Rizalina Gonzales, MD
MANILA, Philippines — Gian, a third-year high school student, has never had to worry about how to get alcohol after class.
Gian studies at a public high school in Santa Rosa, Laguna, where there is no shortage of convenience stores and sari-sari stores selling colorful alcopops or pocket-sized “kiddie packs” of cigarettes. Often, they’re the same stores that sell them pens and snacks.
“If I want to drink alcohol after school like the other kids my age do, there are many ways I can do it. Access isn’t an issue; you just need to put money in front of them, and they will give you what you want,” he says, still in his school uniform. “Nobody stops us, and nobody notices. It’s easy for us to get these products.”
But this isn’t just a matter of visibility. The impact is quantifiable—and staggering.
In 2021, more than one in five Filipino adolescents aged 10 to 19 had already tried alcohol, according to the Department of Science and Technology. Nearly two million children in that age group are drinking regularly today. Meanwhile, one in eight youth use tobacco, often starting before they fully understand the long-term consequences. Together, alcohol and tobacco are responsible for at least 115,000 deaths every year in the Philippines.
The financial toll is equally devastating. The economic cost of alcohol and tobacco use—including healthcare spending, lost productivity, and premature death—reaches an estimated P1.1 trillion annually. And yet, in 2022, seven of the largest alcohol and tobacco corporations in the country reported over P72.2 billion in net profit.
For Department of Education nurse Imelda Tubao, the problem, whether in drinking alcohol or smoking cigarettes, starts early. Assigned to five public elementary schools in Manila City, she says asthma and other respiratory afflictions caused by smoking are slowly rising. It wasn’t like this when she started two decades ago.
“We see it all the time outside the school, children as young as 14 drinking. They will want to be like their peers, but there are parents, high school students, and even teachers who smoke,” she says in Filipino.
In the communities she serves, it’s common for kids to start out fetching a pack of smokes or a beer for a friend or an older sibling. Eventually, they become consumers themselves.
Without fail, there’s a pack of ambulant vendors waiting by the gate of the schools she works in once the bell rings. She says they’re protected by the barangays, despite a Department of Education order banning the sale of these products to children. Wherever they look, they’re bombarded by images of smoking, drinking, and vaping. In a country whose culture has so willingly embraced these products, these signals are ubiquitous.
“Even when they’re not near the school, the kids are the ones who go to them. No matter what the school and the parents do, we aren’t with them all the time, and we can’t control them,” she says.
Grace Barbados, a mother of five in Quezon City, says the problem isn’t just accessibility; it’s normalization.
Her children, who attend General Roxas Elementary School, are constantly exposed to subtle messages that drinking and smoking are part of life. At school, kids trade stories about which vape flavors they’ve tried.
“When I first found a pack of cigarettes in his bag, my blood was boiling,” she says of her eldest son, who was only 14 at the time. “But all his friends did it, and he wanted to fit in.”
Grace runs a sari-sari store directly in front of the school’s main gate. She says the children aren’t shy about vaping on the street within view of teachers and guards. Even when stores follow the rules, the products remain accessible, from 24-hour vape stores to online sellers who deliver directly to minors. The problem, she says, is that these products are everywhere, marketed like candy and easier to buy than books.
“It’s not hard. Some of them even bring alcohol to school. They just pack it in tumblers so they can drink during class,” she says. “I worry for my daughters. I can feel that they’re being targeted by the industry.”
The common trend with these products is how normal they’ve become, especially in the lives of children. Vape is framed as a healthier option. Alcohol is part of every celebration. Cigarettes are still being sold by the stick outside school gates.
This normalization is no accident. It’s the result of decades of deliberate marketing, strategic placement, and weak enforcement. These products don’t have to be advertised as “for children” for them to become consumers. They just have to be everywhere and within reach.
But the call for stronger regulation is gaining ground. On April 8, hundreds of doctors and health advocates with the Sin Tax Coalition gathered at the Lung Center in Quezon City to demand higher taxes on vape, alcohol, and tobacco. By name, they called out election candidates whose track records show they’ve sided with industry over public health. In March, no less than the Department of Health affirmed this call, recognizing alcohol, vape, and tobacco as threats to Filipino youth and public health.
As we head into the May elections, voters like Gian, Imelda, and Grace won’t just be choosing candidates but leaders who will stand up to industries and protect children from early exposure, addiction, and long-term disease.
The question is no longer whether we need regulation — it’s whether we choose leaders who have the courage to act.
Dr. Riz Gonzalez chairs the Committee on Tobacco and Nicotine Control and Cessation of the Philippine Pediatric Society.
