The ‘gold standard’
COMMONSENSE - Marichu A. Villanueva (The Philippine Star) - February 3, 2020 - 12:00am

Lausanne – What many Filipino smokers flippantly ignore is smoking-related diseases. Consumption of this so-called “sin” product has not been dramatically reduced despite much higher prices with increased excise tax, the law on the “no smoking” areas in public places, and graphic picture warnings in cigarette packs. As of latest estimates of health authorities, there are 16 million smokers in the Philippines. And it has not gone down but has, in fact, continues to increase.

The Philippine Statistics Authority (PSA) and the Department of Health (DOH) showed that only about 640,000 out of the country’s 16 million smokers have succeeded to quit smoking, or this is about a negligible four percent. The same statistical data showed 12 million, or 76 percent of tobacco smokers in the country are merely planning to quit lighting up their cigarettes. 

Apparently, existing regulatory measures on tobacco among so-called “sin” products seemed ineffective to cut down smoking.

No less than President Rodrigo Duterte has been most vocal, if not tough in the enforcement of total ban on smoking in public places. The 74-year-old former Davao City Mayor applied this “no smoking” ban nationwide on the basis of his personal experience of contracting Buerger’s disease attributed to heavy smoking during his younger years. 

From available data, total industry production of cigarette sticks in the Philippines last year reached as much as 70.5 billion sticks. According to Philip Morris-Fortune Tobacco Inc. (PMFTC) Inc. director for communications Dave Gomez, their combined production reached 49.7 billion last year, or about 70 percent of their market share of the industry total. However, Gomez noted, quite a sizeable chunk of the market are gobbled up by the continued illicit proliferation of “fake” and smuggled cigarettes.

In fact, Gomez noted the PMI study showed current population trends indicated there will be an estimated more than one billion smokers by year 2025 which is about the same number as of today.

Disclosure: Gomez used to be a senior reporter of The Philippine Star with whom I worked in the coverage of Malacanang Palace during the term of former president Fidel Ramos. Gomez opted to retire early from media and went out to seek greener pasture, as we say, until he joined the PMFTC. For almost two years, he worked with the Philip Morris International (PMI) head office here in Switzerland. He returned to the Philippines when the American tobacco giant PMI combined business with Lucio Tan’s Fortune Tobacco Inc. in 2010.

Speaking of Ramos, the former president who is turning 92 years old next month is fondly called “Tabako” because he loves to chomp his unlit tobacco. During his younger years while still in the active uniformed service, Gen. Ramos used to smoke tobacco. He successfully weaned himself from tobacco smoking when he assumed the presidency. 

Except for ex-president Gloria Macapagal Arroyo who is a non-smoker, succeeding former presidents Joseph Estrada and Benigno Simeon Aquino III could not quit their smoking during their respective tenures at Malacanang. Estrada smokes Lucky Strike while Aquino is a Malboro man.

For a while, Estrada successfully discontinued his chain-smoking habit in the last four years he was Mayor of the city of Manila. Turning 83 years old in April, Estrada is back to smoking after he lost his re-election for a third and last term in office at City Hall. Aquino, who will become a senior citizen next week, refuses to give up smoking despite his doctors’ advice after his recent hospitalization.

According to the World Health Organization (WHO), tobacco use kills more people worldwide than any other preventable cause of death. Global health experts believe the best way to reduce tobacco use is by stopping people starting to use tobacco, and encouraging and helping existing users to stop.

But if the smokers cannot help themselves stop this habit, the PMI successfully designed and developed IQOS heated tobacco device at The Cube – the $6 billion research and development (R & D) facility built in Neuchatel here in Lausanne. With IQOS as the device, the PMI produced a less harmful cigarette that is smoke-free and no harmful combustion. The IQOS has Heets as the heated tobacco product (HTP) they now market in 52 countries around the world.

“Our goal is to offer smoke-free alternatives that have potential to reduce the risk of developing smoking-related diseases as compared with continued smoking. Recent advances in science and technology have made it possible to develop innovative products that current adult smokers accept and that are less harmful alternatives to continued smoking.” This was the brief message from Andre Calantzopoulos, chief executive officer of PMI presented to us editors of various national newspapers, including The Star who were invited to a familiarization trip here of one of the world’s biggest cigarette manufacturers.

In a plant tour of R & D facility here at The Cube, we were taken around the production line of their exclusive HTP brand variants of Heets as a sophisticated smokeless, ash-free HTP that the PMI has developed through science and technology studies over a period of 17 years starting 2002. Nuno Fazenda, PMI manager scientific engagement, explained these studies on IQOS and Heets were done in close consultation and transparency with the WHO, the US Food and Drug Administration (FDA) authorities, medical doctors, behavioral scientists, engineers and other international experts.

“What we’re trying to reach is the ‘Gold Standard’ which is cessation of smoking. The best way is to stop (smoking),” Fazenda conceded. According to the US Institute of Medicine in 2012, Fazenda cited, it stated that cessation is the “Gold Standard” for the assessment of a Modified Risk Tobacco Product.

Since smoking cessation is the “Gold Standard” for assessing the reduction in risk for smokers, Fazenda pointed out: “Our goal is to develop products that have a risk profile as close as possible to the risk profile demonstrated by smoking cessation.”

But switching to IQOS to many of those who refuse to quit smoking, Fazenda argued, is the less harmful alternative offered by PMI. It is a sophisticated smoke-less HTP alternative rather than resort to use nicotine gum, the patch, prescription drugs – and failing – turns cold turkey, he warned.

“IQOS is not a cessation product. It is a consumer product for smokers who opt to continue smoking,” Fazenda candidly admitted. To quit is still the best option, he quipped.

For successfully having kicked the smoking habit, President Duterte has earned the “Gold Standard” in enforcing the law on smoking ban in all public places.

SMOKING DISEASE
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