caring for their smoking-related illnesses will be tremendous. I hear people saying that the problem of “nonperforming assets” is good in terms of family planning, but we’re talking about a “package deal” of many different diseases, including chronic ones which mean long-term treatment, and expenses. Think, too, of premature deaths, meaning people dying early, and leaving behind their young children.
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