‘Sin tax’ is also a ‘health tax’

Increased smuggling, tobacco farmers losing their livelihood, even the rights of individuals who, despite countless warnings, persist in maintaining their smoking habit—all these have been brought up as “legitimate” concerns that legislators should take into consideration as they debate and get ready to vote on the “sin tax” bill.

At the risk of oversimplifying, the bill proposes to increase the taxes on tobacco and alcohol products (in the case of tobacco, a “three-tier” system of taxation will be adopted) not just to enable the government to earn more taxes, but also to collect more money for the government’s efforts to limit tobacco and alcohol use.

Cancer is one disease that has been linked to smoking, the current theory being that nicotine and other substances in cigarettes not only cause cancer but also lower the capacity of a smoker’s immune system. Medical authorities also assert that aside from cancers, smoking has also been linked to heart attack, stroke and chronic obstructive pulmonary disease (the disease that killed “King of Comedy” Dolphy), three major causes of deaths in the Philippines.

The annual cost of diagnosing and treating these four leading smoking-related diseases, says a primer on the issue, “is a staggering P177 billion.” Indeed, even if the sin tax bill is approved, “the government is expected to only generate an estimated P33 billion from the first year of its implementation.”

Still, the money would come in handy, especially in putting in place a system of universal health care. “At the same time, by increasing the price of tobacco to a point where youth and children cannot afford it, we are preventing young people from taking up this deadly habit.”

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The “sin tax” is commonly perceived as a revenue bill, since it would raise the taxes imposed on so-called “sin” products. The thinking is that since cigarettes and liquor are not “essential” products (save maybe for addicted smokers and alcoholics), they can be considered “optional” or “luxury” products that smokers and drinkers would be willing to pay premium prices for.

The reality, though, is that the Philippines has among the lowest prices for cigarettes and liquor in the region. Cheap cigarettes, paired with uncontrolled advertising and promotional activities, made smoking a most accessible and available habit, one fostered, among other things, by peer pressure.

Which is why the Department of Health is urging the Senate (the bill has been passed by the House of Representatives) to look at the proposed measure as a “health bill,” and more specifically, as “an anti-cancer tax.”

“What we are asking our good senators is to put the health of our people as the priority concern in approving this tax measure,” says a group of health experts. “It is just right and responsible to tax the tobacco industry considering the billions of pesos that our health care is forced to carry because of the disease burden from smoking.”

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Health concerns regarding smoking gain even more urgency considering that lung cancer (the form of cancer most directly linked to smoking, but not the only one) is the leading cancer in the country, and that “if we do not do something, there will be a major epidemic of lung cancer among Philippine men.”

(A study in 2008 showed that 11 percent of all deaths in the Philippines were attributed to cancer.)

The World Health Organization, says the briefing material, estimates that a fourth of all types of cancers can be attributed to smoking. “Tobacco is responsible for 71 percent of lung cancer deaths in the world,” says the material, “while the high rates of lung cancer among Filipinos can be attributed to high smoking rates, particularly among men.”

Surveys estimate that about half of all men in the country are currently smoking. “It will not be surprising to see an epidemic of lung cancer among our productive members in the workforce within the next 10-15 years. While this is expected mainly among men, “a lot of women will also develop lung cancer from exposure to second-hand smoke.”

This leads to an almost-apocalyptic scenario, though based on facts and reality. “(M)any children (will be) orphaned early and will have a negative effect on our economic development. This will also cost the Philippines billions of pesos for health care, chemotherapy and palliative care. A major lung cancer epidemic could deplete our resources for universal health care. So we need to focus on prevention.”

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Not only that. While smoking may be the leading cause of lung cancer, it can also increase the risks of other types of cancer, such as cancer of the larynx, esophagus, stomach, pancreas and the colon, and anus.

In one conference on cervical cancer, one speaker also mentioned a “stronger link” between smoking and cervical cancer than even lung cancer. This was mainly because of nicotine’s adverse effect on immunity levels.

You don’t even have to be a smoker to be at risk of cancer. You just have to live with a smoker, or spend a lot of time with one. The International Agency on Cancer Research classifies second-hand smoke as a carcinogen, and since cigarette smoke mixes with other noxious elements in the air, its impact on the second-hand smoker could be even worse.

The WHO says that half of all Filipino women and children are exposed to second-hand smoke. “Many women develop cancer not because they smoke but because they live with smokers.”

Truly, the “sin tax” bill is a bill for health, a bill against cancer.