Tougher measures needed to protect PH youth from ‘vapedemic’

24 January 2024

By, Cristina Eloisa Baclig, Inquirer

(Last part)

First part: VAPE: Flaws in law worsening youth ‘vapedemic’

Second part: E-cigarette, vape marketing lures PH youth

MANILA, Philippines—After the passage of the “anti-smoking” vape law over a year ago, advocates of this significant act had high expectations that its thorough regulation would aid in saving the lives of 16 million smokers, while protecting minors and non-smokers from the harm of smoking and vaping.

Republic Act No. 11900, or the Vaporized Nicotine and Non-Nicotine Products Regulation Act, imposes strict policies and guidelines to ensure that Novel Tobacco Products are properly regulated and protect people from the health risks of so-called cigarette alternatives or vape and heated tobacco.

The vape law mandates the government to oversee various aspects of vaping products, including e-cigarettes and Heated Tobacco Products (HTPs), ranging from importation and manufacturing to sales, packaging, distribution, usage, and even advertising, promotion, and sponsorship.

Jennifer L. Brown on vape

GRAPHIC Ed Lustan

However, research by the Institute of Global Tobacco Control (IGTC) at the Johns Hopkins Bloomberg School of Public Health has revealed that, despite these regulations, many sellers have not been adhering to the law.

Alarmingly, this non-compliance, especially in aspects such as sales, distribution, and marketing of vaping products, is contributing to their increased accessibility among the youth.

“There is ample evidence showing that tobacco companies employ various strategies to promote their products, aiming to attract the attention of children and young individuals,” Elizabeth Crespi, MPH, senior research program coordinator from the IGTC at the Johns Hopkins Bloomberg School of Public Health, told INQUIRER.net in an exclusive email interview.

“[These include] positioning displays at eye level for kids, ensuring the availability of products and advertisements in proximity to schools, parks, and other areas frequented by children, and utilizing eye-catching packaging with enticing flavors to make products appear novel and appealing,” she said.

This comes at a time when smoking and vape addiction is rising alarmingly among Filipino youth, a phenomenon being termed as “vapedemic” due to its widespread nature.

Tighter regulations pushed

Tuo-Yen Tseng, Ph.D., an assistant scientist at the IGTC, emphasized the need for policy intervention based on solid evidence to counter aggressive marketing of e-cigarettes and vape products in the Philippines.

“The government must continue to regulate all products that are developed by the tobacco industry and continue to educate the public about the dangers of using these products,” she said in an email interview.

She stressed that the result of their studies further supports the push for stronger policy measures.

These include “restoring the minimum purchase age to 21, prohibiting flavors [or] additives other than tobacco flavor, applying plain and standardized packaging, and prohibiting health and cessation claims unless evaluated and approved by a specialized government health agency to protect Filipino youth from tobacco and nicotine harm.”

Some chemicals found in vapes

GRAPHIC Ed Lustan

Last week, Health Secretary Teodoro “Ted” Herbosa called for stricter enforcement of regulations that prevent minors from accessing vape and other tobacco products.

“Technically, by law, only those who are 18 years old and above are allowed to vape legally. However, if you go to the mall and look outside, high school students in uniform can be seen using e-cigarettes. Moreover, these products are openly sold,” Herbosa said in Filipino at a media briefing.

The 2019 Global Youth Tobacco Survey found that around 11 percent of students in the Philippines use tobacco, 10 percent smoke cigarettes, and 14 percent use electronic cigarettes (e-cigarettes).

Data from the Philippine Pediatric Society showed that 11 percent of students aged 10 to 15 years old have already tried vapes. The Department of Education (DepEd) also reported that 6.7 percent of Grades 7 to 9 students were found to “have tried and are using e-cigarettes.”

Just as harmful, not risk-free

Then-Food and Drug Administration (FDA) officer-in-charge and Director General Dr. Oscar Gutierrez Jr. previously warned about misleading claims that vapor products and HTPs are substantially safer than conventional cigarettes.

“Vapor products and heated tobacco products (HTPs) are currently being marketed by the industry as an alternative to conventional cigarettes, with some claiming or implying that these products are safer or less harmful,” he said.

“However, these claims are based on opinion rather than empirical evidence, lacking the required studies and substantiations,” he clarified.

According to the Department of Health (DOH), vape liquids and their emissions contain chemicals such as nicotine, propylene glycol, carbonyls, and carbon monoxide that are either addictive, toxic or can cause cancer.

Vaping's harm on respiratory system

GRAPHIC Ed Lustan

The DOH also cited studies that have shown vape use increased the risk of using other known addictive substances such as cigarettes, alcohol, and even marijuana

“There is also growing evidence of the harmful effects of using vapes both to the user and those exposed to its emissions, including its potential to cause cardiovascular diseases, respiratory problems, and explosion injuries,” it added.

In November 2018, the DOH reported the first case of e-cigarette- or vaping product use-associated lung injury (EVALI) in the country involving a 16-year-old patient from Visayas, who was admitted to the hospital after the person had a “sudden-onset severe shortness of breath.”

Baguio’s strict regulations

Jennifer L. Brown, Ph.D., an assistant scientist from the IGTC, asserted that the key to preventing tobacco-caused death and saving over 100,000 lives annually in the Philippines is well within our grasp.

“We have evidence that policies, like 100% smoke-free public places, comprehensive advertising bans, prohibiting flavors, and raising tobacco taxes, can help prevent people from starting to use tobacco products and support those who are addicted to nicotine and want to stop,” Brown told INQUIRER.net.

“With the necessary political will behind them, countries around the world have successfully adopted strong, national-level tobacco control policies that protect [their] residents from tobacco-caused death and disease,” she added.

Smoke-free places in the Philippines

GRAPHIC Ed Lustan

In the Philippines, even before RA 11900 lapsed into law, Baguio City had already implemented stringent anti-smoking policies.

The city became one of the first cities to have a smoke-free ordinance in the country two years after US Surgeon General Luther Terry issued a definitive report that linked smoking cigarettes with lung cancer in 1966.

The smoke-free ordinance evolved over the years, expanding its scope from garages and taxis to cinemas, government offices, assembly halls, and churches; prohibiting smoking in all indoor places, except in designated areas in 2009; and in 2017, prohibiting vape and selling cigarettes by the stick.

In prohibiting the sale of cigarettes per stick, the assumption was that minors would be discouraged from buying a pack of cigarettes or would not be able to afford them.

“[W]e’re actually the first to include e-cigarettes or vape products, we call them ENDDS or electronic nicotine delivery systems, in our [smoke-free] ordinance,” Baguio Public Order and Safety Division Chief Daryll Kim Longid told INQUIRER.net.

“In our case, we have already started treating vape and cigarettes in the same way, so there’s no distinction between them for us,” he said partly in Filipino.

Longid noted that with the implementation of the smoke-free ordinance, it is “easier to memorize’ the locations where smoking is permitted in the city — merely nine in total — as opposed to the places where it’s prohibited.