2008-12-31-世界卫生组织-2009_GATS_Country_report_Philippines_234页_2mb

2009 Philippines Global Adult Tobacco Survey (GATS) Summary

Core Content

The 2009 Global Adult Tobacco Survey (GATS) in the Philippines was a nationally representative household survey conducted to collect standardized data on tobacco use and control measures. It aimed to support the Global Tobacco Surveillance System (GTSS) and provide evidence for the development and implementation of targeted tobacco control interventions.

The survey was implemented by the Department of Health (DOH) and the National Statistics Office (NSO), with technical support from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC). It was funded by the Bloomberg Initiative to Reduce Tobacco Use.

Methodology

• Sample Design: A three-stage stratified cluster sampling method was used to ensure representativeness across gender and urban/rural areas.
• Sample Size: 12,086 households were selected, leading to 9,705 completed interviews.
• Response Rates:
  • Household response rate: 97.3%
  • Individual response rate: 97.4%
  • Overall response rate: 94.8%
• Data Collection: Conducted across the country, with interviews focusing on tobacco use, cessation, secondhand smoke (SHS) exposure, economics, media, knowledge, attitudes, and perceptions.
• Statistical Analysis: Data was weighted to reflect population characteristics, and estimates of sampling error were provided.

Key Findings

Tobacco Use

• Overall Prevalence: 28.3% of adults aged 15 and older (17.3 million) currently smoke tobacco.
• Gender Disparity:
  • 47.7% of men (14.6 million)
  • 9.0% of women (2.8 million)
• Daily Smokers: 80% of current smokers are daily smokers.
• Product Type:
  • 98% of men smoke manufactured cigarettes.
  • 83% of women smoke manufactured cigarettes.
• Average Daily Consumption:
  • Men: 11.3 cigarettes per day
  • Women: 7.0 cigarettes per day
• Age of Initiation:
  • Men: 17.4 years
  • Women: 19.1 years

Smokeless Tobacco Use

• Overall Prevalence: 2.8% of men and 1.2% of women currently use smokeless tobacco.

Cessation

• Quitting Attempts: 47.8% of those who smoked in the last 12 months made a quit attempt.
• Success Rate: Only 4.5% successfully quit.
• Interest in Quitting: 60.6% of current cigarette smokers expressed interest in quitting.

Secondhand Smoke (SHS) Exposure

• Home Exposure: 48.8% of adults allow smoking in their homes; 39.6% are exposed to SHS daily in their homes.
• Workplace Exposure:
  • 36.9% of indoor workers are exposed to SHS at work.
  • 30.8% of non-smokers are exposed to SHS at work.
• Worksite Policies: 65.4% of worksites have policies disallowing smoking in closed areas.
• Public Exposure:
  • 55.3% of public transport users are exposed to SHS.
  • 33.6% of restaurant users are exposed.
  • 25.5% of government building users.
  • 7.6% of health care facility users.

Economics

• Monthly Expenditure on Cigarettes: PHP326.4 for manufactured cigarette smokers.
• Popular Brands: Fortune, Marlboro, Champion, and Hope.
• Economic Cost: Estimated 1–2% of GDP is spent annually on health and economic costs due to tobacco-related death, disease, and lost productivity.

Media

• Anti-Cigarette Ads: 80.0% of adults noticed anti-cigarette advertisements, most commonly in healthcare facilities (47.2%), on TV (59.7%), radio (38.6%), newspapers/magazines (30.9%), billboards (25.9%), and malls (23.6%).
• Pro-Cigarette Ads: 71.2% noticed pro-cigarette advertising, mostly in stores (53.7%), posters/leaflets/calendars (31.7%), and TV (24.3%).
• Pro-Cigarette Promotions: 29.1% noticed brand-related promotions, including 18.3% on clothing, and 2.8% on sponsorships.

Knowledge, Attitudes, and Perceptions

• Awareness of Health Risks: 94.0% of adults believe smoking causes serious illness.
• Awareness of Specific Illnesses:
  • Stroke: 75.5%
  • Heart attack: 81.3%
  • Lung cancer: 95.6%

Policy Implications and Recommendations

• Amend R.A. 9211: To ensure complete smoke-free environments in all indoor public spaces, workplaces, and selected outdoor areas.
• Implement Cessation Programs: Develop and implement effective cessation programs.
• Pictorial Warnings: Pass laws requiring pictorial warnings on all cigarette packages.
• Ban Pro-Tobacco Advertising: Enact a law to ban all direct and indirect pro-tobacco advertising, promotion, and sponsorship.
• Adjust Tobacco Taxes: Periodically adjust tobacco taxes to keep pace with inflation.
• Sustain GATS: Continue the GATS as part of the GTSS and link it to tobacco control program objectives.

Additional Context

• Historical Data: The Philippines has a long history of tobacco surveillance, with early data from the 1980s and 1990s.
• Mortality and Costs:
  • Annual productivity losses from smoking-related diseases (lung cancer, cardiovascular diseases, coronary artery disease, and COPD) range from US$65.4 million to US$5.00 billion.
  • Total costs of illness for these diseases were estimated at US$6.05 billion using SAMMEC methodology.
• Economic Context:
  • The Philippines is a medium-income country with a GNP of Php2,478,809 billion in 2009.
  • Health expenditures to GDP remain low at 3.3%, well below the WHO-recommended 5% for developing countries.

Conclusion

The GATS provides critical data for understanding the burden of tobacco use and its associated health and economic consequences. It underscores the need for stronger tobacco control policies, increased public awareness, and more effective cessation programs. The findings serve as a foundation for policy-making and program implementation at the national and local levels.