Hold that puff
After years of being promoted as a “safer” alternative to cigarettes, vaping and e-cigarettes (collectively known as electronic nicotine and nonnicotine delivery systems or ENDS/ENNDS) are receiving renewed scrutiny—and what’s coming to light so far should give ordinary users and policymakers alike serious pause. The Department of Health (DOH) and the Food and Drug Administration (FDA) have both reiterated warnings regarding the possible health risks of vaping and e-cigs, particularly because of their appeal to the youth. “The Department, together with the Food and Drug Administration, maintains that a series of long-term epidemiological and peer-reviewed studies are required to conclude that e-cigarettes are less harmful than conventional smoking,” Health Secretary Francisco T. Duque III stated in July. “While there is a lack of conclusive data regarding the long-term effects of using e-cigarettes, its health risks cannot be set aside. The precautionary principle recommends that, until conclusive data regarding their safety have been established, regulatory measures should aim at reducing exposures to these products.”
The warning acquires more urgency given reports over the last few weeks from the United States, where ENDS use is widespread. About 1,080 confirmed and probable cases of severe respiratory illness and 18 deaths have been linked to vaping, according to an Associated Press report. The Centers for Disease Control and Prevention (CDC) has characterized the illnesses as an outbreak, noting in particular the speed of the outbreak, with an estimated 275 new cases every week a month after the CDC first sounded the alarm.
“Unfortunately, the outbreak… is continuing at a brisk pace,” said CDC’S Dr. Anne Schuchat. “I cannot stress enough the seriousness of these injuries. This is a critical issue. We need to take steps to prevent additional cases.”
In the meantime, the American Medical Association has already asked Americans to stop vaping until the scientific investigation is through.
Similar concern is growing around the world. “Although the specific level of risk associated with ENDS has not yet been conclusively estimated, ENDS are undoubtedly harmful and should therefore be subject to regulation,” the World Health Organization said in a July report.
Vaping and e-cigs have gained a strong following because they are perceived not only as a safer alternative to smoking, but also as a “cool” social activity among the youth, who share vaping breaks and hang out in vape shops that have proliferated from neighborhood corners to trendy malls. But the DOH has noted that ENDS/ENNDS are dangerous not only for smokers, but for second-hand smokers as well. The second-hand vapor is absorbed by anybody exposed to it and poses the same health risks. By January 2020, the FDA will be requiring licenses for vape shops.
Legislation is also needed to address this potential public health menace. Sen. Manny Pacquiao’s Senate Bill No. 987 sets the tax rate for heated tobacco and vapor products (HTPS) at P45 starting 2020, increasing by P5 each year until it reaches P60 in 2023; a 5-percent annual increase will be imposed after that. The Senate ways and means committee, in its report on the proposed new duties on alcohol, e-cigarettes and HTPS submitted last week for plenary deliberations, recommends that e-cigs should be taxed just like regular cigarettes. But Senate President Vicente “Tito” Sotto III is seemingly unalarmed at the data (or unaware?), and does not agree with curbing the practice via prohibitive pricing. “Personally, I think the [new excise for ecigarettes] was a bit high,” he said.
Arjay Mercado, program officer for the advocacy group Action for Economic Reforms, argued against that position in a letter to the Inquirer. “HTPS and vape must be treated as substitutes to traditional cigarettes and therefore should be taxed equivalently,” he said. “These products expose the young to tobacco addiction… As such, increasing the tax will be an effective means of intervention to protect the Filipino youth from the harms of vaping.”
Indeed, with the mounting cases of illness and deaths prompting grave scrutiny from the scientific community, and while the true extent of the possible adverse effects of vaping and e-cigs is still being determined, the safest and most prudent course of action at the moment would be that wise reminder: Better safe than sorry. Health authorities must keep reminding vaping enthusiasts to hold that puff and stay away from the habit.