Wednesday, May 26, 2010

Up in smoke

This was my column on the date indicated above. This post is antedated.

So the presumptive president is a heavy smoker. If we are to believe reports, he consumes three packs of cigarettes a day.

I know Benigno Simeon Aquino III smokes because I have seen him smoke. When we invited him last February to speak at the general membership meeting of the professional association that I am part of, he had a few minutes before he was due to enter the hall and he took the opportunity to grab some puffs from his Marlboro lights menthol at the designated smoking area.

We all know Noynoy Aquino smokes because it was made an issue during the campaign and it looks like the habit had been turned into a defining issue of his presidency. Whether Aquino likes it or not, whether we like it or not, people will continue to talk about his smoking for many reasons.

But is it really fair to make a big deal out of it? We know a lot of our leaders smoke—I can name quite a number of senators and congressmen who do smoke. Former President Fidel Ramos used to be a heavy cigar smoker although he was supposed to have given it up midway through his presidency (he continued to carry an unlit cigar with him in various public appearances, though).

Aquino never hid his smoking from the public—he has been photographed many times with a cigarette in his fingers. He has also acknowledged publicly that he does smoke. When asked when he would quit the habit, he has never made categorical statements about when he would drop it—just that he would quit at the appropriate time, which really means he will stop when he feels like it. At the height of the campaign, Aquino went on record to acknowledge that smoking relieves him of stress—which was probably indicative of the particular psychological context around his habit.

As someone who used to smoke heavily—and who continues to smoke an occasional cigarette or two when in the company of friends who smoke—I feel a certain empathy towards Aquino’s situation. It’s not easy giving the habit up. I have succeeded in reducing my cigarette intake dramatically—I can go for days without smoking without suffering from withdrawal symptoms. But then again, I am not president of this country and the pressures of my jobs are miniscule compared to what Aquino has to contend with.

But like Aquino, I also used to feel annoyed whenever people felt obliged to give me a lecture about the harmful effects of smoking or whenever friends and relatives hounded me about the need to give it up. The way I saw it, as long as I wasn’t bothering anyone with second-hand smoke, people had no right to pressure me into giving up my habit. There were even a couple of times when I felt compelled to point out that I was using my own money to buy my own cigarettes anyway. It’s just annoying when people pester you about it as if you are a lesser person for having picked up the habit to begin with.

People who smoke know the harmful effects of smoking. Some may be in denial, yes; but let’s make no mistake about it—we know. Aquino knows. Most smokers know more about the effects of smoking than the average person does so pointing these out do not do any good; it’s really like telling a diabetic that sugar is bad for him. It also does not help when people feel compelled to conjure all kinds of dreadful scenarios such as the specter of lung cancer. Talking about long-term effects also does not help precisely because for smokers, the need is often urgent and pressing—as in now, not in ten years. The need is for quick gratification.

Smoking is not a simple and straightforward matter. Very few people can quit the habit cold turkey. Simply put, smoking is most often an addiction. And addiction is a subconscious thing and therefore often beyond the realm of reasoning. One cannot stop a person from smoking by arguing with him or appealing to reason.

This is the reason why I have reservations about the move to put pictures of the harmful effects of cigarettes on cigarette packs. Sure, we should put programs in place that would discourage people from smoking particularly very young people.

But I’m not really sure shock therapy works. I’ve been in countries where they put shocking pictures on cigarette packs—I’ve even bought samples of cigarette packs showing graphic pictures of decaying teeth, open sores in the mouth, or emaciated people presumably dying of lung cancer to show to my students—and these haven’t really reduced the number of smokers in these countries.

There are behavior specialists who argue that repeated exposure to negative or shocking pictures can result in a different kind of conditioned response—people can get used to the pictures and not see the harmful effects anymore. A friend who used to work at a government hospital swears this is true: You get used to seeing pain and suffering around you, in time you don’t even get affected anymore. A friend who works actively caring for people living with HIV/AIDS used to get depressed every time he came face to face with the harsh realities of the disease—but he eventually learned to get used to it. We get used even to the most dreadful stimulus.

Shock also often results in denial; instead of empowering people to consider various options, they feel compelled to rationalize their habits such as by thinking it won’t happen to them or that the negative images don’t have anything to do with them. And obviously, no amount of negative stimulus or persuasion can convince a person who smokes because of psychological reasons to begin with. Addiction is a sickness—it’s not something you can reason with.

And definitely reducing smoking into a moral issue and turning it into a character issue is even more infuriating. Surely there is a lot more about a person than one habit.

So yes, I empathize with Aquino’s situation. I can even go as far as agreeing with him when he said his smoking is probably the last of his remaining freedoms although that’s not really true. He is still single, after all.

On the other hand, I also understand the clamor for Aquino to quit smoking. Smoking may not be as serious an issue when considered at the individual level. However, it is a very serious issue when we look at its impact at a more macro perspective. Smoking-related illnesses when taken together at the national level pose a serious drain on national resources. A third-world country such as the Philippines has many more urgent health concerns that it can pour money into such as vaccination programs that will eliminate certain diseases as well as more basic health care programs for the citizenry. Statistics at the national level are difficult to ignore and lest we forget, these are the kinds of data the President of the Republic should be concerned with.

It is the job of the Department of Health to campaign against smoking. The problem is, there is no way it can succeed in this campaign for as long as the chief executive of the country remains a smoker. It’s just ridiculous having a health secretary going out there telling people about the harmful effects of smoking when everyone knows the president cannot kick the habit.

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