Protect our children from tobacco industry greed and bullying disguised as ‘harm reduction’

26 February 2024

By Dr. Riz Gonzalez, Inquirer

Every day, pediatricians like me see children struggling with addiction, impaired brain development, anxiety, depression and other challenges caused by smoking cigarettes, e-cigarettes or heated tobacco products.

It is an epidemic of mass proportions. Indeed since 2015, the rate of young people in the Philippines using e-cigarettes has more than doubled with almost a quarter of adolescents aged 13-15 having used them. That is millions of Filipino youths getting addicted to nicotine by an industry that sells products targeting the tastes of children with more than 15,000 different fruit and candy flavors present in ESDs sold in the Philippines.

As countries and global health leaders from around the world met this February in Panama for COP 10 – a summit of signatories, including the Philippines, to the international tobacco control treaty called the Framework Convention on Tobacco Control – the tobacco industry attempted to avoid blame for the epidemic they created by distorting a public health concept called harm reduction.

Harm reduction in public health refers to strategies that seek to improve the health of a population. According to the FCTC, harm reduction includes implementing policies that prevent and reduce tobacco consumption and nicotine addiction.

Because real harm reduction would threaten their profits, multinational companies and front groups from the tobacco industry have latched on to the phrase “tobacco harm reduction” and distorted it beyond all recognition by anyone working in public health.

For example, Philip Morris International – the world’s leading tobacco company by market capitalization – has an entire section of its website dedicated to “tobacco harm reduction.” I find it particularly outrageous that a company which has sold deadly cigarettes for almost 180 years and still today sells cigarettes in over 180 countries can claim any kind of high ground. Over the years, their products have led to millions of cases of lung cancer, heart disease and death and yet they claim their efforts are altruistic and designed to reduce harm. In fact, this is cynical corporate marketing designed to entice a new generation to their products. It is clear these multinational companies are selling harm introduction to our young, not harm reduction.

The industry and its front groups claim that they are simply trying to provide current smokers with a way to quit – namely by switching from one of the deadliest products ever made – cigarettes – to other products made by the same industry: e-cigarettes and heated tobacco. This is at best harm replacement, not harm reduction.

We have a lot more to learn about the long-term dangers of products like e-cigarettes and heated tobacco, but we can already see parallelism in marketing and their health and environmental harms.

These addictive products are made with thousands of toxic chemicals that significantly impacts brain development and lung function of young people. People who smoke cigarettes and also use e-cigarettes are less likely to quit smoking and end up smoking more cigarettes than those who don’t use e-cigarettes. E-cigarettes can also deliver more than five times of  nicotine than traditional cigarettes.

If this was an industry trying to reduce addiction and harm, why are they putting even more nicotine in e-cigarettes than they were in traditional cigarettes? And why are they marketing these e-cigarettes with candy flavors that appeal to a new, younger generation of consumers, many of whom have never even tried traditional cigarettes?

While the industry aggressively promotes e-cigarettes and heated tobacco to young people through savvy social media campaigns, thousands of fun flavors, and toy-like product design, they also attack and bully anyone who challenges their billion-dollar profits. They claim tobacco control advocates want to deprive smokers of alternatives, painting a false choice that consumers must either use one of their deadly products or the other. This is a ploy to preserve and expand their market share and their profit margin while they avoid taking steps that would reduce the actual harm of their products.

I’m not surprised that a multinational, multibillion dollar industry would peddle disinformation, bully people, and put their profits above our children’s health. But I am surprised that anyone buys what they are selling. The tobacco industry is using the same tactics they have for decades: attack the public health community of doctors and researchers trying to save people from deadly tobacco use and bully the activists and philanthropists who support actual harm reduction.

There’s a reason the Philippine delegation received the notorious “Dirty Ashtray” award at the recently-concluded COP 10. News reports cited observers present at the conference, who saw the Philippine side constantly derailing discussions by questioning experts on harm reduction. At one point, the Philippines was responsible for a delay that lasted over three hours. We have to ask ourselves, is this the reputation we want to have before the international community?

For the sake of our children, we must see through this smoke screen and focus on their underlying motive: profit. This is an industry that has sold addiction and death for almost two hundred years. It is time that we finally hold them to account so we can safeguard a healthy future for our children.

(The author is chair of the Philippine Pediatric Society Tobacco and Nicotine Control Advocacy Group)