Two leading international experts on tobacco harm reduction (THR) said the Philippines is on the right track to significantly reduce the smoking rate in the country with the passage of the vape bill, as seen in progressive countries like the United States, the United Kingdom, and New Zealand, which adopted smoke-free products as alternatives to smoking.

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Both Houses of Congress overwhelmingly approved their versions of the vape bill which aims to regulate the manufacture, sale, and use of e-cigarettes and heated tobacco products (HTPs) — non-combustible alternatives that are found by scientific studies to be less harmful than combustible cigarettes. A bicameral conference committee is expected to happen next week to unify the versions for President Rodrigo Duterte to sign into law.

Dr. Riccardo Polosa, a professor of Internal Medicine at the University of Catania in Italy and honorary professor of Medicine at the University of Southampton in the UK, said in his letter to Senate President Vicente Sotto III and House Speaker Lord Allan Velasco that the vaporized nicotine product (VPN) bill is a step in the right direction.
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“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. Like the above-mentioned countries, the VPN bill is expected to accelerate the decline in smoking prevalence in the Philippines too,” he said.

Clive Bates — director at Counterfactual Consulting Limited in Abuja, Nigeria, and London — agrees. He said vaporized nicotine poses a much lower risk to health than cigarette smoking. There is also little direct evidence of harm to health arising from nicotine vaping or HTPs. Polosa allayed concerns about the impact of vape products on minors, saying: “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.”
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The VNP bill has stringent measures 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 a school perimeter and playground. The 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.

In 2016, Polosa testified during a House public hearing and shared information about THR with academicians, doctors, and policymakers. He highlighted the need for risk-proportionate regulation for much less harmful nicotine delivery products such as electronic cigarettes HTPs. Polosa 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.
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“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.”

He also stressed 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. Polosa said even the US Food and Drug Administration authorized both e-cigarette products and HTPs as “appropriate for the protection of public health.” He 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.”
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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.”

Polosa 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 added harm reduction in the context of tobacco control should be a key instrument for disease prevention and was recognized in the World Health Organization (WHO) Framework Convention on Tobacco Control, Article. “This is a proud day for public health in the Philippines! Congratulations!” Polosa said.

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