Two international experts on tobacco harm reduction said the approval of the so-called Vape Bill by the Senate and the House of Representatives will enable the Philippines to join the ranks of progressive countries like the United States, the United Kingdom and New Zealand which are seeing sharp declines in smoking prevalence.
Dr. Riccardo Polosa, professor of Internal Medicine at the University of Catania (Italy) and honorary professor of Medicine at the University of Southampton (United Kingdom), said the Vaporized Nicotine Products (VNP) bill, which is set for signing into law by President Rodrigo Duterte, is a step in the right direction to address the smoking problem.
“With this law, the Philippines will join the ranks of the UK, New Zealand and other countries that have included tobacco harm reduction (THR) as part of their state policy. As like the above-mentioned countries, the VPN bill is expected to accelerate the decline in smoking prevalence in the Philippines, too,” Dr. Polosa said in a letter to Senate President Vicente Sotto III and House Speaker Lord Allan Velasco.
Clive Bates, Director at Counterfactual Consulting Limited in Abuja, Nigeria and London, agreed, saying that “vaporized nicotine is much lower risk to health than cigarette smoking” and that there is little direct evidence of harm to health arising from nicotine vaping or HTPs.
The Senate overwhelmingly approved Senate Bill No. 2239—its version of the VNP Bill—on third and final reading on December 16, 2021, while the House of Representatives approved its own version—House Bill No. 9007 on third and final reading on May 25, 2021. Both bills aim to regulate the manufacture, sale and use of e-cigarettes and heated tobacco products (HTPs) which, according to scientific studies, are less harmful than combustible cigarettes.
Dr. Polosa visited the Philippines in 2016 and testified during a public hearing of the House. He also talked about THR to academicians, doctors and policymakers. In his visit, he highlighted the need for risk-proportionate regulation for much less harmful nicotine delivery products such as electronic cigarettes and heated tobacco products (HTPs).
Dr. Polosa, who established the Centre for Tobacco Prevention and Dependence Treatment at the University of Catania and the Center of Excellence for the acceleration of Harm Reduction at the University of Catania, expressed his full support for the VNP Bill. “We applaud and thank Filipino policymakers for taking the step of risk-proportionate regulation of tobacco and other nicotine products,” he said.
He said harm reduction in the context of tobacco control is a key instrument for disease prevention and is recognized in the World Health Organization (WHO) Framework Convention on Tobacco Control, Article.
“In our studies on this subject, we found consistent improvements in respiratory symptoms, exercise tolerance, quality of life, and rate of disease exacerbations in patients with chronic obstructive pulmonary diseases who abstained from smoking or substantially reduced their cigarette consumption by switching to e-cigarettes,” he said.
Citing a review of biomarker studies in 2018 by Public Health England, Bates said, “Vaping poses only a small fraction of the risks of smoking and switching completely from smoking to vaping conveys substantial health benefits over continued smoking.”
Bates also noted that there is no credible evidence to support a “gateway effect” or the existence of vapor or heated tobacco products causes smoking in adolescents that would not otherwise happen.
Dr. Polosa said even the U.S. Food and Drug Administration authorized both e-cigarette products and HTPs as “appropriate for the protection of public health.”
Dr. Polosa noted that 15 past presidents of the Society for Research on Nicotine and Tobacco agreed that “vaping is likely substantially less dangerous than smoking” and that “the totality of the evidence indicates that frequent vaping increases adult smoking cessation.”
They concluded that, “while evidence suggests that vaping is currently increasing smoking cessation, the impact could be much larger if the public health community paid serious attention to vaping’s potential to help adult smokers, smokers received accurate information about the relative risks of vaping and smoking, and policies were designed with the potential effects on smokers in mind.”
Dr. Polosa said while some have raised concerns about the impact of these products on youth, “this is precisely the reason why these products need to be regulated—to maximize the opportunity for adult smokers to move away from combustible tobacco use and to minimize the risks to youth.” he said.
The VNP Bill has strong provisions to protect minors from accessing and consuming the devices. It bans the sale to and use by minors, and the sale, advertising and promotion of vape products within 100 meters of school perimeter and playground. Use of flavor descriptors that unduly appeal to minors in vape products and the display of vape products immediately next to products of particular interest to minors are prohibited.
“This is a proud day for public health in the Philippines! Congratulations!” Dr. Polosa said.
About a million former Filipino smokers have already switched to electronic cigarettes and HTPs, but 17 million Filipinos still use cigarettes.
