Background:
In 2003, the Philippines passed extensive tobacco control legislation, including minimum legal sales age (MLSA) laws, textual warning labels (TWL), and smoke-free public places (SFPP), and pricing strategies. This study examined the impact of these tobacco control policies on cigarette smoking among Filipino youth 13 to 15 years old who attended school.

Methods:
Data from the Philippines Global Youth Tobacco Surveys were analyzed (2000, 2004, 2007, 2011, and 2015). Sample sizes ranged from 3,708 to 5,919, and response rates from 79.5% to 84.8%. Current cigarette smoking was defined as smoking cigarettes on ≥1 day in the past 30 days. Current use of other tobacco products (OTP) was defined as using tobacco products other than cigarettes on ≥1 day in the past 30 days. Annual average cigarette price was obtained for each year from Euromonitor data, and converted into 2015 Philippine pesos Tobacco control legislation (MLSA, TWL, and SFPP) was coded as all three components in effect (1) or none in effect (0, reference). Logistic regression was used to model the association of tobacco control laws with current youth cigarette smoking, adjusting for cigarette price, age, sex, and current OTP use.

Results:
Tobacco control legislation was associated with declines in current cigarette smoking among youth (AOR: 0.65, p< 0.0001). The price of cigarettes was not significantly associated with current cigarette smoking (AOR: 1.01, p=0.2895], which is likely related to the timing and relatively limited magnitude of price increases during this period. Age, sex, and current OTP use were associated with current cigarette smoking (p< 0.0001).

Conclusions:
The development and implementation of the 2003 tobacco control legislation was associated with decreases in current cigarette smoking among Filipino youth in school. Continued implementation and enforcement of comprehensive, evidence-based tobacco control policies can help reduce tobacco use among youths.