Will raising taxes have a significant impact in the battle against smoking, malnutrition and illegal drug use?

Several groups of health professionals and civil society advocates believe taxation could be the solution to cut the number of smokers, the obese and malnourished in the country.

Specifically, they want the proposed Comprehensive Tax Reform Package pending in Congress to include stiffer taxes for tobacco and sugar. Doing so, they said, will help tackle malnutrition, smoking and by extension, illicit drug use.

The Philippine Medical Association has joined forces with the Sin Tax Coalition - composed of 59 concerned groups and represented by Convenor Dr Antonio Dans - in asking government to make the pending tax reform package “pro-poor and pro-health.”

To do this, lawmakers need to agree to raise tobacco products by 60 percent, and to stipulate that all revenues collected from the sugar-sweetened beverage tax be used to lower the prices of healthy food.

The coalition believes this is an effective way to address two of the most critical health problems faced by the country today. Drug use, the coalition added, will likewise be addressed because of its link to smoking.

Former Health secretaries Dr Enrique Ona and Dr Esperanza Cabral, along with current Health chief Paulyn Ubial, backed the proposal.

Tobacco use a prelude to illicit drug use

Dr Dans noted that the Sin Tax Law passed in 2012 is already losing its effect as more people are going back to smoking, using either tobacco products or e-cigarettes. This scenario is a likely prelude to an increase in the number of drug users.

“It’s (smoking) a complication to drug use. The possibility of smokers taking up drug use in the future is 200 times more. Of the 4.5 million Filipinos who tried drugs, 1.5 million used tobacco use as gateway,” he explained, explaining their statistics.

The Dangerous Drug Board has found that people who got into illegal drugs were smokers first.

Other than being a possible introduction to illegal drugs, tobacco use exposes people to 49 life-threatening diseases such as stroke, heart attack, cancer and chronic lung cancer - all of which are in the top 10 causes of mortality in the country.

There are 150,00 deaths related to tobacco use, which further results to millions in annual losses.

PMA President Dr Irineo Bernardo added that in general, exposure to chemical fumes is not good for the health. He mentioned that physicians are seeing an increasing number of patients with respiratory ailments.

Four goals

Increasing tobacco tax by 60 percent in 2018, and 10 percent every year subsequently, would boost efforts in tackling the two major health problems. Doing so would achieve four goals, Dr Dans explained.

First, it will decrease the number of current smokers from 14.5 million to 13.5 million, which will translate to the second goal of reducing annual financial losses of at least Php210 billion from smoking-related diseases.

The third goal is to augment funds for universal health care, government infrastructure projects and crop diversification for tobacco farmers that will be displaced. Finally, the fourth goal is to institute tobacco control as a preventive measure against illegal drugs use.

Dr Dans further noted that without imposing stiffer taxes on tobacco, the country is looking at 550 new smokers daily beginning 2018, which will render ineffective whatever gains have been achieved with the Sin Tax Law of 2012.

“There will be a million more (smokers) at the end of the current President’s term,” he warned.

Dr. Antonio Dans (left) argues that addressing the smoking problem will simultaneously tackle drug use.
Dr. Antonio Dans (left) argues that addressing the smoking problem will simultaneously tackle drug use.

Sugar tax income to pave way for affordable nutritious food

Where malnutrition is concerned, the coalition is hoping that revenues will be utilized to make healthy foods more available to the public, a provision that must be incorporated as a specific purpose in the tax reform law.

“Forty million Filipinos declared involuntary hunger in 2016 while 12.5 million suffered chronic malnutrition based on a study of the Food and Nutrition Research Institute (FNRI),” Dr Dans pointed out.

Malnutrition is the underlying persistent cause of various illnesses such as pneumonia, diarrhoea, and tuberculosis which many in the country suffer from.

Dr Maricar Limpin of the Philippine College of Chest Physicians, said that they want to change the behaviour of the Filipino consumer with the SSB tax. With increased sugar intake, people will just “get bigger” but of a “hollow” kind, which is not healthy.

“We propose that all incomes from taxes on sugar-sweetened beverages be used to finance measures in reducing the cost of health foods to increase accessibility of this healthy food especially for the poor and near-poor and curtail the potential increase in the incidence of undernutrition,” she said.

Tax revenues to fund health projects

Dr Ona agreed that revenue from these taxes will not go to waste.

“From Php 21 billion that was DOH’s budget back in 2010, [we had gains of] Php 54 million, more than Php 80 million in the succeeding years - all because of the Sin Tax Law,” he said, as he noted that the Philippines is the first country to specifically earmark a law’s tax revenue for health projects. Other countries incorporate their tobacco tax earnings into their general fund.

“I fully support the Sin Tax and all other taxes similar to Sin Tax that will be earmarked for our health care,” Dr Ona declared.

Secretary Ubial, meanwhile, agreed even as she pointed out that the country still has a long way to go. “We are the only country that earmarked Sin Tax for our Universal Health Care and it helped a lot in terms of implementation of projects and programmes which upgraded our facilities.”

Still, this is far from being sufficient.

She pointed that Thailand spends USD 300 per capita, compared to the USD 130 per capita spent by the Philippines even with that increase.

The Health chief is looking forward to the tax package’s passage by Congress, and hopes to further discuss the matter with the Department of Finance and legislators to come up with a truly win-win solution for Filipinos in the area of healthcare. MIMS

Read more:

World No Tobacco Day: Health, economic, environmental threats due to smoking
Millions saved by anti-tobacco measures - WHO report