Dangers of disinformation

HIDDEN AGENDA - Mary Ann LL. Reyes - The Philippine Star

Just recently, Health Undersecretary Eric Domingo reiterated the health department’s  warning that the use of electronic cigarettes is not a good alternative to cigarette smoking and that because e-cigarettes or “vapes” contain nicotine, the DOH is concerned that vapers will get addicted to nicotine and then become cigarette smokers. 

Dr. Domingo’s statement is hardly surprising. The DOH follows the World Health Organization (WHO) position that the only way to reduce smoking is for smokers to quit or die, and that anything less than an abstinence-only approach is unacceptable. Like the WHO, the DOH is highly skeptical of the potential for new technologies, such as e-cigarettes, to reduce smoking-related harms. 

What is worrying, however, is the DOH’s stubborn refusal to consider the growing body of evidence supporting e-cigarettes as a less harmful alternative to conventional cigarettes and an effective smoking cessation aid. Moreover, instead of focusing on the scientific evidence, the DOH continues to resort to fear mongering and peddling inaccurate information on e-cigarettes. This is irresponsible and dangerous. Why arbitrarily shut the door on the opportunity to embrace a new technology that can potentially help save millions of Filipino lives? 

Last Feb. 27, Public Health England released its latest evidence update summary on vaping. Public Health England is an operationally autonomous executive agency of the UK Department of Health whose series of expert independent evidence reviews has been influential in shaping the UK government’s policy on e-cigarettes.  

One of the updated evidence review’s key findings immediately stands out because it completely runs counter to Dr. Domingo’s statement. E-cigarettes are not a gateway to smoking. The evidence shows that e-cigarette use in the UK remains largely confined to those who already smoke or ex-smokers, who have now quit using an e-cigarette, while quitting smoking remains the key motivation among adult vapers. The fear that the number of young people using e-cigarettes regularly would increase sharply is not happening in the UK. While experimentation is increasing, vaping among young people remains low at 1.7 percent and is mainly confined to those who already smoke.

Public Health England, which employs 5,500 full-time staff consisting mostly of scientists, researchers and public health professionals, recommended that smokers in the UK should be encouraged to switch to e-cigarettes. Noting that regular e-cigarette use among adults in the UK is now plateauing and a third of smokers have yet to try an e-cigarette, the agency underscored the opportunity to further reduce the harms caused by tobacco by encouraging more smokers to try vaping and for “dual-users” (those who smoke and vape at the same time) to switch completely.

Combining e-cigarettes with stop smoking service support should be a recommended option available to all smokers, according to Public Health England. The agency recommended that health professionals provide behavioral support to smokers who want to use e-cigarettes to help them quit smoking, and health professionals supporting smokers to stop receiving education and training on using e-cigarettes in quit attempts. These recommendations are aligned with the results of a major new study done recently in the UK. The study showed that e-cigarettes, when combined with face-to-face stop smoking service support, are nearly twice as effective as traditional nicotine replacement therapies (NRTs) in helping smokers quit. 

Nicotine has been vilified in the public health and tobacco control arena since the 1960s. In recent years, however, there has been growing interest to examine the changing patterns of nicotine use and the emerging science relating to nicotine. 

In January 2018, the US Food and Drug Administration (FDA) released its Strategic Policy Roadmap, which declared that “nicotine…is not directly responsible for the cancer, lung disease, and heart disease that kill hundreds of thousands of Americans each year. It is the other chemical compounds in tobacco, and in the smoke created by setting tobacco on fire, that directly and primarily cause the illness and death – not the nicotine.” The FDA expressed its commitment to “take a fresh look” at electronic nicotine delivery systems (ENDS), which include e-cigarettes, “that can deliver satisfying levels of nicotine to adults who want access to it without burning tobacco.”

FDA commissioner Dr. Scott Gottlieb described nicotine reduction as “a historic opportunity” to convince smokers to switch from conventional cigarettes to products that provide nicotine without the serious health hazards posed by burning tobacco. In order to successfully address cigarette addiction, we must make it possible for current adult smokers who still seek nicotine to get it from alternative and less harmful sources, he said. 

In June 2018, the world’s leading consumer advocates, policy analysts, and public health experts on tobacco harm reduction gathered in Warsaw, Poland for the fifth Global Forum on Nicotine (GFN), which was themed “Rethinking Nicotine”. During the concluding session of the three-day event, forum participants issued three key messages: first, it is the tar and poisonous gases in cigarette smoke that are harmful to health, not nicotine; second, many people find it hard to stop smoking because it is very difficult for them to go without nicotine; and third, the good news is that safer nicotine products such as e-cigarettes can help people switch from smoking and thus avoid its many health risks.

Peter Paul Dator, president of The Vapers Philippines, is urging the DOH and local healthcare professionals to look at the latest Public Health England evidence update on vaping. He lauded public health officials in the country for doing a good job in raising public awareness on the health risks associated with smoking, but called them out for limiting their efforts in that area only.

According to Dator, to really make an impact in reducing the harms caused by smoking, the public should also be educated about alternative products that can help smokers quit. 

Joey Dulay, president of the Philippine E-Cigarette Industry Association (PECIA), stressed that the estimated 16 million Filipinos who currently smoke should be encouraged to switch to less harmful products such as e-cigarettes. Dulay pointed out that tt would be a monumental tragedy if the DOH continues to vilify e-cigarettes without looking at new evidence.

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