Public health policy experts said excessive regulation on innovative smoke-free products that are far less harmful than traditional cigarettes will only fuel the smoking epidemic and spawn the expansion of the underground market.
“If you make vaping more difficult, less satisfying, harder to access, or more expensive, then expect more cigarette smoking, a black market, user workarounds and more ill-health, accidents and crime,” said Clive Bates, director of Counterfactual Consulting Ltd. and former director of Action on Smoking and Health (UK).
Bates, along with tobacco treatment clinician Dr. Colin Mendelsohn and harm reduction advocate Dr. Alex Wodak, said less harmful alternatives such as e-cigarettes and heated tobacco products can help countries like the Philippines reduce the smoking problem that kills 100,000 Filipinos a year.
Wodak, emeritus consultant for Alcohol and Drug Service at St. Vincent’s Hospital in Sydney, said smoking actually affects about 1.1 billion globally. “Up to two out of every three long-term smokers will die from a smoking-related condition. About eight million people around the world die every year from smoking. Most of these deaths are from cancer, heart or lung disease,” he said.
Around 17 million Filipinos continue to smoke cigarettes, and over 100,000 of them die of smoking-related diseases such as cancer, cardiovascular disease and lung disease each year, data from the World Health Organization show.
Wodak said it is time to consider the merits of alternatives to cigarettes. “It is now 20 years since vaping was developed by a pharmacist in Beijing. Commercial forms of vaping started in 2006. Different kinds of studies confirm that vaping is much less dangerous than smoking. Several highly regarded scientific organizations estimate that vaping is at least 95-percent less risky than smoking. Vaping allows smokers to continue ingesting nicotine but without the tars and many other dangerous chemicals contained in cigarette smoke,” said Wodak, who is also the director of Australian Tobacco Harm Reduction Association.
He said harm reduction, or the use of less harmful alternatives, will help the Philippines reduce the smoking problem. “The idea of people continuing to use a psychoactive drug but avoiding most or all of the health, social or economic costs is called ‘harm reduction’. Indeed the Philippines used harm reduction extensively to minimize the spread of HIV among and from people who inject drugs,” he said.
Other Southeast Asian countries such as Thailand and Malaysia are now seriously considering making it easy for smokers to switch from deadly cigarettes to much lower risk vaping according to Wodak. “The United Kingdom and New Zealand are examples of western countries which make it easy for smokers to switch from smoking to vaping,” he said.
“Indeed. If we accelerate the declining smoking rate, this will over time reduce healthcare expenditure. Adding vaping to existing tobacco control policies will help accelerate the decline in smoking rates. I very much hope that the Philippines will make it easy for smokers to switch to vaping. This will also require risk proportionate regulation,” Wodak said.
This was supported by Mendelsohn, a member of the Expert Advisory Committee of the Royal Australian College of General Practitioners Smoking Cessation Guidelines, who said vaping, the most popular and most effective quitting aid in Australia and other western countries, has helped millions of smokers globally to quit. “It is a far safer alternative to deadly cigarettes for addicted smokers who are otherwise unable to quit,” he said.
Mendelsohn, founding chairman of the ATHRA, said evidence from other countries show that these less harmful alternatives can help smokers quit and lead to accelerated decline in the national smoking rate.
“Vaping has resulted in the accelerated decline in national smoking rates in other countries where it is legally and readily accessible for adult smokers. Other nicotine products such as heated tobacco and nicotine pouches are also safer alternatives to smoking and effective quitting aids. I strongly support legislation to make these products available to adult smokers. This legislation will lead to substantial improvements in public health,” he said.
He said such legislation will prevent hundreds of thousands of premature deaths from smoking in the Philippines.
Filipino legislators already ratified the bicameral conference committee report on the proposed Vaporized Nicotine Products Regulation Act which aims to regulate the use, manufacture, importation, sale, distribution, and promotion of vaping and HTPs in the country. It now awaits the signature of President Rodrigo Duterte to become a law.
The vape bill strikes a good balance between consumer protection and giving ordinary people access to less harmful alternatives to cigarettes so that they can become smoke-free. Bates expressed hope that President Duterte will support the regulation of vaping and other less harmful alternatives to cigarettes.
“The bill sets up an excellent regulatory framework, carefully balancing the needs of people who smoke to access much safer alternatives to cigarettes and the protection of those who do not smoke or use nicotine. This is a fine balancing act and in my view, the bill gets it right,” Bates said.
“I hope the President will place his signature on the bill and give the Philippines truly independent legislation that will be among the best in the world,” said Bates, who previously worked for the UK government and the United Nations.
Bates also lauded the Filipino senators and congressmen for having “done a good job in drafting sound risk-proportionate legislation that has made its way through intense Congressional scrutiny and is now an example of world-class legislation.”
He said the government should also resist the opposition to the proposed bill from anti-vaping American billionaires like Michael Bloomberg. “He comes with a crude prohibition agenda and has been operating in the Philippines since 2011, building his influence by funding public health groups and the civil service,” Bates said, referring to charities financed by Bloomberg to promote vaping ban in many countries.
“The government and President should look hard at their [Bloomberg’s charities] advice and ask if it is compromised. Everyone should ask if their opposition to this legislation is really in the interest of Philippines citizens. Almost everything they propose for regulating vaping, for example, would protect the cigarette trade, stimulate black markets and add to the national burden of ill-health and crime,” he said.
