Smoke at your own risk

Here in our country, more than half of Filipino households are said to be not smoke-free. While smoking cigarettes is bad enough to a person, second-hand smoke is as much toxic to non-smokers. According to official estimates, approximately 10 Filipinos die every hour due to tobacco-related diseases ranging from lung cancer, emphysema, chronic obstructive pulmonary diseases leading to heart failure.

Our very own Department of Health (DOH) has a dedicated program to help stop the smoking habits of Filipinos, many of whom end up with such life-threatening illnesses. One of those measures is to support efforts of Congress to impose higher “sin” taxes on cigarette and other tobacco products that include the latest electronic cigarettes, or e-cigs for short, and vapes.

Amid these illnesses related to smoking cigarettes, there is notably a growing trend in the use of e-cigs and vapes as alternative devices to satisfy the smokers’ nicotine cravings. As we found out during our conversations at the Kapihan sa Manila Bay last Wednesday, there is also now a raging debate among local and international health experts and leading authorities in the medical field on whether or not e-cigs and vapes are less harmful than smoking cigarettes, with its cancer-causing tar. 

Collectively called as ENDS, or the acronym for electronic nicotine delivery systems, smokers who try to quit their habit have resorted to the use of e-cigs and vapes as alternative products that supposedly would help them in transition to ending their nicotine addiction.

We invited Dr. Anton Javier of the Food and Drug Administration (FDA), which is in charge of e-cigs, vapes and heated tobacco products, along with international harm reduction expert Dr. Tikki Pang, and Richie Aquino who is actively involved in “Quit for Good” Coalition in our Kapihan sa Manila Bay at Café Adriatico, Malate.

Giving his own experience when he started smoking at age 15 years old due to “peer pressure” during those days, Aquino recalled how it was difficult for him to go through that phase of turning “cold turkey” when he tried to quit smoking. He used nicotine patch but it did work out well for him. He later turned to using vapes. Now 52 years old, Aquino succeeded in the complete cessation of smoking five years ago already without the ill effects of turning “cold turkey.”

The so-called “cold turkey” describes the similarities between an addict in the throes of withdrawal and a turkey’s carcass. Just like any withdrawal symptoms, a nicotine addict on withdrawal would appear clammy, pale and covered in goose bumps.

Thus, the term “cold turkey.”

Presently active in “Quit for Good Coalition,” Aquino joins fellow advocates in assisting smokers to be weaned away safely from this “bad habit” while they are still healthy. “We do need the help of the government and regulators to give us a fighting chance,” Aquino urged. He particularly noted with concern the proposed higher “sin” tax on e-cigarettes and vapes which could make these alternative devices more expensive that lower income smokers trying to quit in transition would not be able to buy.

Aside from having to bear the higher taxes on cigarettes, Aquino cited the very strict “No Smoking” law of President Rodrigo Duterte as the challenge to quit smoking as early as possible.

Our own FDA here in the Philippines just issued a public advisory to all hospitals, both government and private, to report to their agency or to the DOH cases of illnesses and injuries related to e-cigs and vaping following deaths and injuries related to the use of ENDS as reported in certain parts of the US.

US health officials have reportedly started investigations into the cases of dozens of people, mainly teenagers, who were hospitalized with severe lung injuries in recent weeks after vaping. But as of late, the specific cause or causes of their illnesses remain a mystery.

Since there is no conclusive results yet on these reported cases, a former official of the World Health Organization (WHO), Pang vouched that e-cigs are “less harmful” than traditional cigarettes and that Filipinos should not be deprived of the chance to quit smoking using these products.

Having done several researches on it, the former WHO director for research policy and cooperation noted quite many concrete evidence indicating e-cigs are much less harmful to smokers. Pang admitted he is “personally disappointed” that WHO has taken a negative stand on e-cigs despite it being a “potential of alternative products to deal with smoking problems.” Many countries, including the Philippines, he rued, follow WHO’s position on the products which, he believes, should not happen.

“You should make your decision based on your own local context, including criteria like how big is your disease burden and that you have 16 million smokers. That’s huge,” Pang pointed out. Depriving them the use of such alternative nicotine devices is a violation of their human rights, Pang added.

As the project manager for product research and standards development at the FDA, Javier argued there are clinical cases and evidence pointing to uncertainty on the safety profile of e-cigs. Javier, a 31-year-old doctor of medicine, explained that the side effects of smoking “will not be immediately apparent until 20 years down the line until you already have oral cancer, lung cancer, colorectal cancer and other forms of cancer associated with cigarette smoking.”

He disclosed government efforts to regulate the use of e-cigs are precisely geared toward an “entire gamut of issues,” including the vape users eventually becoming tobacco smokers later instead of the intended purpose as transition to quitting cigarette smoking.

According to Javier, the FDA takes paramount concern on public health and safety through regulation without having to compromise on civil rights of the people if they want to smoke or not, or use vapes or e-cigs. Smoke at your own risk but respect non-smokers’ space for clean air.