To Smoke or Not to Smoke: A Qualitative Study of Smoking in the Philippines

The Philippines has one of the highest smoking rates in Southeast Asia. Despite this problem, there is a dearth of research on smoking patterns and behaviors of Filipinos. The study to be presented explores the interpersonal, cultural, and environmental factors that influence smoking behavior among Filipinos.

This study conducted in two areas of the Philippines in 2007 uses in-depth interviews (n =66), environmental observations, and daily journal entries. Thematic analysis of the narrative qualitative data was performed using ATLAS.ti.

Results show that respondents who smoked initiated smoking during their teenage years, when they felt time with their family significantly decreased. A recurring theme was that respondents initiated smoking because of both internal and external pressure felt from their smoking peers. Two core Filipino cultural values, namely "pakikisama" (getting-along with others so as to avoid conflict) and "hiya" (shame), made it difficult for respondents to refuse or not join their peers from smoking. Environmental factors that reinforce and support smoking behavior include cigarettes' affordability, accessibility to minors, and weak enforcement of the existing tobacco control policies.

Study findings suggest that combating the smoking problem in the Philippines requires stronger enforcement of tobacco control policies, community and school-based smoking prevention and cessation intervention, and anti-smoking media campaigns. Also important is increased parental involvement and supervision of their teenaged children.