A House divided against itself

"Why raise decibel levels over trifling matters instead of conducting sober and intelligent debate on more important issues?"

Is the current leadership of the Lower Chamber of Congress, as the adage goes, "full of sound and fury signifying nothing"?

That appears to be so, from where we sit, as some of our elected representatives have opted to raise decibel levels over trifling matters instead of conducting sober and intelligent debate and discussion on how to fight the coronavirus contagion and the attendant high prices, widespread hunger and job losses.

Why not, indeed, discuss how to put more food on the table of poor Filipinos and create jobs and livelihood opportunities for those thrown out of work and have to scrape by on measly handouts?

Earlier this week, Deputy Speaker and Davao City Congressman Isidro Ungab accused former Speaker Alan Peter Cayetano and former Deputy Speaker Luis Raymund “LRay” Villafuerte of slashing millions from the pension and gratuity fund of retired military personnel.

The claim is totally unfounded, according to an insider. Ungab was the chair of the House panel on appropriations when the 2020 national budget was approved. The Davao lawmaker also headed the House contingent in the bicameral conference committee that sought to harmonize the budgets proposed by the House and the Senate. If any anomaly had taken place at the time, he had every opportunity to speak out. Some are wondering whether he has practically shot himself in the foot with his baseless allegation.

When Anakalusugan Rep. Michael Defensor rebuked the Velasco camp for reducing the military pensions and gratuity fund in the 2021 national budget, House committee on appropriations chair Eric Yap took the bullet for his colleagues and explained that he was at fault for not consulting Velasco on the matter.

It appears that certain lawmakers are pulling out all the stops and want to demonize the former Speaker, who has no interest at all in engaging them over petty issues.

The timing is very telling, however. With the 2022 national and local elections just around the corner, demolition jobs and character assassination are expected to be the order of the day.

The Cayetano camp is asking: Why are some lawmakers so obsessed with attacking him? Do they expect the former Speaker to run for a higher post? If this is the case, they should instead be spending their waking hours trying to surpass Cayetano’s performance.

But the current House leadership seems to be confused about its own priorities. Alas, it seems that under Velasco, the House of the People has become a House divided against itself. 

To ban or to regulate?

What should be done with another health issue involving the use of electronic cigarettes and heated tobacco products (HTPs)?

This is the question that the Department of Health (DOH) and its attached agency Food and Drug Administration (FDA) dealt with when they were tasked to issue the implementing guidelines for the regulation of these innovative and smoke-free products.

Unfortunately, the FDA issued Administrative Order No. 2020-0055 prematurely in January 2021 and failed to consider real-world evidence in other countries which were widely recognized for their separate tobacco control policies.

In September 2020, R Street Institute—a US-based non-profit public policy research organization—shared the results of the study titled “Exploring the Differences in Tobacco Policy between the United Kingdom and Thailand.”

While the two countries were recognized for tobacco regulation, they took opposite routes in terms of treatment of novel tobacco products such as e-cigarettes and HTPs.

It is something that Philippine regulators can learn from, especially as the country has one of the largest populations of smokers in the world—17 million, half of whom are expected to die of smoking-related illnesses if they do not stop smoking.

Two out of five males in the Philippines are smokers.

The study chose the UK because it is recognized as an exceptional example of tobacco use surveillance and monitoring. Thailand was also included for implementing many tobacco control policies supported by international public health organizations, including the World Health Organization (WHO).

The two countries, however, took opposite directions when it came to the issue of innovative smoke-free products such as e-cigarettes and HTPs. The UK embraced these products as less harmful alternatives to combustible cigarettes, while Thailand totally banned them.

The same “quit-or-die approach” by the WHO is being peddled by Bloomberg Philanthropies as we’ve seen here in the Philippines with the FDA, a regulatory body, admitting having received grants from the group in support of crafting tobacco control policies. Just like in Thailand, where Bloomberg funding may have influenced public regulations. According to R Street Institute, the smoking rate in the UK declined from 20 percent in 2011 to 15 percent in 2018, while Thailand’s smoking incidence barely went down from 21 percent in 2011 to 19 percent in 2017.

“While the rate of smoking has been steadily decreasing in the United Kingdom, decreases in the smoking rates in Thailand have been stagnant,” the study said. It particularly noted that the UK was most successful at reducing smoking rate among young adults (18 to 24 years old) who registered a 9-point decline in smoking rate between 2011 and 2019.

On why the UK posted a faster reduction in smoking rate compared to Thailand, R Street Institute said the availability of electronic nicotine delivery systems (ENDS) such as e-cigarettes and HTPs offers a plausible explanation. It said that with e-cigarettes being cheaper than traditional cigarettes in the UK, smokers might have taken the cue to switch to non-combusted nicotine alternatives. Thai smokers, however, did not have the same option.

“The United Kingdom’s approach to cessation which endorses harm reduction through the use of safer alternatives to combustible cigarettes stands in contrast to the Thailand policy of banning e-cigarettes and messaging against their use. It is likely this differentiating factor that moved the smoking rates down in the United Kingdom,” the study said. The UK is a leader in tobacco harm reduction (THR), a public health strategy that aims to reduce the harm from smoking cigarettes. The latest scientific assessment by Public Health England (PHE), an executive agency under the Department of Health and Social Care, provides evidence that e-cigarette is the most effective means to quit smoking.

In its seventh independent report on vaping in England, PHE said more than 50,000 smokers stopped smoking with the aid of a vaping product who would otherwise have carried on smoking in 2017.

It said using a vaping product had some of the highest quit success rates—between 59.7 percent and 74 percent in 2019 and 2020.

If the UK experience was not enough to convince Philippine regulators, they can look at the experience of a nearer country—Japan. The smoking population in Japan actually shrank by a third over the past five years since smoke-free products such as HTPs were introduced in the world’s third largest economy in 2014. The Philippines FDA should have weighed these real-world experiences first before issuing Administrative Order No. 2020-0055 or the guidelines on the regulation of vapor products and HTPs.

The FDA, already under question for receiving grants from anti-tobacco foreign organizations, issued the AO that makes vapor products and HTPs highly inaccessible in the country while allowing combustible cigarettes to be widely available in the market.

Such order was apparently issued without showing any concern for the welfare of 17 million smokers who deserve better choices, because we all know they cannot just quit overnight. FDA officials should have been more attentive because nicotine addiction is not as simple as the “quit-or-die” condition that the WHO would like us to believe. It is a complex condition that deserves scientific studies and real-world analysis. No wonder even the WHO predicts that the number of smokers would stay over a billion globally by 2025 despite its best efforts to force smokers to quit.

The key is to provide smokers better alternatives, if you ask us.

ernhil@yahoo.com